Abstract
We examined relationships between seven dimensions of religion/spirituality (RS) (forgiveness, daily spiritual experiences, belief in afterlife, religious identity, religious support, public practices, and positive RS coping) and three dimensions of well-being (physical, mental, and existential) in a sample of 111 patients with advanced chronic heart failure. Participants completed questionnaires at baseline and 3 months later. Results showed that fairly high levels of RS were reported on all seven dimensions. Furthermore, RS dimensions were differentially related to well-being. No aspect of RS was related to physical well-being, and only a few aspects were related to mental well-being. Forgiveness was related to less subsequent depression, while belief in afterlife was related to poorer mental health. All aspects of RS were related to at least one aspect of existential well-being. In particularly, daily spiritual experiences were linked with higher existential well-being and predicted less subsequent spiritual strain. These results are consistent with the view that in advanced disease, RS may not affect physical well-being but may have potent influences on other aspects of well-being, particularly existential aspects.
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Abeles, R., Ellison, C. G., George, L. K., Idler, E. L., Krause, N., Levin, J. S., et al. (1999). Multidimensional Measurement of Religiousness/Spirituality for use in health research. Kalamazoo, MI: John E. Fetzer Institute.
Beery, T. A., Baas, L. S., Fowler, C., & Allen, G. (2002). Spirituality in persons with heart failure. Journal of Holistic Nursing, 20, 5–25.
Bekelman, D., Dy, S., Becker, D., Wittstein, I., Hendricks, D., Yamashita, T., et al. (2007). Spiritual well-being and depression in patients with heart failure. Journal of General Internal Medicine, 22, 470–477.
Centers for Disease Control (CDC). (2010). Heart failure fact sheet. Retrieved 24 July 2012, from www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm.
Chadiha, L. A., Proctor, E. K., Morrow-Howell, N., Darkwa, O. K., & Dore, P. (1997). Religiosity and church-based assistance among chronically ill African-American and White elderly. Journal of Religious Gerontology, 10, 17–36.
Chochinov, H. M., & Cann, B. J. (2005). Interventions to enhance the spiritual aspects of dying. Journal of Palliative Medicine, 8(supplement 1), S103–S115.
Diener, E. (1994). Assessing subjective well-being: Progress and opportunities. Social Indicators Research, 31, 103–157.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.
Diener, E., Oishi, S., & Lucas, R. E. (2009). Subjective well-being: The science of happiness and life satisfaction. In C. R. Snyder & S. J. Lopez (Eds.), Oxford handbook of positive psychology (pp. 187–194). New York: Oxford University Press.
Exline, J. J., Yali, A. M., & Sanderson, W. C. (2000). Guilt, discord, and alienation: The role of religious strain in depression and suicidality. Journal of Clinical Psychology, 56, 1481–1496.
Fitchett, G., Murphy, P. E., Kim, J., Gibbons, J. L., Cameron, J. R., & Davis, J. A. (2004). Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. International Journal of Psychiatry and Medicine, 34, 179–196.
Flannelly, K. J., Ellison, C. G., Galek, K., & Koenig, H. G. (2008). Beliefs about life-after-death, psychiatric symptomology and theories of psychopathology. Journal of Psychology and Theology, 36, 94–103.
Flannelly, K. J., Koenig, H. G., Ellison, C. G., Galek, K., & Krause, N. (2006). Belief in life after death and mental health: Findings from a national survey. Journal of Nervous and Mental Disease, 194, 524–529.
Francis, L. J. (1997). The psychology of gender differences in religion: A review of empirical research. Religion, 27, 81–96.
Galbreath, A., Krasuski, R., Smith, B., Stajduhar, K., Kwan, M., Ellis, R., et al. (2004). Long-term healthcare and cost outcomes of disease management in a large, randomized, community-based population with heart failure. Circulation, 110, 3518–3526.
Goebel, J. R., Doering, L. V., Shugarman, L. R., Asch, S. M., Sherbourne, C. D., Lanto, A. B., et al. (2009). Heart failure: The hidden problem of pain. Journal of Pain and Symptom Management, 38, 698–707.
Harper, A., & Power, M. (1998). Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychological Medicine, 28, 551–558.
Idler, E. L., Musick, M. A., Ellison, C. G., George, L. K., Krause, N., Ory, M. G., et al. (2003). Measuring multiple dimensions of religion and spirituality for health research. Research on Aging, 25, 327–365.
Joekes, K., Van Elderen, T., & Schreurs, K. (2007). Self-efficacy and overprotection are related to quality of life, psychological well-being and self-management in cardiac patients. Journal of Health Psychology, 12, 4–16.
Johnstone, B., Pil-Yoon, D., Cohen, D., Schopp, L. H., McCormack, G., Campbell, J., et al. (2012). Relationships among spirituality, religious practices, personality factors, and health for five different faith traditions. Journal of Religion and Health, 51, 1017–1041.
Juenger, J., Schnellberg, D., Kraemer, S., Haunstetter, A., Zugck, C., Herzog, W., et al. (2002). Cardiovascular medicine. Health related quality of life in patients with congestive heart failure: Comparison with other chronic diseases and relation to functional variables. Heart, 87, 235–241.
Karademas, E. C. (2010). Illness cognitions as a pathway between religiousness and subjective health in chronic cardiac patients. Journal of Health Psychology, 15, 239–247.
Koenig, H. G. (2002). Religion, congestive heart failure, and chronic pulmonary disease. Journal of Religion and Health, 41, 263–278.
Lo, B., Ruston, D., Kates, L. W., Arnold, R. M., Cohen, C. B., Faber-Langendoen, K., et al. (2002). Discussing religious and spiritual issues at the end of life. Journal of the American Medical Association, 287, 749–754.
MacMahon, K. M. A., & Lip, G. Y. H. (2002). Psychological factors in heart failure. Archives of Internal Medicine, 162, 509–516.
Masters, K. M., & Hooker, S. (in press). Religion and cardiovascular health. In R. F. Paloutzian, & C. L. Park (Eds.), Handbook of the psychology of religion and spirituality, 2nd Edn. New York: Guilford.
McCall, D. (1994). Congestive heart failure. In J. H. Stein, J. J. Hutton, & P. O. Kohler (Eds.), Internal medicine (4th ed., pp. 116–131). St. Louis, MO: Mosby.
McFadden, S. H. (2010). Religion and well-being in aging persons in an aging society. Journal of Social Issues, 51, 161–175.
Moser, D. K. (2002). Psychosocial factors and their association with clinical outcomes in patients with heart failure: Why clinicians do not seem to care. European Journal of Cardiovascular Nursing, 1, 183–188.
Murray, S. A., Kendall, M., Boyd, K., Worth, A., & Benton, T. F. (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their carers. Palliative Medicine, 18, 39–45.
Murray, S. A., Kendall, M., Grant, E., Boyd, K., Barclay, S., & Sheikh, A. (2007). Patterns of social, psychological, and spiritual decline toward the end of life in lung cancer and heart failure. Journal of Pain and Symptom Management, 34, 393–402.
Pargament, K. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. New York: Guilford.
Park, C. L. (2008). Estimated longevity and changes in spirituality in the context of advanced congestive heart failure. Palliative and Supportive Care, 6, 3–11.
Park, C. L., Brooks, M. A., & Sussman, J. (2009). Dimensions of religion and spirituality in psychological adjustment in older adults living with congestive heart failure. In A. Ai & M. Ardelt (Eds.), The role of faith in the well-being of older adults: Linking theories with evidence in an interdisciplinary inquiry (pp. 112–134). Hauppauge, NY: Nova Science Publishers.
Park, C. L., & Slattery, J. M. (in press). Religion and emotional health and well-being. In R. F. Paloutzian & C. L. Park (Eds.), Handbook of the psychology of religion and spirituality, 2nd Edn. New York: Guilford.
Peterman, A. H., Fitchett, G., & Brady, M. J. (2002). Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Theory-Spiritual Well-Being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24, 49–58.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
Rector, T. S. (2005). A conceptual model of quality of life in relation to heart failure. Journal of Cardiac Failure, 11, 173–176.
Rector, T. S., Anand, I. S., & Cohn, J. N. (2006). Relationships between clinical assessments and patients’ perceptions of the effects of heart failure on their quality of life. Journal of Cardiac Failure, 12, 87–92.
Rector, T. S., Kubo, S. H., & Cohn, J. N. (1987). Patients’ self-assessment of their congestive heart failure: II. Content, reliability and validity of a new measure-the Minnesota Living with Heart Failure Questionnaire. Heart Failure, 3, 198–209.
Roger, V. L., Go, A. S., Lloyd-Jones, D. M., Benjamin, E. J., Berry, J. D., Borden, W. B., et al. (2012). Heart disease and stroke statistics—2012 update: A report from the American Heart Association. Circulation, 125(1), e2–e220.
Selman, L., Beynon, T., Higginson, I., & Harding, R. (2007). Psychological, social and spiritual distress at the end of life in heart failure patients. Current Opinion in Supportive and Palliative Care, 1, 260–266.
Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item Short-Form Health Survey: Construction of scales and preliminary test of reliability and validity. Medical Care, 34, 220–226.
Whelan-Gales, M. A., Quinn Griffin, M. T., Maloni, J., & Fitzpatrick, J. J. (2009). Spiritual well-being, spiritual practices, and depressive symptoms among elderly patients hospitalized with acute heart failure. Geriatric Nursing, 30, 312–317.
Wood, B. T., Worthington, E, Jr, Exline, J., Yali, A., Aten, J. D., & McMinn, M. R. (2010). Development, refinement, and psychometric properties of the Attitudes toward God Scale (ATGS-9). Psychology of Religion and Spirituality, 2, 148–167.
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This study was funded by a research grant from the Fetzer Foundation to the first author.
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Park, C.L., Lim, H., Newlon, M. et al. Dimensions of Religiousness and Spirituality as Predictors of Well-Being in Advanced Chronic Heart Failure Patients. J Relig Health 53, 579–590 (2014). https://doi.org/10.1007/s10943-013-9714-1
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DOI: https://doi.org/10.1007/s10943-013-9714-1