Adapting the 2015 Mother-Baby Friendly Birth Facility Guidelines for Semi-nomadic Pastoralist Communities in Laikipia and Samburu Counties of Kenya.

Purpose To adapt the 2015 International Federation of Gynecologists and Obstetricians (FIGO), International Confederation of Midwives (ICM), White Ribbon Alliance (WRA), International Pediatric Association (IPA), and WHO auspiced Guidelines on Mother-Baby Friendly Facilities to a particular sub-population; seminomadic pastoralist communities of Laikipia and Samburu Counties, Kenya. We anticipate an increased utilization of childbirth services by improving their acceptability. Description We drafted a Pastoralist Friendly Birthing Facility Checklist based on the FIGO/ICM/WRA/IPA/WHO guidelines and previous research in this context. We employed mixed methods to finalise the adaptation: a workshop with 27 local stakeholders; interviews with ten health planners and skilled birth attendants (SBAs); and ten focus group discussions (FGDs) with health committee members, community health workers, mothers and traditional birth attendants (TBAs). A facility audit of dispensaries across five group ranches was also undertaken. Assessment The final Checklist was divided into: characteristics of care and the environment; care during labour and birth; post-partum care; and community staff relationships. It was endorsed by the Ministries of Health in the relevant counties, and by women, SBAs and TBAs. No facility currently satisfies all the criteria specified in the Checklist. Conclusion The FIGO/ICM/WRA/IPA/WHO Guidelines were successfully adapted and can be used to ensure health facilities meet the needs of pastoralist women.

Pastoral counseling in the 21st century: the centrality of community.

In this article, I argue that the notion of ecclesia or faith community is a central, existential anthropological premise that can shape how we understand facets of pastoral counseling such as diagnosis, process, and aims. Implicit here is the idea that the distinctiveness of pastoral counseling lies not simply in accountability and authority vis-à-vis community, but in its use of a communitarian anthropology to understand the importance of community for psychosocial development, resiliency, and healing. I argue further that in the 21st century the centrality of the notion of community is, and will continue to be, critical, because of political and economic forces that undermine community, giving rise to psychosocial alienation, depression, etc.

[Support to spiritual needs in hospital care. Integration perspective in modern hospitals]. / Il supporto ai bisogni spirituali nella cura ospedaliera. Prospettive di integrazione nell'ospedale moderno.

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.

Universities' expectations of pastoral care: trends, stressors, resource gaps and support needs for teaching staff.

OVERVIEW: Since the mid-90s, the university environment has challenged the motivation of academic staff to engage in pastoral care. A literature review revealed five themes that aligned with analysis of interview data from a previous study (Laws and Fiedler, 2010). The key themes were i) staff were often disturbed by unplanned intrusions of students who exhibited behavioural problems or sought emotional support, ii) the management of emotions in face-to-face encounters was stressful, iii) staff felt under-equipped for dealing with Mental Health (MH) issues, iv) standards and control needed updating and v) counselling and disability services did not meet academics' need to know about 'at risk' students. OBJECTIVE: Having identified the incidence of mental health issues among Australian University students, this study aims to locate literature that describes how well current university policies/protocols are supported by Evidence Based Practice in the management of MH problems in the student population. DESIGN/SETTING/PARTICIPANTS: Findings from a content analysis of the literature were triangulated with verbatim comments recorded during a previous study that utilised semi structured interviews with 34 academics at the School of Nursing and Midwifery and the School of Commerce at the University of South Australia (Laws and Fiedler, 2010). RESULTS: Lack of clarity on role boundaries around promotion of students' well-being was not clearly defined. The Higher Education (HE) institutions' slowness in responding to mental health needs of students combined with the increasing expectations of academics' performance monitoring has lead staff to avoid deep investment in their students' well-being. The literature indicates that students are in need of psychological support, but pastoral care remains ill-defined despite enduring expectations held by university administrators. Teacher motivation is diminished by time spent with students in need of emotional support which is not acknowledged in workloads. Staff stress is increased by 'emotion work' requiring a greater integration of resources that guide them toward more appropriate and timely student support. CONCLUSION: Staff require ongoing professional development on the nature of MH problems among students. There is a need for specific orientation programs that better define pastoral care and identify support services for staff and students. Universities need to focus on what is needed to create a well-being environment. Workload allocations must include 'emotion work', and mental health professionals must be employed to improve intervention and support not only for students but also for University staff. With better defined pastoral care roles, academics can more effectively balance their intrinsic and extrinsic motivations toward both personal and corporate objectives. Further research into the efficacy of university resourcing of programs and services is needed.

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 relations with the scientific world, 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.

Trends in publication of spirituality/religiosity articles in critical care populations.

Research on spirituality and religion (S/R) is receiving more attention as healthcare staff recognize the importance of treating the whole person. This is especially pertinent in critical care, where patients and families deal with a multitude of issues. As not all research comes exclusively from theologically educated authors, this study explored publication trends of S/R articles in critical care. Findings indicated medically credentialed professionals, not chaplains and/or pastoral care staff, constituted the majority of authors in S/R articles.

An exploratory study of spiritual care at the end of life.

PURPOSE: Although spiritual care is a core element of palliative care, it remains unclear how this care is perceived and delivered at the end of life. We explored how clinicians and other health care workers understand and view spiritual care provided to dying patients and their family members. METHODS: Our study was based on qualitative research using key informant interviews and editing analysis with 12 clinicians and other health care workers nominated as spiritual caregivers by dying patients and their family members. RESULTS: Being present was a predominant theme, marked by physical proximity and intentionality, or the deliberate ideation and purposeful action of providing care that went beyond medical treatment. Opening eyes was the process by which caregivers became aware of their patient's life course and the individualized experience of their patient's current illness. Participants also described another course of action, which we termed cocreating, that was a mutual and fluid activity between patients, family members, and caregivers. Cocreating began with an affirmation of the patient's life experience and led to the generation of a wholistic care plan that focused on maintaining the patient's humanity and dignity. Time was both a facilitator and inhibitor of effective spiritual care. CONCLUSIONS: Clinicians and other health care workers consider spiritual care at the end of life as a series of highly fluid interpersonal processes in the context of mutually recognized human values and experiences, rather than a set of prescribed and proscribed roles.

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.

Transforming chaplaincy: the emergence of a healthcare pastoral care for a post-modern world.

This article provides a snap shot of the current position and recent developments in chaplaincy in health care settings particularly in England, Scotland, the United States of America and Australia in order to guide the emerging modernization agenda in the Australian context, and to assist the acceleration of the local adoption of best practice in pastoral care. Over all, the picture is one of change. As hospitals develop to meet new performance expectations services that work within the hospital system, such as chaplaincy and pastoral care, must also adapt. Rather than chaplaincy being discarded as marginal during these changes, recent research evidence supports the inclusion of pastoral care in holistic health care. Demographic changes also mean that pastoral care needs to have an emphasis on spiritual support if it is to respond to patients of other faith traditions or with secular beliefs.

The development, status, and future of healthcare chaplaincy.

This review article provides insight into the evolution of professional healthcare chaplaincy. It identifies key historical developments identifying the training, qualifications, and competencies of chaplains. Consideration is given to both the unique character of the pastoral role in healthcare as well as the contribution of chaplains to the interdisciplinary care of patients and families. The article points to the emerging need for chaplains to pursue research within the clinical context.

Partners in healing: home care, hospice, and parish nurses.

A creative way to support patients in self-care strategies is to work with the parish nurse as a practice partner. This article shares approaches and innovative ideas on how home care and hospice nurses can work effectively with parish nurses.

Clinical Pastoral Education: reflections on the past and future of a movement.

In the year 2000, the celebration of seventy-five years of Clinical Pastoral Education (CPE) in the United States included attention to the history of the movement. A history of the past twenty-five years of the Association for Clinical Pastoral Education (ACPE) was published, plus several regional histories. This article grows out of the author's study of the history of the Northeast Region of ACPE in the context of the history of the Clinical Pastoral Education movement. The focus of this article is "the vision question"; that is, "What has happened to the visions of clinical training that were important in the beginning of the movement?" The history of the relations of clinical training to theological education is traced from the beginnings of CPE to the present time, with special emphasis on developments in the Northeast. Two implications of this historical review for the future of the movement are suggested.

Survey results spur spiritual care program.

Simple ideas win national recognition. There have been plenty of studies in the last few years that indicate patients do better if their spiritual needs are being met. That is the message that Baxter Regional Medical Center in Mountain Home, AR, recently took to heart.

Towards a pastoral care in a Trinitarian perspective.

Traces the development of pastoral care in Continental Europe during the last century and presents a model of pastoral care rooted in the Christian Doctrine of the Trinity.