Developing the H-5, a Quantifiable Spiritual Assessment for Hospice Care

ObjectiveTo develop a quantifiable spiritual assessment model that identifies spiritual concerns in patients and families receiving hospice care.MethodA survey of interdisciplinary colleagues was conducted at a large hospice program to discover strengths and weaknesses of spiritual assessment documentation. Taking these concerns into account, a pilot group of hospice chaplains (n = 6) adapted the existing PC-7 spiritual assessment for use with hospice patients receiving end of life care. The resulting H-5 assessment model was then utilized by a larger chaplain team (n = 15) which provided feedback via individual interviews at 2 months and 1 year.ResultsThe H-5 assessment model employs 5 spiritual concern themes from the PC-7 model, with added indicators to identify a patient's perceived level of support, relational resources and ability/willingness to access resources. The H-5 broadens the assessment scope to include both patient and family concerns. Additionally, the H-5 includes a scoring rubric to determine overall severity of spiritual distress. Chaplains trained to use the H-5 reported an increase in the quality and consistency of the care they provided, as well as perceived improvement in interdisciplinary rapport and communication.SignificanceHospice agencies are required to complete comprehensive assessments, including spiritual concerns, as well as provide spiritual counseling to patients and families. There is no standard for assessing spiritual care needs in hospice clinical contexts. This report presents the H-5 assessment model, which identifies the spiritual concerns of hospice patients and their families.