Abstract
Hospitalized persons want their spiritual needs addressed and discussed by the healthcare team, but medical providers and nurses lack the necessary training. Patients want chaplaincy care, but very few receive it, and little is known about utilization factors. To identify the population characteristics associated with the utilization of chaplaincy services, hospitalization data from March 2012 to July 2017 were analyzed (N = 15,242 patients). Religiously affiliated individuals and those with the most acute health needs were more likely to receive chaplaincy care and received more total care. Patient-centered healthcare models may need to evaluate strategic integration of spiritual care beyond reactive spiritual care provision.
This is a preview of subscription content, log in via an institution to check access.
adapted from Aday & Andersen, 1974)
Similar content being viewed by others
Availability of Data
Not Applicable.
References
Aboumatar, H. J., Chang, B. H., Al Danaf, J., Shaear, M., Namuyinga, R., Elumalai, S., Marsteller, J. A., & Pronovost, P. J. (2015). Promising practices for achieving patient-centered hospital care: A national study of high-performing US hospitals. Medical Care, 53(9), 758–767. https://doi.org/10.1097/MLR.0000000000000396
Aday, L. A., & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 9(3), 208–220. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/4436074%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC1071804
Andersen, R. (1995). Revisiting the Behavioral Model and Access to Medical Care: Does it Matter? Journal of Health and Social Behavior, 36(1), 1–10. https://doi.org/10.2307/2137284
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. (2016). Doctors discussing religion and spirituality: A systematic literature review. Palliative Medicine, 30(4), 327–337. https://doi.org/10.1177/0269216315600912
Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in health insurance coverage and access to care. Health Affairs (project Hope), 39(3), 395–402. https://doi.org/10.1377/hlthaff.2019.01394
Butala, N. M., Secemsky, E. A., Wasfy, J. H., Kennedy, K. F., & Yeh, R. W. (2018). Seasonality and readmission after heart failure, myocardial infarction, and pneumonia. Health Services Research, 53(4), 2185–2202. https://doi.org/10.1111/1475-6773.12747
Cameron, A. C., & Trivedi, P. K. (2010). Microeconometrics Using Stata (Revised). Stata Press.
Canada, A., Fitchett, G., Murphy, P., Stein, K., Portier, K., Crammer, C., & Petterman, A. (2013). Racial/ethnic differences in spiritual well-being among cancer survivors. Journal of Behavioral Medicine, 36(5), 441–453. https://doi.org/10.1007/s10865-012-9439-8
Carey, L. B., & Cohen, J. (2008). Religion, spirituality and health care treatment decisions: The role of chaplains in the Australian clinical context. Journal of Health Care Chaplaincy, 15(1), 25–39. https://doi.org/10.1080/08854720802698491
Carey, L. B., & Cohen, J. (2009). Chaplain-physician consultancy: When chaplains and doctors meet in the clinical context. Journal of Religion and Health, 48(3), 353–367. https://doi.org/10.1007/s10943-008-9206-x
Chibnall, J. T., Bennett, M. L., Videen, S. D., Duckro, P. N., & Miller, D. K. (2004). Identifying barriers to psychosocial spiritual care at the end of life: A physician group study. The American Journal of Hospice & Palliative Care, 21(6), 419–426. https://doi.org/10.1177/104990910402100607
Choi, P. J., Curlin, F. A., & Cox, C. E. (2015). “The patient is dying, please call the chaplain”: The activities of chaplains in one medical center’s intensive care units. Journal of Pain and Symptom Management, 50(4), 501–506. https://doi.org/10.1016/j.jpainsymman.2015.05.003
Clark, D. E., Ostrander, K. R., & Cushing, B. M. (2016). A multistate model predicting mortality, length of stay, and readmission for surgical patients. Health Services Research, 51(3), 1074–1094. https://doi.org/10.1111/1475-6773.12400
Clark, D. E., & Ryan, L. M. (2002). Concurrent prediction of hospital mortality and length of stay from risk factors on admission. Health Services Research, 37(3), 631–645. https://doi.org/10.1111/1475-6773.00041
Damen, A., Murphy, P., Fullam, F., Mylod, D., Shah, R. C., & Fitchett, G. (2020). Examining the association between chaplain care and patient experience. Journal of Patient Experience. https://doi.org/10.1177/2374373520918723
Ehman, J. W., Ott, B. B., Short, T. H., Ciampa, R. C., & 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
Ellison, C., Hummer, R., Burdette, A., & Benjamins, M. (2010). Race, religious involvement, and health: The case of African Americans. In Religion, Families, and Health: Population-Based Research in the United States (pp. 321–348). Rutgers University Press.
Ernecoff, N. C., Curlin, F. A., Buddadhumaruk, P., & White, D. B. (2015). Health care professionals’ responses to religious or spiritual statements by surrogate decision makers during goals-of-care discussions. JAMA Internal Medicine, 175(10), 1662–1669. https://doi.org/10.1001/jamainternmed.2015.4124
Fahmy, D. (2018). Key findings about Americans' belief in God. (Research Report). Retreived from Pew Research Center: https://www.pewresearch.org/fact-tank/2018/04/25/key-findings-about-americans-belief-in-god/
Fitchett, G., Meyer, P. M., & Burton, L. A. (2000). Spiritual care in the hospital: Who requests it? Who needs it? Journal of Pastoral Care, 54(2), 173–186. https://doi.org/10.1177/002234090005400207
Fitchett, G., Murphy, P. E., Kim, J., Gibbons, J., Cameron, J., & Davis, J. (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-9COX-835M
Flannelly, K. J., Galek, K., & Handzo, G. F. (2005). To what extent are the spiritual needs of hospital patients being met? International Journal of Psychiatry in Medicine, 35(3), 319–323. https://doi.org/10.2190/9X2X-QQEU-GDE9-VUXN
Galek, K., Flannelly, K. J., Koenig, H., & Fogg, S. L. (2007). Referrals to chaplains: The role of religion and spirituality in healthcare settings. Mental Health, Religion & Culture, 10(4), 363–377. https://doi.org/10.1080/13674670600757064
Glenister, D., & Prewer, M. (2017). Capturing religious identity during hospital admission: A valid practice in our increasingly secular society? Australian Health Review : A Publication of the Australian Hospital Association, 41(6), 626–631. https://doi.org/10.1071/AH16139
Gomez, S., Nuñez, C., White, B., Browning, J., & DeLisser, H. M. (2020). Chaplain-physician interactions from the chaplain’s perspective: A mixed method analysis. American Journal of Hospice and Palliative Medicine. https://doi.org/10.1177/1049909120984390
Hammond, W. P., Matthews, D., Mohottige, D., Agyemang, A., & Corbie-Smith, G. (2010). Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men. Journal of General Internal Medicine, 25(12), 1300–1308. https://doi.org/10.1007/s11606-010-1481-z
Handzo, G. F., Flannelly, K. J., Murphy, K. M., Bauman, J. P., Oettinger, M., Goodell, E., Hasan, Y. H., Barrie, D. P., & Jacobs, M. R. (2008). What do chaplains really do? I Visitation in the New York Chaplaincy Study. Journal of Health Care Chaplaincy, 14(1), 20–38. https://doi.org/10.1080/08854720802053838
Hyer, J. M., Paredes, A. Z., Kelley, E. P., Tsilimigras, D., Meyer, B., Newberry, H., & Pawlik, T. M. (2020). Characterizing pastoral care utilization by cancer patients. American Journal of Hospice and Palliative Medicine®, 1049909120951082. https://doi.org/10.1177/1049909120951082
Johnson, J. R., Engelberg, R., Nielsen, E., Kross, E., Smith, N., Hanada, J., Doll O’Mahoney, S. K., & Curtis, J. (2014). The association of spiritual care providers’ activities with family members’ satisfaction with care after a death in the ICU. Critical Care and Medicine, 42(9), 1991–2000. https://doi.org/10.1038/jid.2014.371
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
Kirchoff, R. W., Tata, B., McHugh, J., Kingsley, T., Burton, M. C., Manning, D., & Lapid Chaudhary, M. R. (2021). Spiritual care of inpatients focusing on outcomes and the role of chaplaincy services: A systematic review. Journal of Religion and Health. https://doi.org/10.1007/s10943-021-01191-z
Koenig, H. G. (2015). Religion, Spirituality, and Health: A Review and Update. Advances in Mind Body Medicine, 29(3), 19–26. PMID:26026153.
Labuschagne, D., Torke, A., Grossoehme, D., Rimer, K., Rucker, M., Schenk, K., Slaven, J., & Fitchett, G. (2020). Chaplaincy care in the MICU: Describing the spiritual care provided to MICU patients and families at the end of life. The American Journal of Hospice & Palliative Care. https://doi.org/10.1177/1049909120912933
Marin, D. B., Sharma, V., Sosunov, E., Egorova, N., Goldstein, R., & Handzo, G. F. (2015). Relationship between chaplain visits and patient satisfaction. Journal of Health Care Chaplaincy, 21(1), 14–24. https://doi.org/10.1080/08854726.2014.981417
Massey, K., Barnes, M. J. D., Villines, D., Goldstein, J. D., Pierson, A. L. H., Scherer, C., Laan, B. V., & Summerfelt, W. T. (2015). What do I do? Developing a taxonomy of chaplaincy activities and interventions for spiritual care in intensive care unit palliative care. BMC Palliative Care, 14, 10. https://doi.org/10.1186/s12904-015-0008-0
McFarland, M. J., Wright, B. R. E., & Weakliem, D. L. (2011). Educational attainment and religiosity: Exploring variations by religious tradition. Sociology of Religion, 72(2), 166–188. https://doi.org/10.1093/socrel/srq065
Mitchell, J. A., & Perry, R. (2020). Disparities in patient-centered communication for Black and Latino men in the U.S.: Cross-sectional results from the 2010 health and retirement study. PloS One, 15(9), e0238356. https://doi.org/10.1371/journal.pone.0238356
Mullahy, J. (1986). Specification and testing of some modified count data models. Journal of Econometrics, 33, 341–365. https://doi.org/10.1016/0304-4076(86)90002-3
Norton, S. W., & Tomal, A. (2009). Religion and female educational attainment. Journal of Money, Credit and Banking, 41(5), 961–986. Retrieved from http://www.jstor.org/stable/40271588
Pew Research Center. (2015). America’s Changing Religious Landscape. Retrieved from www.pewresearch.org
Piderman, K. M., Marek, D. V., Jenkins, S. M., Johnson, M. E., Buryska, J. F., Shanafelt, T. D., O’Bryan, F. G., Hansen, P. D., Howick, P. H., Durland, H. L., Lackore, K. A., Lovejoy, L. A., & Mueller, P. S. (2010). Predicting patients’ expectations of hospital chaplains: A multisite survey. Mayo Clinic Proceedings, 85(11), 1002–1010. https://doi.org/10.4065/mcp.2010.0168
Raina, P., Torrance-Rynard, V., Wong, M., & Woodward, C. (2002). Agreement between self-reported and routinely collected health-care utilization data among seniors. Health Services Research, 37(3), 751–774. https://doi.org/10.1111/1475-6773.00047
Rose, C. E., Martin, S. W., Wannemuehler, K. A., & Plikaytis, B. D. (2006). On the use of zero-inflated and hurdle models for modeling vaccine adverse event count data. Journal of Biopharmaceutical Statistics, 16(4), 463–481. https://doi.org/10.1080/10543400600719384
Spetz, J., Dudley, N., Trupin, L., Rogers, M., Meier, D. E., & Dumanovsky, T. (2016). Few hospital palliative care programs meet national staffing recommendations. Health Affairs (project Hope), 35(9), 1690–1697. https://doi.org/10.1377/hlthaff.2016.0113
Tepper, L., Rogers, S. A., Coleman, E. M., & Malony, H. N. (2001). The prevalence of religious coping among persons with persistent mental illness. Psychiatric Services, 52(5), 660–665. https://doi.org/10.1176/APPI.PS.52.t.660
Thiel, M. M., & Robinson, M. R. (1997). Physicians’ collaboration with chaplains: Difficulties and benefits. The Journal of Clinical Ethics, 8(1), 94–103. PMID: 9130114.
VanderWeele, T. J., Balboni, T. A., & Koh, H. K. (2017). Health and spirituality. JAMA, 318(6), 519–520. https://doi.org/10.1001/jama.2017.8136
Voas, D., & Chaves, M. (2016). Is the United States a counterexample to the secularization thesis? American Journal of Sociology, 121(5), 1517–1556. https://doi.org/10.1086/684202
Walter, T. (1997). The ideology and organization of spiritual care: Three approaches. Palliative Medicine, 11(1), 21–30. https://doi.org/10.1177/026921639701100103
Walter, T. (2002). Spirituality in palliative care: Opportunity or burden? Palliative Medicine, 16(2), 133–139. https://doi.org/10.1191/0269216302pm516oa
Whittington, J. W., Nolan, K., Lewis, N., & Torres, T. (2015). Pursuing the Triple Aim: The First 7 Years. Milbank Quarterly, 93(2), 263–300. https://doi.org/10.1111/1468-0009.12122
Williams, J. A., Meltzer, D., Arora, V., Chung, G., & Curlin, F. A. (2011). Attention to inpatients’ religious and spiritual concerns: Predictors and association with patient satisfaction. Journal of General Internal Medicine, 26(11), 1265–1271. https://doi.org/10.1007/s11606-011-1781-y
Wirpsa, J. M., Johnson, E. R., 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
Funding
The authors have nothing to disclose.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by KW, JJ, SK, and GF. The first draft of the manuscript was written by KW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors report no conflicts of interest.
Code Availability
Not Applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendix: Supplemental Table 1
Appendix: Supplemental Table 1
Variable | Source | |
|---|---|---|
Predisposing | Age | EMR |
Sex | EMR | |
Race | HCAHPS | |
Ethnicity | HCAHPS | |
Language | HCAHPS | |
Religious affiliation | EMR | |
Enabling | Education | HCAHPS |
Need | Self-reported health | HCAHPS |
Self-reported mental health | HCAHPS | |
Length of stay | EMR | |
Multiple diagnostic categories | EMR | |
Control | ED admission | HCAHPS |
Admit date | EMR | |
Dependent variables | Chaplain visit | EMR |
Time with chaplain | EMR | |
Rights and permissions
About this article
Cite this article
White, K., Jennings, J.C., Karimi, S. et al. Examining Factors Associated with Utilization of Chaplains in the Acute Care Setting. J Relig Health 61, 1095–1119 (2022). https://doi.org/10.1007/s10943-021-01460-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-021-01460-x