Nava R. Silton

A national study of chaplaincy services and end-of-life outcomes.

BackgroundMedicine has long acknowledged the role of chaplains in healthcare, but there is little research on the relationship between chaplaincy care and health outcomes. The present study examines the association between chaplaincy services and end-of-life care service choices.MethodsHealthCare Chaplaincy purchased the AHA survey database from the American Hospital Association. The Dartmouth Atlas of Health Care database was provided to HealthCare Chaplaincy by The Dartmouth Institute for Health Policy & Clinical Practice, with the permission of Dartmouth Atlas Co-Principal Investigator Elliot S. Fisher, M.D., M.P.H. The Dartmouth Atlas of Health Care is available interactively on-line at http://www.dartmouthatlas.org/. Patient data are aggregated at the hospital level in the Dartmouth Atlas of Health Care. IRB approval was not sought for the project because the data are available to the public through one means or another, and neither database contains data about individual patients, i.e. all the variables are measures of hospital characteristics. We combined and analyzed data from the American Hospital Association’s Annual Survey and outcome data from The Dartmouth Atlas of Health Care in a cross-sectional study of 3,585 hospitals. Two outcomes were examined: the percent of patients who (1) died in the hospital, and (2) were enrolled in hospice. Ordinary least squares regression was used to measure the association between the provision of chaplaincy services and each of the outcomes, controlling for six factors associated with hospital death rates.Results and discussionThe analyses found significantly lower rates of hospital deaths (β = .04, p < .05) and higher rates of hospice enrollment (β = .06, p < .001) for patients cared for in hospitals that provided chaplaincy services compared to hospitals that did not.ConclusionsThe findings suggest that chaplaincy services may play a role in increasing hospice enrollment. This may be attributable to chaplains’ assistance to patients and families in making decisions about care at the end-of-life, perhaps by aligning their values and wishes with actual treatment plans. Additional research is warranted.

Religion, forgiveness, hostility and health: a structural equation analysis.

Religious participation has been shown to increase certain factors thought to be protective of health, including social support and positive health habits. The current study considers whether religious participation may likewise have a positive influence on health by increasing forgiveness and diminishing hostility. A structural equation analysis of data collected from a national survey of 1,629 participants supported the hypothesized model that (a) religiosity is related to greater forgiveness, (b) greater forgiveness, in turn, is related to reduced hostility and finally, (c) reduced hostility is related to better subjective health.

Toward a theory of holistic needs and the brain.

This article reviews Maslows theory of motivation wherein he proposes a hierarchy of human needs. First, it describes the principal elements of Maslows theory and discusses considerations relating to the flexibility of the hierarchy. Second, it explains the relationship among Maslows theory of human needs, attachment theory, and evolutionary threat assessment system theory. Third, it provides an overview of the brain structures posited to be involved in attachment and evolutionary threat assessment system theory and their relation to Maslows hierarchy. Finally, it explains how the 3 theories converge to form a theory of holistic needs.

To Pray or Not to Pray: Considering Gender and Religious Concordance in Praying with the Ill

Analysis of Covariance was conducted on quantitative data collected by chaplains from January 2005 to December 2008. Data from 82 Catholic, Jewish, and Protestant chaplains, consisting of 53 CPE students and 29 professional chaplains were used in this study. Overall, chaplains exhibited a statistically significant higher rate of prayer with patients from their own religion (religious concordance) than they did with patients of different religions (religious discordance). There was also an interaction of chaplain religion and religious concordance wherein Protestant chaplains were 50% more likely to pray with Protestant patients than with patients of other religions, and Catholic chaplains were 20% more likely to pray with Catholic patients than with other patients. Chaplains were also significantly more likely to pray with patients of their own gender (gender concordance) than with patients of the other gender (gender discordance).

Religion in America-1972-2006: Religious affiliation, attendance, and strength of faith.

The present study used data from the General Social Survey, collected between 1972 and 2006 (N = 45,463) to analyze changes over time in three aspects of religion among American adults: religious affiliation, frequency of attending religious services, and strength of faith. The last two measures were analyzed only for survey participants who had a religious affiliation. Ordinary least-squares regression confirmed a significant decrease in religious affiliation over time, after controlling for socio-demographic variables that are known to be associated with religion. A significant decrease in attending religious services was found among those survey participants who were religiously affiliated. As expected, participants who were African American, female, older, and from the South were more religious according to all three measures. No effect of birth-cohort was found for any religious measure. The results are discussed in the context of Stark and Bainbridges 1996 theory of religion.

Religiosity, Empathy, and Psychopathology among Young Adult Children of Rabbis

Rabbis’ children experience unique stresses which may make them particularly susceptible to various forms of psychopathology. Fifty-three rabbis’ children completed questionnaires assessing their frequency of religious service attendance, their reactions towards being a rabbis child, empathy levels, depressive, anxious, and disordered eating symptoms. Linear regression analyses were used for the separate outcome variables of depressive, anxiety, and disordered eating symptoms. More dissatisfaction with life as a rabbis child was significantly associated with higher levels of depressive, Oral Control, and Bulimia and Food Preoccupation symptoms. Attending services daily was associated with higher levels of anxiety and Oral Control symptoms. Higher empathy levels were associated with higher anxiety, depressive and dieting symptoms. Finally, men demonstrated higher scores for Oral Control and women for Bulimia and Food Preoccupation. Counseling may be useful to aid rabbis’ children who may be challenged with depressive, anxious and disordered eating symptoms.

Complementary Alternative Medicine Practices Used by Religious Professionals

Religious professionals completed an online survey of their use of health related practices currently known as complementary and alternative medicine (CAM). They indicated how often they engaged in these practices and how often they had used these practices when helping other people. The majority of religious professionals used at least one of the practices when alone and when helping other people. The most frequently used practices were meditation and deep breathing exercises used both when alone and when helping others. Female respondents were more likely to use these practices on their own and when helping others than were males, and older respondents were more likely to use multiple CAM practices than their younger counterparts. Other Faith/Humanists used the most CAM practices when alone and Jewish respondents used the fewest. In general, religious professionals used fewer practices when helping others than they used for themselves. Limitations of this study and suggestions for future studies for examining CAM practices among religious professionals are discussed.

Informing Our Interventions with the Wisdom of the Sages: Biblical and Rabbinic Inspiration for Fostering Sensitivity Towards Individuals with Disabilities

This chapter presents Jewish perspectives on disabilities that informed the creation of two prosocial interventions to enhance typical children’s sensitivity, intentions, and attitudes towards children with special needs. The first intervention involved a four-part curriculum designed to teach typical students about autism, blindness, cerebral palsy, and deafness. The second intervention introduced a children’s television show, which highlights the special strengths and abilities of individuals with disabilities. Drawing on lessons and stories from traditional Jewish teachings, the chapter calls for children to be better educated to recognise the inherent value and unique strengths of children living with disabilities.