Patients’ spiritual concerns and needs and how to address them during advance care planning conversations: Healthcare chaplains’ perspectives

Abstract

Objectives Advance care planning (ACP) conversations require the consideration of deeply held personal values and beliefs and the discussion of uncertainty, fears, and hopes related to current and future personal healthcare. However, empirical data are limited on how such spiritual concerns and needs are supported during ACP. This study explored board-certified healthcare chaplains’ perspectives of patients’ spiritual needs and support in ACP conversations. Methods An online survey of 563 board-certified chaplains was conducted from March to July 2020. The survey included 3 open-ended questions about patients’ hopes and fears and about how the chaplains addressed them during ACP conversations. Written qualitative responses provided by 244 of the chaplains were examined with content analysis. Results The majority of the 244 chaplains were White (83.6%), female (59%), Protestant (63.1%), and designated to one or more special care units (89.8%). Major themes on patients’ hopes and fears expressed during ACP were (1) spiritual, religious, and existential questions; (2) suffering, peace, and comfort; (3) focus on the present; (4) hopes and fears for family; and (5) doubt and distrust. Major themes on how chaplains addressed them were (1) active listening to explore and normalize fears, worries, and doubts; (2) conversations to integrate faith, values, and preferences into ACP; and (3) education, empowerment, and advocacy. Significance of results ACP conversations require deep listening and engagement to address patients’ spiritual needs and concerns – an essential dimension of engaging in whole-person care – and should be delivered with an interdisciplinary approach to fulfill the intended purpose of ACP.

Healthcare Chaplaincy for Geriatric Patients: A Quasi-Experimental Study into the Outcomes of Catholic Chaplaincy Interventions in Belgium

“…Hope, peace, anxiety, and positive/negative affect are indeed aspects the chaplain cares for and reasons to refer to the chaplain. First, hope and peace have been pointed out by chaplains as themes that often occur during their interventions (Kwak et al, 2022 ). Chaplains care for patients’ hope and peace by being a witness of hope, by identifying and nurturing patients’ hope and inner peace resources, and by sharing and fostering a sense of hope and peace in patients (Massey et al, 2015 ; Nolan, 2011 ; VandeCreek & Lucas, 2001 ).…”