Twenty-two patients in a Midlands acute hospital Trust supplied recorded narratives of their experience of spiritual distress, their hopes for spiritual integrity, and any means that were proving helpful in moving from distress to integrity. The research subjects included both patients in palliative care and those undergoing various therapies. There was little difference between the responses of these two groups. The most frequently expressed spiritual distress centred on the sense of 'not being myself', and concern for the family. The most frequently expressed spiritual integrities, were the hope to help others, and to use the illness as an opportunity for personal growth and acceptance. Support from hospital staff was seen as most important in facilitating change from distress to integrity.