SPIRITUAL WELL-BEING AND DEPRESSION IN HEART FAILURE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。在心力衰竭住院期间检测到的抑郁与健康状况差、生活质量下降、再入院率较高和死亡率较高相关。确定与抑郁症相关的可补救因素可能为干预措施提供目标，以减少这些不良后果。以前的研究已经证明了精神幸福与癌症患者抑郁症发病率较低之间的联系。广义上讲，灵性可以被定义为人们理解生命终极意义和价值的方式。本研究的主要目的是测试评估晚期心力衰竭老年患者的精神健康的可行性，并确定较低水平的精神健康是否与抑郁症相关。65岁以上的晚期心力衰竭患者数量正在迅速增长。需要新的方法来预防和治疗抑郁症。灵性可能是晚期心力衰竭患者抑郁负担的一个重要因素。改善精神健康是预防或治疗抑郁症的潜在干预措施。实现这一长期目标的第一步是更好地了解这一人群中灵性和抑郁症之间的关系。我们将采用横断面设计评价60例年龄超过65岁的纽约心脏协会（NYHA）2、3或4级心力衰竭或D期心力衰竭门诊患者。我们将使用慢性疾病治疗精神健康量表（FACIT-Sb）的功能评估来衡量精神健康，该量表已在患有严重医学疾病的大样本患者中开发和验证。对一部分患者的半结构化访谈将通过探索参与者对精神健康和情绪之间关系的看法来补充调查。这些访谈还将调查医疗保健专业人员如何解决未满足的精神需求。这项初步研究将有助于我们了解灵性与晚期心力衰竭患者抑郁症的关系，并可能表明灵性的哪些方面值得进一步研究，作为减少这一人群抑郁症的潜在目标。此外，该项目将提供有关解决晚期心力衰竭患者未满足的精神需求的潜力的信息。

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.