SpirOnto: Semantically Enhanced

Patient Records for Reflective Learning on Spiritual Care in

Palliative Care

ARTEL Workshop 2013, Paphos, Cyprus

Christine Kunzmann, Traugott Roser, Andreas Schmidt, Tanja

Stiehl

http://spironto.de 2Sep 2013

Motivation

Palliative care is a multi-professional environment Doctors Nurses Chaplains/Spiritual caregivers Social workers

Patient record as „boundary object“ Information store and basis for decision making Foundation for reflection („Supervision“) Gaining evidence and insight into spirtual care

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Reflective practice

Demanding nature of child palliative care

Regular reflective practice in informal group sessions Narratives about individual patients Development of a deep and rich understanding of

their work

At longer time intervals: institutionalized supervision

Sep 2013

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Spiritual care

Sep 2013

Culturally sensitive spiritual care is as important as medical and care in palliative situation

Currently, however, spiritual care is not seen as a systematic approach with observable effects (as medicine or care)

For a basis for a systematic approach, an concept network („ontology“) was created which was derived from existing documentation

Facilitates finding gaps and possibilities for action beyond one‘s own profession

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Ontology development

Ontology developed based on 143 existing patient records (on paper, years 2004-2009)

Qualitative analysis

Formative evaluation of the resulting ontology with staff members with various backgrounds

Sep 2013

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Full ontology

Sep 2013

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Ontology

Facts about a patient or its social environment, demographics, disease/care status, cultural background

Observations that led to the identification of the facts (timestamp and a possibly rich description)

Spiritual concepts that interpret facts, such as eternity and finiteness, eternal love, guilt, purity, powerlessness vs. almightiness, or autonomy context-dependent interpretations

Spiritual interventions are possible spiritual care activities, e.g., support, meaningful silence, pastoral interviews, practical consultancy, or rituals.

Sep 2013

Sep 2013

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The System

Phased development

Summer 2013: First initial prototype developed for Windows Notebooks and Tablets

Intended as a proof of concept for getting feedback Testing planned Further development and larger scale evaluation

planned for 2014

Sep 2013

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Sep 2013

Screenshot

Sep 2013

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Conclusions

Spiritual care is often belittled as lacking evidence of its effectiveness

Development of the ontology has already shown that spiritual care follows a systematic approach. made visible through the general structure of the

ontology: observations/facts, spiritual concepts as interpretations, and spiritual care interventions.

Workshops with physicians, social workers, and carers: can act as a boundary object between the disciplines and can create awareness about spiritual care and its relevance

First prototype with editing capabilities about to be tested, analysis and visualization planned for 2014

Also applicable in related fields, such as elderly care, or care for handicapped people

Sep 2013

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Team

Christine Kunzmann, Pontydysgu, UKkontakt@christine-kunzmann.de 

Traugott Roser, University of Münster, Germanytraugott.roser@uni-muenster.de

Andreas P. Schmidt, Karlsruhe University of Applied Sciences, Germanyandreas_peter.schmidt@hs-karlsruhe.de 

Tanja Stiehl, Center of Pediatric Palliative Care, LMU Munich, Germanytanja.stiehl@med.uni-muenchen.de

Sep 2013