Gazaway Shena, Oppong Kwaku Duah, Burke Emily S, Nix-Parker Tamara, Torke Alexia M, Perez Shelley Varner, Fitchett George, Durant Raegan W, Wells Rachel, Bakitas Marie, Ejem Deborah
School of Nursing, University of Alabama at Birmingham, 485K, 1701 University Blvd, Birmingham, AL, 35294, USA.
School of Nursing, University of Texas at Austin, Austin, TX, USA.
J Racial Ethn Health Disparities. 2024 Dec 11. doi: 10.1007/s40615-024-02258-9.
Acknowledging patients' spiritual concerns can enhance well-being and is essential to patient-centered chronic illness care. However, unmet spiritual care needs remain a major area of suffering, particularly among under-resourced populations. Limited research exists on how spiritual concerns are acknowledged and integrated into the care of chronically ill older Black patients in these settings.
This study aimed to explore the spiritual concerns and needs of chronically ill older Black patients from under-resourced areas and to identify available spiritual support resources for patients seeking healthcare through a community safety net health service.
Using a qualitative descriptive design, we interviewed 13 chronically ill, older Black patients and key clinicians (physicians, nurse practitioners, allied health, and clergy). The interview focused on patients' illness-related spiritual concerns, sources of distress, and desired spiritual support resources. Participants also reviewed the Spiritual Care and Assessment Intervention (SCAI), a spiritual care intervention, and provided feedback on its content, format, and delivery.
Five themes emerged from qualitative interviews: (1) spirituality is integral to seriously ill Southern patients; (2) clinicians should strive to address spiritual health in encounters; (3) socioeconomic barriers and competing demands impact priority of accessing spiritual care services; (4) spiritual care interventions should be patient-driven, compassionate, and fully integrated into medical care as a comprehensive service; and (5) participants thought SCAI was appropriate for use but should be shortened and provided in-person to increase accessibility.
Findings will inform the development and piloting of small-scale culturally responsive spiritual care intervention tailored for seriously ill older Black adults in an ambulatory care setting.
关注患者的精神需求可增进幸福感，这对于以患者为中心的慢性病护理至关重要。然而，未得到满足的精神护理需求仍是一个主要的痛苦领域，尤其是在资源匮乏的人群中。关于在这些环境中，精神需求如何在慢性病老年黑人患者的护理中得到关注和整合的研究有限。
本研究旨在探讨资源匮乏地区慢性病老年黑人患者的精神需求，并确定通过社区安全网健康服务寻求医疗保健的患者可获得的精神支持资源。
采用定性描述性设计，我们采访了13名慢性病老年黑人患者以及关键临床医生（医生、执业护士、专职医疗人员和神职人员）。访谈聚焦于患者与疾病相关的精神需求、痛苦来源以及期望的精神支持资源。参与者还审阅了一种精神护理干预措施——精神护理与评估干预（SCAI），并就其内容、形式和提供方式提供反馈。
定性访谈中出现了五个主题：（1）灵性对于病情严重的南方患者至关重要；（2）临床医生应努力在诊疗过程中关注精神健康；（3）社会经济障碍和相互竞争的需求影响获得精神护理服务的优先级；（4）精神护理干预应以患者为导向、富有同情心，并作为一项综合服务完全融入医疗护理中；（5）参与者认为SCAI适合使用，但应缩短篇幅并亲自提供，以提高可及性。
研究结果将为在门诊护理环境中为病情严重的老年黑人成年人量身定制的小规模文化响应性精神护理干预措施的开发和试点提供参考。
