As a continuing effort to enhance the quality of palliative care for the dying, this study examined (1) the prevalence of spirituality among hospice interdisciplinary team (IDT) members; (2) whether spirituality is related to job satisfaction; and (3) the structural path relationships among four variables: spiritual belief, integration of spirituality at work, self actualization and job satisfaction. The study surveyed 215 hospice IDT members who completed the Jarel Spiritual Well-Being Scale, the Chamiec-Case Spirituality Integration and Job Satisfaction Scales. Multiple regression and structural path modeling methods were applied to explain the path relationships involving all four variables. The IDT members surveyed were: nurses, 46.4%; home health aids, 24.9%; social workers, 17.4%; chaplains, 4.2%; physicians, 2.3%; and other, 4.8%. Ninety-eight percent of the respondents viewed themselves as having spiritual well-being. On a 0-100 scale, IDT staff reported high spiritual belief (mean = 89.4) and they were self-actualizing (mean = 82.6). Most reported high job satisfaction (mean = 79.3) and spiritual integration (mean = 67.9). In multiple regression, spirituality, integration and self-actualization explained 22% of the variation in job satisfaction (R = 0.48; adjusted R(2) = 0.218; df = 3,175; F = 17.2; p = 0.001). Structural path models revealed that job satisfaction is more likely to be realized by a model that transforms one's spirituality into processes of integrating spirituality at work and self actualization (chi(2) = 0.614; df = 1; p = 0.433) than a model that establishes a direct path from spirituality to job satisfaction (chi(2) = 1.65; df = 1; p = 0.199). Hospice IDT member's integration of their spirituality at work and greater self actualization significantly improve job satisfaction.

The forecasting model predicted the probability of ERVH correctly in 87.7% of the patients. The model is simple to use to predict hospice cardiac patients having ERVH. Future studies should validate this model. Interventions should utilize these factors and be evaluated to determine their ability to decrease ERVH in hospice cardiac patients.

variability in perceptions regarding the role and therapeutic goals of ANH based upon cultural, religious, or ethical norms, which can result in distressing quandaries for patients, families, and colleagues on the healthcare team (ie, nurses, nutritionists, physicians, chaplains, social workers, etc). How one defines and understands benefits and burdens may be influenced by, not only, clinical knowledge and evidence of benefit or burdens/risks, but also by the influences of culture, religious directives, or family perceptions and beliefs on the individual patient, family members, and members of the treatment team. In particular the US Catholic Bishops recently revised Directive 58 in the Catholic Ethical and Religious Directives for U.S. Catholic Hospitals. These revisions and their interpretation(s) are causing ethical distress for both individuals and healthcare professionals alike.The primary goal of this session is to provide a forum for further discussion of these issues surrounding AHN and specifically Directive 58 and its possible impact on the provision of end-of-life care to patients in Catholic healthcare Institutions. This session will be an interactive case-based discussion of the ethical and clinical benefits and burdens of AHN particularly in the palliative care setting.