Development of the ONC-5: A quantifiable assessment of spiritual concerns for adult oncology patients

Religious and spiritual (R/S) beliefs are crucial coping resources for cancer patients, yet there's no standard spiritual assessment approach. We developed the ONC-5, an evidence-based model to quantify patients' spiritual concerns in adult oncology. Seventy-one patients with diverse cancer diagnoses completed a survey and a semi-structured ONC-5 interview with a chaplain. Measures included the distress thermometer, PHQ-2, R/S struggle, and spiritual well-being. Thirty interviews were reviewed for inter-rater reliability. Spearman correlations assessed validity, and the concordance correlation coefficient (CCC) was calculated for inter-rater reliability. Results showed 20% of patients had moderate or severe spiritual concerns. ONC-5 scores correlated with R/S struggle (r = .247; p = .038) and spiritual well-being (r = -.247; p = .038). The CCC of 0.4411 indicated moderate agreement. The ONC-5 helps chaplains identify spiritual concerns, prioritize care, and measure improvements. More research is needed to test its validity and reliability in diverse populations.