The efficacy of primary care chaplaincy compared with antidepressants: a retrospective study comparing chaplaincy with antidepressants

Macdonald, Gordon

doi:10.1017/s1463423617000159

Cited by 19 publications

(28 citation statements)

References 37 publications

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“…3 Research has shown that such chaplaincy provision improves spiritual wellbeing to a similar extent as antidepressants while reducing GP consultation rates. 4,5 These results justify the place of chaplaincy within our MDTs at this time of workload realignment.…”

Section: Spiritual Care Is Stagnating In General Practicesupporting

confidence: 64%

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Spiritual care is stagnating in general practice

Macdonald¹

2019

Br J Gen Pract

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training in clinical reasoning, patient safety, human factors, critical thinking, managing uncertainty, cognitive heuristics and biases, test limitations, probability concepts, reliability science and systems thinking. Training focused on the causes and impact of diagnostic error might help providers become more competent in error prevention. Simulations and feedback can be a helpful way to learn.' 3 Communication skills teaching is a core subject in undergraduate medical education, whereas teaching future doctors about the need to adopt a patient safetyfocused approach to the clinical assessment, diagnosis, and management of patients receives surprisingly little attention. Consultation skills teaching should include not only communication skills but also the principles of practices of safer consulting, including risk assessment in clinical decision making, managing diagnostic uncertainty, and safety-netting skills. 4,5 An online educational programme that covered diagnostic reasoning and how to reduce the risk of diagnostic errors, along with methods of managing diagnostic uncertainty safely, could be developed by the RCGP/SAPC to support both GP teachers and students on their primary care attachments, and has the potential to deliver safer doctors to the workplace.

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Section: Spiritual Care Is Stagnating In General Practicesupporting

confidence: 64%

“…Personal continuity of care has been shown to improve patient outcomes, 4 and in building mutually trusting relationships between doctor and patient is likely also to offer greater professional satisfaction. (Think cine films versus albums of random snapshots!…”

Section: The Resilient General Practice: Working As a Packmentioning

confidence: 99%

Spiritual care is stagnating in general practice

Macdonald¹

2019

Br J Gen Pract

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“…The study was observational with no randomisation or allocation occurring. This study was a continuation of previously published data (Macdonald, 2017a), with data collection occurring between March 2015 and July 2017. This generated a further 11 months of data and allowed a more comprehensive analysis of above objectives.…”

Section: Methodsmentioning

confidence: 96%

“…Patients attending PCC have a wide variety of symptoms triggered by a multifaceted interaction between the physical and the spiritual. Often these are expressed in an undifferentiated manner, that is in terms of loss of well-being as distinct but somewhat less tangible than depression or anxiety (Macdonald, 2017a). Such undifferentiated illnesses often present with more than one issue or symptom (Green and Holden, 2003), and this is the experience in PCC.…”

Section: Undifferentiated Illnessmentioning

confidence: 99%

Primary care chaplaincy: an intervention for complex presentation

Macdonald¹

2018

Prim Health Care Res Dev

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Aim To determine the responsiveness of primary care chaplaincy (PCC) to the current variety of presenting symptoms seen in primary care. This was done with a focus on complex and undifferentiated illness. Background Current presentations to primary care are often complex, undifferentiated and display risk factors for social isolation and loneliness. These are frequently associated with loss of well-being and spiritual issues. PCC provides holistic care for such patients but its efficacy is unknown in presentations representative of such issues. There is therefore a need to assess the characteristics of those attending PCC. The effectiveness of PCC relative to the type and number of presenting symptoms should also be analysed whilst evaluating impact on GP workload. Methods This was a retrospective observational study based on routinely collected data. In total, 164 patients attended PCC; 75 were co-prescribed antidepressants (AD) and 89 were not (No-AD). Pre- and post-PCC well-being was assessed by the Warwick–Edinburgh mental well-being score. Presenting issue(s) data were collected on a separate questionnaire. GP appointment utilisation was measured for three months pre- and post-PCC. Findings Those displaying undifferentiated illness and risk factors for social isolation and loneliness accessed PCC. PCC (No-AD) was associated with a clinically meaningful and statistically significant improvement in well-being in all presenting issues. This effect was maintained in those with multiple presenting issues. PCC was associated with a reduction in GP appointment utilisation in those not co-prescribed AD.

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“…Kevern and Hill (2015) used survey methods to show that chaplains improved the wellbeing of people in primary care. In a retrospective review, Macdonald (2017) found primary care chaplains to be as effective as antidepressants. All these authors concluded that the next step for chaplaincy research is to measure outcomes of chaplaincy interventions.…”

Section: Introductionmentioning

confidence: 99%

‘What’s on your mind?’ The only necessary question in spiritual care

Snowden

Lobb

Schmidt

et al. 2018

Journal for the Study of Spirituality

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Around the world, chaplains provide specialist spiritual care for people with complex healthcare needs. If the nature of chaplain interventions was better understood then multidisciplinary colleagues could both improve their own skills in spiritual care and better understand when to refer people to chaplains. A survey was constructed to establish what aspects of the chaplain/ patient relationship were most important for patients in Scotland and Australia. Outcomes were measured with the Scottish Patient Reported Outcome Measure (Scottish PROM ©). Results from 610 respondents showed the strongest correlation was between 'being able to talk about what is on my mind' and the Scottish PROM (r s (452) = .451, p < .0005). 'Being able to talk about what is on my mind' proved more important than being listened to, having faith/ beliefs valued, or being understood. Given the importance placed on listening and understanding by clinicians, this original and counterintuitive finding goes some way to explaining the unique role and function of healthcare chaplaincy.

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The efficacy of primary care chaplaincy compared with antidepressants: a retrospective study comparing chaplaincy with antidepressants

Cited by 19 publications

References 37 publications

Spiritual care is stagnating in general practice

Spiritual care is stagnating in general practice

Primary care chaplaincy: an intervention for complex presentation

‘What’s on your mind?’ The only necessary question in spiritual care

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