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• W2079789744 abstract "Attention to spiritual needs is essential to comprehensive care of patients facing life-threatening illnesses, such as advanced cancer. Cancer predominantly affects older adults, whose spiritual needs may be different than those of younger adults. Healthcare chaplains are uniquely trained to assess and address spiritual needs. However, the content, processes, and impact of spiritual care for older adults with cancer have been minimally studied. Our team has been studying one model (called Spiritual Assessment and Intervention Model, or Spiritual AIM), which has evolved over 20 years of clinical care and has been taught extensively in chaplaincy education. Spiritual AIM defines spirituality as encompassing the dimension of life that reflects the needs to seek meaning and direction, to find self-worth and to belong to community, and to love and be loved, often facilitated through seeking reconciliation when relationships are broken. Spiritual AIM posits that in the context of clinical care of any type—from ongoing care of chronically ill patients to acute healthcare crises—one of three core spiritual needs (corresponding to the needs identified in the definition of spirituality above) will emerge as primary, and that this need emerges within the relationship between chaplain and patient. In the language of Spiritual AIM, the three core spiritual needs are termed “Meaning and Direction,” “Self-Worth/Belonging,” and “Reconciliation.” Spiritual AIM guides chaplains in identifying which core need predominates during the chaplaincy encounter and helps the chaplain devise an intervention plan to address this need. In other words, the “core need” serves as a heuristic rather than as a diagnosis. During the chaplain's sessions with the patient, the chaplain assesses the core spiritual need and develops and implements a plan to address this core spiritual need (which is not spoken aloud to the patient) in order to help the patient move along a path of spiritual healing. The model has not previously been empirically studied. This poster will describe the Spiritual AIM model (including its conceptual, theological, and psychological underpinnings), and will present findings from a mixed methods study of Spiritual AIM in the setting of outpatient palliative care for patients with advanced cancer. The focus of this analysis will be a qualitative evaluation of differences and similarities between chaplain-assessed core spiritual needs and chaplain interventions among patients 60 and older compared to patients younger than 60. Thirty patients receiving concurrent oncologic and palliative care at a comprehensive cancer center participated in three audiorecorded one-on-one sessions with a chaplain, as well as an exit interview with a research assistant. Qualitative methods (iterative development of a codebook) were used to evaluate major themes (both related and distinct from those developed in Spiritual AIM) identified in the transcripts. In this study we used these codes to examine transcripts of the first sessions with chaplains of 14 patients ≥ 60 years old, and compared these findings to those of patients younger than 60. Mean age of participants was 65.9 (SD: 5.2 years, range: 60-80). Participants were diagnosed with a variety of solid tumors and all had distant metastases. Participants were evenly divided between men and women. A codebook was compiled by identifying themes associated with the assessment, intervention and intervention response (outcome in terms of spiritual need and movement along a path toward spiritual healing) for each spiritual core need in the model. Using this coding system, we identified the proportion of patients that exhibited each need in their first session. Among the older patients in the sample, 29% were categorized as having “Meaning and Direction” as their core spiritual need, 36% as “Self Worth and Belonging,” and 36% as “Reconciliation.” (Analysis is ongoing, so these proportions may change by the time of presentation). Differences between older and younger patients in terms of core spiritual need, spiritual/psychological themes, discussion of death and dying, and additional themes will be described. Examples of themes (quotations from participants relevant to each) will be presented. This study fills an important gap in chaplaincy/spiritual care research; namely, to date, little has been documented regarding the nature or added clinical value of chaplains' work in the palliative care setting, nor is there extant work comparing older vs. younger patients' core spiritual needs. This study adds rigor to a field where most published work is anecdotal, allow other healthcare professionals to lift the veil on chaplaincy and highlight the meaningful work chaplains do with older patients. Implications for comprehensive care of older patients with cancer and other serious illnesses will be highlighted." @default.
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• W2079789744 date "2014-03-01" @default.
• W2079789744 modified "2023-09-27" @default.
• W2079789744 title "Spiritual Care in Outpatient Palliative Care: Comparison of Older vs. Younger Patients with Advanced Cancer" @default.
• W2079789744 doi "https://doi.org/10.1016/j.jagp.2013.12.160" @default.
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