The Effect of Spiritual Care Based on the Sound Heart Model on the Spiritual Health of Patients with Acute Myocardial Infarction

The effects of nurse-led spiritual care on psychological well-being in the healthcare services of patients with cardiovascular diseases in Iran: a systematic review

BACKGROUND

Cardiovascular disease (CVD) significantly impacts patients' lives, affecting not only their physical health but also their spiritual well-being. While holistic care acknowledges the importance of addressing spiritual needs, the integration of nurse-led spiritual care within CVD management remains understudied.

OBJECTIVES

This systematic review aimed to evaluate the effectiveness of spiritual and psychological interventions in enhancing quality of life and reducing anxiety among CVD patients.

METHODS

Following the PRISMA guidelines, we conducted a comprehensive search across multiple databases (PubMed, Scopus, EMBASE, CINAHL, Cochrane Library, SID, Magiran, and Web of Science) for relevant articles published in English and Persian between 2013 and 2023. The risk of bias in included experimental and quasi-experimental studies was assessed using ROB 2 and ROBINS-I scales.

RESULTS

The initial search yielded 1416 articles. After applying inclusion and exclusion criteria, along with qualitative evaluation, 15 studies with a total of 1035 participants were selected for review. These studies explored the impact of spiritual interventions (e.g., healthy heart model, emotion-oriented approach, communication with a higher power, acceptance, and relationship improvement) on anxiety, stress, life expectancy, depression, blood parameters, spiritual experiences, pain, and negative emotions in CVD patients. All reviewed studies reported positive outcomes with spiritual interventions, demonstrating their effectiveness in reducing anxiety, depression, pain, stress, and negative emotions, while also improving quality of life and possibly life expectancy.

CONCLUSION

Integrating spiritual care into routine care for CVD patients presents a promising approach to improve their overall well-being. This review highlights the effectiveness of spiritual interventions in reducing various negative emotions and enhancing quality of life.

TRIAL REGISTRATION

PROSPERO (CRD42023448687).

Death Anxiety in Patients with a History of Coronary Artery Bypass Graft Surgery During the COVID-19 Pandemic: The Role of Spiritual Well-Being and Coping Strategies

Patients who have previously undergone coronary artery bypass surgery (CABG) were prone to death anxiety during the COVID-19 pandemic. It appears that spiritual well-being and appropriate coping strategies may mitigate the harmful effects of death anxiety. Therefore, this study aimed to determine the level of death anxiety in patients with CABG during the COVID-19 pandemic and investigate the relationship between spiritual well-being, coping strategies and death anxiety.This cross-sectional study was conducted on 100 patients with CABG history in Tehran from June 2021 to February 2022. The face-to-face questionnaire, containing questions on demographics, Templer's death anxiety scale, the spiritual well-being questionnaire, and the ways of coping questionnaire was administered to collect data. Statistical analysis was performed using descriptive-analytical statistics, correlation tests, and logistic regression models.Participants' mean age was 55.59 ± 12.78 years. The mean death anxiety score was 10.00 ± 2.16, with 87% of participants reporting high levels and 13% reporting low levels of death anxiety. Based on the results, there was a significant negative correlation between death anxiety and coping strategies, as well as subscales of distancing, seeking social support, accepting responsibility, and planful problem-solving. Logistic regression showed that with the increase in the score of spiritual well-being, the odds of having high levels of death anxiety decreased (p < 0.05). Furthermore, increasing the total score of coping strategies, and the score of self-controlling, seeking social support, accepting responsibility, and planful problem-solving, significantly reduced the odds of high levels of death anxiety (p < 0.05).The study showed that patients with a CABG history experienced high death anxiety during the COVID-19 pandemic. According to the findings, spiritual well-being and coping strategies, especially self-controlling, seeking social support, accepting responsibility, and planful problem-solving, may reduce the odds of severe death anxiety. These should be considered as effective targets for psychological intervention in these patients.

Impact of Hope on Stroke Patients Receiving a Spiritual Care Program in Iran: A Randomized Controlled Trial

This study sought to examine the effect of a spiritual program on the hope of stroke patients in Iran. The present study was a randomized controlled trial that included 108 stroke patients referred to Besat Hospital, Hamadan, Iran, in 2021. Participants were randomized to either the intervention group (n = 54) or control group (n = 54). The data were collected before the intervention by using the demographic information form, Snyder's Adult Hope Scale (AHS), the Modified Rankin Scale (MRS), and after the intervention, the  Snyder's Adult Hope Scale (AHS). The intervention group received four sessions of 45-60 min (one session per week) that included a spiritual needs assessment, religious care, spiritual supportive care, and evaluation of benefits. After the intervention, a significant between-group difference was observed (p < 0.001). There was also a significant increase in the mean of hope scores in the intervention group from baseline to follow-up (within-group difference) (p < 0.001), while there was no significant difference between baseline and follow-up in the control group (p = 0.553). (IRCT 20160110025929N36 and date: 2021/09/27).

Spiritual Interventions Delivered by Nurses to Address Patients' Needs in Hospitals or Long-Term Care Facilities: A Systematic Review

Introduction: Despite increasing evidence of the benefits of spiritual care and nurses' efforts to incorporate spiritual interventions into palliative care and clinical practice, the role of spirituality is not well understood and implemented. There are divergent meanings and practices within and across countries. Understanding the delivery of spiritual interventions may lead to improved patient outcomes. Aim: We conducted a systematic review to characterize spiritual interventions delivered by nurses and targeted outcomes for patients in hospitals or assisted long-term care facilities. Methodology: The systematic review was developed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and a quality assessment was performed. Our protocol was registered on PROSPERO (Registration No. CRD42020197325). The CINAHL, Embase, PsycINFO, and PubMed databases were searched from inception to June 2020. Results: We screened a total of 1005 abstracts and identified 16 experimental and quasi-experimental studies of spiritual interventions delivered by nurses to individuals receiving palliative care or targeted at chronic conditions, such as advanced cancer diseases. Ten studies examined existential interventions (e.g., spiritual history, spiritual pain assessment, touch, and psychospiritual interventions), two examined religious interventions (e.g., prayer), and four investigated mixed interventions (e.g., active listening, presence, and connectedness with the sacred, nature, and art). Patient outcomes associated with the delivery of spiritual interventions included spiritual well-being, anxiety, and depression. Conclusion: Spiritual interventions varied with the organizational culture of institutions, patients' beliefs, and target outcomes. Studies showed that spiritual interventions are associated with improved psychological and spiritual patient outcomes. The studies' different methodological approaches and the lack of detail made it challenging to compare, replicate, and validate the applicability and circumstances under which the interventions are effective. Further studies utilizing rigorous methods with operationalized definitions of spiritual nursing care are recommended.

Religious Affiliations and Clinical Outcomes in Korean Patients With Acute Myocardial Infarction

Objective

Although religion is expected to have a direct or indirect effect on various aspects of human life, information on the association between religion and acute myocardial infarction (AMI) is inadequate. Hence, in this study, we aimed to investigate the clinical effect of religion on clinical outcomes in patients with AMI.

Methods

A total of 2,348 patients with AMI who were treated by percutaneous coronary intervention (PCI) were enrolled in the study, and they were categorized into two groups depending on their religious belief: religious and non-religious groups. The characteristics and clinical outcomes of both groups were compared.

Results

Compared with the religious group, the non-religious group was younger, included mostly men, was more likely to smoke, and was more likely to be diagnosed with ST-segment elevation myocardial infarction. However, the non-religious group was less likely to have a history of hypertension and tended to receive PCI more quickly with shorter door-to-balloon time. Regarding 1-year clinical outcomes, no differences were found between the two groups.

Conclusion

Despite a growing body of evidence that religious activities have positive effects on human physical health, our results showed a lack of significant differences in 1-year clinical outcomes in patients with AMI irrespective of their religious beliefs.

Analysis on the Effect of the Rehabilitation Intervention-Centered Targeted Nursing Model on the Cardiac Function Recovery and Negative Emotions in Patients with Acute Myocardial Infarction

Rehabilitation intervention which refers to the functional training by caregivers with the aid of specialized nursing techniques and the progressive promotion of patients' training initiative, with the purpose of improving mobility and quality of life, is of great significance. The purpose of the study was to investigate the effect of the rehabilitation intervention-centered targeted nursing model on the cardiac function recovery and negative emotions in patients with acute myocardial infarction (AMI). A total of 120 AMI patients admitted to our hospital between January 2019 and January 2020 were selected as the study subjects and randomly divided into group A (n = 60) and group B (n = 60), in which the group B patients received routine nursing combined with rehabilitation intervention, while based on the treatment in group B, the patients in group A underwent rehabilitation intervention-centered targeted nursing model. Then, the cardiac function indexes, negative emotion score, levels of risk factors for heart failure, complication rate (CR), and the quality of life (QOL) of the patients were compared between the two groups. The cardiac function indexes of the patients after nursing in group A were significantly better than those in group B (P < 0.001); the negative emotion scores of the patients after nursing in group A were significantly lower than those in group B (P < 0.001); the levels of risk factors for heart failure of the patients after nursing in group A were significantly lower than those in group B (P < 0.001); the CR of the patients in group A at 15 d and 30 d after admission was significantly lower than that in group B (P < 0.05); the QOL scores of the patients after nursing in group A were significantly higher than those in group B (P < 0.001). Rehabilitation intervention-centered targeted nursing model can optimize cardiac function, weaken the levels of risk factors for heart failure, reduce the incidence of complications, improve psychological conditions, and enhance the quality of life in AMI patients, which is worthy of application and promotion in clinical practice.

The influence of spirituality and religion on critical care nursing: An integrative review

BACKGROUND

Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed.

AIMS AND OBJECTIVES

To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing.

METHODS

An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included.

RESULTS

Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinical practice. Nurses are encouraged to increase their knowledge and awareness towards spiritual issues.