Spiritual care, pastoral care, and chaplains: trends in the health care literature.

This study analyzes trends in the health care literature based on electronic searches of MEDLINE between the years 1980 and 2006. The search terms used were "spiritual care," "pastoral care," and "chaplain.*" The results document an expected surge in the rate of English-language journal articles about spiritual care beginning in the mid 1990s. Although the rate of articles about pastoral care was several times higher than that for spiritual care over much of the study period, there was a steady decline in articles about pastoral care during the past 10 years. These two trends produced a convergence in the rates, so by 2006 the rate of published articles on pastoral care (21.1 per 100,000) was less than twice as high as that on spiritual care (13.3 per 100,000). The rate of articles about chaplains rose moderately but significantly from 9.6 per 100,000 in the years 1980-1982 to 12.2 per 100,000 in the years 2004-2006. Increasing interest in spiritual care was evident in nursing, mental health, and general health care journals, being most pronounced in nursing. Declining interest in pastoral care was also most pronounced in nursing. This article discusses some implications of and responses to these trends.

What do chaplains really do? II. Interventions in the New York Chaplaincy Study.

The current study analyzes data from 30,995 chaplain visits with patients and families that were part of the New York Chaplaincy Study. The data were collected at 13 healthcare institutions in the Greater New York City area from 1994-1996. Seventeen chaplain interventions were recorded: nine that were religious or spiritual in nature, and eight that were more general or not specifically religious. Chaplains used religious/spiritual interventions, alone or in conjunction with general interventions, in the vast majority of their visits with patients and families. The types of interventions used varied by the patient's medical status to some degree, but the pattern of interventions used was similar across faith group and medical status. The results document the unique role of the chaplain as a member of the healthcare care team and suggest there is desire among a broad range of patients, including those who claim no religion, to receive the kind of care chaplains provide.

What do chaplains really do? III. Referrals in the New York Chaplaincy Study.

The current study examines patterns of referrals to chaplains documented in the 1994-1996 New York Chaplaincy Study. The data were collected at thirteen healthcare institutions in the Greater New York City area. Of the 38,600 usable records in the sample, 18.4% were referrals, which form the sample for the current study (N = 7,094). The most common sources of referrals were nurses (27.8%) and patients themselves (22.3%), with relatively few referrals coming from physicians and social workers. The study shows the range of patient issues that are referred to chaplains, including emotional, spiritual, medical, relationship/support, and a change in diagnosis or prognosis. Although the reasons for referral varied by hospital setting and referral source, overall, patients were referred more frequently for emotional (30.0%) than for spiritual issues (19.9%). Results are discussed in relation to the need to clarify the role of the chaplain to the rest of the healthcare team, to recognize when there is a spiritual cause of emotional distress, and to establish effective referral protocols.