Healthcare Chaplaincy for Geriatric Patients: A Quasi-Experimental Study into the Outcomes of Catholic Chaplaincy Interventions in Belgium

Journal of Religion and Health (2024) 63:1985–2010 https://doi.org/10.1007/s10943-023-01982-6 ORIGINAL PAPER Healthcare Chaplaincy for Geriatric Patients: A Quasi‑Experimental Study into the Outcomes of Catholic Chaplaincy Interventions in Belgium Lindsy Desmet1 · Jessie Dezutter2 Annemie Dillen1 · Anne Vandenhoeck1 · Accepted: 11 December 2023 / Published online: 19 January 2024 © The Author(s) 2024 Abstract The present non-randomized clinical trial examined the short-term outcomes of oneon-one chaplaincy interventions with 416 geriatric patients in Belgium. Participants were interviewed one or two days before a potential chaplaincy intervention (baseline measurement), and one or two days after a potential intervention (post-measurement). Patients in the non-randomized intervention group received an intervention by the chaplain, while the non-randomized comparison group did not. Patients in the intervention group showed a significant decrease in state anxiety and negative affect, and a significant improvement in levels of hope, positive affect, peace, and Scottish PROM-scores, compared to the comparison group. Levels of meaning in life and faith did not significantly change after the chaplaincy intervention. This study suggests that geriatric patients may benefit from chaplaincy care and recommends the integration of chaplaincy care into the care for older adults. Keywords Outcome · Chaplaincy · Geriatric care · Spiritual care · Healthcare Introduction Aging is a complex process in which the spirituality of older persons evolves and can become more prominent (Moberg, 2001). Stressful and life-changing situations in late life such as the loss of loved ones, the decline of physical and cognitive abilities, and hospitalization can trigger the spiritual dimension of people. On the one hand, people’s spirituality can be a powerful resource to cope with these stressful * Lindsy Desmet 1 Faculty of Theology and Religious Studies, KU Leuven, Sint‑Michielsstraat 6, 3000 Leuven, Belgium 2 Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium 13 Vol.:(0123456789) 1986 Journal of Religion and Health (2024) 63:1985–2010 events (Park, 2007). On the other hand, stressful events can provoke intensified spiritual needs and spiritual distress (Koenig et al., 1995; Moberg, 2005; Wink & Dillon, 2002). For example, doubts can occur about one’s meaning in life, dignity, roles in their (past) life, and about the trust in themselves, others, the world, and/or the transcendent (MacKinlay, 2006). During hospitalization, spiritual needs and spiritual distress can be addressed by healthcare professionals, especially chaplains. Hospital chaplains provide professional spiritual care and are part of an interdisciplinary healthcare team. They can support older adults in the search for meaning in life, reconciliation with (past) life, experiencing peace and hope, coping with death, and in reflecting on and deepening the role of spirituality in one’s life (Prause et al., 2020; Timmins et al., 2018; Visser et al., 2023; Wells et al., 2021). Recent research has shown that patients feel satisfied when they receive chaplaincy care and that their spiritual needs are met (Kirchoff et al., 2021; Marin et al., 2015; Muehlhausen et al., 2022; Tan et al., 2020). Also, patients highly appreciate the chaplain’s presence, trusting relationship, attentive listening, and familiarity (McCormick & Hildebrand, 2015; Sailus, 2017). Of particular interest is what the impact is of healthcare chaplaincy on patients. Recently, several case studies have been published worldwide, providing crucial insights into the impact and outcomes of chaplaincy care (Fitchett & Nolan, 2015, 2018; Kruizinga et al., 2020). The downside is that they are written down from the chaplain’s perspective rather than the patient’s perspective and that they are limited to one individual case. To examine the impact across multiple patients or groups, more quantitative outcome-oriented research is needed (Handzo et al., 2014; Kelly & Vandenhoeck, 2017). The most rigorous method to do this is by using a randomized control trial (RCT). However, in healthcare chaplaincy studies, RCTs are scarce (Bay et al., 2008; Iler et al., 2001; Kruizinga et al., 2019). Moreover, studies examining the outcomes of chaplaincy interventions generally suffer from four methodological limitations (see also Buelens et al., 2023; Jankowski et al., 2011). First, a comparison group is often lacking (Kestenbaum et al., 2017; Kevern & Hill, 2015). Because there is no comparison with a group that received no/an alternative intervention, it is difficult to know whether the effects in the intervention group are caused by the intervention of the chaplain. Second, results are frequently based on small sample sizes (Kestenbaum et al., 2017). Third, there are a large number of studies investigating spiritual care interventions provided by the whole multidisciplinary team (Piderman et al., 2014; Rabow et al., 2004; Sun et al., 2016). This makes it difficult to pinpoint the specific contribution of the chaplain. Fourth, studies investigating pre-defined intervention programs by the chaplain are interesting but do not give insights into the impact of healthcare chaplaincy in a real-life context, where chaplains usually offer unstructured interventions (Liefbroer et al., 2021). In geriatric healthcare, two outcome studies on chaplaincy interventions have been carried out and one study design has been published. First, Baker’s (2001) study with independent-living, assisted-living, and residents with a need for nursing care or treatment in Pennsylvania, investigated the impact of chaplaincy interventions on depression. Participants were first matched according to their age, gender, and level of care, and then, one participant per match was assigned to the 13 Journal of Religion and Health (2024) 63:1985–2010 1987 intervention group and one to the control group. The intervention group received weekly chaplaincy interventions for six months, while the control group received minimal chaplaincy interventions. Depression scores decreased in the intervention group after six months of interventions (post-measurement). Three months after the last intervention (follow-up measurement), depression scores increased in the intervention group. In the control group, depression scores increased both at post- and follow-up measurement. Second, Zhang and colleagues (2020) carried out a retrospective study with older adults in a rehabilitation unit of a long-term care facility in Boston and Dedham. The intervention group was visited by the chaplain; the control group was not. Compared to the control group, no significant changes in outcomes in the intervention group were found for mood, pain level, functional ability and discharge status, at three months and six months after the intervention. Third, an RCT-design has been published (Kittelson et al., 2019). The study ai (...truncated)