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Spiritual well-being in patients with advanced heart and lung disease

Published online by Cambridge University Press:  30 July 2012

E. Alessandra Strada ,
Peter Homel ,
Sharon Tennstedt ,
J. Andrew Billings  and
Russell K. Portenoy
E. Alessandra Strada*
Affiliation:
Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, New York
Peter Homel
Affiliation:
Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, New York
Sharon Tennstedt
Affiliation:
New England Research Institutes, Watertown Massachusetts
J. Andrew Billings
Affiliation:
Harvard Medical School Center for Palliative Care, Boston, Massachusetts
Russell K. Portenoy
Affiliation:
Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, New York
*
Address correspondence and reprint requests to: E. Alessandra Strada, Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, 12 Baird Hall, 17th St. at 1st Ave., New York NY 10003. E-mail: Astrada23@gmail.com
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Abstract

Objective:

The purpose of this study was to evaluate levels of spiritual well-being over time in populations with advanced congestive heart failure (CHF) or chronic obstructive lung disease (COPD).

Method:

In a prospective, longitudinal study, patients with CHF or COPD (each n = 103) were interviewed at baseline and every 3 months for up to 30 months. At each interview, patients completed: the basic faith subscale of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) questionnaire, the Memorial Symptom Assessment Scale (MSAS), the Rand Mental Health Inventory (MHI), the Multidimensional Index of Life Quality (MILQ), the Sickness Impact Profile (SIP), and the Short Portable Mental Health Questionnaire (SPMSQ).

Result:

The mean age was 65 years, 59% were male, 78% were Caucasian, 50% were married, 29% lived alone, and there was no significant cognitive impairment. Baseline median FACIT-Sp score was 10.0 on a scale of 0–16. FACIT-Sp scores did not change over time and multivariate longitudinal analysis revealed higher scores for black patients and lower scores for those with more symptom distress on the MSAS-Global Distress Index (GDI) (both p = 0.02). On a separate multivariate longitudinal analysis, MILQ scores were positively associated with the FACIT-Sp and the MHI, and negatively associated with the MSAS-GDI and the SIP (all p-values < 0.001).

Significance of results:

In advanced CHF and COPD, spiritual well-being remains stable over time, it varies by race and symptom distress, and contributes to quality of life, in combination with symptom distress, mental health and physical functioning.

Keywords

Spiritual well-beingCOPDCHFPalliative careQuality of life
Type
Original Articles
Information
Palliative & Supportive Care , Volume 11 , Issue 3 , June 2013 , pp. 205 - 213
Copyright
Copyright © Cambridge University Press 2012 

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References

REFERENCES

Avis, N.E., Smith, K.W., Hambleton, R.K., et al. (1996). Development of the multidimensional index of life quality. A quality of life measure for cardiovascular disease. Medical Care, 34, 1102–1120.Google Scholar
Beery, T.A., Baas, L.S., Fowler, C., et al. (2002). Spirituality in persons with heart failure. Journal of Holistic Nursing, 20, 5–25.CrossRefGoogle ScholarPubMed
Bekelman, D.B., Dy, S.M., Becker, D.M., et al. (2007). Spiritual well-being and depression in patients with heart failure. Journal of Genral Internal Medicine, 22, 470–477.Google Scholar
Bergner, M., Bobbitt, R.A., Carter, W.B., et al. (1981). The Sickness Impact Profile: Development and final revision of a health status measure. Medical Care, 19, 787–805Google Scholar
Blinderman, C.D., Homel, P., Billings, J.A., et al. (2008). Symptom distress and quality of life in patients with advanced congestive heart failure. Journal of Pain and Symptom Management, 35, 594–603.Google Scholar
Blinderman, C.D., Homel, P., Billings, J.A., et al. (2009). Symptom distress and quality of life in patients with advanced chronic obstructive pulmonary disease. Journal of Pain and Symptom Management, 38, 115–123.Google Scholar
Brady, M.J., Peterman, A.H., Fitchett, G., et al. (1999). A case for including spirituality in quality of life measurement in oncology. Psychooncology, 8, 417–428.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
Charlson, M.E., Pompei, P., Ales, K.L., et al. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal Chronic Diseases, 40, 373–383.Google Scholar
Curtis, J.R. (2008). Palliative and end-of-life care for patients with severe COPD. European Respiratory Journal, 32, 796–803.CrossRefGoogle ScholarPubMed
Curtis, J.R., Engelberg, R.A., Nielsen, E.L., et al. (2004). Patient–physician communication about end-of-life care for patients with severe COPD. European Respiratory Journal, 24, 200–205.Google Scholar
Curtis, J.R., Engelberg, R.A., Wenrich, M.D., et al. (2005). Communication about palliative care for patients with chronic obstructive pulmonary disease. Journal of Palliative Care, 21, 157–164.Google Scholar
Daaleman, T.P. & Nease, D.E. Jr. (1994). Patient attitudes regarding physician inquiry into spiritual and religious issues. Journal of Family Practice, 39, 564–568.Google Scholar
Daaleman, T.P. & VandeCreek, L. (2000). Placing religion and spirituality in end-of-life care. Journal of the American Medical Association, 284, 2514–2517.Google Scholar
Dein, S. & Stygall, J. (1997). Does being religious help or hinder coping with chronic illness? A critical literature review. Palliative Medicine, 11, 291–298.Google Scholar
Edmonds, P., Karlsen, S., Khan, S., et al. (2001). A comparison of the palliative care needs of patients dying from chronic respiratory diseases and lung cancer. Palliative Medicine, 15, 287–295.CrossRefGoogle ScholarPubMed
Ehman, J.W., Ott, B.B., Short, T.H., et al. (1999). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Archives of Internal Medicine, 159, 1803–1806.CrossRefGoogle ScholarPubMed
Fitchett, G., Murphy, P.E., Kim, J., et al. (2004). Religious struggle: prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. International Journal of Psychiatry in Medicine, 34, 179–196.Google Scholar
Gore, J.M., Brophy, C.J. & Greenstone, M.A. (2000). How well do we care for patients with end-stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer. Thorax, 55, 1000–1006.Google Scholar
Grady, K.L., Jalowiec, A., White-Williams, C., et al. (1995). Predictors of quality of life in patients with advanced heart failure awaiting transplantation. Journal of Heart and Lung Transplantation, 14, 2–10.Google ScholarPubMed
Griffin, M.T., Lee, Y.H., Salman, A., et al. (2007). Spirituality and well-being among elders: differences between elders with heart failure and those without heart failure. Clinical Interventions in Aging, 2, 669–675.Google ScholarPubMed
Hardin, K.A., Meyers, F. & Louie, S. (2008). Integrating palliative care in severe chronic obstructive lung disease. Chronic Obstructive Pulmonary Disease, 5, 207–220.Google Scholar
Harvey, I.S. (2006). Self-Management of a chronic illness: An exploratory study on the role of spirituality among older African American women. Journal of Women & Aging, 18, 75–88.CrossRefGoogle Scholar
Jaarsma, T., Halfens, R., Tan, F., et al. (2000). Self-care and quality of life in patients with advanced heart failure: the effect of a supportive educational intervention. Heart & Lung, 29, 319–330.Google Scholar
Kimmel, P.L., Emont, S.L., Newmann, J.M., et al. (2003). ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity. American Journal of Kidney Disease, 42, 713–721.CrossRefGoogle ScholarPubMed
King, D.E. & Bushwick, B. (1994). Beliefs and attitudes of hospital inpatients about faith healing and prayer. Journal of Family Practice, 39, 349–352.Google Scholar
Knauft, E., Nielsen, E.L., Engelberg, R.A., et al. (2005). Barriers and facilitators to end-of-life communication for patients with COPD. Chest, 127, 1886–1888.Google Scholar
Ko, B., Khurana, A., Spencer, J., et al. (2007). Religious beliefs and quality of life in an American inner-city haemodialysis population. Nephrology, Dialysis, Transplantation, 22, 2985–2990.Google Scholar
Koenig, H.G. (2007a). Religion and depression in older medical inpatients. American Journal of Geriatric Psychiatry, 15, 282–291.Google Scholar
Koenig, H.G. (2007b). Religion and remission of depression in medical in patients with heart failure/pulmonary disease. Journal of Nervous and Mental Disorders, 195, 389–395.Google Scholar
Koenig, H.G. (1997). Use of religion by patients with severe medical illness. Mind/Body, 2, 31–36.Google Scholar
Morgan, P.D., Gaston-Johansson, F. & Mock, V. (2006). Spiritual well-being, religious coping, and the quality of life of African American breast cancer treatment: A pilot study. ABNF Journal, 17, 73–77.Google Scholar
Mrus, J.M., Sherman, K.E., Leonard, A.C., et al. (2006). Health values of patients coinfected with HIV/hepatitis C: Are two viruses worse than one? Medical Care, 44, 158–166.Google Scholar
Murray, S.A., Kendall, M., Boyd, K., et al. (2004). Exploring the spiritual needs of patients dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliative Medicine, 18, 39–45.Google Scholar
Nam, C.B. & Powers, M.G. (1983). The Socioeconomic Approach to Status Measurement. Houston: Cap & Gown.Google Scholar
Patel, S.S., Shah, V.S., Peterson, R.A., et al. (2002). Psychosocial variables, quality of life, and religious beliefs in ESRD patients treated with hemodialysis. American Journal of Kidney Diseases, 40, 1013–1022.Google Scholar
Peterman, A.H., Fitchett, G., Brady, M.J., et al. (2002). Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24, 49–58.Google Scholar
Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficits in elderly patients. Journal of the American Geriatric Society, 23, 433–441.CrossRefGoogle Scholar
Portenoy, R.K., Thaler, H.T., Kornblith, A.B., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A, 1326–1336.CrossRefGoogle ScholarPubMed
Rand Corporation & Ware, J.E. Jr. (1996). The Rand Mental Health Inventory. In Measuring Health: A Guide to Rating Scales and Questionnaires, 2nd ed.McDowell, I. & Newell, C. (eds.). pp. 213–219. New York: Oxford University Press.Google Scholar
Rippentrop, E.A., Altmaier, E.M., Chen, J.J., et al. (2005). The relationship between religion/spirituality and physical health, mental health, and pain in a chronic pain population. Pain, 116, 311–321.Google Scholar
Selman, L., Beynon, T., Higginson, I.J., et al. (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.Google Scholar
Singer, P.A., Martin, D.K. & Kelner, M. (1999). Quality of life from patients' perspectives. Journal of the American Medical Association, 281, 163–168.Google Scholar
Skevington, S.M. (1998). Investigating the relationship between pain and discomfort and quality of life, using the WHOQOL. Pain, 76, 395–406.Google Scholar
Steinhauser, K.E., Voils, C.I., Clipp, E.C., et al. (2006). “Are you at peace?” One item to probe spiritual concerns at the end of life. Archives of Internal Medicine, 166, 101–105.CrossRefGoogle ScholarPubMed
SUPPORT Principal Investigators. (1995). A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). Journal of the American Medical Association, 274, 1591–1598.Google Scholar
Szaflarski, M., Ritchey, P.N., Leonard, A.C., et al. (2006). Modeling the effects of spirituality/religion on patients' perceptions of living with HIV/AIDS. Journal of General Internal Medicine, 21, S28–38.CrossRefGoogle ScholarPubMed
Tanyi, R.A. & Werner, J.S. (2007). Spirituality in African American and Caucasian women with end-stage renal disease on hemodialysis treatment. Health Care for Women International, 29, 141–154.Google Scholar
Taylor, R.J., Chatters, L.M. & Jackson, J.S. (2007). Religious and spiritual involvement among older African Americans, Caribbean black, and non-Hispanic whites: Findings from the national survey of American life. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 62, S238–250.Google Scholar
True, G., Phipps, E.J., Braitman, L.E., et al. (2005). Treatment preferences and advanced care planning at the end of life: the role of ethnicity and spiritual coping in cancer patients. Annals of Behavioral Medicine, 30, 174–179.CrossRefGoogle ScholarPubMed
Varkey, B. (2006). Unfulfilled palliative care needs of chronic obstructive pulmonary disease patients. Current Opinion in Pulmonary Medicine, 12, 103–105.Google Scholar
Yohannes, AM. (2007). Palliative care provision for patients with chronic obstructive pulmonary disease. Health Quality of Life Outcomes, 3, 17.Google Scholar