title: Spiritual well-being and depression in patients with heart failure.
abstract: BACKGROUND
  In patients with chronic heart failure, depression is common and associated with poor quality of life, more frequent hospitalizations, and higher mortality. Spiritual well-being is an important, modifiable coping resource in patients with terminal cancer and is associated with less depression, but little is known about the role of spiritual well-being in patients with heart failure.
  
  
  OBJECTIVE
  To identify the relationship between spiritual well-being and depression in patients with heart failure.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Sixty patients aged 60 years or older with New York Heart Association class II-IV heart failure.
  
  
  METHODS
  Spiritual well-being was measured using the total scale and 2 subscales (meaning/peace, faith) of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being scale, depression using the Geriatric Depression Scale-Short Form (GDS-SF).
  
  
  RESULTS
  The median age of participants was 75 years. Nineteen participants (32%) had clinically significant depression (GDS-SF > 4). Greater spiritual well-being was strongly inversely correlated with depression (Spearman's correlation -0.55, 95% confidence interval -0.70 to -0.35). In particular, greater meaning/peace was strongly associated with less depression (r = -.60, P < .0001), while faith was only modestly associated (r = -.38, P < .01). In a regression analysis accounting for gender, income, and other risk factors for depression (social support, physical symptoms, and health status), greater spiritual well-being continued to be significantly associated with less depression (P = .05). Between the 2 spiritual well-being subscales, only meaning/peace contributed significantly to this effect (P = .02) and accounted for 7% of the variance in depression.
  
  
  CONCLUSIONS
  Among outpatients with heart failure, greater spiritual well-being, particularly meaning/peace, was strongly associated with less depression. Enhancement of patients' sense of spiritual well-being might reduce or prevent depression and thus improve quality of life and other outcomes in this population.
authors: Department of Medicine, Division of General Internal Medicine, University of Colorado at Denver and Health Sciences Center, Denver, CO 80262, USA. David.Bekelman@UCHSC.edu
authors: David B
authors: DB
authors: Bekelman
authors: Sydney M
authors: SM
authors: Dy
authors: Diane M
authors: DM
authors: Becker
authors: Ilan S
authors: IS
authors: Wittstein
authors: Danetta E
authors: DE
authors: Hendricks
authors: Traci E
authors: TE
authors: Yamashita
authors: Sheldon H
authors: SH
authors: Gottlieb
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology; D018434:Sickness Impact Profile; D029181:Spirituality