Journal of General Internal Medicine

, Volume 22, Issue 4, pp 470–477

Spiritual Well-Being and Depression in Patients with Heart Failure

  • David B. Bekelman
  • Sydney M. Dy
  • Diane M. Becker
  • Ilan S. Wittstein
  • Danetta E. Hendricks
  • Traci E. Yamashita
  • Sheldon H. Gottlieb
Original Article

DOI: 10.1007/s11606-006-0044-9

Cite this article as:
Bekelman, D.B., Dy, S.M., Becker, D.M. et al. J GEN INTERN MED (2007) 22: 470. doi:10.1007/s11606-006-0044-9

Abstract

Background

In patients with chronic heart failure, depression is common and associated with poor quality of life, more frequent hospitalizations, and higher mortality. Spiritual well-being is an important, modifiable coping resource in patients with terminal cancer and is associated with less depression, but little is known about the role of spiritual well-being in patients with heart failure.

Objective

To identify the relationship between spiritual well-being and depression in patients with heart failure.

Design

Cross-sectional study.

Participants

Sixty patients aged 60 years or older with New York Heart Association class II–IV heart failure.

Measurements

Spiritual well-being was measured using the total scale and 2 subscales (meaning/peace, faith) of the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being scale, depression using the Geriatric Depression Scale—Short Form (GDS-SF).

Results

The median age of participants was 75 years. Nineteen participants (32%) had clinically significant depression (GDS-SF > 4). Greater spiritual well-being was strongly inversely correlated with depression (Spearman’s correlation −0.55, 95% confidence interval −0.70 to −0.35). In particular, greater meaning/peace was strongly associated with less depression (r = −.60, P < .0001), while faith was only modestly associated (r = −.38, P < .01). In a regression analysis accounting for gender, income, and other risk factors for depression (social support, physical symptoms, and health status), greater spiritual well-being continued to be significantly associated with less depression (P = .05). Between the 2 spiritual well-being subscales, only meaning/peace contributed significantly to this effect (P = .02) and accounted for 7% of the variance in depression.

Conclusions

Among outpatients with heart failure, greater spiritual well-being, particularly meaning/peace, was strongly associated with less depression. Enhancement of patients’ sense of spiritual well-being might reduce or prevent depression and thus improve quality of life and other outcomes in this population.

KEY WORDS

heart failurespiritualitydepressionpalliative care

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • David B. Bekelman
    • 1
  • Sydney M. Dy
    • 2
  • Diane M. Becker
    • 3
  • Ilan S. Wittstein
    • 4
  • Danetta E. Hendricks
    • 2
  • Traci E. Yamashita
    • 1
  • Sheldon H. Gottlieb
    • 5
  1. 1.Department of Medicine, Division of General Internal MedicineUniversity of Colorado at Denver and Health Sciences CenterDenverUSA
  2. 2.Department of Health Policy & Management, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  3. 3.Division of Internal MedicineThe Johns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Johns Hopkins HospitalBaltimoreUSA
  5. 5.Johns Hopkins Bayview Medical CenterBaltimoreUSA