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Chaplaincy Visitation and Spiritual Care after Intracerebral Hemorrhage
Melissa L Howell1, Kristin Schwab2, Alison M Ayres2
1a Department of Emergency Medicine , Massachusetts General Hospital , Boston , Massachusetts , USA.
Insights
Spiritual care access varied for critically ill patients with intracerebral hemorrhage (ICH). Family requests drove most chaplain visits, which were more common in Catholic patients and those with severe injuries.
Area of Science:
- Neurology
- Critical Care Medicine
- Spiritual Health
Background:
- Intracerebral hemorrhage (ICH) is a severe neurological condition with high disability and mortality rates.
- Spiritual care is an important aspect of holistic patient management, particularly during critical illness.
- Understanding factors influencing spiritual care access is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the utilization of spiritual care services among patients hospitalized with intracerebral hemorrhage (ICH).
- To identify demographic and clinical characteristics associated with chaplain visits in critically ill ICH patients.
Main Methods:
- Retrospective review of medical charts for adult patients with spontaneous ICH admitted to an academic medical center.
- Data collection spanned from January 2014 to September 2015.
- Analysis focused on patient demographics, clinical severity, and chaplain visit records.
Main Results:
- Chaplains visited 32% (86 of 266) of eligible ICH patients.
- Family requests initiated the majority of chaplain visits (57%).
- Visits were disproportionately higher for Catholic patients and those with more severe ICH injuries. Notably, 28% of deceased Catholic patients did not receive a chaplain visit.
Conclusions:
- Spiritual care access in ICH patients is influenced by patient religion and injury severity, with family requests being a primary driver.
- Current spiritual care provision may not consistently reach all patients in need, even within identified high-risk groups.
- Implementing standardized screening and documentation tools could enhance spiritual care accessibility and better capture patient spiritual preferences.
Abstract:
To better understand factors influencing spiritual care during critical illness, we examined the use of spiritual care in patients hospitalized with intracerebral hemorrhage (ICH), a frequently disabling and fatal disease. Specifically, the study was designed to examine which demographic and clinical characteristics were associated with chaplain visits to critically ill patients. The charts of consecutive adults (>18) with spontaneous ICH presenting to a single academic medical center between January 2014 and September 2015 were reviewed. Chaplains visited 86 (32%) of the 266 patients. Family requests initiated the majority of visits (57%). Visits were disproportionately to Catholic patients and those with more severe injury. Even among Catholics, 28% of those who died had no chaplaincy visit. Standardized chaplaincy screening methods and note templates may help maximize access to spiritual care and delineate the religious and spiritual preferences of patients and families.