Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction.
ABSTRACT 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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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.
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ABSTRACT: Objectives To test the association among depression symptoms, distressed personality type, and preoperative beta-blocker nonadherence and to estimate the prevalence of untreated major depression in this population. Design Prospective observational study. Setting A veterans hospital. Participants One hundred twenty patients on outpatient beta-blocker therapy presenting for surgery. Interventions The Patient Health Questionnaire (PHQ)-9, the D-Scale-14 (DS14), and Modified Morisky Scale (MMS) questionnaires. Measurements and Main Results Of 99 participants who presented for surgery, the incidence of preoperative nonadherence was 14.1% (95% confidence interval 7%-21%), consistent with prior research. Nonadherence was 9.5% among those with no depression, 27.8% among those with mild depression, and 28.6% among those with moderate-to-severe depression (Cochran-Armitage test for trend p = 0.03). Distressed personality type was found in 35% of the cohort (95% confidence interval 26-45%) and was not associated with beta-blocker nonadherence (Fisher’s exact test, p = 0.24). Among participants with symptoms of major depressive disorder (n = 25, 25.3%), more than half (n = 14, 56%) had no indication of depression listed at their most recent primary care visit. Conclusions Patients with symptoms of depression on chronic beta-blocker therapy are susceptible to medication nonadherence on the day of surgery. Most surgical patients with symptoms of major depression lack a diagnosis of depression. Preoperative depression screening may thus (1) identify a population at increased risk of beta-blocker withdrawal, and (2) identify patients who may benefit from anesthesiologist-initiated referral for this treatable condition.Journal of Cardiothoracic and Vascular Anesthesia 09/2014; 28(6). DOI:10.1053/j.jvca.2014.05.006 · 1.48 Impact Factor
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ABSTRACT: This study aims to assess the relationship between religious attitudes of Ilam universities students (west of Iran), their perspectives about the fear of self and other's death and dying, with their general health. This paper is an analytic survey in which 351 college students, who were selected by multistage sampling, participated. To measure interested variables, Persian format of standardized self-administered questionnaires was employed. Religious attitudes with odds ratio (OR) of 0.94 (95 % CI 0.91-0.97) and fear of self dying with 0.88 (95 % CI 0.81-0.96) were identified as a protective factors against the inappropriate general health condition. However, the fear of other's death (OR 1.16; 95 % CI 1.05-1.28) was identified as a risk factor. This study showed that people who had more religious attitudes and fear of self dying had better general health as well as the fear of other's death had a significant direct relationship with inappropriate general health condition.Journal of Religion and Health 06/2014; DOI:10.1007/s10943-014-9903-6 · 1.02 Impact Factor