Both the interpretation and extent of personal spiritual concerns might be different as spiritual needs are multidimensional, and dependent on religious and cultural background. Importantly, for rigorous spiritual needs assessment well-prepared, valid and reliable measurement tools are needed. Initially developed in Germany and published in English, the SpNQ has been translated and validated so far in different languages and used in various countries. In each of these translations, the cross-cultural validation and adaptation process has brought differences in the proposed domains, reflecting the cultural aspects of each of the societies in which the instrument was applied. In this chapter we will discuss findings from Lithuania, Poland, Portugal, Brazil, Iran and China. The intention of this comparative chapter is to underline that, depending on sample size, in a group of persons with different health conditions, cultures and religious background, the factorial structure of spiritual needs measurement may vary