Spirituality, Religion, and Clinical Outcomes in Patients Recovering From an Acute Myocardial Infarction

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Psychosomatic Medicine (Impact Factor: 3.47). 07/2007; 69(6):501-8. DOI: 10.1097/PSY.0b013e3180cab76c
Source: PubMed


To assess the prospective relationship between spiritual experiences and health in a sample of patients surviving an acute myocardial infarction (AMI) with depression or low social support.
A subset of 503 patients participating in the enhancing recovery in coronary heart disease (ENRICHD) trial completed a Daily Spiritual Experiences (DSE) questionnaire within 28 days from the time of their AMI. The questionnaire assessed three spirituality variables-worship service/church attendance, prayer/meditation, and total DSE score. Patients also completed the Beck Depression Inventory to assess depressive symptoms and the ENRICHD Social Support Inventory to determine perceived social support. The sample was subsequently followed prospectively every 6 months for an average of 18 months to assess all-cause mortality and recurrent AMI.
Of the 503 participants who completed the DSE questionnaire at the time of index AMI, 61 (12%) participants either died or sustained a recurrent MI during the follow-up period. After adjustment for gender, education level, ethnicity, and a composite medical prognosis risk score derived specifically for the ENRICHD trial, we observed no relationship between death or nonfatal AMI and total spirituality as measured by the DSE (p = .446), worship service attendance (p = .120), or frequency of prayer/meditation (p = .679).
We found little evidence that self-reported spirituality, frequency of church attendance, or frequency of prayer is associated with cardiac morbidity or all-cause mortality post AMI in patients with depression and/or low perceived support.

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    • "Furthermore, the use of religious practices among African Americans is associated with fewer lifetime mood disorders (Chatters et al., 2008). Although religious practices consist of a variety of behaviors , religious service attendance and praying have been studied most frequently (Blumenthal et al., 2007; Taylor, Chatters, & Levin, 2004). As a result, much less is known about the use of The Bible and scripture passages for guidance and comfort to manage the stress that may lead to negative moods associated with major life events (Taylor et al., 2004). "
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    ABSTRACT: BACKGROUND:: The use of religious practices to promote mental health among African Americans is well documented. African Americans are more likely to report strong religious affiliationsand to use religion over prescribed medications for mental health problems. However, few studies have exploredhow African Americans use religious practices in response to stressful life events. OBJECTIVE:: The aim of this study is to examine how African American women and men find comfort in using scripture passages from The Bible. METHODS:: Fifty-four African American adults residing in the Southeastern United States participated in a qualitative descriptivestudy using open-ended semistructured interviews. Participants were asked to describe their use of scripture passages from The Bible and the personal meanings associatedwith these scriptures in the context of a family death or life-threatening illness. RESULTS:: These participants used scripture passages categorized as God as Protector, God as Beneficent, Praise and Thanksgiving, God as Healer, Memory of Forefathers, Prayers to God, and Life after Death. Few gender differences were noted. However, women were more likely to use scripture passages of God as Protector and Life after Death, whereas men were more likely to use God as Beneficent and God as Healer. DISCUSSION:: The religious practice of reading scripture passages from The Bible is a mental health-promoting strategy used during stressful life events. The findings of this study have practical uses for nurses and can be used to inform acceptable and sensitive approaches in addressing mental health issues and spiritual care needs in African American patients.
    Nursing research 05/2013; 62(3):178-184. DOI:10.1097/NNR.0b013e31828fc816 · 1.36 Impact Factor
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    • "The findings of many quantitative studies conducted on spirituality in cardiac patients support the association between spirituality/religion and prevalence of heart attack risk factors, especially stress,[21–24] quality of life improvement, and self-efficacy after MI,[25] psychological health and coping,[232526] and so on. "
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    ABSTRACT: Life-threatening and stressful events, such as myocardial infarction (MI) can lead to an actual crisis, which affects the patients spiritually as well as physically, psychologically, and socially. However, the focus of health care providers is on physical needs. Furthermore, the spirituality of the patients experiencing heart attack in the light of our cultural context is not well addressed in the literature. This study is aimed at exploring the spiritual experiences of the survivors of the MI. In this qualitative research a grounded theory approach was used. Key informants were 9 MI patients hospitalized in the coronary care units of 3 hospitals in Shiraz. In addition, 7 nurses participated in the study. In-depth interviews and a focus group were used to generate data. Data analysis was done based on Strauss and Corbin method. Constant comparison analysis was performed until data saturation. Five main categories emerged from the data, including perceived threat, seeking spiritual support, referring to religious values, increasing faith, and realization. The latter with its 3 subcategories was recognized as core category and represents a deep understanding beyond knowing. At the time of encountering MI, spirituality provided hope, strength, and peace for the participants. Based on the results we can conclude that connecting to God, religious values, and interconnectedness to others are the essential components of the participants' spiritual experience during the occurrence of MI. Spirituality helps patients to overcome this stressful life-threatening situation.
    Iranian journal of nursing and midwifery research 07/2012; 17(5):343-51.
    • "Study of Morris showed that scores of spirituality significantly were correlated with intensity or recurrence of coronary artery stenosis during four years and it seems level of SWB is an important factor in exacerbation of coronary artery disease.[14] On the contrary, Blumenthal et al. reported few evidences that spirituality, frequency of going to church or praying is correlated with cardiac complications or mortality following acute Myocardial Infraction (MI) in depressed patients or those with little support.[15] "
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    ABSTRACT: Spiritual well-being (SWB) of patients with cardiovascular diseases particularly in those admitted in coronary care unit (CCU) is threatened due to disease crisis. Therefore, implementing spiritual care is necessary for them. This study aimed to determine the effect of spiritual care program on SWB of patients with cardiac ischemia admitted in CCU in Al-Zahra Hospital, Isfahan, Iran. In a single blind randomized clinical trial, 64 ischemic patients in CCU were randomly divided into test and control groups. Spiritual care program included supportive presence, rituals and using supportive systems for 3 days. Spiritual Well-being Questionnaire were completed before and after the intervention for the both groups. Mean scores of SWB had no significant difference between the two groups before the intervention (p = 0.84). Mean score of existence dimension (p < 0.001) and mean total score of SWB (p < 0.001) in the test group showed a significant difference comparing before and after the intervention; however, it was not significant in the control group (p = 0.17). Mean existence dimension (p = 0.01) and mean total score SWB (p = 0.01) had a significant difference between test and control groups after the intervention; however, there was no significant difference in mean score of religious dimension between the two groups after the intervention (p = 0.25). The spiritual care program promoted the SWB of ischemic patients in existence dimension and overall score, and nurses can use these programs to promote patients' SWB.
    Iranian journal of nursing and midwifery research 03/2012; 17(3):195-9.
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