title: Spiritual peace predicts 5-year mortality in congestive heart failure patients.
abstract: OBJECTIVE
  Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness.
  
  
  METHODS
  Participants were 191 CHF patients (64% male; M age = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for 5 years.
  
  
  RESULTS
  Nearly 1/3 of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, whereas alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. Although both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors.
  
  
  CONCLUSIONS
  Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions.
authors.affiliation: Department of Psychology, University of Connecticut.
authors.forename: Crystal L
authors.initials: CL
authors.lastname: Park
authors.affiliation: Program in Human Development & Family Sciences, School of Social & Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Aldwin
authors.affiliation: Program in Human Development & Family Sciences, School of Social & Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University.
authors.forename: Soyoung
authors.initials: S
authors.lastname: Choun
authors.affiliation: Department of Psychology, University of Connecticut.
authors.forename: Login
authors.initials: L
authors.lastname: George
authors.affiliation: Department of Cardiology, St. Elizabeth's Hospital.
authors.forename: Damodhar P
authors.initials: DP
authors.lastname: Suresh
authors.affiliation: Department of Cardiology, St. Elizabeth's Hospital.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bliss
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D016016:Proportional Hazards Models; D018570:Risk Assessment; D029181:Spirituality; D011795:Surveys and Questionnaires