Quigley Denise D, McCleskey Sara G, Lesandrini Jason, McNeal Natalie, Qureshi Nabeel
RAND, Santa Monica, CA, USA.
Department of Ethics, Advance Care Planning and Spiritual Health, Wellstar Health System, Marietta, GA, USA.
Am J Hosp Palliat Care. 2025 Aug;42(8):717-727. doi: 10.1177/10499091241268549. Epub 2024 Aug 2.
ContextSpiritual care is patient and caregiver spiritual/religious needs and those needs. Caregivers of African American hospice patients are more likely to report worse emotional/religious support. Yet, spiritual care delivery and roles of community clergy and chaplains for African American hospice patients are not well understood.ObjectivesExamine who provides spiritual care to African American hospice patients and caregivers.MethodsPartnering with large, urban/suburban community hospice, we interviewed caregivers of deceased African American hospice patients (n = 12), their clergy (n = 3) and chaplains (n = 5). Using a phenomenological qualitative study design, we coded transcripts and deceased patient chart data and conducted thematic analysis to identify themes.ResultsCommunity clergy and chaplains tend to not interact and provide different aspects of emotional, religious and spiritual support to hospice patients and families. Clergy and chaplains agreed that rapport and openness of the patient were main factors in meeting spiritual care needs. Clergy provided interaction with a trusted person and connection to church, congregational support, religious beliefs/theology, and practices. Chaplains focused on present needs and issues of death and dying.ConclusionClergy and chaplains have distinct, complementary roles in providing spiritual care to African American hospice patients and families. Both are needed to provide desired spiritual care for African American hospice patients and their caregivers. Robust spiritual care programs need to ensure chaplains have sufficient time to spend with patients and families and incorporate collaboration, handoffs and integrated processes for clergy and chaplains. Research is needed on effectively including clergy in hospice spiritual care delivery.
背景
灵性照护关注患者及照护者的灵性/宗教需求，并满足这些需求。非裔美国临终关怀患者的照护者更有可能报告称情感/宗教支持较差。然而，针对非裔美国临终关怀患者，社区神职人员和牧师的灵性照护服务及角色尚未得到充分理解。
目的
研究谁为非裔美国临终关怀患者及其照护者提供灵性照护。
方法
我们与大型城市/郊区社区临终关怀机构合作，采访了已故非裔美国临终关怀患者的照护者（n = 12）、他们的神职人员（n = 3）和牧师（n = 5）。采用现象学定性研究设计，我们对访谈记录和已故患者病历数据进行编码，并进行主题分析以确定主题。
结果
社区神职人员和牧师往往不相互交流，并且为临终关怀患者及其家庭提供情感、宗教和灵性支持的不同方面。神职人员和牧师一致认为，患者的融洽关系和开放态度是满足灵性照护需求的主要因素。神职人员提供与可信赖之人的互动、与教会的联系、会众支持、宗教信仰/神学及实践。牧师则关注当下需求以及死亡和临终问题。
结论
神职人员和牧师在为非裔美国临终关怀患者及其家庭提供灵性照护方面具有不同但互补的角色。两者对于为非裔美国临终关怀患者及其照护者提供理想的灵性照护都是必要的。强大的灵性照护项目需要确保牧师有足够时间陪伴患者及其家庭，并纳入神职人员和牧师之间的协作、交接和整合流程。需要开展研究以有效地将神职人员纳入临终关怀灵性照护服务中。
