Department of Psychiatry (L.E.K., H.N.L., J.R.P.), Brigham & Women's Hospital, Boston, MA.
Department of Psychiatry (L.E.K., H.N.L., J.R.P.), Brigham & Women's Hospital, Boston, MA.
Psychosomatics. 2017 Nov-Dec;58(6):614-623. doi: 10.1016/j.psym.2017.06.004. Epub 2017 Jun 23.
Many oncology patients see both chaplains and consultation-liaison (C-L) psychiatrists during medical hospitalizations. Studies show that spirituality and mental health influence one another, and that patients often prefer that physicians understand their spirituality. Though models of inpatient chaplaincy-psychiatry collaboration likely exist, none are apparent in the literature. In this study, we present one model of chaplaincy-psychiatry collaboration, hypothesizing that both specialties would find the intervention helpful.
From April through December 2015, the C-L psychiatry service at Brigham & Women's Hospital piloted 13 sessions of interdisciplinary rounds, where chaplains and C-L psychiatrists discussed common oncology patients. Participants completed questionnaires including quantitative and qualitative prompts before the intervention, after each session, and at the study's conclusion.
Eighteen individuals completed baseline questionnaires. Between baseline and final surveys, the proportion of participants describing themselves as "very satisfied" with the 2 services' integration rose from 0-36%. The proportion of participants feeling "not comfortable" addressing issues in the other discipline declined from 17-0%. The most frequently chosen options on how discussions had been helpful were that they had enhanced understanding of both patient needs (83.3%) and the other discipline (78.6%). Qualitative data yielded similar themes. At conclusion, all respondents expressed preference that interdisciplinary rounds continue.
This study describes a model of enhancing collaboration between chaplains and C-L psychiatrists, an intervention not previously studied to our knowledge. A pilot intervention of the model was perceived by both specialties to enhance both patient care and understanding of the other discipline.
许多肿瘤患者在住院期间既会看牧师，也会看联络-咨询（C-L）精神科医生。研究表明，精神信仰和心理健康相互影响，而且患者通常希望医生了解他们的精神信仰。尽管住院牧师-精神科医生合作模式可能存在，但文献中并未明显体现。在这项研究中，我们提出了一种牧师-精神科医生合作模式，假设这两个专业都会发现这种干预措施很有帮助。
2015 年 4 月至 12 月期间，布莱根妇女医院的 C-L 精神科服务部门试行 13 次跨学科查房，牧师和 C-L 精神科医生讨论常见的肿瘤患者。参与者在干预前、每次会议后和研究结束时完成了包括定量和定性提示的问卷。
18 人完成了基线问卷。在基线和最终调查之间，对 2 种服务整合非常满意的参与者比例从 0-36%上升。对在另一个学科领域处理问题感到不舒服的参与者比例从 17-0%下降。在讨论如何提供帮助的选项中，选择增强了对患者需求（83.3%）和另一个学科（78.6%）的理解的选项的人最多。定性数据得出了类似的主题。在结论中，所有受访者都表示希望继续进行跨学科查房。
本研究描述了一种增强牧师和 C-L 精神科医生之间合作的模式，这是我们所知的一种以前未被研究过的干预措施。该模式的试点干预措施被两个专业都认为既可以增强患者护理，也可以增强对另一个学科的理解。
