Skip to main content
    • Aa
    • Aa

Estimated longevity and changes in spirituality in the context of advanced congestive heart failure

  • Crystal L. Park (a1)

To examine (1) advanced congestive heart failure (CHF) patients' estimates of their longevity and changes in these estimates over time; (2) clinical, functional, and psychological adjustment correlates of these longevity estimates; and (3) correspondence of changes in longevity and changes in multiple dimensions of spirituality over time.


Longitudinal questionnaire-based study of 111 patients diagnosed with severe CHF assessed at two time points separated by 6 months.


Nearly half of the participants estimated their longevity as at least 5–10 years, and there was very little change in estimates across the assessment periods. Longevity estimates were minimally related to clinical or functional indicators, but longer estimates were related to fewer depressive symptoms and higher levels of life satisfaction. Multivariate regression analyses indicated that shifting longevity estimates toward less time or toward uncertainty was related to increases in religious life meaning and forgiveness and to decreased spiritual struggle over the 6-month interval. No effects were observed for daily spiritual experiences.

Significance of results:

Because very little is known about how individuals estimate their remaining life span, these results establish information regarding their basis (i.e., not clinical or functional) and stability, at least in the context of advanced heart failure. In addition, the notion that individuals become more spiritual as they perceive the approach of death was borne out in terms of multiple aspects of spirituality.

Corresponding author
Address correspondence and reprint requests to: Crystal L. Park, Department of Psychology, University of Connecticut, Storrs, CT, 06269-1020, USA. E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

H.B. Bosworth , K.E. Steinhauser , M. Orr , (2004). Congestive heart failure patients' perceptions of quality of life: The integration of physical and psychosocial factors. Aging & Mental Health, 8, 8391.

M. Bretscher , T. Rummans , J. Sloan , (1999). Quality of life in hospice patients: A pilot study. Psychosomatics: Journal of Consultation Liaison Psychiatry, 40, 309313.

E. Diener , R.A. Emmons , R.J. Larsen , (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49, 7175.

J. Exline , M. Yali , & W. Sanderson (2000). Guilt, discord, and alienation: The role of religious strain in depression and suicidality. Journal of Clinical Psychology, 56, 14811496.

G. Fitchett , P.E. Murphy , J. Kim , (2004). Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. International Journal of Psychiatry in Medicine, 34, 179196.

K.E. Freedland & R.M. Carney (2000). Psychosocial considerations in elderly patients with heart failure. Clinical Geriatrics, 16, 649661.

S. Goodlin , P.J. Hauptman , R. Arnold , (2004). Consensus Statement: Palliative and Supportive Care in Advanced Heart Failure. Journal of Cardiac Failure, 10, 200209.

N. Hamrick & M.A. Diefenbach (2006). Religion and spirituality among patients with localized prostate cancer. Palliative and Supportive Care, 4, 345355.

B. Hanratty , D. Hibbert , F. Mair , (2002). Doctors' perceptions of palliative care for heart failure: Focus group study. British Medical Journal, 325, 581585.

P.J. Hauptman & H.P. Havranek (2005). Integrating palliative care into heart failure care. Archives of Internal Medicine, 165, 374378.

S. Heo , D.K. Moser , B. Riegel , (2005). Testing a published model of health-related quality of life in heart failure. Journal of Cardiac Failure, 11, 372379.

J. Hinton (1999). The progress of awareness and acceptance of dying assessed in cancer patients and their caring relatives. Palliative Medicine, 13, 1935.

P. Jaagosild , N.V. Dawson , C. Thomas , (1998). Outcomes of acute exacerbation of severe congestive heart failure: Quality of life, resource use, and survival. SUPPORT Investigators. The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatment. Archives of Internal Medicine, 158, 10811089.

E. Jonas & P. Fischer (2006). Terror management and religion: Evidence that intrinsic religiousness mitigates worldview defense following mortality salience. Journal of Personality and Social Psychology, 91, 553567.

K.P. Kaut (2002). Religion, spirituality, and existentialism near the end of life. American Behavioral Scientist, 46, 220234.

H. Koenig (2002). A commentary: The role of religion and spirituality at the end of life. The Gerontologist, 42, Special Issue III, 2023.

J.W. Levenson , E.P. McCarthy , J. Lynne , (2000). Patients' experiences as death approaches: The last six months of life for patients with congestive heart failure. Journal of the American Geriatrics Society, 48, S101S109.

S.A. Murray , K. Boyd , M. Kendall , (2002). Dying of lung cancer or cardiac failure: Prospective qualitative interview study of patients and their carers in the community. British Medical Journal, 325, 929935.

S.A. Murray , M. Kendall , K. Boyd , (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, 3945.

L.S. Radloff (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.

D.P. Sulmasy , P.B. Terry , C.S. Weisman , (1998). The accuracy of substituted judgments in patients with terminal diagnoses. Annals of Internal Medicine, 128, 621629.

A. Williams (2006). Perspectives on spirituality at the end of life: A meta-summary. Palliative and Support Care, 4, 407417.

C. Zugck , C. Kruger , R. Kell , (2001). Risk stratification in middle-aged patients with congestive heart failure: Prospective comparison of the Heart Failure Survival Score (HFSS) and a simplified two-variable model. European Journal of Heart Failure, 3, 577585.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Palliative & Supportive Care
  • ISSN: 1478-9515
  • EISSN: 1478-9523
  • URL: /core/journals/palliative-and-supportive-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 2
Total number of PDF views: 11 *
Loading metrics...

Abstract views

Total abstract views: 89 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 28th June 2017. This data will be updated every 24 hours.