Journal of palliative medicine · 2026
Describing the Prevalence and Correlates of Spiritual Concerns Using the PC-6 Spiritual Assessment with Palliative Care Patients Near the End of Life.
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Byrne-Martelli Sarah, Palmer Patricia K, Cole Burl, Cullen Ian, Drennan Steven B, Harry Melissa L, Labuschagne Dirk, Peñate Edward, Ulrich Kathryn A, Fitchett George
Аннотация
BACKGROUND: Religious and spiritual (R/S) concerns are common among patients with serious illness. Attending to the R/S concerns of patients is a core component of quality palliative care.
OBJECTIVES: Our aim was to describe the prevalence and demographic, medical, and religious correlates of R/S concerns in patients receiving palliative care.
DESIGN: Multisite, cross-sectional study.
SETTING/SUBJECTS: Adult patients in the United States receiving inpatient or outpatient palliative care.
METHODS: Chaplains completed the PC-6, an interview-based spiritual assessment, as part of routine palliative care practice. The PC-6 evaluates six domains of R/S concern: relationships, meaning, legacy, dying, religious/spiritual struggle, and treatment decision-related concerns. Demographic, clinical, and religious affiliation data were obtained from the medical record.
RESULTS: A total of 172 palliative care patients were included. Fifty percent were assessed to have moderate or severe concerns in at least one of six spiritual domains, and 17% had concerns in two or more domains. The most prevalent concerns involved relationships (19.2%), dying (14.5%), meaning (14.0%), and legacy (11.0%). In multivariable analyses, patients with no religious affiliation were more than three times more likely to have moderate or severe spiritual concerns compared to those with a Protestant affiliation. Demographic characteristics and primary diagnosis were not associated with the presence of spiritual concerns.
CONCLUSIONS: Moderate to severe spiritual concerns are prevalent among patients receiving palliative care, including among those without a religious affiliation. Integrating spiritual assessment into palliative care workflows may facilitate specialty spiritual care and comprehensive attention to patients' multidimensional suffering.
OBJECTIVES: Our aim was to describe the prevalence and demographic, medical, and religious correlates of R/S concerns in patients receiving palliative care.
DESIGN: Multisite, cross-sectional study.
SETTING/SUBJECTS: Adult patients in the United States receiving inpatient or outpatient palliative care.
METHODS: Chaplains completed the PC-6, an interview-based spiritual assessment, as part of routine palliative care practice. The PC-6 evaluates six domains of R/S concern: relationships, meaning, legacy, dying, religious/spiritual struggle, and treatment decision-related concerns. Demographic, clinical, and religious affiliation data were obtained from the medical record.
RESULTS: A total of 172 palliative care patients were included. Fifty percent were assessed to have moderate or severe concerns in at least one of six spiritual domains, and 17% had concerns in two or more domains. The most prevalent concerns involved relationships (19.2%), dying (14.5%), meaning (14.0%), and legacy (11.0%). In multivariable analyses, patients with no religious affiliation were more than three times more likely to have moderate or severe spiritual concerns compared to those with a Protestant affiliation. Demographic characteristics and primary diagnosis were not associated with the presence of spiritual concerns.
CONCLUSIONS: Moderate to severe spiritual concerns are prevalent among patients receiving palliative care, including among those without a religious affiliation. Integrating spiritual assessment into palliative care workflows may facilitate specialty spiritual care and comprehensive attention to patients' multidimensional suffering.