A study led by the American College of Cardiology, suggested that spirituality not only helps improve the quality of life for people with chronic diseases such as cancer, but also affects heart failure patients. (Also read: Experts on Common Meditation Mistakes and How to Avoid Them)
The study was published in the journal, ‘JACC Heart Failure’.
It further concludes that spirituality should be seen as a potential target for palliative care interventions to improve patient-centered and clinical outcomes in these individuals.
“Patients with heart failure experience a poorer quality of life compared to their peer groups, with high levels of depression, anxiety and mental distress,” said Rachel S. Tobin, MD, resident of Internal Medicine at Duke University Hospital, and lead author of the study room.
“What contributes to reduced quality of life is the fact that heart failure, unlike many other chronic diseases, is very unpredictable and can lead to hopelessness, isolation and altered self-esteem,” he added.
The American College of Cardiology and other major cardiovascular associations recommend palliative care for heart failure patients. Spirituality is a core domain of palliative care, with the goal of identifying and addressing spiritual concerns and providing patients with appropriate spiritual and religious resources. However, limited research has been done on spirituality’s impact on patients with heart failure, and there are no known tools designed to measure this.
According to the researchers, spirituality is difficult to define, but they refer to various definitions that describe spirituality as how individuals find meaning and purpose in life, which may be separate from religious beliefs.
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For example, the Institute of Medicine defines spirituality as “the needs and expectations people have of finding meaning, purpose and value in their lives. Such needs may be specifically religious, but even people who have no religious faith or are not members of organized religion has belief systems that give meaning and purpose to their lives.
Researchers conducted a review of 47 articles to examine current knowledge of spirituality in heart failure patients. It describes associations between spirituality and quality of life, as well as patient outcomes and suggests clinical applications and future directions for spirituality in this population. There were about 10 different tools used to measure spirituality, some simple, others complex.
Key data examined include:
In the Palliative Care in Heart Failure (PAL-HF) trial, mental well-being improved in patients randomized to a palliative care intervention compared to regular care as evaluated by FACIT-Sp. The FICA spiritual history tool was also used to gather information about spirituality.
2. Patients randomized to palliative care had increased quality of life as measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Disease Therapy-Palliative Care (FACIT-Pal). They were also found to have lower levels of anxiety and depression.
Another study found that patients who completed the intervention after a 12-week email-based psychosocial intervention had a higher quality of life as measured by KCCQ, as well as less depression and search for meaning. Of the 33 patients included, 85.7 percent felt the intervention was worthwhile. In a pilot study, mental health counseling was associated with improved quality of life, although there was no control group to determine if the effect was significant.
“The literature suggests that not only can spirituality improve patient quality of life, but it can also help support caregivers and potentially help heart failure patients to be readmitted to the hospital,” Tobin said.
“What we have proposed and are doing now is to develop a tool for spiritual screening, similar to that used to look for depression. It can be used to identify heart failure patients in palliative care who are at risk for mental distress. “However, this is just the beginning. More research needs to be done,” he concluded.
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