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Editorial

Spirituality and Cardiovascular Disease: Valuing Cultural Sensitivity in Cardiology

Health professionals should be sensitive to the fact that their patients have different health values, which could be influenced by cultural and spiritual aspects. Current evidence has shown that spiritual and religious (S/R) beliefs can have both a positive and negative association with different health outcomes, such as depression, anxiety, mortality, quality of life, hospitalization, chronic illnesses, and substance use, among others.

In this context, the field of “Spirituality and Health” has been constantly growing in the scientific community, driven by the number of studies, the interest of medical schools, and its incorporation into guidelines from different medical organizations.

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Original Article

Association between Spirituality and Adherence to Management in Outpatients with Heart Failure

Juglans Souto Alvarez et al. Livia Adams Goldraich Alice Hoefel Nunes Mônica Cristina Brugalli Zandavalli … Rafaela Brugalli Zandavalli Karlyse Claudino Belli Neusa Sica da Rocha Marcelo Pio de Almeida Fleck Nadine Clausell

Abstract

Background:

Spirituality may influence how patients cope with their illness.

Objectives:

We assessed whether spirituality may influence adherence to management of outpatients with heart failure.

Methods:

Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence.

Results:

One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments.

Conclusion:

Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.