A Tale of Two Perspectives: Chaplain and Patient Perceptions of Success - Scott Donahue-Martens

Summary:

In spiritual care encounters, chaplains must quickly make interpretive assessments. Initially, chaplains need to assess how welcome a visit is from the patient's perspective and how appropriate the timing of the visit is relative to other patient and staff needs. Many spiritual care visits are initiated by the chaplain, as opposed to at the request of the patient or staff. Hospital patients are not required to talk to chaplains, but hospitals in the United States are required to have spiritual care services available to patients. During the visit, chaplains engage in intentional rapport building, often guided by spiritual care assessment tools, like HOPE, FICA, and/or Four Facts. These tools utilize open-ended questions about the patient’s present and wider situation, coping capacities, and spiritual/religious inclinations. These tools help chaplains make accurate assessments concerning the patient. Later in the visit, chaplains provide fitting spiritual care interventions based on their assessment of the patient’s needs, wants, and receptivity. Chaplains are taught to clarify their assessments with patients to ascertain their accuracy; yet even this assessment and real-time clarification is not without the risk of inferential misunderstanding. 

This project aims to develop, and utilize, a questionnaire designed to assess chaplain and patient perspectives on the same spiritual care encounter. The questionnaire will be especially focused on determining if the chaplain’s assessment of the encounter aligns with the patient’s perspective. This project is guided by the question: do chaplain assessments of patient encounters match the experiences of the patient, especially regarding what constitutes a successful visit? The questionnaire will be intentionally designed to avoid being burdensome to hospital patients. It is meant to elevate the patient’s perspective.  

This study is needed because the spiritual care literature rarely considers actual patient perspectives when it comes to understanding what constitutes a successful spiritual care visit; yet the literature and practice often presume that chaplains can accurately construe the patient's perspectives and needs. This project relates to the fellowship theme in many ways. First, it recognizes that different individuals and traditions understand human flourishing in differing and complex manners. Thus, navigating perspectival differences in how human flourishing is conceived and experienced is important for chaplains who meet people in vulnerable moments of their lives. It would be beneficial for chaplains to know whether their assessments and inferences are accurate, especially since promoting human flourishing in hospitals is a central task of chaplaincy. Psychology and its research methods can help identify how a chaplain experiences the encounter and compare it with how a patient experiences the encounter.