The importance of considering an individual's spirituality and the confusion over definition have been emphasised by the interest shown in this subject over the past decade. A working definition to help to reduce confusion was presented at the College of Occupational Therapists' annual conference in 2004 and it was felt that it would be useful both to review the attitudes and practices of occupational therapists in this area and to evaluate how they assess and meet spiritual needs. It appeared that practical spiritual needs were often thought of only in terms of religious and cultural traditions or rituals and, as a result, the potential of everyday meaningful occupations was not considered fully. Therefore, the use of occupation was reviewed in relation to meeting spiritual needs. Finally, the perceived barriers to incorporating spirituality into practice were investigated. The review showed that: ▪ Although a majority of participants recognise the importance of spirituality to health and illness and the potential benefits to treatment, the number of therapists actually incorporating spiritual needs into daily practice does not demonstrate this recognition ▪ Some occupational therapists feel confident about addressing and assessing spiritual concerns explicitly, but this tends to be situation based and dependent on factors such as client-therapist relationship, therapist awareness of spiritual issues and the expression of spiritual need by the client ▪ Further exploration of the potential of everyday occupations that address the spiritual needs of both religious and non-religious clients needs to be undertaken ▪ Spirituality needs to be addressed more fully in undergraduate occupational therapy programmes.

Eleven people with enduring mental health problems were interviewed about their quality of life. The analysis of the data collected indicated that the key areas that were problems affecting their quality of life were lack of personal achievement, lack of job, difficulty in forming and maintaining relationships, loneliness, health problems (both mental and physical), lack of leisure activities, personal safety and looking after self. The literature review also clearly indicated that finance and access to benefits were priorities for people with enduring mental health problems. The data collected will be used in the development of the Mayers' Lifestyle Questionnaire (2), a tool for use in identifying priority quality of life issues for people with enduring mental health problems. The interviewees said that they would be highly motivated to complete such a questionnaire.

There is an increasing awareness that people with dementia should have their spiritual needs addressed. The aim of this study was to investigate health professionals' understanding of spirituality within dementia care and their perceptions of how patients' spiritual needs are met and by whom. A phenomenological approach was used, with semi-structured interviews undertaken with four nurses, two occupational therapists, two physiotherapists, two doctors and one speech and language therapist (n = 11). All the health professionals found defining 'spirituality' difficult, although common terminology was used. They agreed that spirituality was not solely related to religion. Chaplaincy staff were associated with the provision of spiritual care, but 10 of the health professionals identified themselves as staff who should address such spiritual needs. The majority (n = 10), however, reported a lack of confidence with spiritual care and agreed that training would be valuable. The findings indicate that all health professionals should address the spiritual needs of patients with dementia. A working definition of 'spirituality' is needed and further research is also warranted into the type of training needed by health professionals with regard to the spiritual care of patients.

1;.1s article Is a literature review, undertaken to have a fuller understanding of what Is meant by the term 'quality of life' and how It Is measured or 8S88S8ed. The literature review shows that the term Is not clearly defined. It Is suggested that occupational therapists each have their own definition and may use the term too narrowly: a satisfactory quality of life means something different to all of us, whether we be occupational therapist or client. This suggests that discussion with a client about his/her Individual qualIty of life and what this means to him/her Is probably more realistic than trying to measure aspects of It.

■ IPA has significant merit as a methodology for health-related research. ■ The interpretative nature of IPA would enable occupational therapy researchers to use occupational therapy theories to analyse their research.