humanities and the arts

Interdisciplinary model could help to give patients existential support


According to the current professional standard in Estonia – clinical pastoral care is professional existential and religious support that is offered in compliance with the needs of a supported person and by a specialist. It is part of the palliative care which ranges between symptom alleviation, quality of life improvement, care in the final months of life, care in the case of complex and serious illnesses, care for the patients who are not responsive to the curative treatment, and also specifically as a subspecialty of oncology.

So, clinical pastoral care is something that anyone from us or from our families could need at some point during life, but at the moment, the service is inconsistent. The specialists are involved in some hospitals where they belong to the palliative care unit or department, or they visit hospital occasionally, but most Estonian hospitals do not provide a pastoral care service at all.

Recently, Liidia Meel (PhD) defended her thesis[1] about an interdisciplinary team-based pastoral care model at the University of Tartu. The purpose of this thesis is to improve and make the pastoral health care more effective. “With this thesis, I hope to uphold the view that people should not be deprived or feel isolated from important parts of their lives. This may easily happen to the hospital’s inpatients if they cannot follow their usual religious/spiritual life anymore”, she mentioned.

Professional insight included

Meel created an interdisciplinary team-based pastoral care model given in flexible guidelines that would be adaptable in different Estonian healthcare institutions. To ensure this, the model takes into account the Estonian sociocultural and institutional background.

What is more, Meel gathered the professionals’ insight from Tartu University Hospital, North-Estonian Medical Centre and EELC Tallinn Diaconic Hospital, which all have included a pastoral care service each in different organizational forms and adjusted the model according to the insight provided by professionals, so that the final version of the model could be implemented in the real-life healthcare system.

As such, the model is intended to be useful for involving pastoral care in these institutions which are planning to include pastoral care in their service provision, but are not certain about how, and enhancing interdisciplinary teamwork in the pastoral care provision of these institutions which have already included pastoral caregivers as staff members.

“Different fields of knowledge help to inform the pastoral care and to respond to different needs of the patients. What is more – different aspects help to understand the interconnection of the needs,” explained Meel.

More towards life

She put the greatest emphasis on the support of palliative care patients, but on some points, the focus of pastoral health care is wider. “To also cover these cases when the patient’s life is not in danger, but the need for help is remarkable. These cases also require an interdisciplinary approach for noticing, understanding and meeting the patients’ different needs, as well as the cases of palliative care”, she noted, and added that the research reflected that pastoral care in Estonian hospitals is often related especially to the end of life care, and not so much seen as supporting curative care.

Although pastoral care service provision is greatly dictated by financing issues (not being financed by the state budget’s health insurance funds), the interdisciplinary team-based pastoral care model is one step towards more holistic healthcare care in Estonia, said Meel.

“Limited resources prevent involving pastoral care in many cases. We must find and invent the best ways to spread the ‘butter knob’ of limited pastoral care resource as carefully as possible”, she mentioned. The model created in the thesis offers both: flexibility that respects the differences between institutions and departments, and information that is already extracted from the fieldwork and from the theoretical background concerning different aspects of human being.

Written by Marii Kangur

This article was funded by the European Regional Development Fund through Estonian Research Council.


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