Spirituality can improve quality of life for heart failure patients
Numerous studies have shown that spirituality can help improve quality of life for people with chronic diseases like cancer. According to a literature review published today in JACC Heart Failure, spirituality can also have a positive impact on quality of life for heart failure patients. It further concludes spirituality should be considered a potential target for palliative care interventions to improve patient-centered and clinical outcomes in these individuals.
"Patients who have heart failure experience a poorer quality of life compared to their peers, with high levels of depression, anxiety and spiritual distress," said Rachel S. Tobin, MD, resident in Internal Medicine at Duke University Hospital, and 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."
- 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 said. "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."
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