Preferences for healthcare chaplaincy services among U.S. adults: differences by inpatient and outpatient settings

We examined preferences around spiritual support services delivered by chaplains among U.S. adults in outpatient and inpatient healthcare settings using a cross-sectional national survey of U.S. adults (n = 1,020). For outpatient settings, 5% reported interest in chaplain services, whereas 16% reported interest in inpatient settings. In both settings, a higher perceived value of chaplain services (p < 01) and previous experience with a chaplain (p < .01) were associated with a greater interest in a chaplain consult when adjusting for demographic factors. In both settings, the most desired services were to explore what was most important in the event of a serious illness or injury (46-47%), values related to treatment decisions (43-46%), and connecting to resources for personal strength and resilience (36-39%), whereas exploring more religious concerns was less desirable. There is a need to identify the role of chaplains within the context of healthcare to meet patients' desire for specific services.

Impacts of the COVID-19 pandemic on unmet social needs, self-care, and outcomes among people with diabetes and poor glycemic control

AIMS

The purpose of this study was to examine whether pandemic exposure impacted unmet social and diabetes needs, self-care behaviors, and diabetes outcomes in a sample with diabetes and poor glycemic control.

METHODS

This was a cross-sectional analysis of participants with diabetes and poor glycemic control in an ongoing trial (n = 353). We compared the prevalence of unmet needs, self-care behaviors, and diabetes outcomes in successive cohorts of enrollees surveyed pre-pandemic (prior to March 11, 2020, n = 182), in the early stages of the pandemic (May-September, 2020, n = 75), and later (September 2020-January 2021, n = 96) stratified by income and gender. Adjusted multivariable regression models were used to examine trends.

RESULTS

More participants with low income reported food insecurity (70% vs. 83%, p < 0.05) and needs related to access to blood glucose supplies (19% vs. 67%, p < 0.05) during the pandemic compared to pre-pandemic levels. In adjusted models among people with low incomes, the odds of housing insecurity increased among participants during the early pandemic months compared with participants pre-pandemic (OR 20.2 [95% CI 2.8-145.2], p < 0.01). A1c levels were better among participants later in the pandemic than those pre-pandemic (β = -1.1 [95% CI -1.8 to -0.4], p < 0.01), but systolic blood pressure control was substantially worse (β = 11.5 [95% CI 4.2-18.8, p < 0.001).

CONCLUSION

Adults with low-incomes and diabetes were most impacted by the pandemic. A1c may not fully capture challenges that people with diabetes are facing to manage their condition; systolic blood pressures may have worsened and problems with self-care may forebode longer-term challenges in diabetes control.

A Long Way to Go Understanding the Role of Chaplaincy? A Critical Reflection on the Findings of the Survey Examining Chaplaincy Responses to Covid-19

This contribution reflects on some of the most prominent findings in the survey on the chaplaincy response to the COVID-19 pandemic. The finding that chaplain respondents had difficulty understanding their own role prior to the first wave is of concern. If chaplains cannot articulate their own role, it is not surprising that those around them are also unclear. Chaplains are not the only ones to blame for the confusion around their role though.

Religious/Spiritual Struggle in Young Adult Hematopoietic Cell Transplant Survivors

PURPOSE

This study describes the prevalence of religious and/or spiritual (R/S) struggle in long-term young adult (YA) survivors following hematopoietic cell transplantation (HCT) as well as existential concerns (EC), social support, and demographic, medical, and emotional correlates of R/S struggle.

METHODS

Data were collected as part of an annual survey of survivors of HCT aged 18-39 years at survey completion; age at HCT was 1-39 years. Study measures included measures of R/S struggle (defined as any non-zero response on the negative religious coping subscale from Brief RCOPE), quality of life (QOL), and depression. Factors associated with R/S struggle were identified using multivariable logistic regression models.

RESULTS

Fifty-two of the 172 respondents (30%), who ranged from less than a year to 33 years after HCT, had some R/S struggle. In bivariate analysis, depression was associated with R/S struggle. In a multivariable logistic regression model, individuals with greater EC were nearly five times more likely to report R/S struggle. R/S struggle was not associated with age at transplant, time since transplant, gender, race, R/S self-identification, or medical variables.

CONCLUSION

R/S struggle is common among YA HCT survivors, even many years after HCT. There is a strong correlation between EC and R/S struggle. Given the prevalence of R/S struggle and its associations with EC, survivors should be screened and referred to professionals with expertise in EC and R/S struggle as appropriate. Further study is needed to determine longitudinal trajectory, impact of struggle intensity, causal relationships, and effects of R/S struggle on health, mood, and QOL for YA HCT survivors.