Chaplain Religious/ Spiritual (R/S) Assessment for Depth of Religious Resource or Maturity in US Patients: A Work in Progress. Could Spiritual Maturity be Associated with Possible Divine Enchantment?
Elisabeth McSherry, M.D., MPH, Research Co-PI, Bedford, MA VAMC
Steven S Salisbury, Chief Chaplain, Boston VA Medical Center, Boston, MA
Patients with Religious/Spiritual (R/S) Resources have been shown to fare better in serious hospitalizations than others. Not only in the U.S. but now also seen in Jewish, Muslim and Buddhist patients across the globe. Hall et al (2008) suggested better refinement in the R/S assessment of patients should include theologically-relevant contexts. Previous Spiritual Maturity schema (Fowler 1980) are not useful as they attempt to apply “universally”; also these, use psychosocial and Kohlberg Moral-development stages rather than religiously relevant ones. Prothero argues that development in a Faith is related to the specific goals and exemplars of the major Faith groups and that significant differences exist. This R/S assessment is based on Maturity schemes of the early church fathers (Origen, Augustine, etc.) determined from Apostolic criteria and on the R/S maturity of the great exemplars of the Christian faith, St Paul, St John and Christ.
Method- Using the three non-invariant stages gleaned from these religious Christian writings, we developed a brief 10 item patient R/S assessment with 5 dimensions: Spiritual transformation; Thanksgiving in all circumstances; Fruits of the Spirit; Scriptural Literacy; and Meditation frequency and length. From 2 convenience samples we tested the range: The “Older“group from a 10-person Small Group of a serious Biblically-literate Boston Church, ages 58-82; the “Younger” 6 patient sample was part of a quality improvement study of the Boston VA hospital where chaplains completed a semi-structured patient interview and compared that to the patient’s R/S maturity self-assessment.
Results showed both groups rate very high: God as a source of strength. The younger rate less “religious” but spiritual. The older group was more scripture-literate but the young group meditated on Scripture longer. Fruits of the Spirit appear higher in those who daily meditated on Scripture longer.
Discussion. This R/S Maturity/Depth of Religious Resource (DORR) assessment in pilot testing appears to separate different aspects of faith maturity and Religious resource in committed Christians. It avoids Denominational specificity, applying to all US majority (Christian) faiths.
Significance: This is a very early effort to look at an assessment for Religiously relevant spiritual maturity/depth of religious resource in US patients. More work will be done in different regions of the US. For Chaplains and Pastoral Care workers knowing in more depth about the patient’s religious resource assists in recognizing quickly where the best access points maybe for spiritual support. Especially in Palliative Care and Hospice where the hope of full physical cure is unlikely, knowledge of the patient’s R/S Maturity/DORR allows robust spiritual support earlier.
Relation to Divine Enchantment: If we define "Divine Enchantment” operationally as "To change the natural behavior or expectations through positive Spiritual power or positive apparent supernatural intervention”, then Paul’s driving the evil spirits from the irritating soothsayer girl in Philippi would qualify as a Divine Enchantment, as well as Moses parting the Red Sea or Jesus’ miracles. The question is outstanding: Will Patient R/S Maturity/DORR help predict likelihood of a patient helping their family and the staff thrive in an enchanting way through their presence?
Steven S Salisbury, Chief Chaplain, Boston VA Medical Center, Boston, MA
Patients with Religious/Spiritual (R/S) Resources have been shown to fare better in serious hospitalizations than others. Not only in the U.S. but now also seen in Jewish, Muslim and Buddhist patients across the globe. Hall et al (2008) suggested better refinement in the R/S assessment of patients should include theologically-relevant contexts. Previous Spiritual Maturity schema (Fowler 1980) are not useful as they attempt to apply “universally”; also these, use psychosocial and Kohlberg Moral-development stages rather than religiously relevant ones. Prothero argues that development in a Faith is related to the specific goals and exemplars of the major Faith groups and that significant differences exist. This R/S assessment is based on Maturity schemes of the early church fathers (Origen, Augustine, etc.) determined from Apostolic criteria and on the R/S maturity of the great exemplars of the Christian faith, St Paul, St John and Christ.
Method- Using the three non-invariant stages gleaned from these religious Christian writings, we developed a brief 10 item patient R/S assessment with 5 dimensions: Spiritual transformation; Thanksgiving in all circumstances; Fruits of the Spirit; Scriptural Literacy; and Meditation frequency and length. From 2 convenience samples we tested the range: The “Older“group from a 10-person Small Group of a serious Biblically-literate Boston Church, ages 58-82; the “Younger” 6 patient sample was part of a quality improvement study of the Boston VA hospital where chaplains completed a semi-structured patient interview and compared that to the patient’s R/S maturity self-assessment.
Results showed both groups rate very high: God as a source of strength. The younger rate less “religious” but spiritual. The older group was more scripture-literate but the young group meditated on Scripture longer. Fruits of the Spirit appear higher in those who daily meditated on Scripture longer.
Discussion. This R/S Maturity/Depth of Religious Resource (DORR) assessment in pilot testing appears to separate different aspects of faith maturity and Religious resource in committed Christians. It avoids Denominational specificity, applying to all US majority (Christian) faiths.
Significance: This is a very early effort to look at an assessment for Religiously relevant spiritual maturity/depth of religious resource in US patients. More work will be done in different regions of the US. For Chaplains and Pastoral Care workers knowing in more depth about the patient’s religious resource assists in recognizing quickly where the best access points maybe for spiritual support. Especially in Palliative Care and Hospice where the hope of full physical cure is unlikely, knowledge of the patient’s R/S Maturity/DORR allows robust spiritual support earlier.
Relation to Divine Enchantment: If we define "Divine Enchantment” operationally as "To change the natural behavior or expectations through positive Spiritual power or positive apparent supernatural intervention”, then Paul’s driving the evil spirits from the irritating soothsayer girl in Philippi would qualify as a Divine Enchantment, as well as Moses parting the Red Sea or Jesus’ miracles. The question is outstanding: Will Patient R/S Maturity/DORR help predict likelihood of a patient helping their family and the staff thrive in an enchanting way through their presence?