Journal of religion and health
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Randomized Controlled Trial
Treatment of Moral Injury in U.S. Veterans with PTSD Using a Structured Chaplain Intervention.
Moral injury is a complex phenomenon characterized by spiritual, psychological, and moral distress caused by actions or acts of omission inconsistent with an individual's moral and ethical values. We present two cases from an ongoing randomized controlled trial of a spiritually integrated structured intervention delivered by chaplains for individuals suffering from moral injury. ⋯ Participants were asked to complete validated scales assessing symptoms of moral injury and PTSD, including the PTSD Checklist for DSM-5 (PCL-5), Moral Injury Symptom Scale-Military Version Short Form, and Moral Injury Symptom Scale-Military Version Long Form. We report on two Veterans who completed the intervention and demonstrated significant improvement in moral injury and PTSD symptoms.
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Moral injury tends to be conceptualized through an interplay of psychological and religious concerns. Recent qualitative research has begun utilizing chaplains to bolster the understanding of moral injury within veterans. ⋯ Chaplains highlighted how moral injury is a pervasive issue affecting veterans across multiple domains. Clinical implications discussed further.
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This study investigated pain beliefs, pain coping, and spiritual well-being in surgical patients. The study adopted a cross-sectional, descriptive, and correlational research design. The sample consisted of 213 voluntary patients admitted to a surgery clinic between April and November 2019. ⋯ Spiritual well-being was weakly and positively (r = 0.445, p < 0.000) correlated with self-management and moderately and negatively correlated (r = - 0.528, p < 0.000) with helplessness. Participants with higher organic and psychological beliefs had lower spiritual well-being. The results indicate that nurses should evaluate both pain and spiritual well-being in patients.
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One of the many roles a physician provides to their patients is compassion and comfort, which includes tending to any psychological, spiritual, and religious needs the patient has. The goal of this pilot study was to explore whether religious or spiritual values of physicians at an urban academic hospital affect how physicians care for and communicate with their patients, especially when dealing with death, dying, and end-of-life matters. After surveying 111 inpatient physicians at an academic hospital, we found that 92% of physicians are extremely or somewhat comfortable having end-of-life discussions. ⋯ We found no difference between years in practice and comfort discussing religion and spirituality, though we did find that, of the physicians who believe they are comfortable talking to patients about religion or belief systems, most of them had more than five end-of-life patients in the past 12 months. Lastly, referrals to Palliative Care or pastoral services were not impacted by the physician's religious or spiritual beliefs. Future studies can explore how religious beliefs may more subtly influence physicians' interactions with patients, patient satisfaction, and physician well-being and resilience.
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During life challenging times like the present COVID-19 pandemic, the health care worker (HCW) is faced with a number of questions of an existential nature. There is a sense of guilt, anguish, helplessness, uncertainty and powerlessness when one is fighting something on such a powerful scale with limited resources and no definite end in sight. ⋯ The Holy Indian Epic, the Bhagvad Gita has described the moral distress of the warrior Arjuna, during the battle of Kurukshetra and the advice given to him by the Lord Krishna the gist of which can be encapsulated in the form of the four Ds- Detachment, Duty, Doer-ship and Dhyana or meditation. In this article, the authors explore how these concepts may be useful aids to the HCW faced with moral and psychological distress.