Tom Baker Cancer Centre, Calgary, Canada.
Palliat Support Care. 2009 Dec;7(4):415-22. doi: 10.1017/S1478951509990423.
Tending to the spiritual needs of patients has begun to be formally recognized by professional spiritual care providers, health care councils, and health delivery systems over the last 30 years. Recognition of these programs has coincided with evidence-based research on the effect of spirituality on health. Palliative care has served as a forerunner to an integrated professional spiritual care approach, recognizing the importance of addressing the spiritual needs of the dying from its inauguration within Western medicine almost 50 years ago. Oncology programs have also begun to recognize the importance of spirituality to patients along the cancer continuum, especially those who are approaching the end of life. Although standards and best practice guidelines have been established and incorporated into practice, little is known about the actual factors affecting the practice of spiritual care programs or professional chaplains working within an oncology setting.
Participant observation and interactive interviews occurred at five cancer programs after we conducted a literature search.
This study identified underlying organizational challenges, cultural and professional issues, academic program development challenges, administrative duties, and therapeutic interventions that determined the success of oncology spiritual care programs in practice.
Although spiritual care services have developed as a profession and become recognized as a service within oncology and palliative care, organizational and operational issues were underrecognized yet significant factors in the success of oncology spiritual care programs. Spiritual care programs that were centrally located within the cancer care center, reported and provided guidance to senior leaders, reflected a multifaith approach, and had an academic role were better resourced, utilized more frequently, and seen to be integral members of an interdisciplinary care team than those services who did not reflect these characteristics.
在过去的 30 年中，专业的精神关怀提供者、医疗保健委员会和医疗服务系统开始正式认识到满足患者精神需求的重要性。这些项目的认可恰逢基于证据的关于精神信仰对健康影响的研究。临终关怀是一种综合的专业精神关怀方法的先驱，它从近 50 年前在西方医学中成立以来就认识到满足临终患者精神需求的重要性。肿瘤学项目也开始认识到精神信仰对癌症患者的重要性，特别是那些接近生命终点的患者。尽管已经制定了标准和最佳实践指南，并将其纳入实践中，但对于影响肿瘤学环境中精神关怀项目或专业牧师实践的实际因素知之甚少。
在进行文献检索后，我们在五个癌症项目中进行了参与者观察和互动访谈。
本研究确定了影响肿瘤学精神关怀计划实践成功的潜在组织挑战、文化和专业问题、学术项目发展挑战、行政职责和治疗干预因素。
尽管精神关怀服务已经发展成为一个专业领域，并在肿瘤学和姑息治疗中被认可为一种服务，但组织和运营问题是影响肿瘤学精神关怀计划成功的重要但未被充分认识的因素。那些位于癌症治疗中心核心位置、向高层领导报告并提供指导、反映多信仰方法、具有学术作用的精神关怀计划得到了更好的资源支持，使用频率更高，并且被视为跨学科护理团队的不可或缺的成员，而那些没有反映这些特征的服务则不然。
