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Chaplains’ Professional Identity and a Structured Approach to Chaplaincy: Mutually Exclusive or Complementary?
No full textThe trend towards evidence-based health care challenges chaplains to work with structured—predefined and standardized—interventions that lead to measurable outcomes. However, chaplaincy literature raises various objections against using a structured approach. These include compromising the chaplain-client relationship, standardizing and limiting chaplaincy content, and the instrumentalization of the spiritual dimension. Based on a thematic analysis of 20 interviews and 33 workbooks, the current study investigates the experiences of chaplains in the Netherlands who participated in a structured intervention provided in palliative clients’ homes. The results show that most chaplains did indeed struggle with developing a healing relationship with their clients in which they are attuned to their specific needs. At the same time, the participating chaplains reported that a structured approach enriches and broadens the content of their care, improves the impact on clients, and grasps the spiritual dimension of their work. We found that the chaplains’ experiences differed depending on the professional role they emphasized. When they integrate and balance the roles of companion, counselor, and spiritual guide evenly, a structured approach can complement chaplains’ professional identity
Navigating Dilemmas on Advance Euthanasia Directives of Patients with Advanced Dementia.
No full textObjectivesThis study revisited the complexities faced by physicians in meeting due care criteria for euthanasia in patients with advanced dementia in The Netherlands. Despite increasing cases and legal provisions for advance euthanasia directives (AEDs), physicians encounter challenges with ethical issues, including patient communication and assessing unbearable suffering in patients who lack decisional capacity. This study examines the perspectives of elderly care physicians (ECPs), support and consultation on euthanasia in The Netherlands (SCEN) physicians, and euthanasia expertise center (EEC) physicians.DesignA multimethod descriptive study using a questionnaire with both closed and open-ended questions.Setting and ParticipantsThis study explores the complexities faced by physicians in handling AED-based euthanasia requests of patients with advanced dementia.MethodsBaseline characteristics of physician subgroups were analyzed descriptively, and subgroup variations were assessed using univariate regression. Qualitative data underwent thematic content analysis.ResultsWith a 13.8% response rate, the study included 290 participants: 108 ECPs, 188 SCEN physicians, and 53 EEC physicians. Some had combined roles: ECP and SCEN physicians (n = 29), ECP and EEC physician (n = 1), SCEN physicians and EEC physicians (n = 17), and ECP, SCEN physicians, and EEC physicians (n = 6). ECPs received most AED-based euthanasia requests but only 7 EEC physicians and 1 SCEN physician performed euthanasia. All subgroups stressed the importance of patient communication. ECPs found euthanasia ethically justifiable only when communication was possible, highlighting the need to understand current euthanasia wishes and verify unbearable suffering. Effective communication was deemed crucial for confirming request relevance, identifying obstacles, involving patients, fostering trust, and alleviating fears. Physicians generally agreed that unbearable suffering could be assessed through patient expressions, observations, and family input.Conclusions and ImplicationsDespite receiving AED-based euthanasia requests, few physicians proceeded. Subgroup analysis showed varying views, with ECPs emphasizing communication and EEC physicians focusing on determining unbearable suffering. All subgroups highlighted the importance of current patient expressions and involvement in the decision-making process
Baken of labyrint?:Reflecties bij de zorgstandaard Zingeving in de psychische hulpverlening
No full textDe zorgstandaard ‘Zingeving in de psychische hulpverlening’ werd in mei 2023 uitgebracht door Akwa ggz, het kwaliteitsinstituut voor het borgen en verbeteren van werkmethoden in Nederlandse geestelijke gezondheidszorg. Een interdisciplinaire werkgroep van vakverenigingen heeft samen met het patiënten- en naastbetrokkenenplatform Mind bijgedragen aan de totstandkoming van dit nieuwe kwaliteitsdocument. Ook de expertise en kunde van de geestelijk verzorger in de ggz komt daarin aan de orde. Dat er nu een interdisciplinair kwaliteitsdocument beschikbaar is, stemt tot optimisme en creëert nieuwsgierigheid. Tijdens een studiedag met de feestelijke werktitel ‘Flower Power in de ggz?’ bespraken onderzoekers en praktijkbeoefenaars die bij de zorgstandaard betrokken waren welke onderzoeksvragen er gaandeweg zijn ontstaan en aandacht behoeven. Deze bundel bevat de uitgewerkte bijdrages aan de studiedag. Ook komt de geschiedenis van de zorgstandaard Zingeving in de psychische hulpverlening aan de orde
The Existential Dimension of Loss and Grief.
No full textThis chapter discusses integrating grief support and spiritual care in palliative care. It explores the existential dimension of grieving and focuses on the process of loss both patients and families are going through. First, the state of the art of grief research is sketched, and some reasons are given why until now the existential dimension of loss and grief has not had sufficient attention. From there, we will develop a multi-dimensional understanding of loss and grief, connected with the four ultimate concerns identified by Irvin Yalom in his existential therapy. Following the total pain approach in palliative care, we will develop an understanding of loss and grief that brings together the physical, emotional, cognitive, social, and spiritual dimension of the phenomena. We will conclude the chapter by introducing a case of a palliative care patient and his wife, illustrating how an integrative understanding of loss and grief in palliative care may lead to a deeper and more comprehensive approach to loss as a universal human experience
De zorg is mooi, belangrijk en economisch vitaal: dat mag best wat kosten
No full textWerk in de zorg zal naar zijn aard vaak niet efficiënter kunnen, schrijft hoogleraar Evelien Tonkens. Het hoeft dan ook niet goedkoper
Needling the Public/Private Divide:How to Stitch a Common World to Care For
No full textTaking its starting point in the influential work of care ethicist Joan Tronto, this article critically examines the public/private divide within liberal political theory. This distinction not only conceals gendered power hierarchies in private life but also obscures mutual interdependencies from public view. Utilizing Palestinian embroidery as a companion to unlearn this division, the analysis explores three pivotal aspects of the craft. In the production process, the role of women, the voice of the embroiderers, and the treatment of materials and fabric emerge as vital concerns and active sites for change. Regarding curation, public exhibitions emerge as a means of preserving Palestinian cultural heritage but also contribute to the commodification of embroidered goods, challenging the deeply rooted geographical context of the craft. Concerning solidarity, the article elaborates the distinction between the private purchases of embroidered items and collective public action. A care ethics perspective underscores the interconnectedness of the private and public within a shared world. Embroidery becomes a metaphor for weaving a just and caring society, overcoming divisive boundaries