Some studies involving chaplains and measures Prof Austyn Snowden Iain Telfer

Overview History of PROM Description of CCL study Results Analysis Recommendations Discussion

PROM CCL VBRP History of PROM Lothian PROM: face and content validity 2012 Scottish PROM: reliability, construct and convergent validity 2016 First outcome measure. Replicated in Australian study ERICH: 4 studies in Europe, 1 in AHPCC, Sally Nash in paediatrics etc CCL before and after study 2017- present Lobb, E. A., Schmidt, S., Jerzmanowska, N., Swing, A. M., & Thristiawati, S. (2018). Patient Reported Outcomes of Pastoral Care in a Hospital Setting Patient Reported Outcomes of Pastoral Care in a Hospital Setting. Journal of Health Care Chaplaincy, 0(0), 1–16. http://doi.org/10.1080/08854726.2018.1490059

The Scottish PROM© During my meeting with the chaplain I felt: Age, gender, religious, spiritual, both, neither During my meeting with the chaplain I felt: In the last two weeks I have felt: I was listened to I was able to talk about what was on my mind My situation was understood My faith/beliefs were valued I could be honest with myself about how I was really feeling Anxious I had a positive outlook on my situation In control of my life A sense of peace

Data gathering process Chaplain Complete survey ‘as if’ patient online Analysis Completes f/up PROM & survey Patient Meet for as many sessions as needed Patient & Chaplain Create PROM packs and gather list of participating listeners. Send to listeners Researchers refers patient to chaplain and informs them of study GP/ other Store PROM packs securely and familiarise themselves with contents & protocol Chaplains Visit Prepare Refer Discharge Post survey back to research team Step 4 Patient Completes baseline PROM & survey Step 2 Study documents Step 1

Hypotheses Patients will record higher scores on the Scottish PROM after CCL. Patients will report higher scores on EQ5D after CCL The patient experience of CCL will be associated with Scottish PROM scores. There will be no difference in outcome according to whether patients self-describe as religious, spiritual, both, or neither. Power analysis: paired sample t-test with effect size 0.4, power 80% and alpha 0.0125, G*Power version 2 calculated a necessary sample size of 62.

Age and gender (n=88)

Religious, spiritual, both, neither

Patients will record higher scores on the Scottish PROM after CCL. N=19 p=0.001

Patients will report higher scores on EQ5D after CCL N = 25, p=0.001

The patient experience of CCL will be associated with Scottish PROM scores. Minimal variance in patient experience. All 4

There will be no difference in outcome according to whether patients self-describe as religious, spiritual, both, or neither. 5 12 5 2 Not significant

Comparable text (N=1) Patient Chaplain I went because of bereavement and the chaplain …was excellent at listening and just coming in when I wanted help. She did exactly what was needed at a difficult time and it was a good, neutral, independent, sympathetic service. It helped to be able to talk about my bereavement and understand my feelings and responses as normal in the circumstances.

Discussion: hypotheses Even with small sample the difference in PROM scores between baseline and follow up is significant!! Same for EQ5D VAS Not enough variance in sample to obtain correlations VERY high satisfaction with chaplain Trend to higher scores for religious people?

So… Personal involvement in PROM, ERICH, APC, AHPCC Personal interest in research engagement and gatekeeping behaviour* Short history of chaplaincy 50% engagement with UKBHCC Why???? Snowden, A., Fitchett, G., Grossoehme, D. H., Handzo, G., Kelly, E., King, S. D. W., … Flannelly, K. J. (2017). An International Study of Chaplains’ Attitudes about Research. Journal of Health Care Chaplaincy. http://doi.org/10.1080/08854726.2016.1250556

Gatekeeping continuum Will you ask your patients to participate in this research?

NMC Standards At the point of registration, the registered nurse will be able to:  …demonstrate an understanding of research methods, ethics and governance in order to critically analyse, safely use, share and apply research findings to promote and inform best nursing practice  https://youtu.be/2KKMtJyFqq4

UKBHC It is the aspiration of all the associations that healthcare chaplaincy becomes a healthcare profession. To achieve the status of a ‘registered healthcare profession’ healthcare chaplaincy requires to become a self-regulating profession …(NHS Education Scotland, 2008) UKBHC exists to support the work of the four professional chaplaincy bodies in the UK… to work towards professional registration of Healthcare Chaplaincy.

In a very short time: UK Chaplains have organised themselves: Agreed a set of competencies Agreed a code of conduct Agreed standards of practice Become accredited health professionals But… voluntarily. So…how do chaplains decide? evidence that they meet the eligibility criteria for registration; compliance with the professional Code of Conduct and requirements for Continuing Professional Development; fitness to practice; paid the relevant registration fee. ensure that their UKBHC record is complete, accurate and contemporary; maintain their CPD activity; comply with the professional Code of Conduct; pay the relevant registration fee.

Plan: ask the chaplains! UK wide issue Ask all UK chaplains, service users, ‘stakeholders’ NIHR fund Need to test protocol first: CSO feasibility study Too many chaplains in UK to interview: survey instead. Chaplain survey needs to be fit for purpose Invite chaplains to help

AHPCC: do chaplains make a difference? Ask their day patients!! PROM at beginning PROM at end Chaplain record of visits Relationship between number and depth of encounters?

Interested? Please come to workshop tomorrow! These guys will explain all…