Amputation: A case study in institutional culture of the treatment of limb loss.

摘要

The study began as a pilot project to develop a spiritual program of clinical practice in rehabilitative medicine for Chaplains in the Department of Veterans Affairs. I coordinated with the interdisciplinary medical staff of the rehabilitative unit of the Community Living Center at the Lyons Campus of the New Jersey Heath Care System (NJHCS) to form a multidisciplinary Advisory Council. Together, the team proposed a research project to implement an evidence-based spiritual intervention of meditation into the ninety-day rehabilitation program at the Department of Veterans Affairs, New Jersey Health Care System, and the Nursing Home Care Unit at the Lyons Campus.;As primary investigator, I pursued the requirements for credentialing and approval from the Institutional Review Board of the New Jersey Health Care System (NJHCS), which was granted May 2007. The Research and Development Committee of VANJHCS approved the proposal January 2008. However, because of a low base patient count which was not statistically significant, the research project was deferred and a multi-site cohort study was recommended.;Faculty advisors from Drew University recommended that I reframe the project into a case study in the institutional cultures of medicine and spirituality in professional healthcare and relate the findings and conclusions.;In addition, the Director of Occupational Therapy and I co-facilitated a "Loss of Limb Support Group" which met for 16 months during the process of presenting the original proposal. This is a report of that "group experience" and how the group utilized spiritual and religious resources as a strategy for coping.;There are no planned spiritual programs of clinical practice within the Chaplain Services of the Department of Veterans Affairs for persons who experience amputation and are in the rehabilitative process. A curriculum review reveals there are no educational programs, training, or curricula available for physical or occupational therapists regarding spirituality and introducing spirituality into the rehabilitative process in the civilian modern healthcare field.;The startling omission of spirituality within rehabilitation captures a smaller account of a larger problem demonstrating the tensions between science and religion. The manifestation of the duality is lived out in many hospitals, clinics, nursing homes, and among the professional interdisciplinary medical teams. In this paper, I offer my voice to amplify the absence of any spiritual practice within the rehabilitative process.;I suggest I found that spirituality has been "amputated" from whole person healthcare. Historically, ethically, philosophically, morally and Biblically, I call the medical profession to return to its history, and bring new life to the old form of medicine, which is compassionate, competent and all inclusive, bio-psychosocial whole person health care. My conclusion is rehabilitation both for the patient in the Medical Model, and the restoration of spirituality into the rehabilitation process in professional healthcare practice today.