Digital Commons Network^™

A Randomized Controlled Trial Of A Compassion-Centered Spiritual Health Intervention To Improve Hospital Inpatient Outcomes, Jennifer S Mascaro, Patricia K Palmer, Marcia J Ash, Marianne P Florian, Deanna M Kaplan, Roman Palitsky, Steven P Cole, Maureen Shelton, Charles L Raison, George H Grant

Faculty and Staff Publications

Background: Inpatient medical settings lack evidence-based spiritually integrated interventions to address patient care needs within a pluralistic religious landscape. To address this gap, CCSH™ (Compassion-Centered Spiritual Health) was developed to leverage the skillsets of healthcare chaplains to improve patient outcomes through spiritual consultation. Here, we report the results of a randomized, wait-list controlled, pre-registered (NCT03529812) study that evaluated the impact of CCSH on patient-reported depression and explored putative mediators of CCSH's effects.

Method: Chaplain residents were randomized to be trained in CCSH as part of their clinical pastoral education (CPE) residency in the fall (n = 8) or …

The Remote Supervision Road To Registrar Training In Australia - Paving The Path With Pixels And Phones (A Narrative Review)., Nicholas Coburn, Kylie Fitzgerald, Brett Vaughan

Health Professions Education

Purpose: Specialist medical training in rural or remote Australia is limited due to current requirements of specialist medical colleges to supervise and train registrars onsite. Remote supervision, where the registrar is supervised via telephone and videoconferencing technology remotely, offers a solution that allows doctors to train in rural or remote areas. This review describes the opportunities, challenges, and recommendations to pave the path for a best practice model of remote supervision for private practice focused registrar training in Australia which may offer insights for other countries with rural and remote medical workforces.

Methods: Ovid Medline and Ovid Embase were …

Exploring The Impact Of Covid-19 And The Role Of The Church On African Americans’ Mental Well-Being In South Georgia, Adrian D. Lewis

College of Graduate Studies: Theses & Dissertations

The emergence of COVID-19 in 2020 disrupted the social dynamics of communities in the United States. Furthermore, public health mandates led to closures that changed how populations access faith. Historically, African Americans have utilized the church to cope with societal stressors. This study will explore the history of church utilization in the African American community, assess how COVID-19 public health mandates led to church closures for the first time in recent history and impacted this marginalized population, and provide a qualitative perspective on the quality of life during the closures and what changed after the closures for African Americans in …

Inside The Circle 2025: Exploring The Ontario Cpe Supervisors' Lived Experience Of The Interpersonal Relations Group Process Portion Of Cpe, Kelly L. Collins

Theses and Dissertations (Comprehensive)

This research used a philosophical phenomenological (primarily Gadamer) methodology and asked the question, “What is the lived experience of Ontario Clinical Psychospiritual Education (CPE) Supervisors in the Interpersonal Relationships (IPR) group process portion of CPE?” It used a 90-minute, semi-structured interview format as it sought to understand the supervisor experience of safety in the group. 11 Ontario Certified Supervisors were interviewed and explored this question in relationship to participant supervisors’ experience as students and/or as educators. In the history of CPE, there has been significant harm done to students by some supervisors who were well-meaning, but unaware of their impact …

Healthcare Utilization Unchanged In The Control Arm Of A Randomized Clinical Trial, Pratik Gongloor, Saad Nadeem, Xiaoying Yu, Mukaila Raji, Kristina D Mena, Elizabeth M Vaughan

Faculty, Staff and Students Publications

including among control groups. Increased access to care and heightened health awareness during trial enrollment could lead to altered behaviors, a phenomenon known as the Hawthorne effect, which may obscure true intervention impacts; however, this effect remains poorly studied in low-income environments.

Aim: To conduct a secondary exploratory analysis of healthcare utilization among control participants of a randomized clinical trial (RCT).

Methods: We retrospectively analyzed electronic medical records from the control arm (n = 26) of an RCT involving low-income Hispanic adults with type 2 diabetes receiving care at a community clinic. Before randomization to a 12-month diabetes education intervention …

From Trials To Practice: Implementing A Clinical Intervention In Community Settings, Elizabeth M Vaughan, Xiaoying Yu, Victor J Cardenas, Craig A Johnston, Salim S Virani, Ashok Balasubramanyam, Christie M Ballantyne, Aanand D Naik

Faculty, Staff and Students Publications

Introduction/objectives: Diabetes increases the risk of complications, especially for vulnerable populations. Our previous randomized clinical trial (RCT), TIME (Telehealth-supported, Integrated Community Health Workers (CHWs), Medication access, group visit Education), showed the efficacy of CHW-led diabetes care. This study aimed to gather data on transitioning TIME from clinical trials to practical implementation.

Methods: We conducted a 12-month RCT at a nonprofit community clinic using the Consolidated Framework for Implementation Research (CFIR). Participants, Hispanic adults without insurance and with type 2 diabetes (N = 58; 29/arm), were randomized to TIME (intervention) or usual care (control). The intervention included monthly group visits and …

Effectiveness Of Compassion-Focused Group Therapy To Increase Self-Compassion And Forgiveness In High School Students, Kristin Melliyati Benu, Mungin Eddy Wibowo, Mulawarman Mulawarman

Jurnal Kajian Bimbingan dan Konseling

Self-compassion and forgiveness are inseparable in the lives of adolescents because adolescents are vulnerable to various conflicts due to social changes and demands that cause negative emotions and other psychological problems. Adolescents need self-compassion and forgiveness to be able to regulate negative emotions in dealing with difficult situations. Compassion focused group therapy is an approach that focuses on compassion so that it can help adolescents to foster kindness to themselves, accept themselves and difficult situations as human and be able to provide forgiveness to themselves and others. This study aims to test the effectiveness of compassion-focused group therapy to increase …

Preparing Spiritually Resilient Warriors In The Canadian Special Operations Forces Command, Vic Morris

Doctor of Ministry Major Applied Project

Morris, Victor E. “Preparing Spiritually Resilient Warriors in the Canadian Special Operations Forces Command.” Doctor of Ministry. Major Applied Project, Concordia Seminary, 2024. 285 pp.

The Canadian Armed Forces has outcomes and expectations for warriors to be spiritually resilient but does not have a training program that has been researched, tested, and validated to achieve this. This study investigates how chaplains can prepare spiritually resilient warriors in CANSOFCOM. A chaplain-led spiritual resilience course was created and delivered to CANSOFCOM members. The course was aligned with the holistic wellness strategy of OPF2, and designed as an inductive, experiential learning experience. An …

Addressing End-Of-Life Care Education Gaps For Registered Nurses: A Quality Improvement Project, Mayra Villalba, Alejandra Angel, Arvinder Singh

Nursing & Health Sciences Research Journal

Background: As the global elderly population grows rapidly, end-of-life care (EOLC) needs have expanded, warranting comprehensive nursing education. There is a significant gap in exposure to EOLC during nursing undergraduate education, clinical experiences, and training opportunities in the professional setting. The purpose of this quality improvement project was to educate nurses about end-of-life care. Methods: In an established medical-surgical unit, hospice patients with comfort-only measures were placed into a cohort labeled Transitional Care Unit (TCU). Between October 2023 and May 2024, nurses working in the TCU were surveyed on their knowledge regarding EOLC. Staff attended mandatory education sessions after the …

A Framework To Improve Your System’S Well-Being Through Crisis Response Planning, Emily Lisco, Md, Alexandra Pierlott, Lcsw, Meghan O’Meara, Lpc

Jefferson Hospital Staff Papers and Presentations

- Crises of all kinds can affect the learning environment in undergraduate and graduate medical education, including illnesses, assaults, and deaths that affect learners, faculty, and staff.

- Postvention plans have been deployed by college counseling centers to offer psychological support and crisis intervention to those affected by suicide.

- The term postvention has come to refer to, "an organized response in the aftermath of suicide, to facilitate healing of individuals who are experiencing grief, mitigate potential effects of exposure to suicide, and prevent suicide among those who may be high-risk in the population.”

- It is important for those …

The Blessed Assembly: Irreplaceable Physical Co-Presence In Worship And Healthy Hybridity Reimagined After The Pandemic In The Digital Age, Yvette, Ying Wai Lau

Doctor of Pastoral Music Projects and Theses

Because of the unprecedented and unexpected force of the pandemic since 2020, most churches around the world have experienced some online worship during the lockdown of their cities or the mandated closure of the church buildings. For many people, online worship seems to be an equivalent, if not better, alternative for gathering together—a physical co-presence in worship—even after the pandemic has ended. As necessary and vital as online worship experiences have been for Christians during the pandemic, the witness of the church from Pentecost throughout Christian history indicates that gathered worship in physical spaces is irreplaceable for faith formation and …

The Pause: Impacting Moral Distress In Our Caregivers, An Integrative Review, Bethany Corinne Furman

Doctoral Dissertations and Projects

Moral distress is endemic to healthcare in the emerging post-covid era. Moral distress is defined as the knowledge of the correct or ethical action but the repeated inability to act in that manner. First studied in nursing, it has been found in nearly every facet of healthcare and is strongly associated with clinician burnout, intent to leave position, and behaviors that can in turn compromise patient safety. Intensive care unit (ICU) nurses experience moral distress at higher rates than other subspecialties. Prevention of and recovery from moral distress is complex, but various forms of debriefing have long been suggested to …

Transforming Chaplain Ethics: The Clinical Ethics Of Spiritual Care In A Pluralistic Healthcare Environment In The United States, Robert Alan Price

Electronic Theses and Dissertations

This dissertation, “Transforming Chaplain Ethics: The Clinical Ethics of Spiritual Care in a Pluralistic Healthcare Environment in the United States,” aims to examine the clinical ethics of religious and spiritual care provided by clinical chaplains for patients and families receiving treatment in a pluralistic healthcare context in the United States.

Clinical chaplains are more than clergypersons and they are more than clinicians; they are a highly specialized marriage of both worlds. There is a fundamental asymmetry between functioning as a leader in a local religious community or faith tradition and providing clinical spiritual care in a pluralistic healthcare environment. This …

Dnp Final Report: Balancing Self-Care And Patient Care: An Intervention To Enhance Well-Being For Acute Care Nurses, Robert V. Rose Jr.

DNP Final Reports

This project delves into the profound impact of the COVID-19 pandemic on healthcare and nursing, focusing on the well-being of nurses within the context of acute care settings. Poor well-being leads to increased levels of burnout and the evidence-based practice project aimed to increase the perception of well-being.

The formulated PICOT question driving this project was: In acute care nurses (P), how does the use of Acceptance and Commitment Therapy (ACT) program (I) compared to no Acceptance and Commitment Therapy (ACT) (C) impact nurses’ perception of well-being (O). The evidence substantiates that ACT interventions effectively elevate perceptions of well-being, as …

Mental Health And Theologies Of Suffering, Sarah Skrove

Celebrating Scholarship and Creativity Day (2018-)

Theologies of suffering have been used by theologians, ministers, and faithful alike to try to understand why God allows innocent suffering. These ideas have been applied to wars, violence, starvation, grief, mental health challenges, and the list goes on. The primary focus of this project is the impact that theologies of suffering have had on the perception of mental health, the experience of those enduring the suffering, and the stigma surrounding treatment. While certain theological narratives are helpful for an individual to find meaning in their own pain, theologians must be careful of uninvited application of scholarship to another’s lived …

Protection Or Punishment? Reimagining The Hospital Care Environment For People Who Use Drugs, Natalina Contoreggi, Md, Jillian Zavodnick, Md, Kathleen Mechler, Md, Helene Dailey, Dnp, Rn, Ccrn, Ccctm, Rebecca Jaffe, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem: Jefferson serves a large population of patients who use drugs (PWUD). As the opioid epidemic has evolved, our practice has adapted. Examples of Jefferson's dynamic response include hospital-wide guidelines for withdrawal management and medications for opioid use disorder, establishment of a bridge clinic, and the JAMS service. However, there is little consensus on how to best support this population in the hospital, particularly if they are using or suspected of using non-prescribed substances during their admission.

Aim: Development of accessible guidelines to manage and support PWUD in thehospital.

Protocols For Enhancing The Role And Value Of Spiritual Care Resources In The Metropolitan Nashville Police Department, Garrett Harper

Doctor of Ministry Theses and Dissertations

This thesis addresses the assessment of innovative practices in police chaplaincy. The purpose of the project intervention is to develop protocols that can guide police chaplains through an assessment process. The intervention relies on practical theology as exemplified through the ministry of chaplaincy. This ministry comprises police chaplains offering spiritual comfort to persons encountering critical incidents involving violence, accident, or other trauma-intensive events and situations. Adoption of innovations can allow police chaplains to be more effective in fulfilling many outward-focused tasks such as delivery of death notifications. I conclude that: (1) police chaplaincy is amenable to use of protocols to …

Advancing Health Equity On Campus A Minority Health Promotion Quality Improvement Initiative, Natasha Wilson

DNP Projects

Abstract Background: Minority students at predominantly white institutions face unique stressors due to their minority status, impacting their health. Initiatives promoting community engagement, diversity, equity, and inclusion can help reduce minority stress and foster health equity and success in higher education Method: This project employed a Community-Based Participatory Research (CBPR) framework to enhance minority student involvement in sexual and mental health services both on campus and in the wider community. It involved forming partnerships between minority student organizations, faculty, and community partners to organize wellness events focusing on sexual and mental health during the fall semester of 2023. The events …

The Effect Of The Covid Pandemic On Parish Nursing In The Uk, Helen Wordsworth

International Journal of Faith Community Nursing

This article describes the impact that the Covid pandemic of 2020/2021 had on the work of UK Parish Nurses and the churches with which they worked. It explains how they adapted to the restrictions imposed by the government, changing the nature of the interventions they were able to make. It concludes that the resilience, flexibility, and creativity of the Parish nurses and of their national umbrella organisation, Parish Nursing Ministries UK, have enabled the emergence of a growing and vibrant ministry.

Acute Care Staff Interactions With Chaplains To Discuss Team Or Personal, Non-Work-Related Stressors, Gary Weisbrich, Sarah Sumner, Teresa Rangel

Providence Nursing Research Conference 2023 – Present

Background: Healthcare staff experience stress from the workplace when providing complex patient care and often may lean on specially trained spiritual support caregivers, or chaplains, for support navigating patient-related stressors. Yet, healthcare staff can also suffer from team-related or personal stressors that, if unresolved, could negatively impact care delivery. Little is known about whether, how often, and which staff may interact with chaplains for emotional support when experiencing non-patient-related stressors originating from work or personal lives.

Purpose: To describe the proportion of individuals who report discussing team-related or personal stressors with chaplains in the past 12 months, and to …

Alleviating Health Professionals' Moral Distress Through Hospital-Based Chaplain Care, Karen Colorafi, Sarah Sumner, Teresa Rangel

Providence Nursing Research Conference 2023 – Present

Background: Healthcare workers frequently experience occupational stressors that negatively impact their emotional well-being. Recent evidence suggests that healthcare workers’ occupational stressors may translate to moral distress, defined as emotional turmoil occurring over an ethical dilemma secondary to a patient care or team-related issue. Following the COVID-19 pandemic, moral distress and a wide range of psychological and physical issues have been linked to high rates of healthcare worker burnout. Increased occupational stressors significantly augment turnover intentions and behaviors and negatively impact well-being. The resultant turnover rates have reached an all-time high among professional registered nurses. Some evidence suggests that the …

Bioethics And A Theology Of Vulnerability, Carrie Oneil-Smith

Obsculta

This essay looks at how a theology of vulnerability can contribute to ethical decision-making in an increasingly secular society. Relationality, power dynamics and scriptural justifications are considered, as well as early contributions made to this nascent field of Christian thought. This essay was written for a class on Health Care Ethics taught by Dr. Mary Ann Kish.

Emotional Stressors Faced By Medical Students Expressed Using Cartoons: A Qualitative Study, Casey Fishman, Ba, Justin Do, Bs, Fred W. Markham Jr., Md

Alpha Omega Alpha Research Symposium Posters

Purpose: Empathy, a fundamental pillar of medicine, has been shown to decrease in medical school. Increased stress is linked to decreased empathy, but specific stressors remain unclear. The goal of this study was to qualitatively explore specific stressors among third year medical students.

Methods: Third year medical students (n=248) participated in Reflection Rounds with a clinician and a member of pastoral care at Thomas Jefferson University and in their final sessions created a cartoon to express sentiments surrounding medicine. Qualitative analysis of the cartoons was conducted on both the images and text. Common themes were identified from the students’ …

Cancer Survivorship Care In The United States At Facilities Accredited By The Commission On Cancer, Julia Stal, Kimberly A. Miller, Timothy W. Mullett, Judy C. Boughey, Amanda B. Francescatti, Elizabeth Funk, Heidi Nelson, David R. Freyer

Markey Cancer Center Faculty Publications

IMPORTANCE Since 2021, American College of Surgeons Commission on Cancer (CoC) accreditation standards require providing a survivorship program for patients with adult-onset cancer treated with curative intent. Since more than 70% of all patients with cancer in the US are treated at CoC-accredited facilities, this presents an opportunity for a landscape analysis of survivorship care availability.

OBJECTIVE To determine the prevalence, types, and outcomes of cancer survivorship services at CoC-accredited facilities.

DESIGN, SETTING, AND PARTICIPANTS This survey study used an anonymous, online, cross-sectional survey conducted from May 4 to 25, 2023. Participants were CoC-accredited facilities in the US representing diverse …

A Mixed-Method Evaluation Of Implementation Determinants For Chaplain Intervention In A Hospital Setting, Jennifer S Mascaro, Marianne P Florian, Erin Brauer, Patricia K Palmer, Marcia J Ash, Maureen Shelton, Roman Palitsky, Deanna M Kaplan, Shaheen Rana, Cam Escoffery, Charles L Raison, George H Grant

Faculty and Staff Publications

Healthcare chaplains address broad social and emotional dimensions of care within a pluralistic religious landscape. Although the development and evaluation of chaplaincy interventions has advanced the field, little research has investigated factors influencing the implementation of new chaplain interventions. In this mixed-method study, we examined attitudes about evidence-based interventions held by chaplain residents (n = 39) at the outset of an ACPE-accredited residency program in the southeast United States. We also used semi-structured interviews (n = 9) to examine residents' attitudes, beliefs, and decision-making processes after they trained in the delivery of a novel manualized intervention, Compassion-Centered Spiritual Health (CCSH). …

Promoting Independence In An Existing Cancer Survivorship Program: Adaptive Equipment And Intimacy & Sexuality, Bailee Scheer

Occupational Therapy Capstones

Purpose: The purpose of this project was to create educational materials for cancer survivors and their caregivers/families on the topics of adaptive equipment and intimacy/sexuality. A person is considered a cancer survivor at any point after receiving a cancer diagnosis, regardless of what stage they are at in their course of treatment (American Cancer Society, 2024). The rate of cancer survivors within the United States has grown drastically over the past several years, due to advances in treatment and early detection (Cronin et al., 2022). Cancer survivors experience many changing side effects during and after treatment that influence the way …

Transitional Support Programming For First-Year Occupational Therapy Graduate Students, Samantha Proctor

Occupational Therapy Capstones

Title: Transitional Support Programming for First-Year Occupational Therapy Graduate Students

Background: The focus of the project represents the Scholarship of Application, which is the translation of existing research into practice. A student’s transition from undergraduate to graduate-level programs can be challenging due to the increased academic rigor inherent to graduate programs. This can lead to an imbalance in students' lives and an increase in stress, anxiety, and burnout. As the overall well-being of students decreases, the likelihood of students experiencing academic hardships increases. Students need diverse academic and professional skills to navigate graduate school successfully; however, many students lack those …

Switching The Narrative: Pastors’ Beliefs And Reasonings, Dejaune K. Thompson, Sheriyse M. Williams, Shuntay Tarver, Portia C. Stokes

Psychology Faculty Publications

Although many African Americans experience mental health/addiction (MH/A), only 39% of the population seek professional treatment. Several significant barriers contribute to their ability to seek treatment, and as such, many African Americans feel more comfortable relying on the Black Church and pastors for support. However, many pastors are not prepared to support the MH/A needs of their parishioners thus leaving those who seek help without the proper MH/A care they need. The purpose of this qualitative study was to investigate the perceptions held by African American pastors on preparedness based on experience and theological beliefs to address MH/A issues within …

The Sense Of Safety Theoretical Framework: A Trauma-Informed And Healing-Oriented Approach For Whole Person Care, Kurt C. Stange

Faculty Scholarship

Objectives: This research describes four aspects of the development of the Sense of Safety Theoretical Framework for whole person care: exploring the meaning of the phrase “sense of safety”—the whole person language; the range of human experience that impacts sense of safety—whole person scope; the dynamics that build sense of safety—the healing goals; and the personal and cross-disciplinary trauma-informed practitioner skills and attitudes that facilitate sense of safety. Methods: This qualitative participatory study was conducted in two phases. Researchers iteratively explored the concept of sense of safety using focus groups and semi-structured interviews. Overarching research questions were: “Does the transdisciplinary …

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …