Zusammenfassung: Hintergrund: In diesem Beitrag wird erstmals im deutschen Sprachraum ein Fragebogen zur Erfassung von Spiritual Care-Kompetenzen (SCCQ) validiert. Fragestellung: Welche Reliabilität und welche faktorielle Struktur hat der SCCQ? Methode: Querschnittserhebung (N=717, 74 % Frauen, 65 % katholisch). Statistische Methoden: Interne Konsistenz (Cronbachs α), explorative Faktorenanalyse (EFA), Strukturgleichungsmodellierung (SEM). Ergebnisse: Die EFA erbringt eine 7-faktorielle Struktur des SCCQ mit 26 Items: (1) Wahrnehmungs-Kompetenz; 2) Team-Spirit; 3) Dokumentations-Kompetenz; 4) Selbsterfahrung und proaktive Öffnung; 5) Wissen über andere Religionen; 6) Gesprächsführungs-Kompetenz; 7) proaktive Empowerment-Kompetenz. Cronbachs α der Skalen reicht von .73 bis .86. Die SEM bestätigt das Modell (cfi = 0.96, tli = 0.95, rmsea = 0.04, srmr = 0.05). Die „Gesprächsführungs-Kompetenz“ wird als am stärksten ausgeprägt eingeschätzt, die „Dokumentations-Kompetenz“ am geringsten. Keine wesentlichen Geschlechts-assoziierten, jedoch Alters-assoziierte Unterschiede. Schlussfolgerung: Der SCCQ eignet sich zur Erfassung von strukturellen und individuellen Förderungsbedarfen und zur Evaluierung von Trainingsmaßnahmen.

Modern healthcare research has only in recent years investigated the impact of health care workers’ religious and other moral values on medical practice, interaction with patients, and ethically complex decision-making. Thus far, no international data exist on the way such values vary across different countries. We therefore established the NERSH International Collaboration on Values in Medicine with datasets on physician religious characteristics and values based on the same survey instrument. The present article provides (a) an overview of the development of the original and optimized survey instruments, (b) an overview of the content of the NERSH data pool at this stage and (c) a brief review of insights gained from articles published with the questionnaire. The questionnaire was developed in 2002, after extensive pretesting in the United States and subsequently translated from English into other languages using forward-backward translations with Face Validations. In 2013, representatives of several national research groups came together and worked at optimizing the survey instrument for future use on the basis of the existing datasets. Research groups were identified through personal contacts with researchers requesting to use the instrument, as well as through two literature searches. Data were assembled in Stata and synchronized for their comparability using a matched intersection design based on the items in the original questionnaire. With a few optimizations and added modules appropriate for cultures more secular than that of the United States, the survey instrument holds promise as a tool for future comparative analyses. The pool at this stage consists of data from eleven studies conducted by research teams in nine different countries over six continents with responses from more than 6000 health professionals. Inspection of data between groups suggests large differences in religious and other moral values across nations and cultures, and that these values account for differences in health professional’s clinical practices.

Strategies to improve the care of elderly, multimorbid patients frequently focus on implementing evidence-based knowledge by structured assessments and standardization of care. In Germany, disease management programs (DMPs), for example, are run by general practitioners (GPs) for this purpose. While the importance of such measures is undeniable, there is a risk of ignoring other dimensions of care which are essential, especially for elderly patients: their spiritual needs and personal resources, loneliness and social integration, and self-care (i.e., the ability of patients to do something on their own except taking medications to increase their well-being). The aim of this study is to explore whether combining DMPs with interventions to address these dimensions is feasible and has any impact on relevant outcomes in elderly patients with polypharmacy. An explorative, cluster-randomized controlled trial with general practices as the unit of randomization will be conducted and accompanied by a process evaluation. Patients aged 70 years or older with at least three chronic conditions receiving at least three medications participating in at least one DMP will be included. The control group will receive DMP as usual. In the intervention group, GPs will conduct a spiritual needs assessment during the routinely planned DMP appointments and explore whether the patient has a need for more social contact or self-care. To enable GPs to react to such needs, several aids will be provided by the study: a) training of GPs in spiritual needs assessment and training of medical assistants in patient counseling regarding self-care and social activity; b) access to a summary of regional social offers for seniors; and c) information leaflets on nonpharmacological interventions (e.g., home remedies) to be applied by patients themselves to reduce frequent symptoms in old age. The primary outcome is health-related self-efficacy (using the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES-6G)). Secondary outcomes are general self-efficacy (using the General Self-Efficacy Scale (GSES)), physical and mental health (using the Short-Form Health Survey (SF-12)), patient activation (using the Patient Activation Measure (PAM)), medication adherence (using the Medication Adherence Report Scale (MARS)), beliefs in medicine (using the Beliefs About Medicines Questionnaire (BMQ)), satisfaction with GP care (using selected items of the European Project on Patient Evaluation of General Practice (EUROPEP)), social contacts (using the 6-item Lubben Social Network Scale (LSNS-6)), and loneliness (using the 11-item De-Jong-Gierveld Loneliness Scale (DJGS-11)). Interviews will be conducted to assess the mechanisms, feasibility, and acceptability of the interventions. If the interventions prove to be effective and feasible, large-scale implementation should be sought and evaluated by a confirmatory design. German Clinical Trials Register (DRKS), DRKS00015696 . Registered on 22 January 2019.

This systematic review synthesises the available evidence regarding the European understanding of workplace spirituality (definitions), the importance of spirituality and religion (evidence) as well as spiritual leadership (meaning and practice) in for-profitorganizations. The search for eligible studies was conducted in OPAC Plus, SCOPUS, Science Direct, JSTOR, EBSCO, and Google Scholar from 2007/01 to 2017/07. Three independent scholars extracted the data. Twenty studies were included (two mixed-methods, eight quantitative, ten qualitative) for the final quality assessment. A study quality assessment and thematic analysis was conducted. This review gives suggestions for study quality improvement and reporting. Thematically, two different approaches to religion and spirituality (R/S) were detected: a) work has a spiritual dimension and b) religious and spiritual orientation as “spiritual capital”. Studies demonstrated positive effect on job satisfaction, health, commitment, company productivity and sustainability; Christian leadership does not address personal religious orientation; the spiritual dimension may lead to a change of perspective; workplace spirituality may exploit people for profit-oriented business goals; non-white Muslims experience discrimination. This systematic review provides robust evidence and findings for evidence-informed policymaking and encourages a more rigorous research in this field of study.

Objective: Teaching about spirituality and health is recommended by the American Association of Medical Colleges and partially implemented in some US medical schools as well as in some faculties of other countries. We systematically surveyed Medical School Associate Deans for Student Affairs (ADSAs) in three German-speaking countries, assessing both projects on and attitudes towards Spiritual Care (SC) and the extent to which it is addressed in undergraduate (UME), graduate (GME), and continuing (CME) medical education (in this article, UME is understood as the complete basic medical education equivalent to college and Medical School. GME refers to the time of residency). Methods: We executed a cross-sectional qualitative complete online-survey, addressing ADSAs of all accredited 46 medical schools in these countries. Anonymized responses could be analyzed from 25 (54.3%). Results: No faculty provides a mandatory course exclusively dedicated to SC. Fourteen medical schools have UME courses or contents on SC, and 9 incorporate SC in mandatory classes addressing other topics. While most of the respondents indicate that spirituality is important for (a) the patients for coping and (b) for health care in general and thus, support the teaching of SC in UME, only half of them indicate a need for an SC curriculum in UME. Even if funding and training support were available, only a few of the respondents would agree to provide more of the sparse curricular time. Conclusion: A majority of the participating medical schools have curricular content on SC, predominantly in UME. However, most of the content is based on voluntary courses. Despite acknowledging its importance to patients, ADSAs and medical teachers are still reflecting on the divergences in patients’ and doctors’ spiritual orientations and its consequences for implementing spirituality into the medical education.