PEACE Spiritual Assessment Model

How is the patient presenting, and what is needed to establish a safe, compassionate, therapeutic presence?

Presence is where every spiritual care encounter begins. Before assessment, before documentation, before any clinical intervention, the chaplain attends to how the patient is presenting and to what the moment requires. Presence is not passive. It is the intentional, skilled act of creating the relational and clinical conditions in which spiritual care can actually happen.

What gives the patient meaning, hope, purpose, strength, or concern? Explore beliefs, values, fears, relationships, and spiritual or existential needs.

Exploration is the heart of the spiritual assessment. This dimension surfaces what matters most to the patient, the sources of meaning that sustain them, the fears and concerns that weigh on them, the relationships and values that shape how they understand their illness and their care. Skilled exploration does not impose a framework on the patient's spiritual life. It listens for the patient's own language and follows it.

What spiritual, religious, cultural, relational, or community resources does the patient have access to, and are there barriers to those resources?

Access moves from what the patient has internally to what they can draw on from outside themselves. This dimension identifies the spiritual, religious, cultural, and relational resources available to the patient, and, critically, whether they can actually reach those resources. A patient may have a faith community but feel disconnected from it. They may hold religious beliefs but face cultural or family barriers to practicing them in the clinical setting. Access names both the resources and the gaps.

What needs to be communicated through the chaplain's interventions, documentation, interdisciplinary collaboration, or advocacy so the patient's spiritual needs are understood and incorporated into care?

Communication is where spiritual care becomes interdisciplinary care. This dimension captures what the chaplain needs to communicate, and how, so that the patient's spiritual needs, concerns, and resources are understood by the full care team, reflected in the medical record, and incorporated into the care plan. It encompasses documentation, verbal handoffs, case conferences, and chaplain advocacy. Communication is what makes spiritual care visible.

Are there ethical, cultural, values-based, or end-of-life concerns affecting the patient's care, decision-making, dignity, or goals?

Ethics ensures that the spiritual assessment surfaces concerns that directly affect care decisions and patient dignity. This dimension addresses religious or cultural values that inform medical decision-making, end-of-life concerns, advance directive conversations, conflicts between the patient's values and the care plan, and moral distress, for the patient, the family, or the clinical team. The Ethics dimension is where spiritual care intersects most directly with the interdisciplinary team's hardest conversations.