Spiritual, religious, and personal beliefs are important and distinctive to assessing quality of life in health: A comparison of theoretical models

Objectives. The study investigates theoretical debates on the contribution of spiritual, religious, and personal beliefs (SRPB) to quality of life (QoL) in health, by examining contrasting models.

Design and method. The WHOQOL-SRPB assesses QoL relating to SRPB where 33 QoL facets are scored in 6 domains, of which SRPB is one. The measure was completed by a heterogeneous sample of 285 sick and well people representing a cross-section of religious, agnostic, and atheist beliefs in UK, and structured for gender (52% female) and age (mean 47 years).

Results. No evidence was found to support the model of spiritual QoL as a concept that overarches every other QoL domain. Confirmatory factor analysis showed that SRPB is an integral concept to overall QoL, with a very good fit (comparative fit index = .99). Spiritual QoL made a significant, relatively independent contribution, similar to the other five domains (beta = 0. 68). Spiritual QoL is most closely associated with the psychological domain, particularly hope and optimism and inner peace; two of the nine SRPB facets. Spiritual QoL, but not most other aspects of QoL, is higher for religious people.

Conclusion. The results explain theoretical confusion arising from previous research. Spiritual QoL makes a significant and distinctive contribution to QoL assessment in health and should be assessed routinely in health care populations.