Spirituality, Quality of Life, and associated health outcomes. A literature and scoping review of the evidence

Abstract

Objective: Associations between spirituality and physical health, mental health, and quality of life are increasingly being acknowledged, aligning with Indigenous Australian understandings of the importance of spirituality in health. Spirituality has traditionally been misrepresented as synonymous to religion in its instrumentation. Despite the increased interest in spirituality, a review of tools that measure spirituality as distinct from religion has not been conducted since 2011. Methods: This systematic scoping review mapped studies utilising non-religious spirituality instruments in order to understand how spirituality relates to health, and to describe the cultural groups and countries in which these tools have been validated. Results: Sixty-one studies were included in the review. The most commonly used spirituality instrument was the Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing Scale (39.3% of studies). A total of 41 health outcomes were explored in their relationship to spirituality, and of the physical health (35.7%) and mental or psychological health (66.7%) outcomes assessed, the most frequently reported associations were with depression (n = 29), anxiety (n = 15) and quality of life (n = 15). Identification of cultural orientation in these studies was low, and the majority of studies were conducted in the USA with mostly White populations. Only 3 studies utilised instruments developed for specific cultural groups. Conclusion: Few spirituality instruments have been developed to measure spirituality adequately across cultures or as distinct from religion. However, encouraging associations between spirituality and a broad range of health outcomes have been observed which provides implications for future healthcare research and practice.