I was very aware that, this being our first visit to China, we had much to learn about Chinese culture and diversity. We were fascinated and really enjoyed the experience. The warmth of welcome was second to none, and the days spent travelling to Xian and to Beijing were illuminating. A key limitation was our inability to speak Mandarin.
This visit was as much about listening and developing relationships as about me offering insights into a Scottish model of spiritual care.
In preparation for the teaching sessions in Shenyang, I spent some time reflecting on learning processes.
First with reference to Maslow’s hierarchy of needs, I considered the needs of the learner to be comfort, safety, recognition, self esteem and autonomy.
Second, being aware of different learning personalities and styles, I planned my sessions to balance four types of learner:
- Pragmatists –who like to try out ideas and see if they work in practice
- Theorists – who are fascinated by the principles, assumptions, models, systems and theories of spiritual care
- Activists – who are enthusiastic and open minded and keen to take on new ideas; and
- Reflectors – who like to listen then go away and take time to reflect on what was said.
I wanted to ensure that my teaching sessions each day were ‘SMART’ – significant, meaningful, action orientated, rewarding and timely (derived from the person centred care in the NHS).
Aims of the teaching sessions
My hope was that over the six days the students would gain an appreciation of the territory of spiritual care in Scotland.
The first day consisted of spiritual listening, spiritual screening, relational and conversational models of spiritual care. The purpose of this was to begin sharing our stories in preparation for the rest of the sessions.
Day Two dealt with facing loss, grief and bereavement. The purpose of the second days’ sessions was to introduce the students to the latest thinking in loss and bereavement, and in particular to begin to invite the students to share their own story.
The sessions of Day Three included organisational spirituality based on Value Based Reflective Practice (VBRP) and the International Futures Forum (IFF) Kit bag. The aim of this day was to introduce a way of thinking, an attitude towards reflection.
Person centered care was the theme of Day Four, which was centred around some of the practical strategies that I employ in the Ayrshire Hospice, particularly the This is Me documentation.
The fifth day introduced an asset based approach to spiritual care, which had particular relevance for the Rehabilitation team. This approach called for a philosophy of ‘a glass half full’, rather than ‘a glass half empty’, and to begin spiritual care by acknowledging the strengths and resources that people already have.
The final day of the training was in essence a summary of all the days. The discussion that day was grounded in the Ayrshire Hospice spiritual care strategy that works at three levels: individual, organisational and community.
The group of learners who attended on each day included doctors (palliative care and rehabilitation), nurses, volunteer social workers who worked in an HIV project, and psychologists.
There were also visits from local people who had a particular interest, such as a professor of social care, and a Roman Catholic bishop.
What I noticed was that all the people I taught wanted spiritual care that was inclusive for all people and not limited by religion.
The workshop participants appreciated the Envision cards as a communication tool, which empowered them to think through issues in their own terms and in their own language.
I found that the whole group were very participative and engaging and that they valued the integration of theory and practice.
The fact that my wife, Dr Stirling, was with me and contributed to the teaching was added value, as her contribution grounded spiritual care within the wider health care setting.
I noticed that the participants were very keen to examine the evidence base of spiritual care and were open to the concept of doing spiritual care research.
I would be interested to find out how the local team responded to the various elements of my teaching. I am sure some dimensions made more impact than others.
When I returned, I made a number of recommendations. Firstly, I saw the value in strengthening the relationships between a core team of people in Shenyang who are interested in spiritual care and myself. This could be done by regular visits to Shenyang, email contact, or hosting members of the core team in Scotland. We have recently hosted Dr Wang, from the hospital in Shenyang, at Ayrshire hospice. This visit was facilitated by the Scottish Churches China Group.
I advised that spiritual care teaching in Shenyang be expanded to include the rehabilitation and the Caritas project with the Roman Catholic Church, and to consolidate the delivery of spiritual care within the palliative care ward.
Finally, I recommended that a spiritual care research team be established in Shenyang.
Following the visits, I recognised that I need to have a greater understanding of the health care system in China and of the role and place of palliative care within the wider health and social care system. Also, I aim to cultivate a greater awareness of the sources of spiritual well being in China, such as Confucinism, Buddhism etc., and also to learn greater cultural sensitivity.
On a practical note, I would like to conduct an autoethnographic research study on spiritual care in China, and to start work on a spiritual care resource for use in China.