Cadge Wendy, Freese Jeremy, Christakis Nicholas A
Department of Sociology, Brandeis University, Waltham, MA 02454-9110, USA.
South Med J. 2008 Jun;101(6):626-30. doi: 10.1097/SMJ.0b013e3181706856.
Over the past 25 years, the Joint Commission for the Accreditation of Healthcare Organizations has changed its guidelines regarding religious/spiritual care of hospitalized patients to increase attention concerning this aspect of hospital-based care. Little empirical evidence assesses the extent to which hospitals relied on hospital chaplains as care providers during these years. This study investigates (1) the extent of chaplaincy service availability in US hospitals between 1980 and 2003; (2) the predictors of having chaplaincy services in 1993 and 2003; and (3) the change in the magnitude of these predictors between years. This study examines the presence or absence of chaplaincy or pastoral care services in hospitals using the American Hospital Association Annual Survey of Hospitals (ranging from 4,946-6,353 hospitals) in 1980-1985, 1992-1993, and 2002-2003. Between 54% and 64% of hospitals had chaplaincy services between 1980 and 2003, with no systematic trend over this period. In 1993 and 2003, hospital size, location, and church affiliation were central factors influencing the presence of chaplaincy services. 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; but between 1993 and 2003, church-operated hospitals were more likely to drop chaplaincy services than to add them. Not-for-profit hospitals were more likely than investor-owned hospitals to add chaplaincy services. Changes to Joint Commission for the Accreditation of Healthcare Organizations policies about the religious/spiritual care of hospitalized patients between 1980 and 2003 seem to have had no discernible effect on the fraction of US hospitals that had chaplaincy services. Rather, characteristics of hospitals, their surroundings, and their religious affiliations influenced whether they provided chaplaincy services to patients.
在过去25年里，医疗保健机构认证联合委员会已更改其关于住院患者宗教/精神关怀的指导方针，以提高对医院护理这一方面的关注度。几乎没有实证证据评估这些年医院在多大程度上依赖医院牧师作为护理提供者。本研究调查了：（1）1980年至2003年间美国医院提供牧师服务的程度；（2）1993年和2003年拥有牧师服务的预测因素；以及（3）这些预测因素在不同年份间的变化幅度。本研究使用1980 - 1985年、1992 - 1993年和2002 - 2003年美国医院协会医院年度调查（涉及4946 - 6353家医院）来考察医院中是否存在牧师或宗教关怀服务。1980年至2003年间，54%至64%的医院提供牧师服务，在此期间没有系统的趋势。在1993年和2003年，医院规模、位置和教会附属关系是影响牧师服务存在的核心因素。规模较小的医院以及农村地区的医院提供牧师服务的可能性较小。教会运营的医院更有可能提供牧师服务；但在1993年至2003年间，教会运营的医院减少牧师服务的可能性大于增加服务的可能性。非营利性医院比投资者所有的医院更有可能增加牧师服务。1980年至2003年间医疗保健机构认证联合委员会关于住院患者宗教/精神关怀政策的变化似乎对提供牧师服务的美国医院比例没有明显影响。相反，医院的特征、周边环境及其宗教附属关系影响了它们是否为患者提供牧师服务。
