To measure or not to measure? Reviewing the assessment of spirituality and religion in health-related quality of life.

Measures of quality of life have not conventionally or routinely included concepts of spirituality, religion, or existential wellbeing. Although spirituality has been seen as irrelevant, or difficult to measure, a growing body of peer-reviewed articles point to a positive and important relationship between spiritual beliefs and other domains of quality of life in health. Following a discussion of current theoretical issues surrounding the inclusion of these generic concepts, we select and review seven quality-of-life assessments in health that provide a spiritual and/or religious dimension, and evaluate each in psychometric terms. Such information could be useful to clinicians working in chronic illness, surgery and terminal care, who seek concept clarification before using an assessment that includes a spiritual domain.