Opportunities of Spiritual Support for Hospital Staff in Estonian Health Care Institutions


  • Liidia Meel Tartu University
  • Indrek Linnuste Tartu University




chaplaincy, holistic care, pastoral care, spiritual support, staff support


The current article aims to give an initial qualitative insight into the opportunities to offer spiritual support for hospital staff in Estonian health care institutions. The article addresses the section of pastoral care and the questions about spirituality and spiritual support in a wider survey conducted during 2015-2016 in 19 Estonian hospitals. The results indicated the medical staff's need for information concerning the spiritual and existential questions; the lack of time, work overload and feeling of psychological discomfort were brought out as hindering the discussions about spiritual/religious or existential topics with the patients. The need to deal with the staff members' feelings emerged together with the patient deaths and mentioned also together with the perceived rigidness of the health care system.

Author Biographies

Liidia Meel, Tartu University

Tartu University, Faculty of Theology, PhD studies (clinical pastoral care)

Indrek Linnuste, Tartu University

Indrek Linnuste is a PhD student of religious studies at the University of Tartu. He also works part-time at the Psychiatric Clinic of Pärnu Hospital, which focuses on helping people with mental disorders using integrative psychiatry


Arshinoff, R. (2011) “When Answers Elude Us: Spiritual Care as a Tool for Healing”. In Caregiver Stress and Staff Support in Illness, Dying and Bereavement, ed. I. Renzenbrink, 178–88. Oxford: Oxford University Press.

Benson, J., and K. Magraith (2005) “Compassion Fatigue and Burnout: The Role of Balint Groups”. Australian Family Physician 34(6): 497–98. https://tinyurl.com/2440-17227

Büssing, A., A. Günther, K. Baumann, E. Frick and C. Jacobs (2013) “Spiritual Dryness as a Measure of a Specific Spiritual Crisis in Catholic Priests: Associations with Symptoms of Burnout and Distress”. Evidence-Based Complementary and Alternative Medicine, Article ID 246797. 246797. http://dx.doi.org/10.1155/2013/246797

Campbell, D. (2013) “Spirituality, Stress, and Retention of Nurses in Critical Care”. Dimensions of Critical Care Nursing 32(2): 78–83. https://doi.org/10.1097/DCC.0b013e31828083a4

Chiang, Y.-C., H.-C. Lee, T.-L. Chu, C.-Y. Han, Y.-C. Hsiao (2016) “The Impact of Nurses’ Spiritual Health on Their Attitudes Toward Spiritual Care, Professional Commitment, and Caring”. Nursing Outlook 64(3): 215-24. https://doi.org/10.1016/j.outlook.2015.11.012

Cunningham, M. M. (1985, expanded edition 1993) “Consultation, Collaboration and Referral”. In Clinical Handbook of Pastoral Counseling, Volume 1, ed. R. J. Wicks, R. D. Parsons and Donald Capps, 162–70. New York: Paulist Press.

Dobson, W., and P. T. P. Wong (2007) “Women Living with HIV: The Role of Meaning and Spirituality”. In Existential and Spiritual Issues in Death Attitudes, ed. A. Tomer, G. T. Eliason and P. T. P. Wong, 173–208. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Dyson, J., M. Cobb and D. Forman (1997) “The Meaning of Spirituality: A Literature Review”. Journal of Advanced Nursing 26: 1183–88. https://doi.org/10.1111/j.1365-2648.1997.tb00811.x

Exline, J. J., and E. Rose (2005) “Religious and Spiritual Struggles”. In Handbook of the Psychology of Religion and Spirituality, ed. R. F. Paloutzian and C. L. Park, 315–30. New York: Guilford.

Exline, J. J. (2014) “Getting Angry at God”. Institute for Faith and Learning at Baylor University. Available at: https://www.baylor.edu/content/services/document.php/235696.pdf

Figley, C. R., ed. (2002) Treating Compassion Fatigue. New York: BrunnerRoutledge.

Grof, S., and C. Grof, eds (1989). Spiritual Emergency: When Personal Transformation Becomes a Crisis. Los Angeles, CA: Tarcher.

Hodge, D. R., and V. E. Horvath (2011) “Spiritual Needs in Health Care Settings: A Qualitative Meta-Synthesis of Clients’ Perspectives”. Social Work 56(4): 306–16. Available at: https://doi.org/10.1093/sw/56.4.306

James, R. K., and B. E. Gilliland (2013 [2008]) Crisis Intervention Strategies. Belmont, CA: Brooks/Cole.

Joinson, C. (1992) “Coping with Compassion Fatigue”. Nursing 22(4): 116–20. https://doi.org/10.1097/00152193-199204000-00035

Koenig, H. G. (2007) Spirituality in Patient Care: Why, How, When, and What. Philadelphia, PA and London: Templeton Foundation Press.

Koenig, H. G., M. E. McCullough and D. B. Larson (2001) Handbook of Religion and Health. Oxford: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780195118667.001.0001

Koenig, H. G., D. King and V. B. Carson (2012) Handbook of Religion and Health, 2nd ed. Oxford: Oxford University Press.

McMillan, K. (2016) “Employee Spiritual Care: Supporting Those Who Care for Others”. Journal of Christian Nursing 33(2): 98–101. https://doi.org/10.1097/CNJ.0000000000000258

McSherry, W., K. Cash and L. Ross (2004) “Meaning of Spirituality: Implications for Nursing Practice”. Journal of Clinical Nursing 13(8): 934–41. https://doi.org/10.1111/j.1365-2702.2004.01006.x

Meel, Liidia (2016a) “Socio-Cultural Aspects of the Development of Contemporary Clinical Pastoral Care in Estonia: A Systematic Review”. Health and Social Care Chaplaincy 4(1): 57–70. https://doi.org/10.1558/hscc.v4i1.28461

—(2017) “Defining the Context for Best Practices: Institutional Setting for Clinical Pastoral Care in Estonia”. Journal of Religion and Health 57(1): 328–32.

Meel, Liidia, and Tõnu Lehtsaar (2017) “Interdisciplinary Team based Pastoral Care: A Potentially Adaptable Model for Estonian Healthcare Institutions”. Occasional Papers on Religion in Eastern Europe 37(3): 1?33.

Miner-Williams, D. (2006) “Putting a Puzzle Together: Making Spirituality Meaningful for Nursing Using an Evolving Theoretical Framework”. Journal of Clinical Nursing 15(7): 811–21. https://doi.org/10.1111/j.1365-2702.2006.01351.x

Moeini, M., T. Momeni, A. Musarezaie and S. Sharifi (2015) “Nurses’ Spiritual Well-Being and their Perspectives on Barriers to Providing Spiritual Care”. Iranian Journal of Critical Care Nursing 8(3): 159–66. Available at: http://inhc.ir/article-%201-725-fa.pdf

O’Connor, M., and C. Fisher (2011) “Exploring the Dynamics of Interdisciplinary Palliative Care Teams in Providing Psychosocial Care: ‘Everybody Thinks that Everybody Can Do It and They Can’t’”. Journal of Palliative Medicine 14(2): 191–96. https://doi.org/10.1089/jpm.2010.0229

Ringvee, R. (2011) Riik ja religioon nõukogudejärgses Eestis 1991–2008 [State and Religion in Post-Soviet Estonia]. Tartu: Tartu University.

Saame, I., A. Reino and M. Vadi (2011) “Organizational Culture Based on the Example of An Estonian Hospital”. Journal of Health Organization and Management 25(5): 526–48. http://dx.doi.org/10.1108/14777261111161879

Sellers, S. C. (2001) “The Spiritual Care Meanings of Adults Residing in the Midwest”. Nursing Science Quarterly 14(3): 239–48. https://doi.org/10.1177/08943180122108355

Tanyi, R. A. (2002) “Towards Clarification of the Meaning of Spirituality”. Journal of Advanced Nursing 39(5): 500–509. https://doi.org/10.1046/j.1365-2648.2002.02315.x

Thompson, E. D. (2015) “Referral, Consultation and Collaboration”. In Understanding Pastoral Counseling, ed. E. A. Maynard and J. L. Snodgrass, 344–71. New York: Springer Publishing Company.

Thompson, N. (2011) “Workplace Well-Being: A Psychological Perspective”. In Caregiver Stress and Staff Support in Illness, Dying and Bereavement, ed. I. Renzenbrink. Oxford: Oxford University Press, 25–37.

Todaro-Franceschi, V. (2013) Compassion Fatigue and Burnout in Nursing. New York: Springer Publishing Company.



How to Cite

Meel, L., & Linnuste, I. (2019). Opportunities of Spiritual Support for Hospital Staff in Estonian Health Care Institutions. Health and Social Care Chaplaincy, 6(2), 144-158. https://doi.org/10.1558/hscc.34970