Spiritual needs change with time and circumstances. The National Institute for Clinical Excellence guidance, Supportive and Palliative Care for Adults with Cancer, published in March 2004, acknowledges this and recommends that healthcare teams ensure accurate and timely evaluation of spiritual issues through regular assessment. This reflects the increasing emphasis on spirituality as a factor contributing to wellbeing and coping strategies.1–4 A proliferation of textbooks and book chapters with titles containing the word “spirituality” seek to elucidate what spiritual care is, how it might be assessed, and how needs might be met.5 However, a lack of consensus remains as to what spirituality actually is.6

Some key words occur quite regularly in the various descriptions of spirituality in journals and textbooks (box). In health research we should differentiate between …