A Palliative Care Framework for Unmet Spiritual Needs of Patients with ALS (GP101).

1. Utilizing case studies informed by qualitative data from recorded chaplain-patient encounters, participants will be able to articulate spiritual needs and resources impacting care plans for patients with ALS receiving palliative care. 2. Utilizing preliminary data from validated symptom assessment measures, participants will self-report components for collaboration with interprofessional team members (e.g. chaplains) in spiritually-informed care's relationship with quality of life. This project assesses spiritual well-being amongst palliative care outpatients with ALS using the evidenced-based chaplain-led Spiritual Assessment and Intervention (AIM) Model. Spirituality may be a method of coping for patients, but needs related to this are not routinely addressed in clinic, and the role of a chaplain in outpatient settings has been poorly defined. Data describing potential effects of spiritual interventions in ALS is limited. 1) To describe the spiritual well-being, dignity, and symptoms among outpatients with ALS using Spiritual AIM, 2) To assess the feasibility of use of Spiritual AIM with ALS patients in outpatient palliative care. Audio-recorded interviews were analyzed for themes. Pre- and post-study questionnaires assessed symptoms, QOL, and spiritual wellbeing. Quantitative analysis of validated tools included Modified Medical Research Council Dyspnea Scale (MMRC), The Patient Health Questionnaire-2 (PHQ-2), Edmonton Symptom Assessment System (ESAS-R), The Functional Assessment of Chronic Illness Therapy- Spiritual Well-Being 12 Item Scale (FACIT-Sp-12), and Spiritual Wellbeing Assessment (SWB). We recruited 10 patients with ALS, of whom five completed three one-hour chaplain visits utilizing the Spiritual AIM Model over four months. Quantitative analyses indicated themes of isolation, loss of independence, depression, and vulnerability. Despite these, several patients expressed finding gratitude in the midst of their disease. Spiritual needs indicated existential distress as evidenced by the Spiritual AIM Model, with a need to identify a meaning in disease and a direction or purpose. ALS patients described unmet spiritual needs and themes of distress, including isolation, loss of independence, and vulnerability. The Spiritual AIM Model serves to identify patients' spiritual needs and provide a framework for the interprofessional care team to target these, providing a method for further advancement of ALS care. Several themes for future study emerged including the role of meaning, gratitude and sense of purpose as spiritual resources to cope with existential suffering. This study also highlights challenges of recruitment and retention given severity of illness and symptom burden for this population. [ABSTRACT FROM AUTHOR]