Nieuwsma Jason A, Jackson George L, DeKraai Mark B, Bulling Denise J, Cantrell William C, Rhodes Jeffrey E, Bates Mark J, Ethridge Keith, Lane Marian E, Tenhula Wendy N, Batten Sonja V, Meador Keith G
Mental Health and Chaplaincy, Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,
J Gen Intern Med. 2014 Dec;29 Suppl 4(Suppl 4):885-94. doi: 10.1007/s11606-014-3032-5.
Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs.
Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings.
A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains.
Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities.
Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete.
When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved.
Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.
认识到神职人员和精神关怀提供者是心理健康护理系统的关键组成部分，美国退伍军人事务部（VA）和国防部（DoD）联合审视了牧师在照顾有心理健康需求的退伍军人和军人方面的当前及潜在作用。
我们的目标是评估VA和DoD中牧师与心理健康护理实践的交叉点，以确定是否需要改进，若需要，则根据评估结果制定可行的建议。
一个由38名成员组成的多学科任务组与研究人员合作设计、实施和解释一项混合方法研究，该研究包括：1）对VA和DoD牧师的定量调查；2）对心理健康提供者和牧师的定性访谈。
定量：调查包括所有全职VA牧师和所有现役军队牧师（3464名受邀者中有2163名完成调查；回复率为62%）。定性：在对33个VA和DoD设施进行实地考察期间，共对心理健康提供者和牧师进行了291次访谈。
定量：在线调查评估了牧师工作与心理健康护理之间的交叉点，平均需要37分钟完成。定性：访谈评估了心理健康和牧师服务的当前整合情况，平均需要1小时完成。
当牧师被纳入跨学科心理健康护理团队时，他们感到被理解和重视（82.8%-100%的牧师表示如此，具体取决于团队）。然而，调查和实地考察的结果表明，服务整合往往不足，仍有改进空间。
与多学科任务组密切合作，对VA和DoD中牧师与心理健康整合进行混合方法评估，有助于确保研究人员评估相关领域，并使研究结果能够迅速转化为可行的建议。
