Chaplaincy in South African government hospitals : a holistic approach to care

Abstract

The consumers of health care (patients) want their religious and spiritual needs to be addressed within the South African Government Hospitals’ (SAGH) settings. Similarly, the providers of health care (doctors, nurses, and other clinical staff in the multi-disciplinary health care teams) are not religious and spiritual experts to respond to these needs in the health care settings. Therefore, this challenge can be resolved by the Department of Health (DoH) by recognising and embracing the health care chaplaincy. On the same vein, the DoH must employ a holistic and patient-centred medical model in its clinical approach to care. This will translate into the patients’ religious and spiritual needs being provided by the religious and spiritual experts in the SAGH settings. This approach ensures that these services are not counter-productive to the medical approach. The other challenge is lack of trained and licenced providers of religious and spiritual care to practice in the clinical setting by employing the methods which are supported by scientific evidence. The purpose of this research is to investigate a need for the possible establishment of chaplaincy in South African Government Hospitals for holistic approach to care which includes the patients’ religious and spiritual dimensions of being, with a view to develop a chaplaincy model that is responsive to the patients’ religious and spiritual needs. The DoH is expected to provide a well-balanced, holistic and patient-centred health care to all the SA citizenry which resonates with the Constitution of the RSA (1996), the NPRC, the WHO (2010) principles, and global health care norms, standards and principles on addressing the patients’ religious and spiritual needs through the practice of the professional health care chaplaincy. The study employed a qualitative research designs of ethnography (participant observation), to gather first-hand information (data) at the research field, that helps to describe how the religious and spiritual needs are addressed in the SAGH settings; phenomenological approach, to gather information (data) that describe the meaning of the lived experiences of the caregivers and patients in the health care settings; and grounded theory, by analysing and interpreting data from research interviews, in order to explore theory of health care chaplaincy in the SAGH settings with a view to understand its phenomenon. The study followed Osmer’s four task of Practical Theological Interpretation (PTI) as a framework and plan to guide the process of the study, and on how to interpret and respond to the challenges of this research project. The researcher was a participant observer at the PHC research field, purposively sampled and conducted semi-structured interviews with 30 research participants at the PHC research field who consented. The researcher employed a computer spreadsheet to capture, code, analyse and interpret data from the research interviews. The researcher applied a collective social scientists’ approaches from Babbie (et al.), Corbin and Strauss, Flick (et al.), Neuman, Osmer, and Ritchie (et al.). The researcher followed the Limpopo Provincial Department of Health’s (LPDoH) approval letter, applied the ethical principles as prescribed by the University of Pretoria’s Research Ethical Committee (REC) in tandem with the World Medical Association Declaration (WMA) of Helsinki (2013), and the PHC protocol from the DoH and Social Development (SD)/ abbreviation DoHSD, during the entire course of this project. The findings of this research show that there is a need for the establishment of chaplaincy in South African Government Hospitals, and that the DoH need to review its health policy and the medical model with a view to embrace a professional chaplaincy, as experts to respond and address the patients’ religious and spiritual dimensions of being in the clinical health care settings, as member of a multi-disciplinary health care team. The findings provide recommendations towards addressing the patients’ religious and spiritual needs to ensure that the SAGH provides the holistic-patient-centred needs.