Pastoral care in hospitals: a literature review

Aims and background. This literature review investigates the potential contribution of the pastoral care provided in hospitals by hospital chaplains, as part of an integrated view of patient care, particularly in institutions dealing with severe disease. Methods and study design. A search was conducted in the Medline database covering the last 10 years. Results. Ninety-eight articles were considered concerning the modern hospital chaplains'relationships and the principal procedures and practices associated with their roles, i.e., their relationswith the scientificworld,with other religious figures in the community, with other faiths and religious confessions, with other public health professionals and operators, with colleagues in professional associations and training activities, and with the hospital organization as a whole, as well as their patient assessment activities and the spiritual-religious support they provide, also for the patients' families. Conclusions. Improvements are needed on several fronts to professionalize the pastoral care provided in hospitals and modernize the figure of the hospital chaplain. These improvements include better relations between modern chaplains and the hospital organization and scientific world; more focus on a scientific approach to their activities and on evaluating the efficacy of pastoral care activities; greater clarity in the definition of the goals,methods and procedures; the design of protocols and a stance on important ethical issues; respect for the various faiths, different cultures and both religious and nonreligious or secularized customs; greater involvement in the multidisciplinary patient care teams, of which the hospital chaplains are an integral part; stronger integration with public health operators and cooperation with the psychosocial professions; specific training on pastoral care and professional certification of chaplains; and the development of shared ethical codes for the profession

Easing Existential Distress in Pediatric Cancer Care

Children with serious illnesses may have special needs that are not strictly clinical in nature and that are not always easily discerned. The capacity to detect and respond to this type of need becomes an increasingly important focus in palliative care. Spiritual care falls within this sphere of interest, for both the child with an illness and their family. In the care of children with advanced cancer and other life-threatening illnesses, spiritual care providers partner with families as they navigate a life-threatening illness, offering empathy, spiritual companionship, and guidance in balancing personal beliefs, values, and medical decision making. This chapter will explore the history and study of spiritual care of children with life-threatening illnesses and their families and present practical approaches for spiritual screening and intervention, as well as mechanisms for enhancing the infrastructure

Hope in severe disease : a review of the literature on the construct and the tools for assessing hope in the psycho-oncologic setting

Aims and background: Research on the topic of hope began a long time ago but, more recently, interest in this construct has focused mainly on the development of psychometric tools for its assessment. The 2 steps of the present article are defining the construct of hope by completing a preliminary review of the literature and analyzing the tools used to assess hope in the setting of oncologic medicine, conducting a systematic review of the existing scientific literature. Methods and study design: Our study was conducted in 2 stages. The first stage involved a nonsystematic preliminary review of the literature, the second a systematic search in all the medical journals contained in the Medline database as of 2012. The literature identified at the first stage was divided according to several topical categories, i.e., theoretical, empirical, and clinical works on the construct of hope. In the second systematic search, we identified the main psychometric tools used to measure hope in the field of clinical oncology and assessed their validity. Results: A total of 22 articles were identified. What emerged when we pooled the findings of our 2 lines of research was that, despite its broad theoretical definitions, the construct of hope can be broken down to a few constituent elements when hope is studied using currently available psychometric tools. In particular, these identified constituent elements were coping, spiritual well-being, quality of life, distress, and depression. Conclusions: The factors contained in the construct of hope include temporality, future, expectancy, motivation, and interconnectedness. The review of the scientific literature does not reveal a clear definition of hope. Multidisciplinary studies are needed to communicate different perspectives (medical, psychological, spiritual, theological) among each other for better definition of the constituent elements of hope in order to support the hope with specific interventions

Cooperation between in-hospital psychological support and pastoral care providers: obstacles and opportunities for a modern approach

The meaning that patients with cancer attribute to life influences their expectations and their attitudes to the disease and its treatment. Over the centuries, religion has commonly been the answer encoded by the social setting when it came to matters of life and death. The present article analyzes the historical grounds for forms of cooperation between the scientific disciplines that focus on mental health and the approach of religion, centered on the Italian situation. Such cooperation was hard to imagine in the past, but the situation has changed considerably and cooperation is not only possible but extremely desirable. Acknowledgment of their spiritual needs helps patients to battle with their disease. The care of patients should include catering for their spiritual needs by ensuring the constant presence of a chaplain on hospital wards

Spiritual aspects of care for adolescents with cancer

Aims and background. Adolescents with cancer have psychosocial issues that need to be adequately addressed. Spirituality is a fundamental aspect of their psychological well-being. Methods. A chaplain is a daily presence in the Youth Project ward for adolescents at the Pediatric Oncology Unit of the Istituto Nazionale Tumori, Milan. The chaplain conducts daily visits to the ward and the outpatient clinic/day hospital, holds daily meetings with the psychologists on staff, and attends biweekly meetings with doctors and/or nurses. The cases of patients referred for spiritual assistance between January and December 2012 were analyzed by patient age and reasons for consultation, and were compared with cases referred for psychological consultation. Results. A psychological consultation was offered to 84% of patients/families, and further support was needed for 23% of children and 45% of teenagers. Spiritual support was provided for 2 children and 20 adolescents (24% of the sample considered). Conclusions. Acknowledgment of their spiritual needs helps patients to battle with their disease. The reasons patients and parents ask for spiritual assistance only partially overlap with the motives behind requests to see a psychologist. The care of adolescents with cancer should include catering for their spiritual needs by assuring the constant presence of a chaplain on hospital wards

[Support to spiritual needs in hospital care. Integration perspective in modern hospitals]

All\u2019interno del percorso di cura medica nei contesti sanitari pi\uf9 evoluti, trova un\u2019attenzione crescente la cosiddetta umanizzazione delle cure. In questa prospettiva si cerca di integrare, all\u2019interno dei consueti percorsi di cura, anche aspetti legati alla dimensione spirituale e religiosa delle persone ammalate e dei familiari, oltre che del personale stesso. Risulta evidente l\u2019importanza di fondare anche questo tipo di pratiche sulla base di evidenze scientifiche. Da qui la necessit\ue0 di migliorare la conoscenza relativa al contributo che un\u2019assistenza di ordine spirituale pu\uf2 offrire all\u2019interno dell\u2019attuale contesto sanitario. Obiettivo di questo lavoro \ue8 illustrare l\u2019attualit\ue0 delle prospettive di integrazione dell\u2019assistenza spirituale nel contesto ospedaliero in una logica multidisciplinare. Sono analizzati i diversi dati che emergono dalla letteratura scientifica internazionale, cos\uec come la definizione che viene data al concetto di \u201cspiritualit\ue0\u201d; definizione che, ancora oggi, non trova unanime consenso. \uc8, inoltre, analizzata la situazione normativa vigente all\u2019interno del panorama Europeo a seconda delle diverse legislazioni e realt\ue0 sociali. Sono, infine, descritte possibili prassi organizzative relative al supporto spirituale, l\u2019opportunit\ue0 di specifici percorsi di accreditamento e la formazione accurata dei cappellani in grado di integrare pratiche religiose tradizionali con le moderne prospettive spirituali.Within the course of medical care in the most advanced health care settings, an increasing attention is being paid to the so-called care humanization. According to this perspective, we try to integrate the usual care pathways with aspects related to the spiritual and religious dimension of all people and their families, as well as the employees themselves. It is clearly important to establish this kind of practices on the basis of scientific evidences. That is the reason why it's a necessity to improve the knowledge about the importance that spiritual assistance can offer within the current health service. The aim of this work is to show the relevance of the integration of spiritual perspectives in the hospital setting according to a multidisciplinary point of view. In this work many data that emerge from the international scientific literature, as well as the definition that is given to the concept of "spirituality" are analyzed; about this definition in fact there is not unanimous consent even today. It is also analyzed the legal situation in force within the European territory according to the different laws and social realities. Finally, the possible organizational practices related to spiritual support are described and the opportunity to specific accreditation pathways and careful training of chaplains able to integrate traditional religious practices with modern spiritual perspectives is discussed

When a foreign adolescent orphan refuses to be treated : considerations on a clinical case

Providing medical treatment for unaccompanied foreign minors can prove particularly demanding when a patient is not fully compliant. This report describes the case of a 13-year-old boy from Sub-Saharan Africa brought to Italy to receive treatment for a neoplasm. Right from the start, he showed strong oppositional reactions, with aggressive and self-harming behavior. This made it necessary to activate various different psychological, psychiatric, and social-support resources, and to adapt the proposed treatments to the patient's willingness and ability to cooperate. Here we outline the assessments and actions (also from the economic and organizational standpoint) that need to be implemented in any scheme to bring young foreign orphans to Italy for specialist medical care

Stepwise electron-induced demolition of the Ni-I sigma-bond in complexes with tetradentate tripodal ligands: A theoretical rationalization of structural and electrochemical results

The X-ray structural analysis of the compound [(pp3)Nil]BPh4 (complex d), pp3 = P(CH2CH2PPh2)3, is presented. The complex cation has an almost regular trigonal bipyramidal geometry (TBP) with distances Ni-I and Ni-Pax of 2.546(2) and 2.142(3) \uc5, respectively. This structure completes a series of strictly related nickel complexes, namely [(np3)Nil]I, complex a; (np3)Nil, complex b; (np3)Ni, complex c; [(pp3)NiHClO4), complex e; [np3 = N(CH2CH2PPh2)3] The complexes are redox derivatives [Ni(II), Ni(I), Ni(O)] that can be isolated via chemistry and/or electrochemistry. In the solid state complexes c and e have a trigonal pyramidal (TP) structure, whereas, electrochemical measurements suggest that in solution the TBP structure with a very elongated Ni-I bond can also have a finite lifetime. EHMO calculations offer a satisfying interpretation of the main structural trends in complexes a rarr e, in particular, those relative to axial bond stretching, and clarify the different roles of phosphine vs. the amine axial donor. Moreover, the correlation is discussed between the electrode potentials and the nature of the Ni-I sgr* MO that accepts or releases the electrons exceeding thed 8 configuration of Ni(II)