Many heart failure patients struggle with related issues that jeopardize their sense of well-being and quality of life. Patients try to figure out how to deal with their new situation.

The present qualitative research showed that spirituality is a key for patients with chronic heart failure to better cope with the disease and deal with their multiple problems.

Several studies found that religious belief certainty allows the patients to believe in God as a source of power that can control them. 

Since heart failure puts patients in a precarious situation, faith in God as the supreme power helps patients avoid a sense of desperation in their new situation, alters their perspective on the issues, and assists them in managing the consequences of the disease with a positive attitude and experiencing positive outcomes.

Several studies have found that religion helps patients with chronic diseases like heart failure manage stress. By trusting in God and using problem-solving strategies, they are able to manage life events and reduce negative effects of the disease like depression, anxiety, low quality of life, and lack of communication with family and friends.

A new study published in JACC Heart Failure found that patients with heart failure who practised spirituality reported better overall health and well-being.

Spirituality could also be evaluated as a potential target for palliative care interventions to improve patient-centered and clinical outcomes in these people, according to the study.

“Patients who have heart failure experience a poorer quality of life compared to their peers, with high levels of depression, anxiety and spiritual distress,” says Rachel S. Tobin, lead author of the study. “Contributing to diminished 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-image.”

Spirituality is a key component of palliative care, with the purpose of recognizing and addressing spiritual difficulties as well as connecting patients with spiritual and religious resources. However, little study has been done on the impact of spirituality on people with heart failure, and no instruments to measure it have been developed.

Spirituality is difficult to define, according to the researchers, but they cite various definitions that explain spirituality as how people find meaning and purpose in life, which can be distinct from religious beliefs.

For instance, the Institute of Medicine defines spirituality as “the needs and expectations which humans have to find meaning, purpose and value in their life. Such needs can be specifically religious, but even people who have no religious faith or are not members of an organized religion have belief systems that give their lives meaning and purpose.”

Researchers looked at 47 studies to see what they could about spirituality in heart failure patients, as well as the links between spirituality and quality of life and patient outcomes. They also proposed clinical uses and future possibilities for spirituality in this population. Spirituality was measured using around ten different tools, some simple and others difficult. The following are some of the key data that were examined:

• In the Palliative Care in Heart Failure (PAL-HF) trial, spiritual well-being improved in patients randomized to a palliative care intervention compared to usual care as evaluated by FACIT-Sp. ​The FICA spiritual history tool was also used to gather information on spirituality. 
• Patients randomized to palliative care had increased quality of life as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-Pal). They were also found to have lower levels of anxiety and depression. 
• Another study found that after a 12-week mail-based psychosocial intervention, patients completing the intervention had higher quality of life as measured by KCCQ, as well as less depression and searching for meaning. Out of the 33 patients included, 85.7% felt that the intervention was worthwhile. In a pilot study, spiritual counseling was associated with improved quality of life, although there was no control group to determine if the effect was significant.

“The literature suggests not only can spirituality improve quality of life for the patient, it can help support caregivers and potentially help heart failure patients from needing to be readmitted to the hospital,” Tobin adds.

“What we have suggested and are now doing is developing a spirituality screening tool, similar to ones used to screen for depression. This can be used to identify heart failure patients in palliative care who are at risk for spiritual distress. However, this is just a start. More research needs to be done.”

Source: 10.1016/j.jchf.2022.01.014

Image Credit: Getty

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