Abstract
This overview of the current literature of spirituality and health and the role of professional chaplains specifically considers intensive care unit survivorship, instead of the more common focus on end-of-life circumstances or family support on an ICU. The purpose is to enhance clinicians’ understanding and use of spiritual resources for patient care and outcomes. It is a product of comprehensive daily monitoring of the Medline database from 2002 to 2022 for all publications indexed by the terms “spiritual,” “religion,” and “chaplain.” A case will be used throughout, to illustrate spirituality dynamics. Also, a practical strategy, developed by the authors from clinical experience, will be outlined for clinicians’ spiritual support of patients, requiring little time or specialized knowledge and avoiding the blurring of professional roles and boundaries, while potentially yielding clinical benefits suggested in the medical literature.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
No data collection was required for this review, other than the article information included in the references.
Code Availability
This review does not involve cade, and all materials are represented in the references.
References
ACPE: The Standard for Spiritual Care & Education, Association of Professional Chaplains, Canadian Association for Spiritual Care/Association canadienne de soins spirituels, National Association of Catholic Chaplains, & Neshama: Association of Jewish Chaplains. (2018). The Impact of Professional Spiritual Care. https://www.professionalchaplains.org/content.asp?pl=86&sl=875&contentid=875.
Antoine, A., Fitchett, G., Marin, D., Sharma, V., Garman, A., Haythorn, T., White, K., Greene, A., & Cadge, W. (2020). What organizational and business models underlie the provision of spiritual care in healthcare organizations? An initial description and analysis. Journal of Health Care Chaplaincy, 28(2), 272–284. https://doi.org/10.1080/08854726.2020.1861535
Arslanian-Engoren, C., & Scott, L. D. (2003). The lived experience of survivors of prolonged mechanical ventilation: A phenomenological study. Heart and Lung: Journal of Acute and Critical Care, 32(5), 328–334. https://doi.org/10.1016/s0147-9563(03)00043-8
Balboni, M. J., Babar, A., Dillinger, J., Phelps, A. C., George, E., Block, S. D., Kachnic, L., Hunt, J., Peteet, J., Prigerson, H. G., Vanderweele, T. J., & Balboni, T. A. (2011). “It depends”: Viewpoints of patients, physicians, and nurses on patient-practitioner prayer in the setting of advanced cancer. Journal of Pain & Symptom Management, 41(5), 836–847. https://doi.org/10.1016/j.jpainsymman.2010.07.008
Balboni, T., & Balboni, M. (2018). The spiritual event of serious illness. Journal of Pain and Symptom Management, 56(5), 816–822. https://doi.org/10.1016/j.jpainsymman.2018.05.018
Berning, J. N., Poor, A. D., Buckley, S. M., Patel, K. R., Lederer, D. J., Goldstein, N. E., Brodie, D., & Baldwin, M. R. (2016). A novel picture guide to improve spiritual care and reduce anxiety in mechanically ventilated adults in the intensive care unit. Annals of the American Thoracic Society, 13(8), 1333–1342. https://doi.org/10.1513/annalsats.201512-831oc
Best, M., Butow, P., & Olver, I. (2015). Do patients want doctors to talk about spirituality? A systematic literature review. Patient Education & Counseling, 98(11), 1320–1328. https://doi.org/10.1016/j.pec.2015.04.017
Borneman, T., Ferrell, B., & Puchalski, C. M. (2010). Evaluation of the FICA tool for spiritual assessment. Journal of Pain and Symptom Management, 40(2), 163–173. https://doi.org/10.1016/j.jpainsymman.2009.12.019
Calder, A., Badcoe, A., & Harms, L. (2011). Broken bodies, healing spirits: Road trauma survivor’s perceptions of pastoral care during inpatient orthopaedic rehabilitation. Disability and Rehabilitation, 33(15–16), 1358–1366. https://doi.org/10.3109/09638288.2010.532280
Chamsi-Pasha, M., & Chamsi-Pasha, H. (2021). A review of the literature on the health benefits of Salat (Islamic prayer). Medical Journal of Malaysia, 76(1), 93–97. https://e-mjm.org/2021/v76n1/health-benefits-of-Salat.pdf
Christensen, A. R., Cook, T. E., & Arnold, R. M. (2018). How should clinicians respond to requests from patients to participate in prayer? AMA Journal of Ethics, 20(7), E621-629. https://doi.org/10.1001/amajethics.2018.621
Eaton, T. L., Scheunemann, L. P., Butcher, B. W., Donovan, H. S., Alexander, S., & Iwashyna, T. J. (2022). The prevalence of spiritual and social support needs and their association with postintensive care syndrome symptoms among critical illness survivors seen in a post-ICU follow-up clinic. Critical Care Explorations, 4(4), e0676. https://doi.org/10.1097/cce.0000000000000676
Ehman, J. W., Ott, B. B., Ciampa, R. C., Short, T. H., & Hansen-Flaschen, J. (1999). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine, 159(15), 1803–1806. https://doi.org/10.1001/archinte.159.15.1803
Fitchett, G., Murphy, P. E., Kim, J., Gibbons, J. L., Cameron, J. R., & Davis, J. A. (2004). Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. International Journal of Psychiatry in Medicine, 34(2), 179–196. https://doi.org/10.2190/ucj9-dp4m-9c0x-835m
Goldstein, H. R., Marin, D., & Umpierre, M. (2011). Chaplains and access to medical records. Journal of Health Care Chaplaincy, 17(3–4), 162–168. https://doi.org/10.1080/08854726.2011.616172
Gomez, S., Christine Nunez, B. A., White, B., Browning, J., & DeLisser, H. M. (2021). Chaplain-physician interactions from the chaplain’s perspective: A mixed method analysis. American Journal of Hospice and Palliative Medicine, 38(11), 1308–1313. https://doi.org/10.1177/1049909120984390
Hermann, C. P. (2001). Spiritual needs of dying patients: A qualitative study. Oncology Nursing Forum, 28(1), 67–72.
Ho, J. Q., Nguyen, C. D., Lopes, R., Ezeji-Okoye, S. C., & Kuschner, W. G. (2018). Spiritual care in the intensive care unit: A narrative review. Journal of Intensive Care Medicine, 33(5), 279–287. https://doi.org/10.1177/0885066617712677
Holden, J. M., Kinsey, L., & Moore, T. R. (2014). Disclosing near-death experiences to professional healthcare providers and nonprofessionals. Spirituality in Clinical Practice, 1(4), 278–287. https://doi.org/10.1037/scp0000039
Hufford, D. (2014). The healing power of extraordinary spiritual experiences. Journal of near-Death Experiences, 32(3), 137–156. https://doi.org/10.17514/JNDS-2014-32-3-p137-156
Hupcey, J. E. (2000). Feeling safe: The psychosocial needs of ICU patients. Journal of Nursing Scholarship, 32(4), 361–367. https://doi.org/10.1111/j.1547-5069.2000.00361.x
Jones, A. C., Hilton, R., Ely, B., Gororo, L., Danesh, V., Sevin, C. M., Jackson, J. C., & Boehm, L. M. (2020). Facilitating post-traumatic growth after critical illness. American Journal of Critical Care, 29(6), e108–e115. https://doi.org/10.4037/ajcc2020149
Khanna, S., & Greyson, B. (2014). Near-death experiences and spiritual well-being. Journal of Religion and Health, 53(6), 1605–1615. https://doi.org/10.1007/s10943-013-9723-0
King, J., O’Neill, B., Ramsay, P., Linden, M. A., Darweish Medniuk, A., Outtrim, J., & Blackwood, B. (2019). Identifying patients’ support needs following critical illness: A scoping review of the qualitative literature. Critical Care (london), 23(1), 187. https://doi.org/10.1186/s13054-019-2441-6
King, S. D. W., Fitchett, G., Murphy, P. E., Pargament, K. I., Harrison, D. A., & Loggers, E. T. (2017). Determining best methods to screen for religious/spiritual distress. Supportive Care in Cancer, 25(2), 471–479. https://doi.org/10.1007/s00520-016-3425-6
Klimasinski, M. W. (2021). Spiritual care in the intensive care unit. Anestezjologia Intensywna Terapia, 53(4), 350–357. https://doi.org/10.5114/ait.2021.109920
Koenig, H. G. (2015). Religion, spirituality, and health: A review and update. Advances in Mind-Body Medicine, 29(3), 19–26. https://europepmc.org/article/med/26026153
Lo, B., Kates, L. W., Ruston, D., Arnold, R. M., Cohen, C. B., Puchalski, C. M., Pantilat, S. Z., Rabow, M. W., Schreiber, R. S., & Tulsky, J. A. (2003). Responding to requests regarding prayer and religious ceremonies by patients near the end of life and their families. Journal of Palliative Medicine, 6(3), 409–415. https://doi.org/10.1089/109662103322144727
MacLean, C. D., Susi, B., Phifer, N., Schultz, L., Bynum, D., Franco, M., Klioze, A., Monroe, M., Garrett, J., & Cykert, S. (2003). Patient preference for physician discussion and practice of spirituality. Journal of General Internal Medicine, 18(1), 38–43. https://doi.org/10.1046/j.1525-1497.2003.20403.x
Margolis, S. A., Carter, T., Dunn, E. V., & Reed, R. L. (2003). Validation of additional domains in activities of daily living, culturally appropriate for Muslims. Gerontology, 49(1), 61–65. https://doi.org/10.1159/000066509
Menezes Junior, A., & Moreira-Almeida, A. (2009). Differential diagnosis between spiritual experiences and mental disorders of religious content. Revista De Psiquiatria Clínica, 36(2), 75–82. https://doi.org/10.1590/S0101-60832009000200006
Murphy, J. N. (2017). The chaplain as the mediator between the patient and the interdisciplinary team in ethical decision making: A chaplaincy case study involving a quadriplegic patient. Health and Social Care Chaplaincy, 5(2), 241–256. https://doi.org/10.1558/hscc.34301
Newberg, A. B., Wintering, N., Waldman, M. R., Amen, D., Khalsa, D. S., & Alavi, A. (2010). Cerebral blood flow differences between long-term meditators and non-meditators. Consciousness & Cognition, 19(4), 899–905. https://doi.org/10.1016/j.concog.2010.05.003
Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients: A two-year longitudinal study. Archives of Internal Medicine, 161(15), 1881–1885. https://doi.org/10.1001/archinte.161.15.1881
Pew Research. (2015). U.S. public becoming less religious. https://www.pewresearch.org/religion/2015/11/03/u-s-public-becoming-less-religious.
Pew Research. (2017). More Americans now say they're spiritual but not religious. https://www.pewresearch.org/fact-tank/2017/09/06/more-americans-now-say-theyre-spiritual-but-not-religious.
Pew Research. (2018). When Americans say they believe in God, what do they mean? https://www.pewresearch.org/religion/2018/04/25/when-americans-say-they-believe-in-god-what-do-they-mean.
Puchalski, C., & Romer, A. L. (2000). Taking a spiritual history allows clinicians to understand patients more fully. Journal of Palliative Medicine, 3(1), 129–137. https://doi.org/10.1089/jpm.2000.3.129
Puchalski, C. M., Vitillo, R., Hull, S. K., & Reller, N. (2014). Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine, 17(6), 642–656. https://doi.org/10.1089/jpm.2014.9427
Robinson, M. R., Thiel, M. M., Shirkey, K., Zurakowski, D., & Meyer, E. C. (2016). Efficacy of training interprofessional spiritual care generalists. Journal of Palliative Medicine, 19(8), 814–821. https://doi.org/10.1089/jpm.2015.0373
Roze des Ordons, A. L., Stelfox, H. T., Sinuff, T., Grindrod-Millar, K., & Sinclair, S. (2022). Exploring spiritual health practitioners’ roles and activities in critical care contexts. Journal of Health Care Chaplaincy, 28(1), 41–62. https://doi.org/10.1080/08854726.2020.1734371
Samoilo, L., & Corcoran, D. (2020). Closing the medical gap of care for patients who have had a near-death experience. Narrative Inquiry in Bioethics, 10(1), 37–42. https://doi.org/10.1353/nib.2020.0011
Snowden, A., Fitchett, G., Grossoehme, D. H., Handzo, G., Kelly, E., King, S. D., Telfer, I., Tan, H., & Flannelly, K. J. (2017). International study of chaplains’ attitudes about research. Journal of Health Care Chaplaincy, 23(1), 34–43. https://doi.org/10.1080/08854726.2016.1250556
Tedeschi, R. G., Cann, A., Taku, K., Senol-Durak, E., & Calhoun, L. G. (2017). The posttraumatic growth inventory: A revision integrating existential and spiritual change. Journal of Traumatic Stress, 30(1), 11–18. https://doi.org/10.1002/jts.22155
Timmins, F., Caldeira, S., Murphy, M., Pujol, N., Sheaf, G., Weathers, E., Whelan, J., & Flanagan, B. (2018). The role of the healthcare chaplain: A literature review. Journal of Health Care Chaplaincy, 24(3), 87–106. https://doi.org/10.1080/08854726.2017.1338048
Wahlin, I., Ek, A. C., & Idvall, E. (2009). Empowerment in intensive care: Patient experiences compared to next of kin and staff beliefs. Intensive & Critical Care Nursing, 25(6), 332–340. https://doi.org/10.1016/j.iccn.2009.06.003
Willemse, S., Smeets, W., van Leeuwen, E., Nielen-Rosier, T., Janssen, L., & Foudraine, N. (2020). Spiritual care in the intensive care unit: An integrative literature research. Journal of Critical Care, 57(6), 55–78. https://doi.org/10.1016/j.jcrc.2020.01.026
Wirpsa, J. M., Johnson, R. E., Bieler, J., Boyken, L., Pugliese, K., Rosencrans, E., & Murphy, P. (2019). Interprofessional models for shared decision making: The role of the health care chaplain. Journal of Health Care Chaplaincy, 25(1), 20–44. https://doi.org/10.1080/08854726.2018.1501131
Zauszniewski, J. A., Burant, C. J., Lekhak, N., Herbell, K., Badr, H. A., & Martin, R. J. (2022). Development and testing of a spiritual resourcefulness scale: Holistic expansion in operationalizing the resourcefulness construct. Journal of Holistic Nursing, 40(1), 7–15. https://doi.org/10.1177/08980101211025370
Funding
The authors declare that no funds, Grants, or other support were received during the preparation of this manuscript.
Author information
Authors and Affiliations
Contributions
Principal author, JWE, developed the basic bibliography for the review and wrote the first draft of the manuscript. Co-author, JRE, consulted on the project throughout, to expand the bibliography and shape and edit the text. Both authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
Consent to Participate
This review did not require consent of research subjects.
Ethical Approval
This review did not require an institutional review board approval process.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Ehman, J.W., Edgar, J.R. Spirituality and Chaplaincy Supporting ICU Survivorship: A Practical Overview and Strategy for Clinicians. J Relig Health 62, 65–82 (2023). https://doi.org/10.1007/s10943-022-01730-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-022-01730-2