What are the benefits of Pastoral Care to hospital patients and aged care residents?
30 Jan 2019
This article originally appeared in Health Matters issue 88, published Summer 2018/2019
By Prof Sandra Jones and Dr Chloe Gordon
While we know intuitively and from personal feedback that pastoral care practitioners provide hospital patients and aged care residents with support that enhances their wellbeing, there is surprisingly little research into this important area of care. This evidence is important for several reasons. First, in an era of increasingly limited budgets, healthcare providers need to be able to demonstrate the benefits of care in order to retain and expand funding for the provision of services. Second, this dedicated group of professionals need to be recognised and acknowledged for the contribution they make to the wellbeing of the community. Third, increasing our understanding of who benefits, and how they benefit, will enable us to continue to improve the provision of pastoral care.
Australian Catholic University partnered with six healthcare organisations (hospitals and residential aged care facilities), to collect data to better understand and demonstrate the benefits of pastoral care for Australian hospital patients and aged care residents. The six organisations - BaptCare, Cabrini, Mercy Health, Southern Cross Care Vic, St John of God, and Villa Maria Catholic Homes -were located in Victoria, New South Wales, Queensland and Western Australia. The project, which commenced in 2017, was a truly collaborative effort. Pastoral care managers and practitioners and ACU academics co-designed the research protocol and the questionnaire used in the project; staff and volunteers from each of the organisations were involved in the distribution and collection of the questionnaires; and project champions at each organisation ensured the smooth running of the project.
Across the six organisations, seven hundred and twenty-eight hospital patients and aged care residents participated in the study. The 575 aged care residents who participated were from 41 residential aged care sites, and the 153 patients who participated had received care from 11 different hospital sites. The majority of participants were female (74%), secondary school educated (65%), and aged 80 and above (58%). Forty-four percent identified as Catholic and 17% as Anglican.
What did we find?
Participants were asked five questions about the quality of care they received from the pastoral care practitioner. The overwhelming majority (more than 85%) reported that during their meetings with the pastoral practitioner they were listened to, were able to talk about what was on their mind, had their situation understood, and had their faith/beliefs valued. Ninety-nine percent reported that they were treated with dignity and respect.
Participants were asked five questions about the benefits of the pastoral care they received, using the items from the Scottish Patient Reported Outcome Measure (PROM). Overall, more than three-quarters of the participants reported that they benefited from their meeting with the pastoral care practitioner 'often' or 'all of the 'time'. Examining the individual questions, similar proportions reported that 'often' or 'all of the time' after meeting with the pastoral care practitioner they were able to be honest with themselves about how they were really feeling, had a positive outlook on their situation, felt in control of their life, felt peaceful and did not feel anxious.
Through open-ended questions, participants shared their thoughts aboutthe most helpful aspect of their experience with the pastoral care practitioner. Three overarching and closely connected themes were; identified: personal qualities of the pastoral care practitioner; pastoral care practitioner met specific needs; and positive impacts on their emotional wellbeing.
Personal qualities of the pastoral care practitioner
The caring, supportive and empathetic presence of the pastoral care practitioners was a common theme amongst the participants:
"...The pastoral care person was warm and engaging and sensitive to my capacity to engage..."
"The compassion and understanding and empathy is what stood out for me. It created a safe and secure place to share what I was experiencing honestly."
Pastoral care practitioner met specific needs
The participants valued having a range of specific needs met by the pastoral care practioner, including their spiritual needs, friendship/social support needs, and practical needs:
"I enjoy prayer group - it keeps me in touch with the Lord. She enables me to have a link with church."
"As a parent in SCN it can be very isolatiflg. Having that friendly face really helped on some really hard days."
"[She] is always helpful and approachable and brings me communion if I am unable to attend daily mass. Never a trouble to her."
Positive impact on the participant
Participants frequently commented on the value of feeling listened'to and being able to freely express their emotions; and feeling encouraged and uplifted by their time with the pastoral care practitioner:
"I am not religious, I do not go to church but it is good that [she] will come and listen to me. One day when my daughter was very ill I asked [her] to pray with me and it made me feel at peace and positive."
"Pastoral carer was very calm, cheerful and lovely to talk to. Her relaxed attitude made it easy to talk about a range of issues. Her insights and suggestions were very valuable."
"She uplifts me. I am always happy when we talk. She gives me a sense of worth -that somebody cares."
In terms of opportunities for improvement, the majority of participants noted that there was no aspect that they found unhelpful when meeting with the pastoral care practitioner. A number of participants instead took the opporunity to express that their experiences with the pastoral care practitioner were completely positive. A very small number of participants (six) noted specific religious aspects of the service that they found unhelpful, for example: "I am Anglican but sometimes taken as Catholic."
Do people have to be religious to benefit from pastoral care?
In relation to the perceived quality of care, there were no significant differences between those that did and those that did not identify as religious and/or spiritual in feeling that they were listened to, that they were able to talk about what was on their mind, that they had their situation understood, or that they were treated with dignity and respect. Those participants who identified as both religious and spiritual were significantly more likely to feel that their faiths/beliefs were valued than participants who identified as neither religious nor spiritual. This difference may be because of
the shared religion/spirituality of the practitioners and participants. The majority of pastoral care practitioners in this study's sample had a Catholic affiliation, and close to half of the participants identified as Catholic.
ln relation to the perceived benefits of care, there were no significant differences between those that did and those that did not identify as religious and/or spiritual in being able to be honest with themselves about how they were really feeling and in (not) feeling anxious. Participants who identified as religious and/or spiritual were more likely to report having a positive outlook on their situation, feeling in control of their life, and feeling a sense of peace. These results are not surprising given that several studies have reported a positive correlation between religious practices and indicators of psychological well-being, including life satisfaction, happiness, positive affect, and higher morale.
What does it mean, and where to now?
The results demonstrate that participants perceive considerable benefits from engaging with a pastoral care practitioner. Participants also perceive the quality of care that they receive to be high and characterised by empathy, care, dignity and respect. As aptly stated by Dr Brene Brown:
"We are hardwired to connect with others, it's what gives purpose and meaning to our lives, and without it there is suffering." Brene Brown.
Equally importantly, the study itself demonstrates the significant advances to knowledge that can be gained when multiple organisations collaborate to answer the big questions that face us in the provision of healthcare. The quality of the study was underpinned by deep and meaningful engagement of the university research team with the individuals and organisations who provide this important, but often undervalued, aspect of health and aged care. The value of the findings is enhanced by the multi organisation dataset, enabling us to state with confidence that these very real benefits of pastoral care are not limited to a single organisation or a single context.
Catholic Healthcare runs a Pastoral Care Service staffed by dedicated pastoral care coordinators. To find out more call us on 1800 225 474.