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There are many proposed new definitions of spirituality that attempt to separate it from religion. In their review article, Alexander Moreira-Almeida and colleagues19 propose the following division between spirituality and religion:

• “Spirituality is a personal quest for understanding answers to ultimate questions about life, about meaning and about relationship to the sacred or transcendent [which may or may not be connected to religion or religious community].”

• “Religion is an organized system of beliefs, practices, rituals and symbols designed to facilitate closeness to the sacred or transcendent.”

Despite a growing body of research, “the spiritual concerns continue to be one of the most overlooked aspects of research, while the importance of physical and psychological factors are routinely acknowledged.”20 In a critical review on coping with heart failure, Clark and Hunter propose, “spirituality is expressed through beliefs, values, traditions, and practices.”21 They further stress that “the quantitative evidence also confirms that spiritual needs and/or distress contribute to greater individuals’ experiences of suffering.”