Spiritual Well-Being and Depression in Patients with Heart Failure
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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.
To identify the relationship between spiritual well-being and depression in patients with heart failure.
Sixty patients aged 60 years or older with New York Heart Association class II–IV heart failure.
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).
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.
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.
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- Spiritual Well-Being and Depression in Patients with Heart Failure
Journal of General Internal Medicine
Volume 22, Issue 4 , pp 470-477
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- heart failure
- palliative care
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, Division of General Internal Medicine, University of Colorado at Denver and Health Sciences Center, 4200 East Ninth Avenue, B180, Denver, CO, 80262, USA
- 2. Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- 3. Division of Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- 4. Johns Hopkins Hospital, Baltimore, MD, USA
- 5. Johns Hopkins Bayview Medical Center, Baltimore, MD, USA