A pastoral model for dealing with death and dying.
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Most contemporary urban hospitals in Canada provide social services, pastoral care and psychological services, usually in separate departments. The similarities in many of the services provided by these three professions has often been noted, along with the observation that organizational restructuring could support such collaboration. The Misericordia Hospital, Edmonton, has amalgamated social services, pastoral care, psychological services and the pastoral institute into the Department of Patient Counselling Services. Its main purpose is to allocate more resources to direct patient care and enhance interdisciplinary collaboration.
Argues that with individual, family, and world issues becoming increasingly complicated, those involved in pastoral care can benefit from using a comprehensive ecological approach to understanding and helping those in need. Suggests that the "family ecosystem model" that emphasizes interactions among individuals/families and their multifaceted environments, including their natural, human-constructed, and human-behavioral environments, can be used to incorporate a holistic view of these diverse issues. Explains and illustrates this approach to family concerns often encountered by pastoral caregivers.
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Proposes a systematic and systemic pastoral diagnosis model based on the formulations of James W. Fowler, Stephen S. Ivy, and Wayne E. Oates. Illustrates the application of the model via a care-planning case study.
Rev. Gérard Gingras is the chaplain and Lise Savoy-Malenfant, a pastoral care worker at the Centre hospitalier Robert-Giffard in Beauport, Quebec. They provide some insight into the unique techniques needed to minister to those who have a psychiatric illness.
We discuss the various stages of Alzheimer's disease and related disorders (ADRD) and present a psychosocial model which spiritual caregivers can use in their ministry, the Progressively Lowered Stress Threshold (PLST) model. We argue that religious activities are very important to these patients and that spiritual caregivers can make an important contribution.
Hospice care has consistently recognized the need to integrate spiritual care into holistic plans of care for dying patients and their families. Designing and implementing spiritual care interventions can be potentially difficult for hospice practitioners who have not had specific training in theology or pastoral care. Matthew Fox, a theologian, has developed a model of spiritual development that utilizes an ecumenical, ethical framework that can be directly applied to the care of hospice patients and families. This model employs a Sacred Circle approach that begins with an emphasis upon the sense of awe and wonder (the Via Positiva), moves into the next cycle by recognizing problems and negative emotions (the Via Negativa), that then flows into the creative solutions to problems (the Via Creativa), which finally transforms the problem into a new level of understanding (the Via Transformativa).
There are ways in which more holistic approaches to medicine can be achieved through the establishment of alternative hospitals and health-care centers, as has happened in the United States, and changes in midwifery and care for the dying through a more compassionate approach and the use of prescriptive music. Transformations of medical care in The Netherlands are also taking place, with existing hospitals gradually developing more patient-centered approaches and organizations like the Helen Dowling Institute providing tailor-made forms of psycho-social counseling for those with cancer and life-threatening illness.
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Several types of self-care strategies have been reported by patients with HIV/AIDS to manage their HIV/AIDS related symptoms. However, little research has examined the factors influencing the use of different HIV symptom self-care strategies. This paper presents the results of testing a predictive model of the use of eight types of symptom self-care strategies: medications, complementary treatments, self-comforting, daily thoughts/activities, changing diet, help-seeking, exercise, and spiritual care. Logistic regression tests were used to examine the likelihood of using the eight types of symptom self-care strategies that were summarized and categorized from the questionnaires reported by patients with HIV/AIDS (n = 359). Sociodemographic variables (age, gender, race, education, injection drug use, insurance status, income status) and disease-related variables (taking antiretroviral medications, symptom intensity, symptom bothersomeness, impact of symptom on daily life) were selected as predictive variables. Logistic regression analysis demonstrated that race (white vs. non-white) was a significant predictor for the use of medications (odds ratio [OR] = 0.55, 95% confidence interval [CI] = 0.33-0.92), self-comforting (OR = 2.17, 95% CI = 1.24-3.79), help seeking (OR = 5.71, 95% CI = 2.57-12.70), and spiritual care (OR = 5.09, 95% CI = 1.81-14.30). In addition, symptom intensity significantly predicted the use of medications (OR = 1.22, 95% CI = 1.05-1.40) and gender significantly predicted the use of spiritual care (OR = 3.76, 95% CI = 1.71-8.25). Racial difference is the predominant predictor for the use of symptom self-care strategies. The cultural differences in the use of symptom self-care strategies should be considered in symptom management.
The management of patients with suspected or known lung cancer is becoming increasingly complex. State-of-the-art care often requires input from many sources, including pulmonology, thoracic surgery, medical oncology, radiation oncology, pathology, and radiology. Valuable contributions to care also come from nursing, social work, psychology, psychiatry, pastoral care, and palliative care, among others. As a result, multidisciplinary input into care is vital. Patients with suspected lung cancer should be expeditiously evaluated and referred for management. Clear and understandable information on the diagnosis, treatment options, and possible outcomes should be provided. Treatment recommendations should be based on locally agreed-on adaptations of clinical practice guidelines. Provisions for ongoing care should be apparent to all concerned
Reports that there are 800,000 children below the age of 16 serving as prostitutes in Thailand and approximately 200,000 of these children are under the age of twelve. Estimates that 20% of these children will end up with AIDS. Relates these realities to several mental health and theological questions. Argues that God will become real for these children only if sensitive human participation takes place. Proposes that pastoral caregivers can play a crucial role in the confrontation and the resolution of this tragedy.