School of Nursing, 12330The University of Texas at Austin, TX, USA.
Human Services Department, The City University of New York, City Tech, Brooklyn, New York, NY, USA.
Am J Hosp Palliat Care. 2021 Dec;38(12):1495-1502. doi: 10.1177/1049909121989996. Epub 2021 Jan 28.
Healthcare chaplains have key roles in providing palliative support to patients and families, and they are well-suited to facilitate advance care planning (ACP). However, empirical data on the roles and responsibilities of chaplains in facilitating ACP are limited.
To examine the roles of board-certified healthcare chaplains in ACP in various healthcare settings.
A cross-sectional, web-based self-report survey was conducted with 585 board-certified chaplains recruited from 3 major professional chaplains' organizations in the U.S. The survey data included chaplains' demographic and professional characteristics, their roles and responsibilities, and responses regarding communication and participation with other healthcare team members in facilitating ACP, including experienced barriers.
More participants worked in community hospital settings (42%) and academic medical centers (19.6%) than in any other setting. Over 90% viewed ACP as an important part of their work, 70% helped patients complete advance directives, and 90% helped patients discuss their preferences about end-of-life treatments. Many chaplains were not consistently included in team discussions regarding decision-making, although most chaplains reported that they could always find ways to communicate with their teams.
Professional board-certified chaplains regularly engage in facilitating ACP discussions with patients and families in various healthcare settings. There is a need to recognize and provide systematic support for the role of chaplains in facilitating ACP conversations and to integrate chaplains into routine interdisciplinary team and family meetings.
医疗保健牧师在为患者和家属提供姑息治疗支持方面发挥着关键作用，他们非常适合促进预先医疗指示（ACP）。然而，关于牧师在促进 ACP 方面的角色和职责的经验数据有限。
研究在各种医疗保健环境中，委员会认证的医疗保健牧师在 ACP 中的角色。
对美国 3 个主要专业牧师组织招募的 585 名委员会认证的牧师进行了横断面、基于网络的自我报告调查。调查数据包括牧师的人口统计学和专业特征、他们的角色和职责，以及关于与其他医疗团队成员沟通和参与促进 ACP 的回应，包括经验障碍。
更多的参与者在社区医院（42%）和学术医疗中心（19.6%）工作，而不是在任何其他环境中。超过 90%的人认为 ACP 是他们工作的重要组成部分，70%的人帮助患者完成预先指示，90%的人帮助患者讨论他们对临终治疗的偏好。许多牧师在团队关于决策的讨论中并没有始终被包括在内，尽管大多数牧师报告说，他们总能找到与团队沟通的方法。
专业委员会认证的牧师经常在各种医疗保健环境中与患者和家属一起促进 ACP 讨论。有必要认识到并为牧师在促进 ACP 对话中的角色提供系统支持，并将牧师纳入常规的跨学科团队和家庭会议。
