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Estimated longevity and changes in spirituality in the context of advanced congestive heart failure

Published online by Cambridge University Press:  19 February 2008

Crystal L. Park
Crystal L. Park*
Affiliation:
Department of Psychology, University of Connecticut, Storrs, Connecticut
*
Address correspondence and reprint requests to: Crystal L. Park, Department of Psychology, University of Connecticut, Storrs, CT, 06269-1020, USA. E-mail: [email protected]
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Abstract

Objective:

To examine (1) advanced congestive heart failure (CHF) patients' estimates of their longevity and changes in these estimates over time; (2) clinical, functional, and psychological adjustment correlates of these longevity estimates; and (3) correspondence of changes in longevity and changes in multiple dimensions of spirituality over time.

Methods:

Longitudinal questionnaire-based study of 111 patients diagnosed with severe CHF assessed at two time points separated by 6 months.

Results:

Nearly half of the participants estimated their longevity as at least 5–10 years, and there was very little change in estimates across the assessment periods. Longevity estimates were minimally related to clinical or functional indicators, but longer estimates were related to fewer depressive symptoms and higher levels of life satisfaction. Multivariate regression analyses indicated that shifting longevity estimates toward less time or toward uncertainty was related to increases in religious life meaning and forgiveness and to decreased spiritual struggle over the 6-month interval. No effects were observed for daily spiritual experiences.

Significance of results:

Because very little is known about how individuals estimate their remaining life span, these results establish information regarding their basis (i.e., not clinical or functional) and stability, at least in the context of advanced heart failure. In addition, the notion that individuals become more spiritual as they perceive the approach of death was borne out in terms of multiple aspects of spirituality.

Keywords

Advanced heart failureEstimated longevitySpiritualitySpiritual struggleForgiveness
Type
Original Articles
Information
Palliative & Supportive Care , Volume 6 , Issue 1 , March 2008 , pp. 3 - 11
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

American Heart Association (2007). Heart Disease and Stroke Statistics—2007 Update. Dallas, Texas: American Heart Association.Google Scholar
Bosworth, H.B., Steinhauser, K.E., Orr, M., et al. (2004). Congestive heart failure patients' perceptions of quality of life: The integration of physical and psychosocial factors. Aging & Mental Health, 8, 83–91.CrossRefGoogle ScholarPubMed
Bretscher, M., Rummans, T., Sloan, J., et al. (1999). Quality of life in hospice patients: A pilot study. Psychosomatics: Journal of Consultation Liaison Psychiatry, 40, 309–313.CrossRefGoogle ScholarPubMed
Diener, E., Emmons, R.A., Larsen, R.J., et al. (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49, 71–75.CrossRefGoogle ScholarPubMed
Exline, J.J. & Rose, E. (2005). Religious and spiritual struggles. In Handbook of the Psychology of Religion and Spirituality, Paloutzian, R.F. & Park, C.L. (eds.), pp. 315–330. New York: Guilford.Google Scholar
Exline, J., Yali, M., & Sanderson, W. (2000). Guilt, discord, and alienation: The role of religious strain in depression and suicidality. Journal of Clinical Psychology, 56, 1481–1496.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Fetzer Institute/National Institute on Aging Working Group (1999). Multidimensional measurement of religiousness/spirituality for use in health research. A report of a national working group supported by the Fetzer Institute and The National Institute on Aging, Kalamazoo, MI: John E. Fetzer Institute.Google Scholar
Fitchett, G., Murphy, P.E., Kim, J., et al. (2004). Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. International Journal of Psychiatry in Medicine, 34, 179–196.CrossRefGoogle ScholarPubMed
Freedland, K.E. & Carney, R.M. (2000). Psychosocial considerations in elderly patients with heart failure. Clinical Geriatrics, 16, 649–661.CrossRefGoogle ScholarPubMed
Gibbs, J.S.R., McCoy, A.S.M., Gibbs, L.M.E., et al. (2002). Living with and dying from heart failure: The role of palliative care. Heart, 88, 36–39.Google ScholarPubMed
Goodlin, S., Hauptman, P.J., Arnold, R., et al. (2004). Consensus Statement: Palliative and Supportive Care in Advanced Heart Failure. Journal of Cardiac Failure, 10, 200–209.CrossRefGoogle ScholarPubMed
Gottlieb, S.H. (2003). Palliative care in heart failure. Advanced Studies in Medicine, 3, 456–464.Google Scholar
Hamrick, N. & Diefenbach, M.A. (2006). Religion and spirituality among patients with localized prostate cancer. Palliative and Supportive Care, 4, 345–355.CrossRefGoogle ScholarPubMed
Hanratty, B., Hibbert, D., Mair, F., et al. (2002). Doctors' perceptions of palliative care for heart failure: Focus group study. British Medical Journal, 325, 581–585.CrossRefGoogle ScholarPubMed
Hauptman, P.J. & Havranek, H.P. (2005). Integrating palliative care into heart failure care. Archives of Internal Medicine, 165, 374–378.CrossRefGoogle ScholarPubMed
Heo, S., Moser, D.K., Riegel, B., et al. (2005). Testing a published model of health-related quality of life in heart failure. Journal of Cardiac Failure, 11, 372–379.CrossRefGoogle ScholarPubMed
Hinton, J. (1999). The progress of awareness and acceptance of dying assessed in cancer patients and their caring relatives. Palliative Medicine, 13, 19–35.CrossRefGoogle ScholarPubMed
Jaagosild, P., Dawson, N.V., Thomas, C., et al. (1998). Outcomes of acute exacerbation of severe congestive heart failure: Quality of life, resource use, and survival. SUPPORT Investigators. The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatment. Archives of Internal Medicine, 158, 1081–1089.CrossRefGoogle 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.CrossRefGoogle ScholarPubMed
Kaut, K.P. (2002). Religion, spirituality, and existentialism near the end of life. American Behavioral Scientist, 46, 220–234.CrossRefGoogle Scholar
Koenig, H. (2002). A commentary: The role of religion and spirituality at the end of life. The Gerontologist, 42, Special Issue III, 20–23.CrossRefGoogle ScholarPubMed
Levenson, J.W., McCarthy, E.P., Lynne, J., et al. (2000). Patients' experiences as death approaches: The last six months of life for patients with congestive heart failure. Journal of the American Geriatrics Society, 48, S101–S109.CrossRefGoogle ScholarPubMed
McCall, D. (1994). Congestive heart failure. In Internal Medicine, 4th ed., Stein, J.H., Hutton, J.J., & Kohler, P.O. (eds.), pp. 116–131. St. Louis, MO: Mosby.Google Scholar
Murray, S.A., Boyd, K., Kendall, M., et al. (2002). Dying of lung cancer or cardiac failure: Prospective qualitative interview study of patients and their carers in the community. British Medical Journal, 325, 929–935.CrossRefGoogle ScholarPubMed
Murray, S.A., Kendall, M., Boyd, K., et al. (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their carers. Palliative Medicine, 18, 39–45.CrossRefGoogle ScholarPubMed
Pargament, K.I. (1997). The Psychology of Religion and Coping: Theory, Research, Practice. New York: Guilford.Google Scholar
Pulchaski, C.M., Dorff, R.E., & Hendi, I.Y. (2004). Spirituality, religion, and healing in palliative care. Clinics in Geriatric Medicine, 20, 689–714.Google Scholar
Radloff, L.S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Rector, T.S., Francis, G.S., & Cohn, J.N. (1987). Patients' self-assessment of their congestive heart failure. Part 1. Patient perceived dysfunction and its poor correlation with maximal exercise tests. Heart Failure, 114, 192–196.Google Scholar
Sodestrom, K. & Martinson, I. (1987). Patients' spiritual coping strategies: A study of nurse and patient perspectives. Oncology Nursing Forum, 14, 41–46.Google ScholarPubMed
Sulmasy, D.P. (2002). A biopsychosocial-spiritual model for the care of patients at the end of life. The Gerontologist, 42 Special Issue III, 24–33.Google ScholarPubMed
Sulmasy, D.P., Terry, P.B., Weisman, C.S., et al. (1998). The accuracy of substituted judgments in patients with terminal diagnoses. Annals of Internal Medicine, 128, 621–629.CrossRefGoogle ScholarPubMed
Ware, J.E. & Kosinski, M. (2001). SF-36 Physical & Mental Health Summary Scales: A Manual for Users of Version 1, 2nd ed. Lincoln, RI: QualityMetric.Google Scholar
Williams, A. (2006). Perspectives on spirituality at the end of life: A meta-summary. Palliative and Support Care, 4, 407–417.CrossRefGoogle ScholarPubMed
Zugck, C., Kruger, C., Kell, R., et al. (2001). Risk stratification in middle-aged patients with congestive heart failure: Prospective comparison of the Heart Failure Survival Score (HFSS) and a simplified two-variable model. European Journal of Heart Failure, 3, 577–585.CrossRefGoogle Scholar