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APHA Scientific Session and Event Listing

Wendy Cadge, PhD, Harvard University, Robert Wood Johnson Foundation Scholar in Health Policy Research, CGIS South, Harvard University, 1730 Cambridge Street, Cambridge, MA 02138, 617-496-6219, wcadge@rwj.harvard.edu and Elizabeth A. Catlin, MD, Pediatric Service, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114.

Background: The Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) requires all hospitals to respect patients' “cultural, psychosocial, spiritual and personal beliefs” and to “accommodate the right to pastoral and other spiritual services for patients” (Standard R1.2.10). A small (but growing) body of research describes how hospitals provide for and accommodate patients' religious and spiritual beliefs, primarily through departments of chaplaincy. In addition to hospital chaplains, other hospital staff are also called on to respond to patients' religious and spiritual issues, particularly in intensive care units where psychosocial distress and mortality is high. Research Question: We examine how intensive care unit staff (physicians, nurses, respiratory therapists, social workers, and chaplains) in a large academic medical center respond to religion and spirituality amongst the patients and families. Specifically we consider what staff learned about religion and spirituality in their training, how these issues come up now in the course of their work, how they understand the importance of religion and spirituality for patients and families, and how they respond. Population: We compare the staff of a neonatal intensive care unit and a medical intensive care unit at one large academic medical center. We compare these units to understand how the age of the patient might influence how religion / spirituality is present and addressed. Research Methods: In-depth interviews were conducted with thirty-five staff in each intensive care unit. Inductive grounded theory methods common in the social sciences were used to identify common themes in the interviews. Discussions / Conclusions: Few staff have received training about religion / spirituality though the majority respond to patients' and families' religious and spiritual issues. One group of staff actively work to ensure that patients and families are cared for religiously or spirituality and consider this work a central part of their job. A second group accommodate religion and spirituality amongst patients' and families' when it is brought up but do not seek additional information or consider the issue one of their central responsibilities. A third group actively avoid religion and spirituality either because they do not think it is important or because they do not see it as part of their job as a health care provider. The length of time staff have worked in intensive care units, their staff role, and their own religious / spiritual background influence how they respond to religion and spirituality amongst patients and families in their work.

Learning Objectives: After listening to our presentation the learner will

• Understand JCAHO's guidelines around religious and spiritual care in hospitals.
• Be able to articulate different ways critical care staff respond to religious and spiritual issues in their work.
• Present hypotheses about why different staff respond to religious and spiritual issues in different ways.

Keywords: Religion, Health Service

Presenting author's disclosure statement:

Any relevant financial relationships? No