Can spirituality improve quality of life for heart failure patients? A literature review published today in JACC: Heart Failure suggests that it can, and its authors are now working on a spirituality screening tool similar to the Patient Health Questionnaire-2 which screens for depression.
“This [spirituality screening tool] can be used to identify heart failure patients in palliative care who are at risk for spiritual distress,” lead author Rachel S. Tobin, MD, said in an ACC statement about the review. “However, this is just a start. More research needs to be done.”
Acknowledging that spirituality is difficult to define, the authors largely interpret it as the way in which individuals find meaning, purpose, and value in life. They also note that spirituality doesn’t necessarily include religion, although it certainly can.
Through this lens, the authors looked at 47 articles to see what they could glean from existing studies about the relationships between spirituality, quality of life, and patient outcomes for people with heart failure. What they found was promising.
“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 said.
One key observation was the potential role that palliative care can play in boosting spiritual well-being for heart failure patients, and the other benefits that seem to come along with that.
Patients in palliative care often have access to spiritual and religious resources, with the ACC announcement noting that spirituality is “a core domain of palliative care.” The authors found palliative care to be associated with greater spiritual well-being as well as increased quality of life, lower levels of anxiety, and lower levels of depression.
The review also highlighted a pilot study which found that spiritual counseling and psychosocial interventions led to a higher quality of life for heart failure patients.
“Patients completing the intervention had higher quality of life as measured by [the Kansas City Cardiomyopathy Questionnaire], 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 ACC notes.
More work is needed to fully understand the relationship between spirituality and patient outcomes, Tobin said. However, the potential applications of the review’s findings are worth exploring, especially given high levels of anxiety and depression among heart failure patients.
“Heart failure, unlike many other chronic diseases, is very unpredictable and can lead to hopelessness, isolation and altered self-image,” Tobin said.
By viewing spirituality as a potential target for palliative care interventions, the report concludes, it may be possible to improve this difficult reality.