Validity, Reliability, and Clinical Usefulness of the PC-6 Model for Spiritual Assessment in Palliative Care.

Résumé

CONTEXT: Spiritual care is a core component of quality palliative care (PC), yet a validated tool for spiritual assessment in PC has been lacking. The PC-6, a six-theme model for assessing and quantifying spiritual concerns in PC patients, aims to fill this gap.OBJECTIVES: This study tested the validity, reliability, and clinical usefulness of the PC-6.METHODS: End-of-life patients (≥ 18 years) in inpatient, outpatient, or home care settings of three Midwest medical centers were interviewed by a chaplain trained in using the PC-6. Patients completed pre and postinterview self-report measures. For validity, PC-6 scores were compared (Spearman correlation) with Spiritual Pain, Religious/Spiritual Struggles Scale (RSS), and QUAL-E (Preparation and Completion subscales). Inter-rater and intra-rater reliability were tested using the iccCount coefficient.RESULTS: The study enrolled 110 patients (mean age 64.95, SD 15.01) who were majority female (60.9%) and White (80%), with 56.4% having a primary cancer diagnosis. Overall, 43% had moderate or severe spiritual concerns, 15% in two or more themes. PC-6 scores correlated significantly with Spiritual Pain (.217, P < 0.05), RSS (.394, P < 0.001), and QUAL-E Preparation and Completion subscales (-0.249 and -0.288, respectively, both P < 0.01). Reliability testing found inter-rater reliability (n = 57) of 0.402 (95% CI 0.111, 0.629) and intra-rater reliability (n = 54) of 0.593 (95% CI 0.019, 0.873). Most patients found the interview helpful (90%) and the duration appropriate (91%).CONCLUSION: The PC-6 is a valid, reliable, and patient-valued tool for spiritual assessment in PC. Further research is needed to explore its interdisciplinary use and validity across diverse subgroups.