Defense Date

2008

Document Type

Thesis

Degree Name

Master of Public Health

Department

Epidemiology & Community Health

First Advisor

Dr. Elizabeth Eustis Turf

Abstract

Background: The US health care system faces increased costs from end of life (EOL) care. The intensive approach to EOL treatment with greater use of procedures in ICUs has led to decedent spending six times greater than that of survivors in the hospital. Experts in ICU and Palliative care fields have called for greater utilization of end of life planning and education. To date, EOL education has been dominated by the technologically driven medical field and the church has been under-utilized. The US population relies on clergy support for many mental health and EOL issues. Clergy report feeling uncomfortable in their ability to provide EOL care and desire more education. Research in clergy preparation for EOL education is relatively small and no studies in Virginia have been completed. Purpose: Document the current state of Richmond, VA, seminary education on EOL issues and document graduating seminarians' desire for more EOL education. Methods: A two-page questionnaire was approved by the VCU IRB and distributed amongst graduating seminarians at the three Richmond Theological Consortium seminaries: Union-PSCE, Baptist Theological Seminary at Richmond, and Virginia Union University Seminary. The first section of the survey evaluated education on EOL issues received while in seminary. Experience with counseling the dying and bereaved along with placement at medical institutions was also evaluated. The second section evaluated the desire for more didactic and practical education. Desire for future Continuing Education Classes was also evaluated along with demographics. SAS was utilized to create frequencies and chi square associations and odds ratios.Results: Overall, 75 surveys were returned, a 35% response rate. Eighty-six percent of respondents stated that pastoral care overall education was covered (missing = 20), while 38.3% stated that medical aspects of dying was covered (missing = 9). Fifty-seven percent had some kind of placement at a medical institution. Sixty-nine percent had experience in an EOL situation. Approximately 75% wanted more education, with practical education and pastoral care predominating. Forty-eight percent desired more theologically-focused EOL continuing education classes. Prior education in preaching sermons and pastoral care of the bereaved was associated with desire for further education in those respective topics, OR = 3.42, 95%CI 1.58, 11.05 and OR = 4.64, 95%CI 1.10, 19.50, respectively. Placement at an institution was associated with desire for more didactic (OR = 3.10, 95%CI 1.03, 9.35) and practical education (OR = 3.89, 95%CI 1.22, 12.35). Experience with counseling the bereaved was associated with a decreased likelihood of wanting more education on how to interact with medical and hospice staff. Demographics were not statistically associated with desire for more education.Conclusions: Several EOL topics do not receive full coverage, specifically self care of the pastor, teaching adults about end of life planning, the medical aspects of end of life, and mobilizing the laity for the care of the dying and bereaved. Placement at an institution or experience was absent in 30-40% of participants. The majority of participants wanted more education. Placement along with previous education was associated with desire for further education. Curriculum change to reflect these findings may benefit in increasing the overall confidence and competence of pastors, increase the ministerial goals of the church, and aid in preparing the public for the end of life, thus decreasing the burden on the health care system.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

June 2008

Included in

Epidemiology Commons

Share

COinS