01 02 03 Understand Explore Discuss telechaplaincy emerging - - PDF document

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• Telechaplaincy: Taking

Chaplaincy beyond the Patient Room

• Rev. Petra Sprik, MPH, MDiv, BCC

Aims

Understand telechaplaincy research

01

Explore emerging best practices

02

Discuss application to clinical context

03

• “Telehealth

Chaplaincy”

• r

“Telechaplaincy”

• The use of telecommunications and virtual

technology to deliver spiritual and religious care by healthcare chaplains or other religious/spiritual leaders

• Telehealth modalities can include telephone,

smartphone applications, live videoconferencing and internet interventions, which are delivered synchronously or asynchronously

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Telechaplaincy: A history

1900's Telehealth 1950's VA Telechaplaincy 2000's Telechaplaincy programs Today Research & COVID Response

• True or False?

In-person chaplaincy is more effective than telechaplaincy.

• The Research

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Lay pastoral telecare of church attenders

The Issue

• Large churches unable to

provide social support The Intervention

• Lay-person delivered

telephone counseling, weekly

• r biweekly for 6 months
• Randomized Control

Zwart et al. 2000

The Measures

• Spiritual Wellbeing Scale
• Church Satisfaction

Questionnaire

• Greater positive change in

spiritual wellbeing

• Trend toward greater church

satisfaction The Findings

Home Telehealth for Holistic End-of-Life

Care

The Issue

• Physical, emotional and

spiritual needs for veterans with chronic end stage illnesses The Intervention

• Text and videophone to

provide psychosocial and spiritual support

Maudlin et al, 2006

The Measures

• Quality data
• Clinical data
• Business indicators
• Better management of

medical condition

• Better connection/security

The Findings

Chaplain-led intervention for

caregivers of seriously ill patients

The Issue

• Physical, emotional and

spiritual well-being of caregivers of patients with life-limiting illnesses The Intervention

• 3 semi-structured telephone

conversations with chaplain

Steinhauser et al, 2016

The Measures

• Quality of life
• Psychological measures
• Spiritual/Religious measures
• Stable outcomes
• Appreciate aspects of

program The Findings

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Telephone-based Chaplaincy Intervention

for Parents of Children with Cystic Fibrosis

The Issue

• Spiritual Struggles of parents
• f children with cystic fibrosis

The Intervention

• 3 semi-structured telephone

conversations with chaplain

• Randomized Control

Betz et al, 2019

The Measures

• Brief RCOPE
• Feasibility and Acceptability
• Acceptable and feasible
• Positive religious coping

increased The Findings

Patient-Reported-Outcome-Directed

Telephone-Chaplaincy with Cancer Patients

The Issue

• Identifying patients receptive

to telechaplaincy at outpatient cancer center The Intervention

• Telephone from chaplain to

patients who identify religious/spiritual need

Sprik et al, 2018

The Measures

• Acceptance of intervention
• Patients with struggle to find

meaning/hope, fear of death and anxiety more likely to accept an intervention The Findings

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Telephone-based Chaplaincy

Intervention at Cancer Institute

The Issue

• Acceptability of telephone

intervention to cancer patients as first point of contact The Intervention

• Telephone call as first point of

contact

Sprik et al, 2020

The Measures

• Feasibility
• Acceptability
• Acceptable and feasible

The Findings

Sprik et al, 2020 Sprik et al, 2020

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Nationwide analysis of telechaplaincy

practice

The Issue

• What does telechaplaincy

look like in the US? The Intervention

• Survey of NACC, APC and

NAJC The Measures

• Survey
• 48%

52%

Have you ever practiced virtual chaplaincy (VC) ? (N=704; Missing 76)

Yes No

8% 92%

For chaplains who haven’t practiced virtual chaplaincy: Have you ever had the

• pportunity to practice virtual chaplaincy?

(N=365)

Yes No 106 113 79 46 21

Definitely Probably Undecided Probably Not Definitely Not

For chaplains not practicing VC: Would you be willing to practice virtual chaplaincy? (N=365)

30 31 23 5 88 206 9 45 54 57 18 7 11 9 20 14 49

OF CHAPLAINS PRACTICING VIRTUAL CHAPLAINCY: IN WHICH SETTING(S) HAVE YOU PRACTICED VIRTUAL CHAPLAINCY? (MULTISELECT) TOTAL COUNT (N=338) MISSING:27

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322 41 64 25 16 50 100 150 200 250 300 350

For those practicing virtual chaplaincy: Which mediums have you used? Multiselect (N=340, Missing 25)

68 38 78 40 112 LESS THAN 6 MONTHS 6 MONTHS TO LESS THAN 1 YEAR 1 YEAR TO LESS THAN 3 YEARS 3 YEARS TO LESS THAN 5 YEARS 5+ YEARS

For those practicing virtual chaplaincy: How much experience do you have practicing virtual chaplaincy? (N=336, Missing 19)

• Reasons for

Telechaplaincy

Expand Reach

• Geographic distance
• Small clinics
• Outpatient settings
• Low mobility/transportation patients
• After hours

Continuity of care Timeliness

• Quick access to many patients
• Easy access at time of need

Preferred by patients

• Symptoms
• Comfort of own home
• Outside of clinical setting
• Anonymity

COVID-19

• Prevent spread of COVID-19 to patients/family/staff/yourself
• Recommended by the World Health Organization
• Operate within healthcare organization’s directives
• Conserve PPE
• Reduce patient/family fear of transmission
• Expand access of care during high-stress time

Cost

• Which of

these cannot be done by phone?

• Prayer
• Communion
• End-of-life support
• Anxiety reduction
• Developing coping

strategies

• Grief counseling
• Treatment compliance

conversations

• Ethical consultation
• Staff care
• Advance Directives
• Reading scripture
• Pastoral touch
• Suicide prevention
• Funeral planning
• Presence

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• Weaknesses of

Telechaplaincy

• Body language not seen or limited to what is on screen
• Patient/recipient may be doing something else
• Physical touch not possible
• Silences may feel harder to endure for the chaplain/patient
• Not everybody has access to a phone
• Technology issues
• Hard of hearing/speaking patients are not ideal candidates
• Difficulty getting ahold of the patient
• Perception of intrusive phone calls
• If share office, difficult to get privacy
• Physical mirroring not possible
• Emotionally draining for chaplain

What we still need to know

Ideal timing of phone calls Ideal length of phone calls Fleshed-out Intervention strategies Types of spiritual needs ideal for phone Reception in different contexts

• Best Practices

for Telechaplaincy

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Make sure you are

using a system- approved platform

Almost everybody

is nervous at first: Just Do it!

• Check the patient’s chart

before calling

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Have an

emergency plan.

Limit distraction

while you are on the phone

Develop a semi-

structured script

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• Develop a Casual Introduction
• “I am calling from the spiritual care department” NOT “This is the chaplain”
• “We recognize that medical appointments/hospitalizations can affect you

spiritually and emotionally as well as physically. How are you doing/holding up?”

• “I don’t have any medical information”
• Ensure you are talking

to the right person and that this is a good time to talk

Address

awkwardness

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Do not provide

medical information

• r advice

Ensure that you are

HIPAA compliant in your messaging

Intentionally use

voice to convey emotion

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Use well thought-

• ut language to

convey care

Be creative in

rituals and interventions

• Be creative in deepening the

conversation

• “As people are going through medical appointments, sometimes medicine’s all we

talk about. I would like to know more about you. Tell me something that is really important to you right now.”

• “I hear X in the background….”
• What feels like the most important thing to you now?

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• Limit length of the phone call

tactfully

• “I will need to go in 5 minutes. Is there anything else you wanted to talk about

before we end the conversation?”

• “We have talked about some pretty important things today. I would like to follow-

up with you. Is there a time of day that generally works best?”

Care for yourself

and patient with Zoom Fatigue

• Clinical

Application

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• Context Matters
• Questions and

Discussion

• Betz J, Szczesniak R, Lewis K, Pestian T, Bennethum AS, McBride J, Grossoehme

DH (2019) Feasibility and acceptability of a telephone-based chaplaincy intervention to decrease parental spiritual struggle. J Relig Health 58(6):2065-2085. Jaing, M. The reason Zoom calls drain your energy. BBC. April 22 2020. Mahar JH, Rosencrance GJ, Rasmussen PA ((2018) Telemedicine: past, present and

• future. Cleveland clinic journal of medicine 85(12):938-942.

Maudlin J, Keene J, Kobb R (2006) A road map for the last journey: home telehealth for holistic end-of-life care. American Journal of Hospice & Palliative Medicine 23(5): 399-403. Sprik P, Janssen Kennan A, Boselli D, Cheeseboro S, Meadors P, Grossoehme D (2020) Feasibility and acceptability of a telephone-based chaplaincy intervention in a large, outpatient oncology center. Support Car Cancer, Epub. Sprik PJ, Walsh K, Boselli DM, Meadors P (2019) Using patient-reported religious/spiritual concerns to identify patients who accept chaplain interventions in an

• utpatient oncology setting. Support Care Cancer 27(5): 1861-1869.

Steinhauser KE, Olsen A, Johnson K, Sanders LL, Olsen M, Ammarell N, Grossoehme D (2016) The feasibility and acceptability of a chaplain-led intervention for caregivers of seriously ill patients: a caregiver outlook pilot study. Palliative and Supportive Care 14(5):456-467. Weiner J. (2020) ‘Telechaplaincy’ is Effective and Can Lead to Meaningful Spiritual Conversations . Jewish Journal. Zwart LM, Palmer SL, Strawn BD,Milliron JT, Brown WS (2000)The impact of lay pastoral telecare on the spiritual well-being of church attenders. J Pastoral Care 54(1):63–73

Cited Resources

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