Shields Michele, Kestenbaum Allison, Dunn Laura B
Spiritual Care Services Department,University of California San Francisco Medical Center and Benioff Children's Hospital,San Francisco,California.
Center for Pastoral Education,Jewish Theological Seminary, New York, New York.
Palliat Support Care. 2015 Feb;13(1):75-89. doi: 10.1017/S1478951513001120. Epub 2014 Mar 10.
Distinguishing the unique contributions and roles of chaplains as members of healthcare teams requires the fundamental step of articulating and critically evaluating conceptual models that guide practice. However, there is a paucity of well-described spiritual assessment models. Even fewer of the extant models prescribe interventions and describe desired outcomes corresponding to spiritual assessments.
This article describes the development, theoretical underpinnings, and key components of one model, called the Spiritual Assessment and Intervention Model (Spiritual AIM). Three cases are presented that illustrate Spiritual AIM in practice. Spiritual AIM was developed over the past 20 years to address the limitations of existing models. The model evolved based in part on observing how different people respond to a health crisis and what kinds of spiritual needs appear to emerge most prominently during a health crisis.
Spiritual AIM provides a conceptual framework for the chaplain to diagnose an individual's primary unmet spiritual need, devise and implement a plan for addressing this need through embodiment/relationship, and articulate and evaluate the desired and actual outcome of the intervention. Spiritual AIM's multidisciplinary theory is consistent with the goals of professional chaplaincy training and practice, which emphasize the integration of theology, recognition of interpersonal dynamics, cultural humility and competence, ethics, and theories of human development.
Further conceptual and empirical work is needed to systematically refine, evaluate, and disseminate well-articulated spiritual assessment models such as Spiritual AIM. This foundational work is vital to advancing chaplaincy as a theoretically grounded and empirically rigorous healthcare profession.
要明确牧师作为医疗团队成员所做出的独特贡献和发挥的作用,就需要迈出关键的一步,即阐述并批判性地评估指导实践的概念模型。然而,目前缺乏详尽描述的精神评估模型。现存模型中规定干预措施并描述与精神评估相对应的预期结果的更是少之又少。
本文介绍了一种名为精神评估与干预模型(Spiritual AIM)的模型的开发、理论基础和关键组成部分。文中呈现了三个案例,用以说明Spiritual AIM在实践中的应用。Spiritual AIM是在过去20年中为解决现有模型的局限性而开发的。该模型的演变部分基于观察不同的人如何应对健康危机以及在健康危机期间哪些精神需求似乎最为突出。
Spiritual AIM为牧师提供了一个概念框架,用于诊断个体未得到满足的主要精神需求,制定并实施通过体现/关系来满足这一需求的计划,并阐明和评估干预的预期和实际结果。Spiritual AIM的多学科理论与专业牧师培训和实践的目标相一致,这些目标强调神学的整合、对人际动态的认识、文化谦逊与能力、伦理学以及人类发展理论。
需要进一步开展概念性和实证性工作,以系统地完善、评估和传播诸如Spiritual AIM这样阐述清晰的精神评估模型。这项基础性工作对于将牧师职业发展成为一个有理论依据且实证严谨的医疗保健专业至关重要。