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Religious beliefs and well-being and distress in congestive heart failure patients

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Abstract

Religiousness (typically assessed as service attendance) is often associated with well-being and psychological distress in persons with life-threatening illnesses, but little of this work has focused explicitly on religious beliefs. We examined the longitudinal relationships of religious beliefs (i.e., in God and in the afterlife) with well-being and distress (assessed 6 months later) in a sample of patients with congestive heart failure, a chronic and progressive disease. After controlling for religious service attendance, belief in God was associated with negative affect and spiritual well-being, while belief in the afterlife was associated with physical health, post-traumatic depreciation, and spiritual well-being. However, after controlling for baseline values of well-being or distress, religious beliefs were not associated with nearly all well-being or distress outcomes at follow-up. Over the 6-month duration of the study, participants increased in belief in afterlife but decreased in their belief in God. Increases in religious beliefs across time were associated with higher levels of distress. These results suggest that religious beliefs are neither positively nor negatively associated with well-being and distress independent of religious attendance among seriously ill patients with CHF. Based on these findings, healthcare providers are encouraged to assess religious belief change at the individual level to better understand and inform spiritual care for patients with late-stage CHF.

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References

  • American Heart Association. (2018). Heart disease and stroke statistics: 2018 update. Circulation,137, 67–492.

    Google Scholar 

  • Andersson, G. (2008). Chronic pain and praying to a higher power: useful or useless? Journal of Religion and Health,47, 176–187.

    Article  PubMed  Google Scholar 

  • Bahrami, H., Kronmal, R., Bluemke, D. A., Olson, J., Shea, S., Liu, K., et al. (2008). Differences in the incidence of congestive heart failure by ethnicity: The multi-ethnic study of atherosclerosis. Archives of Internal Medicine,168, 2138–2145.

    Article  PubMed  PubMed Central  Google Scholar 

  • Balboni, M. J., Sullivan, A., Enzinger, A. C., Epstein-Peterson, Z. D., Tseng, Y. D., Mitchell, C., et al. (2014). Nurse and physician barriers to spiritual care provision at the end of life. Journal of Pain and Symptom Management,48, 400–410. https://doi.org/10.1016/j.jpainsymman.2013.09.020

    Article  PubMed  PubMed Central  Google Scholar 

  • Bellizzi, K. M., Miller, M. F., Arora, N. K., & Rowland, J. H. (2007). Positive and negative life changes experienced by survivors of non-Hodgkin’s lymphoma. Annals of Behavioral Medicine,34, 88–199.

    Article  Google Scholar 

  • Blaine, B., & Crocker, J. (1995). Religiousness, race, and psychological well-being: Exploring social psychological mediators. Personality and Social Psychology Bulletin,21, 1031–1041.

    Article  Google Scholar 

  • Bollwinkel, E. M. (1994). Role of spirituality in hospice care. Annals of the Academy of Medicine, Singapore,23, 261–263.

    CAS  PubMed  Google Scholar 

  • Cadge, W. (2018). Healthcare chaplaincy as a companion profession: Historical developments. Journal of Health Care Chaplaincy,25, 45–60. https://doi.org/10.1080/08854726.2018.1463617

    Article  PubMed  Google Scholar 

  • Carver, C. S., & Antoni, M. H. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology,23, 595–598.

    Article  PubMed  Google Scholar 

  • Clark, C. C., & Hunter, J. (2019). Spirituality, spiritual well-being, and spiritual coping in advanced heart failure: Review of the literature. Journal of Holistic Nursing,37, 56–73.

    Article  PubMed  Google Scholar 

  • Contrada, R. J., Goyal, T. M., Cather, C., Rafalson, L., Idler, E. L., & Krause, T. J. (2004). Psychosocial factors in outcomes of heart surgery: The impact of religious involvement and depressive symptoms. Health Psychology,23, 227–238.

    Article  PubMed  Google Scholar 

  • Durkheim, E. (1912). The elementary forms of the religious life. Oxford University Press.

  • Edmondson, D., Park, C. L., Chaudoir, S. R., & Wortmann, J. H. (2008). Death without God: Religious struggle, death concerns, and depression in the terminally iII. Psychological Science,19, 754–758.

    Article  PubMed  Google Scholar 

  • Edwards, A., Pang, N., Shiu, V., & Chan, C. (2010). The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care: A meta-study of qualitative research. Palliative Medicine,24, 753–770.

    Article  CAS  PubMed  Google Scholar 

  • Ellison, C. G., Boardman, J. D., Williams, D. R., & Jackson, J. S. (2001). Religious involvement, stress, and mental health: Findings from the 1995 Detroit Area Study. Social Forces,80, 215–249.

    Article  Google Scholar 

  • Ellison, C. G., Burdette, A. M., & Hill, T. D. (2009). Blessed assurance: Religion, anxiety, and tranquility among US adults. Social Science Research,38, 656–667.

    Article  PubMed  Google Scholar 

  • Exline, J. J., & Rose, E. (2005). Religious and spiritual struggles. Handbook of the Psychology of Religion and Spirituality,2, 380–398.

    Google Scholar 

  • Falsetti, S. A., Resick, P. A., & Davis, J. L. (2003). Changes in religious beliefs following trauma. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies,16, 391–398.

    Article  Google Scholar 

  • Fetzer, N. I. A. (1999). Religiousness/spirituality for use in health research: A Report of the Fetzer Institute/National Institute on Aging Working Group (pp. 31–33). Kalamazoo, MI: Fetzer.

    Google Scholar 

  • Fitchett, G., Murphy, P. E., Kim, J., Gibbons, J. L., Cameron, J. R., & Davis, J. A. (2004). Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. The International Journal of Psychiatry in Medicine,34, 179–196.

    Article  PubMed  Google Scholar 

  • Frazier, P., Conlon, A., & Glaser, T. (2001). Positive and negative life changes following sexual assault. Journal of Consulting and Clinical Psychology,69, 1048–1055.

    Article  CAS  PubMed  Google Scholar 

  • Gandhi, S. K., Salmon, J. W., Zhao, S. Z., Lambert, B. L., Gore, P. R., & Conrad, K. (2001). Psychometric evaluation of the 12-item short-form health survey (SF-12) in osteoarthritis and rheumatoid arthritis clinical trials. Clinical Therapeutics, 23, 1080–1098.

    Article  CAS  PubMed  Google Scholar 

  • Gardner, R. S., & McDonagh, T. A. (2014). Chronic heart failure: Epidemiology, investigation and management. Medicine,42, 562–567.

    Article  Google Scholar 

  • Gutierrez, I. A., & Park, C. L. (2015). Emerging adulthood, evolving worldviews: How life events impact college students’ developing belief systems. Emerging Adulthood, 3, 85–97.

    Article  Google Scholar 

  • Harding, S. R., Flannelly, K. J., Weaver, A. J., & Costa, K. G. (2005). The influence of religion on death anxiety and death acceptance. Mental Health, Religion & Culture,8, 253–261.

    Article  Google Scholar 

  • Heflick, N. A., & Goldenberg, J. L. (2012). No atheists in foxholes: Arguments for (but not against) afterlife belief buffers mortality salience effects for atheists. British Journal of Social Psychology,51, 385–392.

    Article  PubMed  Google Scholar 

  • Idler, E. (1999). Beliefs. Religiousness/Spirituality for use in health research: A report of the Fetzer Institute/National Institute on Aging Working Group (pp. 31–33). Kalamazoo, MI: Fetzer.

  • Jahani, A., Rejeh, N., Heravi-Karimooi, M., Hadavi, A., Zayeri, F., & Khatooni, A. R. (2013). The relationship between spiritual health and quality of life in patients with coronary artery disease. Islamic Life Center Health,1, 17–21.

    Article  Google Scholar 

  • Jim, H. S., Pustejovsky, J. E., Park, C. L., Danhauer, S. C., Sherman, A. C., Fitchett, G., et al. (2015). Religion, spirituality, and physical health in cancer patients: A meta-analysis. Cancer,121, 3760–3768.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jonas, E., & Fischer, P. (2006). Terror management and religion: evidence that intrinsic religiousness mitigates worldview defense following mortality salience. Journal of Personality and Social Psychology,91, 553–567.

    Article  PubMed  Google Scholar 

  • Jong, J., Halberstadt, J., & Bluemke, M. (2012). Foxhole atheism, revisited: The effects of mortality salience on explicit and implicit religious belief. Journal of Experimental Social Psychology,48, 983–989.

    Article  Google Scholar 

  • Jong, J., Ross, R., Philip, T., Chang, S., Simons, N., & Halberstadt, J. (2018). The religious correlates of death anxiety: A systematic review and meta-analysis. Religion, Brain & Behavior,8, 4–20. https://doi.org/10.1080/2153599X.2016.1238844

    Article  Google Scholar 

  • Koenig, H. G., King, D. A., & Carson, V. B. (2012). Handbook of religion and health (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Krause, N., Liang, J., Shaw, B. A., Sugisawa, H., Kim, H. K., & Sugihara, Y. (2002). Religion, death of a loved one, and hypertension among older adults in Japan. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences,57, S96–S107.

    Article  PubMed  Google Scholar 

  • Lavery, M. E., & O’Hea, E. L. (2010). Religious/spiritual coping and adjustment in individuals with cancer: Unanswered questions, important trends, and future directions. Mental Health, Religion and Culture, 13(1), 55–65.

    Article  Google Scholar 

  • Li, S., Stampfer, M. J., Williams, D. R., & VanderWeele, T. J. (2016). Association of religious service attendance with mortality among women. JAMA Internal Medicine,176, 777–785.

    Article  PubMed  Google Scholar 

  • Macavei, B., & Miclea, M. (2008). An empirical investigation of the relationship between religious beliefs, irrational beliefs, and negative emotions. Journal of Cognitive & Behavioral Psychotherapies,8, 1–16.

    Google Scholar 

  • Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., et al. (2016). Heart disease and stroke statistics—2016 update: A report from the American Heart Association. Circulation,133, 38–360.

    Google Scholar 

  • Oman, D. (2013). Defining religion and spirituality. Handbook of the Psychology of Religion and Spirituality,2, 23–47.

    Google Scholar 

  • Park, C. L. (2007). Religiousness/spirituality and health: A meaning systems perspective. Journal of Behavioral Medicine,30, 319–328.

    Article  PubMed  Google Scholar 

  • Park, C. L. (2017). Religious cognitions and well-being: A meaning perspective. In M. D. Robinson & M. Eid (Eds.), The happy mind: Cognitive contributions to well-being (pp. 443–458). New York: Springer.

    Chapter  Google Scholar 

  • Park, C. L., Aldwin, C. M., Choun, S., Suresh, D. P., & Bliss, D. (2016). Spiritual peace predicts 5-year mortality in congestive heart failure patients. Health Psychology, 35, 203–210.

    Article  PubMed  Google Scholar 

  • Park, C. L., & Carney, L. M. (2018). The role of spirituality and mindfulness in supporting a patient’s cancer journey. Expert Review of Quality of Life in Cancer Care. https://doi.org/10.1080/23809000.2018.1519371

    Article  Google Scholar 

  • Park, C. L., & Folkman, S. (1997). The role of meaning in the context of stress and coping. Review of General Psychology,1, 115–144.

    Article  Google Scholar 

  • Park, C. L., Lim, H., Newlon, M., Suresh, D. P., & Bliss, D. (2014). Dimensions of religiousness and spirituality as predictors of well-being in advanced CHF patients. Religion and Health,53, 579–590.

    Article  Google Scholar 

  • Park, C. L., & Sacco, S. J. (2017). Heart failure patients’ desires for spiritual care, perceived constraints, and unmet spiritual needs: Relations with well-being and health-related quality of life. Psychology, Health & Medicine, 22, 1011–1020.

    Article  Google Scholar 

  • Park, C. L., Wortmann, J. H., & Edmondson, D. (2011). Religious struggle as a predictor of subsequent mental and physical well-being in heart failure patients. Journal of Behavioral Medicine,6, 426–436.

    Article  Google Scholar 

  • Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., & Cella, D. (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.

    Article  PubMed  Google Scholar 

  • Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Biard, P., Bull, J., et al. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference. Journal of Palliative Medicine,12, 885–904. https://doi.org/10.1089/jpm.2009.0142

    Article  PubMed  Google Scholar 

  • Radloff, L. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement,1, 385–401.

    Article  Google Scholar 

  • Rohrbaugh, J., & Jessor, R. (1975). Religiosity in youth: A personal control against deviant behavior. Journal of Personality,43, 136–155.

    Article  CAS  PubMed  Google Scholar 

  • Schuetz, B. (1995). Spirituality and palliative care. Australian Family Physician, 24, 775–777.

    CAS  PubMed  Google Scholar 

  • Selman, L., Harding, R., Beynon, T., Hodson, F., Coady, E., Hazeldine, C., et al. (2007). Improving end-of-life care for patients with chronic heart failure: “Let’s hope it’ll get better, when I know in my heart of hearts it won’t”. Heart,93, 963–967.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vail, K. E., III, Arndt, J., & Abdollahi, A. (2012). Exploring the existential function of religion and supernatural agent beliefs among Christians, Muslims, atheists, and agnostics. Personality and Social Psychology Bulletin,38, 1288–1300.

    Article  PubMed  Google Scholar 

  • Vail, K. E., III, Rothschild, Z. K., Weise, D. R., Solomon, S., Pyszczynski, T., & Greenberg, J. (2010). A terror management analysis of the psychological functions of religion. Personality and Social Psychology Review,14, 84–94.

    Article  PubMed  Google Scholar 

  • VanderWeele, T. J. (2017). Religious communities and human flourishing. Current Directions in Psychological Science,26, 476–481.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ware, J. E., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care,34, 220–233.

    Article  PubMed  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology,54, 1063–1070.

    Article  CAS  PubMed  Google Scholar 

  • Willer, R. (2009). No atheists in foxholes: Motivated reasoning and religious belief. In J. T. Jost, A. C. Kay, & H. Thorisdottir (Eds.), Social and psychological bases of ideology and system justification (pp. 241–264). New York, NY: Oxford University Press.

    Chapter  Google Scholar 

  • World Health Organization. (2004). Palliative care: Symptom management and end-of-life care: Integrated management of adolescent and adult illness. Retrieved September, 2016 from https://www.who.int/hiv/pub/imai/genericpalliativecare082004.pdf.

  • Yaghoobzadeh, A., Soleimani, M. A., Allen, K. A., Chan, Y. H., & Herth, K. A. (2018). Relationship between spiritual well-being and hope in patients with cardiovascular disease. Journal of Religion and Health, 57, 938–950.

    Article  PubMed  Google Scholar 

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Correspondence to Lauren M. Carney.

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All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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This study was funded by a Grant from by the American Heart Association-Ohio Valley through a Scientist Development Grant (#1 R03 AG 023883). The study was approved by the University of Connecticut Institutional Review Board.

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Carney, L.M., Park, C.L. & Gutierrez, I.A. Religious beliefs and well-being and distress in congestive heart failure patients. J Behav Med 43, 437–447 (2020). https://doi.org/10.1007/s10865-019-00115-3

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