Harvard Divinity School, Cambridge, MA, USA.
Dana-Farber Cancer Institute, Boston, MA, USA.
J Relig Health. 2018 Aug;57(4):1413-1427. doi: 10.1007/s10943-018-0645-8.
Community-based clergy are highly engaged in helping seriously ill patients address spiritual concerns at the end of life (EOL). While they desire EOL training, no data exist in guiding how to conceptualize a clergy-training program. The objective of this study was used to identify best practices in an EOL training program for community clergy. As part of the National Clergy Project on End-of-Life Care, the project conducted key informant interviews and focus groups with active clergy in five US states (California, Illinois, Massachusetts, New York, and Texas). A diverse purposive sample of 35 active clergy representing pre-identified racial, educational, theological, and denominational categories hypothesized to be associated with more intensive utilization of medical care at the EOL. We assessed suggested curriculum structure and content for clergy EOL training through interviews and focus groups for the purpose of qualitative analysis. Thematic analysis identified key themes around curriculum structure, curriculum content, and issues of tension. Curriculum structure included ideas for targeting clergy as well as lay congregational leaders and found that clergy were open to combining resources from both religious and health-based institutions. Curriculum content included clergy desires for educational topics such as increasing their medical literacy and reviewing pastoral counseling approaches. Finally, clergy identified challenging barriers to EOL training needing to be openly discussed, including difficulties in collaborating with medical teams, surrounding issues of trust, the role of miracles, and caution of prognostication. Future EOL training is desired and needed for community-based clergy. In partnering together, religious-medical training programs should consider curricula sensitive toward structure, desired content, and perceived clergy tensions.
社区神职人员在帮助重病患者解决临终关怀（EOL）的精神问题方面非常投入。虽然他们渴望接受 EOL 培训，但目前尚无数据可用于指导如何构思神职人员培训计划。本研究的目的是确定 EOL 培训计划的最佳实践，以针对社区神职人员。作为国家临终关怀神职人员项目的一部分，该项目在美国五个州（加利福尼亚州、伊利诺伊州、马萨诸塞州、纽约州和德克萨斯州）对活跃的神职人员进行了重点信息采访和焦点小组讨论。一个由 35 名活跃神职人员组成的多元化目的样本，代表预先确定的种族、教育、神学和教派类别，假设这些类别与在 EOL 更密集地利用医疗保健有关。我们通过采访和焦点小组评估了神职人员 EOL 培训的建议课程结构和内容，目的是进行定性分析。主题分析确定了课程结构、课程内容和紧张局势问题的关键主题。课程结构包括针对神职人员以及非神职的会众领袖的想法，并发现神职人员愿意将宗教和基于健康的机构的资源结合起来。课程内容包括神职人员对增加医学知识和审查牧灵咨询方法等教育主题的渴望。最后，神职人员确定了 EOL 培训需要公开讨论的具有挑战性的障碍，包括与医疗团队合作的困难、信任问题、奇迹的作用以及预后的谨慎。未来社区神职人员需要并需要进行 EOL 培训。在合作过程中，宗教医学培训计划应考虑对结构、所需内容和感知神职人员紧张局势敏感的课程。
