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Association between Spirituality and Adherence to Management inOutpatients with Heart Failure

View Article: PubMed Central - PubMed

ABSTRACT

Background: Spirituality may influence how patients cope with their illness.

Objectives: We assessed whether spirituality may influence adherence to management ofoutpatients with heart failure.

Methods: Cross sectional study enrolling consecutive ambulatory heart failure patientsin whom adherence to multidisciplinary treatment was evaluated. Patientswere assessed for quality of life, depression, religiosity and spiritualityutilizing validated questionnaires. Correlations between adherence andpsychosocial variables of interest were obtained. Logistic regression modelsexplored independent predictors of adherence.

Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) wereinterviewed. Adequate adherence score was observed in 38.5% of the patients.Neither depression nor religiosity was correlated to adherence, whenassessed separately. Interestingly, spirituality, when assessed by bothtotal score sum (r = 0.26; p = 0.003) and by all specific domains, waspositively correlated to adherence. Finally, the combination ofspirituality, religiosity and personal beliefs was an independent predictorof adherence when adjusted for demographics, clinical characteristics andpsychosocial instruments.

Conclusion: Spirituality, religiosity and personal beliefs were the only variablesconsistently associated with compliance to medication in a cohort ofoutpatients with heart failure. Our data suggest that adequately addressingthese aspects on patient’s care may lead to an improvement in adherencepatterns in the complex heart failure management.

No MeSH data available.


Score of spirituality (WHOQoL-SRPB) according to quartiles of adherenceas per REMADHE score. p-value of 0.052 by Kruskal-Wallis test Error barsrepresent standard-deviation.
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f2: Score of spirituality (WHOQoL-SRPB) according to quartiles of adherenceas per REMADHE score. p-value of 0.052 by Kruskal-Wallis test Error barsrepresent standard-deviation.

Mentions: The correlations between the adherence score with clinical characteristics andpsychosocial scores are demonstrated in Table3. A description of associations of demographic and clinical variableswith the adherence score is also described in the Supplemental Table. Among demographics, REMADHE score differed onlyaccording to marital status. Clinical characteristics associated to higher adherencescores were ischemic HF etiology, presence of an implantable cardiac defibrillatorand chronic kidney impairment. Adherence was positively correlated to the genericquality-of-life measure, but not to the disease-specific HF score. Neitherdepression nor religiosity was correlated to adherence. Interestingly, spirituality,when assessed by both total WHOQoL-SRPB score sum and by many specific domains, waspositively correlated to adherence. Although significantly correlated to adherencescore, the magnitude of spirituality association was relatively weak (Figure 1). Notably, there was a trend towardshigher spirituality scores across quartiles of the adherence score (Figure 2).


Association between Spirituality and Adherence to Management inOutpatients with Heart Failure
Score of spirituality (WHOQoL-SRPB) according to quartiles of adherenceas per REMADHE score. p-value of 0.052 by Kruskal-Wallis test Error barsrepresent standard-deviation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940148&req=5

f2: Score of spirituality (WHOQoL-SRPB) according to quartiles of adherenceas per REMADHE score. p-value of 0.052 by Kruskal-Wallis test Error barsrepresent standard-deviation.
Mentions: The correlations between the adherence score with clinical characteristics andpsychosocial scores are demonstrated in Table3. A description of associations of demographic and clinical variableswith the adherence score is also described in the Supplemental Table. Among demographics, REMADHE score differed onlyaccording to marital status. Clinical characteristics associated to higher adherencescores were ischemic HF etiology, presence of an implantable cardiac defibrillatorand chronic kidney impairment. Adherence was positively correlated to the genericquality-of-life measure, but not to the disease-specific HF score. Neitherdepression nor religiosity was correlated to adherence. Interestingly, spirituality,when assessed by both total WHOQoL-SRPB score sum and by many specific domains, waspositively correlated to adherence. Although significantly correlated to adherencescore, the magnitude of spirituality association was relatively weak (Figure 1). Notably, there was a trend towardshigher spirituality scores across quartiles of the adherence score (Figure 2).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Spirituality may influence how patients cope with their illness.

Objectives: We assessed whether spirituality may influence adherence to management ofoutpatients with heart failure.

Methods: Cross sectional study enrolling consecutive ambulatory heart failure patientsin whom adherence to multidisciplinary treatment was evaluated. Patientswere assessed for quality of life, depression, religiosity and spiritualityutilizing validated questionnaires. Correlations between adherence andpsychosocial variables of interest were obtained. Logistic regression modelsexplored independent predictors of adherence.

Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) wereinterviewed. Adequate adherence score was observed in 38.5% of the patients.Neither depression nor religiosity was correlated to adherence, whenassessed separately. Interestingly, spirituality, when assessed by bothtotal score sum (r = 0.26; p = 0.003) and by all specific domains, waspositively correlated to adherence. Finally, the combination ofspirituality, religiosity and personal beliefs was an independent predictorof adherence when adjusted for demographics, clinical characteristics andpsychosocial instruments.

Conclusion: Spirituality, religiosity and personal beliefs were the only variablesconsistently associated with compliance to medication in a cohort ofoutpatients with heart failure. Our data suggest that adequately addressingthese aspects on patient’s care may lead to an improvement in adherencepatterns in the complex heart failure management.

No MeSH data available.