Questions Posed to Hospital Chaplains by Palliative Care Patients

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Abstract
Context: Questions of vital importance are actualized when facing one's own death. Studies on patient need for a hospital chaplaincy as an integral part of hospital care are lacking. Objective: To categorize the three most important questions patients pose to hospital chaplains at the end of life and to assess the degree to which hospital staff should be able to handle them. Design and Setting: A Swedish national survey using an open-ended questionnaire and content analysis. Participants: One hundred seventy-two Swedish hospital chaplains (national coverage, 74% response rate). Categories developed from open-ended questions. Categories of questions posed to hospital chaplains. Results: Five main categories were identified: meaning (34%); death and dying (21%); pain and illness (13%); relationships (15%); and religious issues (8%). Questions of a general existential nature concerned with meaning-related issues and with death and dying were frequently the primary issue. Many questions dealt with pain, fear of suffocation, and illness in general (i.e., questions that the palliative team should be able to handle). Only 8% of the issues were explicitly religious and these were often third-hand choices. Conclusion: The role of the hospital chaplaincy has changed. Today it entails specialized competence and is needed in existential discussions with different patients in crisis, regardless of their personal faith or lack of faith. Nonetheless, physicians and other staff members should be able to handle many of the questions that are of a more general/medical character.