Purpose and Design: The specific aims of this pre-experimental pilot study were to determine the feasibility and preliminary efficacy of an individualized spirituality-based intervention on health-related outcomes (quality-of-life [QOL], depression, and anxiety) in community-dwelling patients with cardiovascular disease (CVD). Methods: Self-reported QOL, depression, and anxiety data were provided by cardiac patients recruited from three community-based organizations, ( N = 27) at baseline and one month later. The Spirituality Scale developed by the principal investigator assessed study participants’ level of spirituality and scoring on the subscales activated one or more of three spirituality-based interventions. Repeated measures analysis of variance was used to evaluate temporal changes. Findings: Patients who participated in the 1-month intervention demonstrated a significant modest increase in overall QOL. There was a trend toward lower depression scores but this was not significant. No significant changes were seen in anxiety scores. Content analysis of patients’ perceptions of feasibility supports the acceptability of the intervention. Conclusion: Results from this small pilot study provide preliminary evidence that the individualized spirituality-based intervention used in this study holds promise as an addition to traditional cardiac care and has the potential to improve QOL in community-dwelling adults with CVD.
Ai, A.L., Peterson, C., Bolling, S.F., & Koenig, H. ( 2002). Private prayer and optimism in middle-aged and older patients awaiting cardiac surgery. The Gerontologist, 42, 70-81.
2.
American Association of Colleges of Nursing. ( 2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author. Retrieved from http://www.aacn.nche.edu/education/pdf/baccessentials08.pdf
3.
American Nurses Association. (2007). Code of ethics for nurses with interpretive statements. Retrieved from http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses.aspx
4.
Arnold, D.M., Burns, K.E.A., Adhikari, N.K.J., Kho, M.E., Meade, M.O., & Cook, D.J. ( 2009). The design and interpretation of pilot trials in clinical research in critical care. Critical Care Medicine, 37(1), S69-S74.
5.
Bekelman, D.B., Dy, S.M., Becker, D.M., Wittstein, I.S., Hendricks, D.E., Yamashita, T.E., & Gottlieb, S.H. (2007). Spiritual well-being and depression in patients with heart failure. Journal of General Internal Medicine, 22, 470-477.
6.
Bellg, A.J., Borrelli, B., Resnick, B., Hecht, J., Minicucci, D.S., Ory, M., . . . Czajkowski, S. (2004). Treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH behavior consortium. Health Psychology, 23, 443-451.
7.
Berry, T.A., Baas, L.S., Fowler, C., & Allen, G. ( 2002). Spirituality in persons with heart failure. Journal of Holistic Nursing, 20, 5-25.
8.
Blumenthal, J.A., Babyak, M.A., Ironson, G., Thoresen, C., Powell, L., Czajkowski, S., . . . Catellier, D. ( 2007). Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction. Psychosomatic Medicine, 69, 501-508.
Burkhardt, M.A., & Nagai-Jacobson, M.G. (2009). Spirituality and health . In B. Dossey & L. Keegan (Eds.), Holistic nursing: A handbook for practice (5th ed., pp. 617-645). Sudbury, MA: Jones & Bartlett.
11.
Curiati, J.A., Bocchi, E., Freire, J.O., Arantes, A.C., Braga, M., Garcia, Y., . . . Fo, W.J. ( 2005). Meditation reduces sympathetic activation and improves quality of life in elderly patients with optimally treated heart failure: A prospective randomized study. Journal of Alternative and Complementary Medicine, 11, 465-472.
12.
Delaney, C. ( 2005). The spirituality scale: Holistic assessment of the human spiritual dimension. Journal of Holistic Nursing, 23, 145-167.
13.
Delaney, C., & Barrere, C. ( 2008). Blessings: The influence of a spirituality-based intervention on psycho-spiritual outcomes in a cardiac population. Holistic Nursing Practice, 22, 210-219.
14.
Delaney, C. & Barrere, C.(2009) Eco-spirituality: The experience of environmental meditation in patients with cardiovascular disease. Holistic Nursing Practice, 23, 361-369.
15.
Delgado, C. ( 2007). Sense of coherence, spirituality, stress and quality of life in chronic illness. Journal of Nursing Scholarship , 39, 229-234.
16.
Etyrne, A., Rauschhuber, M., Gilliland, I., Cook, J., Mahon, M., Allwein, D., . . . Jones, M.E. ( 2006). Cardiovascular risk among older Hispanic women. American Association of Occupational Health Journal, 54(3), 120-128.
17.
Ferrans, C., & Powers, M. ( 1992). Psychometric assessment of the quality of life index . Research in Nursing and Health, 15, 29-38.
18.
Fredrickson, B.L., Cohn, M.A., Coffey, K.A., Pek, J., & Finkel, S.M. ( 2008). Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95, 1045-1062.
19.
Hui, P.N., Wan, M., Chan, W.K., & Yung, P.M.B. ( 2006). An evaluation of two behavioral rehabilitation programs, Qigong versus progressive relaxation, in improving the quality of life in cardiac patients. Journal of Alternative and Complementary Medicine, 12, 373-378.
20.
Hussey, T. ( 2009). Nursing and spirituality. Nursing Philosophy , 10(2), 71-80.
The Joint Commission. (2008). Spiritual assessment/Joint Commission. Retrieved from http://search.jointcommission.org
23.
Jonas, S. ( 2006). Blessings. Walland, TN: Inner Harmony Health Center.
24.
Kabat-Zinn, J. ( 1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY : Delacourt.
25.
Kabat-Zinn, J. ( 2002). Commentary on Majumdar et al.: Mindfulness meditation for health. Journal of Complementary and Alternative Medicine , 8, 731-735.
26.
Koenig, H. ( 2003). Meeting the spiritual needs of patients. The Satisfaction Monitor, July/August, 1-2. Retrieved from http://www.ourjourneyofhope.com/resources/meetingthe-spiritual-needs-of-patients.pdf
27.
Koenig, H.G., McCullough, M., & Larson, D.B. ( 2001). Handbook of religion and health: A century of research reviewed. New York, NY: Oxford University Press.
28.
Krippendorff, K. ( 2004). Content analysis: An introduction to its methodology . Thousand Oaks, CA: Sage.
29.
Lancaster, G.A., Dodd, S., & Williamson, P.R. (2004). Design and analysis of pilot studies: Recommendations for good practice. Journal of Evaluation in Clinical Practice, 10, 307-312.
30.
Lincoln, V. ( 2000). Ecospirituality: A pattern that connects. Journal of Holistic Nursing, 18, 227-244.
31.
Moritz, S., Quan, H., Rickhi, B., Liu, M., Angen, M., Vintila, R., . . . Toews, J. ( 2006). A home study-based spirituality education program decreases emotional distress and increases quality of life: A randomized, controlled trial. Alternative Therapies in Health and Medicine, 12(6), 26-35.
32.
Moser, D.K., Doering, L.V., & Chung, M.L. ( 2005). Vulnerabilities of patients recovering from an exacerbation of chronic heart failure. American Heart Journal, 150, 984.e7-984.e13.
33.
National Institute of Mental Health. (2008 ). The numbers count: Mental disorders in America. Retrieved from http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml
34.
National Institutes of Health: National Center for Complementary and Alternative Medicine. (2009). Meditation: An introduction. Retrieved from http://nccam.nih.gov/health/meditation/overview.htm
35.
Radloff, L.S. ( 1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement , 1, 385-400.
36.
Sandor, M.K., & Froman, R.D. ( 2006). Exploring the effects of walking the labyrinth. Journal of Holistic Nursing, 24, 103-110.
37.
Spielberger, C.D. ( 1983). Manual for the State-Trait Anxiety Inventory (Form Y) . Redwood City, CA: Mind Garden .
38.
Szekely, A., Balog, P., Benko, E., Breuer, T., Szekely, J., Kertal, M.D., . . . Thayer, J.F. ( 2007). Anxiety predicts mortality and morbidity after coronary artery and valve surgery: A 4-year follow-up study. Psychosomatic Medicine, 69, 625-631.
Tacón, A.M., McComb, J., Caldera, Y., & Randolph, P. ( 2003). Mindfulness meditation, anxiety reduction, and heart disease: A pilot study. Family Community Health, 26(1), 25-33.
41.
Villagomeza, L.R. ( 2006). Mending broken hearts: The role of spirituality in cardiac illness: A research synthesis, 1991-2004. Holistic Nursing Practice, 20, 169-186.
42.
Walker, M., & Walker, J. ( 2003). Heart massage: A simple approach. New York, NY: Delmar Thomson.
43.
Walker, M.J. ( 2006). The effects of nurses’ practicing of the HeartTouch Technique on perceived stress, spiritual well-being, and hardiness. Journal of Holistic Nursing, 24, 164-175.
44.
Walker M. J. ( 2008). Nurses’ experiences of practicing the HeartTouch Technique for one month. Journal of Holistic Nursing, 26, 271-282.
45.
Watson, J. ( 2008). Nursing: The philosophy and science of caring (2nd ed.). Boulder: University Press of Colorado.
46.
World Health Organization QOL Spirituality, Religion, and Personal Beliefs Group. (2006). A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life. Social Science & Medicine, 62, 1486-1497.
