How Distress Prior to a Spiritual Health Consult is Associated with Patient-Reported and Clinical Outcomes Public
Gross, Skylar (Spring 2020)
Published
Abstract
Introduction: Chronic diseases are the main contributor to hospitalization in the United States. Consequently, hospitalization has been shown to lead to distress, anxiety, depression, and compromised quality of life for patients. However, religiosity and spirituality has been shown to be an effective coping mechanism for mitigating distress due to hospitalization and chronic diseases. Specifically, hospital chaplains have been associated with decreased stress, anxiety, and depression, in addition to a decreased length of stay and risk of death. Therefore, the spiritual framework of coping suggests that spiritual coping can increase patients meaning-making and improve their overall mental and physical well-being.
Objective: The following study was conducted to understand how hospital distress prior to a spiritual health consult is associated with patient-reported and clinical outcomes. Patients underwent a chaplain consultation, and prior to the chaplain visit, patients’ distress was assessed. After the chaplain visit concluded, patients’ well-being and meaning-making were assessed through a self-report questionnaire. Lastly, patients’ length of stay after the consult and readmission to the hospital within six months was assessed through accessing their respective medical records.
Methods: This prospective secondary data analysis used data from a longitudinal quasi-experimental waitlist crossover study which was conducted from August 2018 through June 2020. The first stage of the data collection was conducted from December 2018 through March 2019. Descriptives and frequencies were conducted for demographic variables; chi square tests, independent sample t-tests, and pearson correlations were conducted between predictor and outcome variables at the bivariate level.
Results: A total of 133 hospital patients in the Metro Atlanta area were recruited from 6 different hospitals and met eligibility criteria. Of patients who were eligible and provided informed consent, 123 participants completed the chaplain consult and survey. In addition, only 106 patients ‘medical records could be accessed. The majority of participants reported high distress prior to the spiritual health consult (n=91;74.0%) of participants experienced high distress prior to the chaplain consult and were not readmitted into the same department within 6 months (n=75;70.8%). In addition, at the bivariate level, meaning-making and well-being were statistically significantly correlated (p<.0001). All other bivariate analyses resulted in null results.
Conclusions: The results from this study, despite mainly being null, suggest important preliminary and descriptive findings. Meaning-making and well-being were statistically significantly correlated, however, these two variables have similar constructs. Moreover, due to this study being observational, causal relationships could not be determined, and the findings could not be generalized. Therefore, further research can be conducted to further fill the gap in literature.
Table of Contents
Chapter 1: Introduction 5
Purpose 5
Chronic Disease 5
Hospitalization 7
Distress 8
Religion and Spirituality 8
Chaplain Benefits 9
Problem Statement 9
Theoretical Framework 10
Chapter 2: Review of the Literature 11
Introduction 11
Chronic Disease 11
Hospitalization 13
Distress 14
Religious and Spiritual Coping 15
Chaplain Visit 16
Theoretical Framework 18
Study Aim 23
Chapter 3: Methods 23
Participants 23
Procedures 24
Survey Measures 24
Medical Record Data 25
Data Analysis 26
Chapter 4: Results 27
Univariate Analysis 27
Bivariate Analysis 30
Chapter 5: Discussion 33
Overview 33
Summary of Key Results 33
Strengths and Limitations 35
Implications and Future Directions 36
References 39
Figure 1. Spiritual Framework of Coping 19
Figure 2. Conceptual Framework of Spiritual Coping 22
Table 1. Patient Demographics 27-28
Table 2. Univariate statistics of patients’ feelings during the spiritual health consult 28-29
Table 3. Univariate statistics of patients’ meaning-making 29-30
Table 4. Univariate statistics of patients’ well-being 30
Table 5. Distress: Independent sample t-tests for well-being, meaning-making and length of stay 31
Table 6. Chi-Square test of independence for distress and readmission 31
Table 7. Readmission: Independent sample t-test for well-being and meaning-making 32
Table 8. Pearson Correlation for well-being, meaning-making and length of stay 32
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