When the spirit moves into the hospital

New research assesses hospital chaplaincy services

Despite changes over the last fifteen years in national accreditation guidelines making the religious and spiritual care of hospitalized patients a right, there is no evidence yet that this protection has had any effect on the number of hospitals with chaplains. Rather, new research from Brandeis University published in this month’s issue of Southern Medical Journal reports that whether hospitals had a chaplain or not was strongly predicted by general demographic and institutional characteristics.

The study also suggests that greater attention to religion and spirituality in medicine may be the result of doctors’ and nurses’ greater attention to spirituality and religion rather than increasing numbers of hospitals with chaplains, said lead author Wendy Cadge, a sociologist and expert on spirituality in healthcare services.

“Between 1980 and 2003, the Joint Commission made it clear that patients have a right to pastoral care and other spiritual services,” said Cadge. “But these guidelines do not seem to influence whether or not hospitals have chaplains.”

The study found that between 54 percent and 64 percent of hospitals had chaplaincy services between 1980 and 2003, with no systematic trend over this period. Smaller hospitals and those in rural areas were less likely to have chaplaincy services. Church-operated hospitals were much more likely to have chaplaincy services. Between 1993-2003, church-operated hospitals were more likely to drop chaplaincy services than to add them. Finally, the study reported that non-profit hospitals were more likely than investor-owned hospitals to add chaplaincy services.

The study is the first of its kind to provide a systematic national overview of hospital chaplaincy based on the American Hospital Association’s annual survey of hospitals. The study collected data from 1980-85; 1992-93, and 2002-03, corresponding to each time the survey included questions about chaplaincy services. The number of hospitals surveyed in these years varied from 4,946 to 6,353.

“While this study describes whether or not a hospital has a chaplain, future research will explore the number of chaplains a hospital has, their religious backgrounds and training, and how they work with hospital staff, patients, and families,” Cadge explained. “Chaplains provide valuable support for many patients, families, and staff. We need to better understand their contributions to healthcare teams.”

Jeremy Freese of Northwestern University and Nicholas A. Christakis of Harvard Medical School also contributed to the study. The study was funded by the Robert Wood Johnson Foundation.
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