Kevin J. Flannelly, Ph.D., on demonstrating our worth to institutions

The Need for a Systematic Spiritual Needs Assessment

A study published earlier this year reported that 72 percent of patients at five cancer hospitals in Connecticut, Texas, and New York said their spiritual needs were not met. The study appears to have caught the attention of many of us who are interested in religion and health, inside and outside of professional chaplaincy. Commentaries about the article in the Journal of Clinical Oncology, here in PlainViews, and elsewhere have naturally focused on the importance of assessing and responding to patients’ spiritual needs.

We were fortunate to have one of the authors, Dr. Lauren Vanderwerker, spend the summer working with some of our chaplains and research staff on a number of pastoral care studies with hospitalized patients. Dr. Vanderwerker, who is an epidemiologist, is interested in becoming a chaplain. She enrolled in Union Theological Seminary last year and is currently taking her first CPE course. While we were discussing the article, Lauren mentioned how odd it was that some of the most compelling findings of the study came from a couple of simple questions about the spiritual support patients received, especially since these questions were not the primary purpose of the research project. Perhaps it is not that odd, however, since much of what we know about the relationship between religion and health is still based on a few questions about religion, embedded in large epidemiological surveys.

While the article has caught the attention of those interested in religion and health, I wonder whether it has caught the attention of hospital administrators. Has this article convinced them of the importance of assessing and responding to patients’ spiritual needs? I often hear that chaplains have to demonstrate their economic value to hospital administrators. This implies that research should be done on the cost-effectiveness of chaplains, and some possible measures of cost-effectiveness have been suggested to me. However, having worked as a researcher in the field of religion and health for over a decade and directly with chaplains for over a half-dozen years, I do not believe this is the most fruitful line of research to undertake.

As a professional outsider (I am a psychologist not a chaplain), but one deeply committed to the mission of professional chaplaincy, I think the most valuable research for professional chaplaincy, at this time, is the systematic study of the religious and spiritual needs of patients and their family members. We must move beyond one or two questions appended to surveys designed for other purposes and design surveys to specifically identify the spiritual and religious needs of different populations (e.g., cancer patients, heart patients). We need to assess the incidence and prevalence of these needs, to use the terminology of epidemiology. These suggestions are generally consistent with, and an extension of, the Rev. George Handzo's recommendations in PlainViews earlier this year (Vol. 4, No.4).

Some valuable studies in this area have been published, but aside from the research of Dr. George Fitchett and his colleagues, they mainly have been done by nurses. I know other chaplains who are doing research on these topics, and I encourage them to publish their findings in professional journals. I am convinced that methodologically sound studies with different patient populations would be welcomed by journals in the corresponding medical specialties. I believe a systematic “needs assessment” of the spiritual needs of patients and family members would reveal a latent demand for pastoral care, and that the recognition of this demand would lead some hospital administrators to see the economic value of pastoral care, thus, supplying professional services to meet these needs.

Do you have thoughts about education & research you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.