SPIRITUAL WELL-BEING AND DEPRESSION IN HEART FAILURE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Depression detected during hospitalization for heart failure is associated with poor health status, decreased quality of life, higher readmission rates, and higher mortality. Identifying remediable factors associated with depression may provide targets for interventions to reduce these adverse outcomes. Previous research has demonstrated a link between spiritual well-being and lower rates of depression in patients with cancer. Broadly, spirituality may be defined as the way in which people understand ultimate meaning and value in their lives. The primary objectives of this study are to test the feasibility of assessing spiritual well-being in a sample of elderly patients with advanced heart failure and to determine if lower levels of spiritual well-being are associated with depression. The number of patients over age 65 with advanced heart failure is growing rapidly. Novel approaches to prevent and treat depression are needed. Spirituality may be an important factor in the large burden of depression in patients with advanced heart failure. Improving spiritual well-being represents a potential intervention to prevent or treat depression. The first step in achieving this long term goal is to better understand the relationship between spirituality and depression in this population. We will use a cross-sectional design to evaluate 60 outpatients over age 65 with Class 2, 3, or 4 New York Heart Association (NYHA) heart failure or Stage D heart failure. We will measure spiritual well-being with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sb), a measure that has been developed and validated in a large sample of patients with serious medical illness. Semi-structured interviews in a subset of patients will complement surveys by exploring participants' views about the relationship between spiritual well-being and mood. These interviews will also investigate how healthcare professionals might address unmet spiritual needs. This preliminary study will contribute to our understanding of the relationship of spirituality to depression in patients with advanced heart failure and may suggest what aspects of spirituality merit further study as potential targets for reducing depression in this population. Furthermore, this project will provide information about the potential for addressing unmet spiritual needs in patients with advanced heart failure.