The Morrison 4C's Spiritual & Emotional
Self-Assessment
When a person is faced with a health crisis such as cancer it can be a very emotional time for that person and his/her family.
Dr. Morrison has developed the Morrison 4C's Spiritual &
Emotional Self-Assessment - For a Health Crisis and for Cancer. This tool can be used to help evaluate one's emotional and spiritual well-being during a medical crisis.
Morrison 4C’s Spiritual & Emotional Self-Assessment background notes [short form, non-scientific].
Medical doctors, social workers, nurses, social workers, clergy, students, chaplains and spiritual care practitioners have been exposed to various spiritual and spiritual/ religious assessment tools - to name a few - H.O.P.E., FICA, the SPIRITual history, Duke Religious Index (DRI). Systems of Belief Inventory (SBI-15R), Brief Measure of Religious coping (RCOPE), plus several (histo)gram models. NCCN treatment guidelines for Distress prove helpful. Also, many hospital practitioners have created their own tools. Systematic and practical usage often has been less than significant. We repeatedly hear that time is the major impediment for many types of assessments. This instrument responds to that real concern.
The Morrison 4C’s Spiritual and Emotional Self-Assessment is designed to give a snapshot assessment, not a quantifiable measurement. It is the result of the need to have an instrument which is useable by all staff, is simple in application, is accurate for outcomes, and is patient centered.
Patients are always subject to numerous fact-finding questions. This pencil-paper self-assessment affirms the patient and the patient’s own self, and allows the patient a feeling of participation. A self-assessment is more accurate for this type of information than an interview process. It serves as a “talking-point” where there are signals for a more in-depth follow-up. For example, one might be alerted to anxiety and/or depression indicators, and then administer the well-used HADS (Hospital Anxiety & Depression Scale) in order to determine a level of intervention.
Since institutions vary in their protocols, perhaps it is easiest to indicate briefly how it works in our Centre. It is given out to patients through our admissions secretaries, who are responsible for all patient input. The form is embossed (top right corner) with the patient’s health card. Completed, it is then forwarded to my office where it is seen, noted on an electronic master sheet, a copy made, then placed in the patient’s medical records chart. Naturally, absolute care is taken to ensure and guard privacy. The responses lead to a triage decision for intervention. Members of the health care team have immediate access to this aspect of the patient’s profile. Doctors have reported that it is helpful to their treatment plans.
Thus, the goal of treating the whole person has been successfully attempted. You will note that there is not a space for religious affiliation/ participation rate / request for chaplaincy service. This omission is a decision based on research, guidelines and post-implementation reflection.
At rounds, when a patient is “introduced” (not physically present) to members of the team, this instrument is a valuable part of the picture. The bottom line is that to date it has proven useful, helpful, friendly and well received.
The instrument is designed for two groups: diagnosed cancer patients; other patients facing an illness crisis. 1. How do you feel about the cancer? or 2. How do you feel about this illness crisis ?
After consultations with individual researchers, the 4C’s instrument has been subject to various focus groups whose suggestions have been helpful (for example, a national CAPO workshop, an Atlantic CAPPE workshop, our Cancer Care Team). It has been through usual channels, including a literacy evaluation and modification.
It is always a work in progress and will be updated periodically. To download the instrument, please contact me for a site. I would like to think that by reviewing this instrument you will be a participant, informing us of your questions, comments or reflections, and please forward them to davidm@strathmor.com. Thank-you.
Dr David Morrison. PEI Cancer Treatment Centre, Canada..
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