The relevance of spirituality, religion and personal beliefs to health-related quality of life: Themes from focus groups in Britain


Correspondence should be addressed to Prof Suzanne Skevington, WHO Centre for the Study of Quality of Life, University of Bath, Bath BA2 7AY, UK (e-mail:


Background Generic health-related quality of life (QoL) instruments have not routinely assessed spirituality, religion, and personal beliefs (SRPB) in their measurement. This research addresses the perceived importance of 18 facets (dimensions) of SRPB, for example, inner peace, to QoL that are not specific to a religion, but address the experience of having this belief, in relation to health.

Method Adult focus groups were structured according to beliefs from UK surveys. Quotas targeted gender and health status. Nine focus groups (N = 55, age 51, 47% male) contained sick and well people who were religious, Christians, Buddhists, Quakers (50.1%), agnostic (27.4%), or atheist (21.8%) participants.

Results Qualitative and quantitative analysis showed considerable variability in the importance attributed to some concepts, although spiritual strength, meaning in life and inner peace were relevant to all groups. Spiritual strength (4.42), the meaning of life (4.09), wholeness/integration (4.06), and inner peace (4.02) were most important. Divine love, freedom to practice beliefs, and attachment/detachment were less relevant, conceptually confusing or had religious bias; atheists rated them as unimportant and as less important (p <.04) than agnostics or religious people.

Conclusions SRPB is relevant to health-related QoL and consensually important facets should be included in generic health care assessments. Their inclusion permits a more holistic assessment and improves the case for a biopsychosociospiritual model of health.