Spiritual well-being and depression in patients with heart failure

J Gen Intern Med. 2007 Apr;22(4):470-7. doi: 10.1007/s11606-006-0044-9.


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.

Design: Cross-sectional study.

Participants: Sixty patients aged 60 years or older with New York Heart Association class II-IV heart failure.

Measurements: 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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Depressive Disorder / complications*
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Heart Failure / complications*
  • Heart Failure / epidemiology*
  • Heart Failure / psychology
  • Humans
  • Male
  • Quality of Life / psychology
  • Sickness Impact Profile
  • Spirituality*