BACKGROUND: High quality care of pediatric neuro-oncology patients requires a whole person approach. Attending to spiritual needs is a crucial aspect of this. Understanding what the chaplain does precedes appropriate utilization and integration of spiritual care into clinical practice. To our knowledge, this research represents the first explicit description of what the chaplain does in pediatric oncology. METHODS: We conducted a qualitative analysis of chaplain chart notes on the pediatric oncology service of a large children’s hospital. We selected 30 patients for thematic analysis of chaplain notes. The selection included a representative sample of patients who varied as to these factors: age, tumor type, prognosis, and mortality. Thematic analysis was applied to all chaplain notes from these 30 patients to derive a code book. The data in the code book was further explored to look for overarching themes. RESULTS: From the 166 pediatric patients diagnosed with cancer in the study period, 112 had at least one chaplain note. From the 30 patients selected, 230 chaplain encounters were documented. Four major themes emerged: 1. A rich description of the psychosocial and spiritual dimensions of the patient and family; 2. Deep, empathic listening as both an assessment tool and intervention; 3. Both universal and age specific interventions; and 4. A longitudinal therapeutic relationship. DISCUSSION: The chaplains’ observations are an important contribution to high quality whole person care. More prospective research is needed to test integrated chaplain interventions in a neuro-oncology team setting.
