Background: Attending to the religious/spiritual (R/S) concerns of patients is a core component of palliative care. A primary responsibility of the chaplain is to conduct a thorough assessment of palliative care patients' R/S needs and resources. Problems with current approaches to spiritual assessment in all clinical contexts, including palliative care, include limited evidence for their validity, reliability, or clinical usefulness; narrative content; and lack of clinical specificity. Objectives: The aim of our work was to develop an evidence-based, quantifiable model for the assessment of unmet spiritual concerns of palliative care patients near the end of life. Design: The PC-7 model was developed by a team of chaplains working in palliative care. Phase 1 used literature in the field and the chaplains' clinical practice to identify key concerns in the spiritual care of palliative care patients. Phase 2 focused on developing indicators of those concerns and reliability in the chaplains' rating of them. Results: Key concerns in the model include the following. Need for meaning in the face of suffering; need for integrity, a legacy; concerns about relationships; concern or fear about dying or death; issues related to treatment decision making; R/S struggle; and other concerns. An approach to scoring the patients' degree of unmet spiritual concerns was adapted from the literature. Assessing cases from the chaplains' practice led to high levels of agreement (reliability). Conclusion: Using the PC-7 model, chaplains can describe and quantify the key spiritual concerns of palliative care patients. Further research is needed to test its validity, reliability, and clinical usefulness.

Apply selected clinical assessment tools for palliative care and hospice quality improvement or research. Objectives. Palliative care assessment is holistic, covering a broad array of domains important to comfort, quality of life and supportive needs for patients with serious illness and their caregivers. Clinical assessments may be enhanced with validated measurement instruments, yet finding those that are ready for application in clinical quality improvement or in a research project is a ''needle in a haystack'' problem. Session attendees will learn: 1) to appraise clinical assessment tools using freely available Palliative Care Research Cooperative resources, and 2) to apply selected clinical assessment tools for palliative care and hospice quality improvement or research.