Nourishing the soul
Pediatric center invites patients, families to explore spiritual aspects of care

By Melissa Gaskill
January 22, 2001
Photo: M.D. Anderson Cancer Center

One hour each week, a corner of the pediatric floor in the Albert B. and Margaret M. Alkek Hospital of Houston’s M.D. Anderson Cancer Center becomes the Pediatric Spirituality Center, where patients and families come together for an interfaith prayer service. According to the chaplains who spearheaded the project, the service is intended to bring the healing power of prayer to families and patients.

Fulfilling family needs
"Families were asking for something like this. Parents don’t want to be far from their children," said Chaplain Jose Cedillo, who conducts the services, consisting of mostly meditation, silent prayer and music. "We feel like the children in the hospital are in a special category, and wanted to be in an environment where people could relate to their struggle, with other parents of children with cancer."

The spirituality center is set up with movable walls and a stained-glass backdrop designed by a pediatric art teacher.

Volunteers go door-to-door to inform inpatient families of the service and post notices in the outpatient clinic. Parents are good about passing the word around, said Cedillo, who expects attendance to increase as more people hear about the services.

"Spiritual and emotional aspects of care are very important, especially in a cancer hospital," Mary Choroszy, MSN, a pediatric nurse practitioner at M.D. Anderson said. "They may come to the forefront more here than in other times in your life."

Proof positive
According to the Robert Wood Johnson Foundation, the social support of religious involvement shared in a community buffers stress and enhances coping mechanisms, aiding in recovery from illness. An analysis of 10 years of the Journal of Family Practice by the U.S. Office of Technology Assessment found that 83 percent of the studies on spirituality showed a positive effect on physical health.

Barbara Damron, Ph.D., RN, an educational psychologist with 20 years’ experience as an oncology clinical nurse specialist, agreed.

"From a nursing perspective, spirituality plays a pivotal part in cancer care," Damron said. "The disease affects mind, body and soul. You have to think about life-and-death questions with cancer. It is almost impossible to separate the disease from the person’s spiritual core, whatever that core may be."

Because nurses are in constant contact with patients, Choroszy said, they often become the focal point for spiritual care. "I try to ascertain if someone is part of a religion or has any relationship with one and work with that."

A report in The Journal of Christian Nursing noted that children’s spiritual needs are closely related to their physical, psychosocial and developmental needs, and therefore should be incorporated into the plan of care. For example, children may need help understanding that illness and hospitalization are not punishments for bad behavior, or dealing with feelings of anger or guilt about the illness.

Cindy Adanene, RN, a pediatric nurse at Minneapolis Children’s Hospital, added that addressing a person’s faith is part of taking care of the family, which is particularly important in pediatrics. "Nurses need to be aware of the spiritual needs, and feel comfortable addressing them. Sometimes by the time the chaplain gets there, the need has passed," she said.

Need for training
However, Damron said, nurses get little training in this area. "An organized service, with some training, is a good way to help nurses be effective in this area. We need to meet the patient where he or she is, including going to where the patient is physically."

Mary Thompson, MSN, RN, national director of the Nurses Christian Fellowship, teaches nurses how to do spiritual assessments, which cover the patient’s concept of God, sources of hope and strength, religious practices, and thoughts about the relationship between beliefs and health.

"If a child is used to saying bedtime prayers or mealtime prayers, for example, it would be important to maintain that while the child was hospitalized," she said.

More hospitals, M.D. Anderson among them, are including these assessments as part of the admission process.

To Choroszy, the assessment is an integral part of assessing a person’s needs. "We always knew it was important, but didn’t always have an organized tool to help get those needs attended to. It is important to work around the religious needs of the entire family."

In a crisis such as illness, families look for hope in a variety of ways, Thompson said. "The role of spirituality is an important part of caring for people, and nurses need to recognize that. Any avenue of providing for and acknowledging those needs, whether through a service or something else, would be very helpful."

Caregivers should not assume that a lack of identified religious affiliation means that a family is not interested in spiritual issues. "I think people turn to faith in situations of serious illness whether it has been a part of their life before or not," Adanene said. "I haven’t had many people refuse spiritual care."

Damron added that talking to patients about their spiritual needs opens the door.

"It gives the patient permission to bring it up, and most patients take it from there and let us know what they need and want. Fellowship and communion with other people are an important – and effective – part of the process. There is some good science to back that up."

A permanent pediatric spirituality center is part of long-term plans at M.D. Anderson, but Cedillo points out that space is a precious commodity at the hospital.

"I hope that it will grow and people will see the need for the space."

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