Relationship Between Spiritual Well-Being and Hope in Patients with Cardiovascular Disease

The Effect of Self-Regulation on Spiritual Well-Being Among Parents of Children with Hearing Impairment in China: Does Resilience Function as a Mediator?

This study explores spiritual well-being among parents of children with hearing impairment and how self-regulation and resilience relate to spiritual well-being in mainland China. The Self-Regulation Scale, the Resilience Scale, and the 4-Item Spiritual Well-Being Index were administered to 416 parents of children with hearing impairment. Results indicated that self-regulation positively affected resilience, and resilience positively affected spiritual well-being. Notably, resilience, as a mediating variable, weakened the effect of self-regulation on spiritual well-being. The contributions, limitations, and implications of the present research are discussed.

Multiple Mediating Roles of Self-Efficacy and Hope in the Relationship Between Teachers' Spiritual Well-Being and Job Satisfaction in Türkiye

Teachers' job satisfaction is a fundamental factor shaping school effectiveness and productivity. Therefore, identifying the psychological factors that influence job satisfaction is crucial in efforts to enhance teachers' job satisfaction. In this study, we aimed to reveal the multiple mediating roles of self-efficacy and hope in the relationship between teachers' spiritual well-being and job satisfaction. To achieve this aim, we tested our theoretical model with data collected from 356 teachers. The findings suggest that teachers' hope, and self-efficacy partially mediate the relationship between their spiritual well-being and job satisfaction. These results indicate that teachers' levels of spiritual well-being play an effective role in enhancing job satisfaction via psychological resources such as self-efficacy and hope. In this context, educational leaders should consider teachers' spiritual and psychological needs, organize school environments accordingly, and foster a positive institutional culture.

A latent profile analysis of spiritual well-being and their relation to perceived social support and hope in patients with early-stage lung cancer

PURPOSE

This study aimed to investigate the subtypes of spiritual well-being among patients with early-stage lung cancer, examine the characteristics of each subtype, and determine the relationship between spiritual well-being and perceived social support as well as hope within these subtypes.

METHODS

A sample of 418 patients with early-stage lung cancer from three hospitals in Hubei Province completed the general sociodemographic questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, the Perceived Social Support Scale, and the Herth Hope Index. Latent profile analysis (LPA) was used to identify the patterns of spiritual well-being in patients with early-stage lung cancer, and influencing factors of different patterns were identified by univariate analysis and multinomial logistic regression analysis.

RESULTS

Three latent classes were identified: the "low spiritual well-being" (C1, 33.97%), the "moderate spiritual well-being" (C2, 38.28%), and the "high spiritual well-being" (C3, 27.75%). Factors such as nationality, religion, annual household disposable income, perceived social support scores, and hope scores influenced the potential categories of spiritual well-being in patients with early-stage lung cancer.

CONCLUSIONS

The spiritual well-being of patients with early-stage lung cancer varies, necessitating customized spiritual care to meet the diverse needs of patients. Additionally, providing comprehensive social support and helping patients achieve positive states of spiritual well-being can promote better cancer treatment outcomes.

Spiritual Health in Iranian Patients With Cardiovascular Diseases: A Systematic Review and Meta-analysis

This systematic review and meta-analysis aimed to evaluate the spiritual health status of Iranian patients with cardiovascular diseases. A literature search was conducted in national (MagIran and Scientific Information Database) and international (Scopus, PubMed, and Web of Science/ISI) databases from inception to December 2021. A random-effects model was used to estimate the pooled score of spiritual health. Based on the eligibility criteria, 22 articles were selected for the final analysis. The pooled score of spiritual health in Iranian patients with cardiovascular diseases was 61% (95% confidence interval: 54%-68%). In subgroup analysis, the pooled score in patients with heart failure was higher than other patients (67% vs. 58%). Publication bias was not significant (p = 0.554). Results indicated that the spiritual health of Iranian patients with cardiovascular diseases was moderate. Therefore, it is recommended that proper training be provided to these patients to enhance their adaptation to the complications of cardiovascular diseases.

The Effect of Spiritual Care on Hope in Patients with Multiple Sclerosis Referred to the MS Association of Hamadan in Iran

The negative impact of hopelessness on mental health makes multiple sclerosis (MS) disease unmanageable. This study aimed to determine the effect of spiritual care on hope in MS patients. In the present randomized controlled trial study, 70 MS patients were selected from the MS Association of Hamadan, Iran, and randomly allocated to intervention and control groups (35 patients per group). A demographic characteristic form and Snyder's Adult Hope Scale were completed before and after the intervention. Spiritual care was provided in weekly group sessions held for four weeks (45-60 min each). The data were analyzed using SPSS-16. Before the intervention, there were no significant between-group difference (P = 0.323). After the intervention, a significant between-group difference was observed (p < 0.001). There was also a significant increase in the mean of hope scores in the intervention group from baseline to follow-up (within-group difference) (p < 0.001), while there was no significant difference between baseline and follow-up in the control group (p = 0.38), confirming the effectiveness of spiritual care in improving hope. Given the impact of spiritual care on increasing patients' hope and improving their psychological state, nurses are advised to devote adequate time to their patients' spiritual needs.

Investigation of Hope and Spiritual Well-Being Levels among Relatives of Intensive Care Patients in Turkey

This study was conducted to determine the levels of hope and spiritual well-being among relatives of intensive care patients. The data were collected using the Patient Descriptive Information Form, Trait Hope Scale, and Spiritual Well-Being Scale. The mean total scores on the Trait Hope Scale and the Spiritual Well-Being Scale were 48.24 ± 8.37 and 104.99 ± 8.06, respectively. The mean scores on the Trait Hope Scale differed significantly according to the employment status, income status, and the reaction of the patient's relatives during the visit (p < 0.05). A significant difference was found between the mean scores of patient relatives on the Spiritual Well-Being Scale according to the level of education, income, and the intensive care unit where the patient was hospitalized (p < 0.05). A significant positive correlation was found between the Trait Hope Scale and the Spiritual Well-Being Scale (p < 0.05). This study found that patient relatives had good hope and spiritual well-being levels, and spiritual well-being increased the level of hope among patient relatives.

Predictive influence of disease knowledge and hope on self-care behavior among adults with heart failure

Background

Self-care, disease knowledge, and hope are critical concepts in health-related studies. Therefore, all three are considered solutions for controlling heart failure (HF) and reducing its complications. This study aimed to identify the predictive influence of disease knowledge and hope on self-care behavior among adults with HF.

Materials and Methods

This descriptive-analytical and cross-sectional study examined the data of 113 HF patients referred to the Imam Reza Clinic in Shiraz, Iran, in 2021. This study used HF patients' self-care instruments based on Orem's self-care theory, the HF Knowledge Scale-Persian version, and the Heart Hope Index-Persian version. The data were analyzed using the general linear model (GLM) and Pearson's correlation coefficients.

Results

Of the 113 HF patients, 54.90% (n = 62) were male, and 45.10% (n = 51) were female. The analysis of the Pearson correlation coefficient indicated the presence of a positive and significant correlation between "self-care and hope" (r = 0.532, P = 0.0001), "HF knowledge and hope" (r = 0.432, P = 0.0001), and "self-care and HF knowledge" (r = 0.410, P = 0.0001). GLM showed that HF knowledge symptoms (P = 0.0001), hope (P = 0.0001), unemployed patients (P = 0.042), and housewife patients (P = 0.0001) predicted self-care behavior of HF patients.

Conclusion

Considering the positive and significant correlation between "self-care and HF knowledge," "self-care and hope," and "HF knowledge and hope," it seems necessary for doctors and nurses should pay attention to providing educational programs to increase HF knowledge to improve self-care and hope in HF patients.

Spiritual well-being and associated factor among adult cancer patients in Hawassa University Comprehensive Specialized Hospital, Oncology Center, Hawassa, Ethiopia

Background

Spiritual well-being has been shown to boost resistance to mental health crises in cancer patients during the diagnosis and treatment process, but there is a paucity of studies about spirituality in cancer patients, which may make it difficult for healthcare clinicians to assess spirituality and provide spiritual care.

Objective

The aim of this study was to assess the level of spiritual well-being and associated factors among cancer patients in HUCSH Oncology Center in 2022.

Methods and materials

An institution-based cross-sectional study was done from May 30 to June 30, 2022 among 267 cancer patients, and the respondents were selected by a simple random sampling technique. Data was collected by using standardized interviewer-administered questionnaires (FACIT sp12). Data was entered using Epi data version 4.6, and analysis was carried out by using Statistical Package for Social Science version 25. Bivariate and multivariate logistic regression was conducted to determine the relationship between the independent and dependent variables. The strength of association was tested by using p-value at 95% CI. Ethical clearance was obtained from the Institutional Review Board of Hawassa University College of Medicine and Health Science. During data collection, the purpose of the study was clearly explained to the patients, and consent was obtained.

Result

A total of 267 cancer patients were included in the study. There was 100% response rate. Majority of the patients (80.5%) were in a poor spiritual well-being state. Mental distress (AOR = 0.246; 95% CI: 0.114-0.531) and religious education (AOR = 1.288; 95% CI: 1.438-9.142) were factors significantly associated with spiritual well-being among cancer patients.

Conclusion and recommendation

This study showed that more than two-thirds of patients had poor spiritual well-being. Mental distress and religious education were factors associated with spiritual well-being. Attention should be given by nurses of the center for spiritual well-being assessment in clinical practices favoring holistic care in the center.

Factors Affecting Death Anxiety in Patients Undergoing Open Heart Surgery: A Cross-Sectional Study

After the operation, death anxiety of patients is affected by many factors. This study aims to investigate the factors affecting death anxiety of patients undergoing open heart surgery. A descriptive, cross-sectional study. Data were collected using the 'Introductory Information Form,' the 'Templer's Death Anxiety Scale,' and the 'Spiritual Well-being Scale.' This study was conducted with 313 intensive care patients. The mean scores of the patients on the "Death Anxiety Scale" were moderate (7.96 (4.28)). According to the study findings, age, gender, length of stay in the intensive care unit, and spiritual well-being were found to be important predictors of death anxiety (F (4,308) = 16.149, p < .001). Considering gender differences in nursing care, it is thought that the intensive care period will be shortened, the level of spiritual well-being will increase and death anxiety will decrease.

The Relationship Between Spiritual Well-Being, Life Satisfaction and Hope in Elderly Individuals in Turkey

Life satisfaction and hope are important features in elderly individuals. Spiritual well-being is thought to affect life satisfaction and hope in the elderly. This study was conducted to determine the association between spiritual well-being and life satisfaction and hope in elderly persons. This study followed a cross-sectional design. The sample size of the study was 1383 individuals aged 65 or older. The Spiritual Well-Being Scale (FACIT-Sp), Satisfaction with Life Scale, and Hope Scale were administered to participants. Results indicated that spiritual well-being was significantly associated with life satisfaction and hope (p < 0.05). A limitation of this finding is the possible contamination of the measure of spiritual well-being with indicators of meaning and peace that could explain the relationship between spiritual well-being and hope. The spiritual well-being scale used in this research included indicators of meaning and peace that could explain the relationship between spiritual well-being and hope.

Spiritual Well-Being and Death Anxiety: A Cross-Sectional Study Among Iranian Patients With Acute Coronary Syndrome

Acute coronary syndrome (ACS) patients experience a tremendous psychological burden, typically in the form of death worry due to acute medical conditions and the possibility of mortality. The unfavourable conditions of ACS patients cause them to reconsider the meaning of life and their spiritual well-being. This study evaluated the association between death anxiety and spiritual well-being in a total of 241 ACS patients in Shahroud, northeast of Iran. The data were collected using the Templer Death Anxiety Scale, and the Spiritual Well-being Scale by convenience sampling method. All patients indicated a high degree of death anxiety, and roughly half reported a moderate level of spiritual well-being. There was a significant and direct correlation between death anxiety and spiritual well-being levels. Older age, single status, and non-smoking were other predictors of good spiritual well-being. A multidisciplinary health team should identify and implement approaches to promote spiritual well-being and reduce mental suffering.

Hope and healthy lifestyle behaviors in older adulthood

OBJECTIVES

Hope has been associated with better health and social well-being outcomes, including emotional adjustment, positive affect, life satisfaction, reduced risk of all-cause mortality, and increased physical activity, yet how hope as a construct impacts these health benefits in older adults is not very well-understood. This study examined: (1) the relationship between hope and health behaviors in older adults; (2) how this relationship may differ across different socio-demographic groups; and (3) how hope relates to perceived future selves among older adults.

METHODS

The study used cross-sectional data from 711 community-dwelling adults aged ≥55 years (280 men, 431 women). Survey measures included the Snyder Adult Dispositional Hope Scale (ADHS) and the Herth Hope Index (HHI), a health behaviors checklist, self-reported health, and a future self-scale. Data were analyzed using bivariate and multiple regressions.

RESULTS

Hope was positively associated with healthy behaviors in older adults. Participants with higher levels of hope also reported more positive future selves and better health. The associations were similar across different racial/ethnic groups.

CONCLUSIONS

This study fills an important gap in our understanding of hope and its association with health behaviors in community-dwelling older adults. These findings highlight a need to promote hope in older adults in order to enhance their sense of well-being.

Spirituality and Hope Levels of Lung Cancer Patients Who Had Surgery in Turkey

This study explores the relationship between spirituality and hope levels in lung cancer patients. Cancer patients often use their spirituality as a way of coping. Among a sample of 124 Turkish lung cancer patients, spirituality levels were assessed using the Spiritual Orientation Scale (SOS) and hope levels were measured using the Herth Hope Scale (HHS). Spirituality and hope levels in Turkish lung cancer patients were found to be above average. While no significant effect of demographic and disease-related variables was detected on spirituality and hope levels, spirituality and hope were found to be positively correlated in Turkish lung cancer patients.

PANDORA dyadic project: hope, spiritual well-being and quality of life of dyads of patients with chronic obstructive pulmonary disease in Switzerland - a multicentre longitudinal mixed-methods protocol study

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is responsible for 2.9 million deaths annually in Europe. Symptom burden and functional decline rise as patients reach advanced stages of the disease enhancing risk of vulnerability and dependency on informal caregivers (ICs).Evidence shows that hope is an important psycho-social-spiritual construct that humans use to cope with symptom burden and adversity. Hope is associated with increased quality of life (QoL) comfort and well-being for patients and ICs. A better understanding of the meaning and experience of hope over time as patients transition through chronic illness may help healthcare professionals to plan and deliver care more appropriately.

METHODS AND ANALYSIS

This is a longitudinal multicentre mixed-methods study with a convergent design. Quantitative and qualitative data will be collected from dyads of advanced COPD patients and their ICs in two university hospitals at two points in time. The Herth Hope Index, WHO Quality of Life BREF, Functional Assessment of Chronic Illness Therapy-Spiritual Well-being and the French version of the Edmonton Symptom Assessment Scale will be used to collect data. Dyadic interviews will be conducted using a semi-structured interview guide with five questions about hope and their relationship with QoL.Statistical analysis of data will be carried out using R V.4.1.0. To test whether our theoretical model as a whole is supported by the data, structural equation modelling will be used. The comparison between T1 and T2 for level of hope, symptom burden, QoL and spiritual well-being, will be carried out using paired t-tests. The association between symptom burden, QoL, spiritual well-being and hope will be tested using Pearson correlation.

ETHICS AND DISSEMINATION

This study protocol received ethical approval on 24 May 2022 from the Commission cantonale d'éthique de la recherche sur l'être humain-Canton of Vaud. The identification number is 2021-02477.

The predictive role of hope and social relational quality in disability acceptance among Iranian patients under hemodialysis

BACKGROUND

Patients undergoing hemodialysis face disabilities that its acceptance may influenced by several factors. This study aimed to determine the predictive role of hope and quality of social relationship on accepting disability amongst patients undergoing hemodialysis.

METHODS

This cross-sectional study was conducted on 120 hemodialysis patients referred to hemodialysis centers in Nemazi and Shahid Faghihi hospitals and Imam Reza Clinic in Shiraz. Snyder Hope Scale, Acceptance of Disability Scale (ADS), and Social Relational Quality Scale (SRQS) were used for data collection. The data were analyzed through the Smart PLS-3 and SPSS software using Pearson's correlation and multiple linear regression analysis tests, and confirmatory factor analysis.

RESULTS

Face, content, and construct validities and internal consistency of the Persian version of ADS and SRQS were confirmed. The patients' mean score of hope was 38.83 (SD = 4.35), which was not desirable. Their mean score of SRQS was 45.45 (SD = 3.87), which was at the moderate level. Nonetheless, the mean score of disability acceptance (66.01 (SD = 7.15)) was lower than expected. The results showed disability acceptance was associated with having good level of hope (β = 0.44, p = 0.002) and social relationship (β = 0.31, p = 0.04).

CONCLUSIONS

Hope and social relational quality predicted the acceptance of disabilities. Therefore, designing interventions to promote hope and social relationship in hemodialysis patients may increase their disability acceptance.

The effect of spiritual well-being on compassion fatigue among intensive care nurses: A descriptive study

OBJECTIVES

This study aimed to determine the effect of spiritual well-being of intensive care nurses on compassion fatigue.

METHODS

It is a descriptive study. The sample of the study was composed of 167 nurses who were working in the intensive care units of the hospitals in Turkey. Data were collected by using "Personal Information Form", "The Spiritual Well-Being Scale" and "The Compassion Fatigue-Short Scale" between July and October 2022. Descriptive statistics, t-tests, correlation, and simple regression analysis were used to analyse data.

FINDINGS

35% (n = 59) of the participants were between 22 and 27 years old; 73% (n = 122) were females; 67% (n = 112) had an undergraduate degree; 57% (n = 96) had an experience of 1 to 5 years in the intensive care. It was determined that intensive care nurses had a moderate level of compassion fatigue and a high level of spiritual well-being. Although especially the educational levels of the nurses contributed to their level of spiritual well-being, a younger age and being single and less experienced in the nursing profession and intensive care were identified as significant factors in determining compassion fatigue. Nurses' Spiritual Well-Being Scale mean score was 113.89 ± 15.50. The mean score of the Compassion Fatigue Scale was 60.15 ± 29.24. A positive correlation was found between the Spiritual Well-Being and the Compassion Fatigue Scales (ß = 0.358, p = 0.000).

CONCLUSIONS

Although intensive care nurses have a high level of spiritual well-being in general, they experience a moderate level of compassion fatigue. Younger and less experienced nurses should get more attention in intensive care units against compassion fatigue.

IMPLICATIONS FOR CLINICAL PRACTICE

Management of feelings of compassion can be a protective factor for compassion fatigue and can be used as a prevention strategy in the context of improving mental well-being among intensive care nurses. Awareness and knowledge of nurses on spiritual needs should be enhanced.

A 10-Year Cardiovascular Risk in Adults with Different Levels of Spiritual Health: Tehran Lipid and Glucose Study

Background

Previous studies have shown that spiritual experience may reduce cardiovascular disease (CVDs). However, little is known about the relationship between spiritual health and the gender-specific risk of CVDs in communities with different cultures.

Methods

A total of 3249 individuals (53.7% female, 75.0% middle-aged) participated in the Tehran Lipid and Glucose Study (TLGS) from 2015 to 2017 were included. Based on the ACC/AHA pooled cohort equation, CVD risk over ten years was examined. Spiritual health was measured using a developed tool for measuring spiritual health in Muslim populations (SHIMA-48). Linear regression models were used to assess the association between spiritual health and ACC/AHA risk scores. The natural logarithm scale was calculated to consider the normal distribution hypothesis of the regression model.

Results

The current results suggest a slight but significant increase in the mean of spiritual health in women compared to men in both cognitive/emotional and behavioral dimensions (P < 0.001). In both sexes, a higher prevalence of smoking was observed in participants with lower levels of spiritual health (P < 0.004). In men, compared to those with a low level of spiritual health (the first tertile), the logarithm of the ACC-AHA risk score was reduced by 0.11 (P = 0.004) and 0.18 (P < 0.001) for those in the second and third tertiles of spiritual health, respectively. This result may be attributed to higher cigarette smoking among the latter group. Similar results were not observed in women.

Conclusions

Current results indicate a gender-specific association between spiritual health and cardiovascular disease risk. Our findings imply that promoting spiritual health can be considered an effective strategy in future preventive interventions, primarily by controlling the desire to smoke in men.

Effectiveness of Spiritual Counseling on the Enhancement of Hope in Iranian Muslim Patients with Myocardial Infarction: A Two-Month Follow-Up

Hope is the most important source of coping in patients who have experienced acute cardiac events, and despair is considered an important cause of discontinued treatment and a threat to patients' mental health. This study aimed to determine the effectiveness of spiritual counseling on hope in patients with myocardial infarction over a two-month period. Fifty-six Iranian Muslim patients with myocardial infarction participated; participants were randomly allocated to either the intervention group (n = 28) or the control group (n = 28). The experiment group received three sessions of group spiritual counseling. The patients' hope was measured before intervention and immediately, one month, and two months after the intervention. The results indicated that no significant difference in hope was present between the intervention and control groups at baseline (Z = - 2.56, effect size = 0.75, P = 0.1). Significance between-group differences favoring the intervention group, however, were noted immediately post-intervention (Z = - 2.72, effect size = 0.91, P = 0.007), one month afterward (Z =  - 6.22, effect size = 3.14, P < 0.001), and two months afterward (Z = - 6.10, effect size = 2.65, P < 0.001). Hope significantly improved in the intervention group during the study. Utilizing spiritual counseling as an effective non-aggressive form of treatment can improve hope among patients with myocardial infarction.

The Effect of Spiritual Well-being on Hope in Immobile Patients Suffering From Paralysis Due to Spinal Cord Injuries

This study aimed to determine the effect of spiritual well-being on hope in immobile patients suffering from paralysis due to spinal cord injuries. The sample size of this cross-sectional study was determined to be 100 immobile patients suffering from paralysis due to spinal cord injuries via power analysis. "Descriptive Characteristics Form," "Spiritual Well-being Scale," and "Dispositional Hope Scales" were used to collect the data. It was determined that participants' spiritual well-being scores were 22.25 ± 9.62 and their hope scores were 29.53 ± 9.83. There was a weak but positive correlation between the total scores on the hope scale and the spiritual well-being scale (p = 0.001, r = 0.477). Among immobile patients suffering from paralysis due to spinal cord injury, spiritual well-being levels accounted for 22% of the variance in hope levels (p = 0.001, R² = 0.22). This study showed that as patients' spiritual well-being levels increased, their hope levels also increased.

The Association Between Religiosity, Spirituality, and Medication Adherence Among Patients with Cardiovascular Diseases: A Systematic Review of the Literature

This systematic review aimed to summarize the literature on the relationship between religiosity or spirituality (R/S) and medication adherence among patients with cardiovascular diseases (CVDs) and to describe the nature and extent of the studies evaluating this relationship. Seven electronic databases (PubMed, MEDLINE, EMBASE, Scopus, the Cochrane Central Library, ProQuest Theses and Dissertations, and Google Scholar) were searched with no restriction on the year of publication. The Crowe Critical Appraisal Tool was used to evaluate the methodological quality of the eligible studies. Due to the heterogeneity observed across the included studies, data synthesis was performed using a narrative approach. Nine original studies published between 2006 and 2018 were included in the review. Only a few quantitative studies have examined the relationship between R/S and medication adherence among patients with CVDs. Most studies were conducted in the USA (n = 7) and involved patients with hypertension (n = 6). Five studies showed a significant correlation between R/S (higher organizational religiousness, prayer, spirituality) and medication adherence and revealed that medication adherence improved with high R/S. The other four studies reported a negative or null association between R/S and medication adherence. Some of these studies have found relationships between R/S and medication adherence in hypertension and heart failure patients. This review showed a paucity of literature exploring the relationship between R/S and medication adherence among patients with other CVDs, such as coronary artery diseases, arrhythmia, angina and myocardial infarction. Therefore, the findings suggest that future studies are needed to explore the relationship between R/S and medication adherence among patients with other types of CVDs. Moreover, there is a need to develop interventions to improve patients' medication-taking behaviors that are tailored to their cultural beliefs and R/S.

Spiritual Well-being in Patients with Chronic Diseases: A Systematic Review and Meta-analysis

As a significant health challenge, chronic disease can have critical spiritual consequences for patients. Therefore, the study of spiritual well-being as an aspect of health is essential but has been less considered with regard to chronic diseases. Thus, this systematic review and meta-analysis were conducted to investigate spiritual well-being in patients with chronic diseases. For this purpose, in the initial search that was performed of valid databases, a total of 615 descriptive studies published between 2000 and 2018 were found. After carefully assessing these, only 24 studies were included in the review. Overall, the spiritual well-being of 3289 patients with chronic disease was investigated. This study showed that the total mean score of the spiritual well-being of patients with chronic diseases was 86.65 (P < 0.001, 95%, CI: 80.34-92.96), indicating a moderate level of spiritual well-being in these patients. Thus, patients with chronic diseases are recommended to consider spiritual consultation programs.

Relationship of spiritual wellbeing with life expectancy and quality of life for patients living with heart failure

Aim: Spirituality is a crucial dimension in human health. However, it is often overlooked in patients with heart failure (HF) in Iran. Thus, the purpose of this study was to determine the relationship between spiritual wellbeing, life expectancy and quality-of-life (QOL) in patients with HF. Methods: This cross-sectional study was performed with 150 HF patients, who were enrolled through convenience sampling. Data were collected using a questionnaire comprising four parts: the Minnesota Living with Heart Failure Questionnaire, Schneider's life expectancy instrument, Ellison's and Paulotzin's (1982) Spiritual Well-Being Scale, and a demographic checklist. SPSS software was used for data analysis. Results: In this study, mean and standard deviation of QOL, life expectancy and spiritual wellbeing were 41.82±19.17, 30.20±4.58 and 87.80±5.28 respectively. There was a significant relationship between spiritual wellbeing and quality of life (r=-0.633, P<0.001) and also life expectancy (r=0.544, P<0.001). Quality of life and life expectancy were significantly higher in men than in women. Linear regression tests showed that the existential and religious dimensions of spirituality could influence 44.9% of the QOL variance (F=54.54, P<0.001) and increased values of existential spirituality would improve QOL by an average of 3.45 units. Improving life expectancy also raised QOL by 14.0% (F=21.26, P<0.001). This study also demonstrated that life expectancy is impacted by spiritual health, with a variance of 34.2%, in which the role of existential-spiritual health is of particular significance (t=7.10, P<0.001). Conclusion: The results revealed that spiritual wellbeing, especially the existential type, enhances life expectancy and quality-of-life among HF patients. Therefore, it is recommended that healthcare professionals design a comprehensive and supportive care model for the promotion of spiritual wellbeing in HF patients.

Relationship between Neuroticism, Spiritual Well-Being, and Subjective Well-Being in Korean University Students

Previous studies on mental health and quality of life have revealed that religiosity/spirituality was positively associated with indicators of well-being and personality factors. However, limited research has examined the relationship between spiritual well-being, the subfactors of the personality factor Neuroticism (i.e., anxiety, hostility, depression, self-consciousness, impulsiveness, and vulnerability), and subjective well-being in a non-Western sample. The present findings revealed that the five subfactors of neuroticism did not have an equally negative or positive effect on spiritual and subjective well-being among Korean undergraduate University students. Regarding its subdimensions, vulnerability was strongly associated with spiritual well-being, while depression was closely linked to subjective well-being. Moreover, we found that spiritual well-being exerted significant effects on subjective well-being above personality factors. The significance of the findings and directions for further research have been discussed.

Factors Associated With Hope and Quality of Life in Patients With Coronary Artery Disease

BACKGROUND

Psychological resources such as hope have been suggested to affect quality of life (QoL) positively in patients with heart disease. However, little information regarding the relationship between these two constructs is available.

PURPOSE

This work was aimed at examining the factors associated with hope and QoL in patients with coronary artery disease.

METHODS

In this descriptive work, perceived QoL and hope were assessed in 500 patients with heart disease. The information was collected using the McGill QoL Questionnaire, demographic variables, and the Herth Hope Index. The Pearson correlation test and general linear model were used to examine correlations through SPSS Version 22.

RESULTS

A considerable correlation was discovered between QoL and hope (r = .337, p < .001). Multivariate analyses with regression revealed that religious beliefs and social support both had significant and positive effects on the total perceived hope of patients and that patient age had a considerable negative impact on QoL (p < .05). None of these factors had a significant impact on hope (p < .05). In addition, the total QoL had a significant and positive effect on patient feelings and thoughts, whereas the physical problems component of QoL had a significant and negative effect on hope (p < .05). Participants with higher levels of education reported more hope.

CONCLUSIONS

QoL relates significantly to self-perceived hope in patients. Understanding QoL and hopefulness in patients with coronary artery disease has implications for nurses and other healthcare professionals.

Religious and Spiritual Practices: Association with Dispositional Optimism in an Underprivileged Population in Lascano, Uruguay

Optimism seems to foster the ability to manage adverse situations better-a finding especially relevant for disadvantaged populations. Employing a unique sample from a small underprivileged village, we studied the association between religious/spiritual practices and dispositional optimism. The village belongs to a developing country that is, by far, the most secular country in Latin America; this makes it particularly interesting for exploring the role of religious/spiritual practices in this context. We found that these practices were positively associated with higher optimism, measured by the Life Orientation Test-Revised (LOT-R): those who practice spirituality, score, on average, 14.4 percentage points higher on the LOT-R than those who did not. This association seems to be especially robust in the case of the poor and less educated: those with religious/spiritual practices score 20 percentage points higher on the LOT-R. Thus, the role that these practices may play in dispositional optimism in disadvantaged populations deserves more attention.

Self-Care and Its Predictive Factors in Hemodialysis Patients

Introduction: Chronic kidney disease is a serious problem and patients need active self-care. This study focuses on the relationship between self-care and its predictive factors in hemodialysis (HD) patients.

Methods: This multicenter correlational study was conducted on 201 HD patients referring to HD centers in the west of Tehran, Iran. A multi-stage sampling method was used to select the samples. Data were collected using self-care Scale, Paloutzian-Ellison Spiritual Well-Being Scale, and Connor Davidson Resilience Questionnaires. Data were analyzed using SPSS software version 13 and descriptive statistics and linear regression with stepwise method.

Results: The mean (SD) scores of self-care, resilience, and spiritual well-being were 35.5 (5.69), 53.4 (12.94), and 97.4 (17.9), respectively. Univariate analysis showed that self-care had a statistically significant relationship with gender, occupation, education, being diabetic, and hyperlipidemia. Self-care positively correlated with the resilience and negatively correlated with age. Multivariate regression indicated that the resilience (β = 0.78, P = 0.001), being diabetic (β = -0.09, P = 0.01), and age (β = -0.11, P = 0.005) could be predictors of self-care. These variables accounted for 78% of variance in self-care in HD patients.

Conclusion: Our results showed that resilience was positively correlated with self–care, but being diabetic and age were negatively correlated with self-care in HD patients. Therefore, the health care providers should pay more attention to HD patients who are diabetic and older, as they are at a higher risk of having impaired self-care.

Spiritual Well-Being, Social Support, and Financial Distress in Determining Depression: The Mediating Role of Impact of Event During COVID-19 Pandemic in Iran

This study investigates the relationship between spiritual well-being, social support, and financial distress with depressive symptoms due to the COVID-19 pandemic. A path analysis was used to analyze data collected from 1,156 Iranian participants via an online survey. The results showed that spiritual well-being and social support were negatively related to depressive symptoms and financial distress. The impact of COVID-19 events showed negative associations with depressive symptoms. In addition, the link between spiritual well-being and financial distress with depressive symptoms was partially mediated by the impact of events.

Unpacking characteristics of spirituality through the lens of persons of colour living with serious illness: The need for nurse-based education to increase understanding of the spiritual dimension in healthcare

AIMS AND OBJECTIVES

To examine the characteristics of spirituality as expressed by persons of colour living with serious illness.

BACKGROUND

Spiritual, Religious and Existential Care, as specified in the National Consensus Project (NCP) Guidelines, is a core domain of palliative nursing.

DESIGN OF THE STUDY

A constructionist approach to narrative analysis was used for this study and reported in accordance with the COREQ guideline.

METHODS

In-depth narrative interviews were conducted with 20 participants. These participants included persons of colour living with serious illness who were admitted to an acute-care hospital. Through a deductive coding approach, a codebook was created based on a broad definition of spirituality including: religion, self, family, community, nature and art/music/literature.

RESULTS

The major themes expressed were religion, self and family. Subthemes of religion included increased faith, support of the church community and God's intervention in patients' lives. Subthemes of self included increased self-worth, self-awareness of one's place in the world and individualised transition to new meaning in life. Subthemes of family included family adding meaning and purpose to their lives, family as an important source of strength and support, wanting to regain their health to go back to caring for their families, and believing that their illness had brought their family closer together.

CONCLUSION

The thematic analysis revealed a broader existential aspect of what brought value, meaning and purpose into their lives, despite their progressive physical illness. More research is needed to understand spiritual, religious or existential needs of persons of colour living with serious illness and how nurses can best support these needs. By understanding the components of spirituality, nurses can learn to recognise the signs of spiritual distress. This awareness also helps to know when a spiritual specialist is needed-either the patient's own spiritual guide(s) or the hospital chaplain. Nurses can also use spiritual assessment tools when performing a general assessment on the patient.

RELEVANCE TO CLINICAL PRACTICE

By understanding the components of spirituality, nurses can learn to recognise the signs of spiritual distress. This awareness also helps to know when a spiritual specialist is needed-either the patient's own spiritual guide(s) or the hospital chaplain. Nurses can also use spiritual assessment tools when performing a general assessment on the patient.

Religious Perfectionism Scale: Assessment of Validity and Reliability Among Undergraduate Students in Iran

Religious perfectionism is a construct that may help to either improve mental health or cause mental health difficulties. The Religious Perfectionism Scale (RPS; Wang in J Relig Health 59: 318-333, 2020) is a useful tool for assessing religious perfectionism around the world, but its psychometric properties have yet to be tested in Iran. The sample in the present study consisted of 300 Iranian undergraduate students (180 females) from Azad University who completed the RPS, the Depression Anxiety Stress Scale-2, and the Moral Perfectionism Scale. The impact score was used to determine face validity, and the values of the impact score for all translated items were greater than 1.5, meaning that the items had satisfactory face validity. The Content Validity Index (CVI) values were above the acceptable cutoff score of 0.7, indicating the acceptable content validity of items. The Content Validity Ratio (CVR) scores were greater than the cutoff score of the Lawshe table (.78), indicating the satisfactory essentiality of the items. To measure construct validity, the results of a confirmatory factor analysis (CFA) using AMOS software confirmed the scale with two subscales (zealous religious dedication and religious self-criticism). No item was removed from the scale as all factor loading values were greater than 0.49. The findings support the psychometric properties of the scale for measuring religious perfectionism among undergraduate students in Iran.

Childhood Loss Experiences, Religiousness/Spirituality, and Hope as Predictors of Adult Life Satisfaction

Purpose The purpose of this study was to explore how adaptive patterns of religiousness/spirituality and hope predict adult life satisfaction in adults, even if they had childhood loss experiences.Design and Methods Using a cross-sectional survey design with132 adult participants (mean age 33.8 ± 15.2, 82% female, 78% Caucasian) we estimated two hierarchical regression models to examine how dimensions of religiousness/spirituality (Brief Multidimensional Measure of Religiousness/Spirituality) and hope (Herth Hope Index) predicted adult life satisfaction (Satisfaction with Life Scale) after controlling for effects of adverse childhood experiences (Adverse Childhood Experiences Study Questionnaire) or chronic sorrow from childhood loss (Kendall Chronic Sorrow Instrument).Results When effects of adverse childhood experiences (ACE) were controlled, higher levels of hope (β = .416, p < .001) and forgiveness (β = .273, p = .023) and lower levels of religious/spiritual values/beliefs (β = -.298, p = .014) predicted higher levels of adult life satisfaction. ACE remained a significant predictor of adult life satisfaction in the final model. When controlling for effects of chronic sorrow, higher life satisfaction was predicted only by forgiveness (β = .379, p = .003), values/beliefs (β = -.354, p = .007), and hope (β = .357, p < .001), with chronic sorrow not a significant predictor of adult life satisfaction in the final model.Conclusion: Greater life satisfaction for adult survivors of childhood loss experiences could be promoted by interventions to enhance hope and foster forgiveness. These adult survivors may also need support as they engage with religious/spiritual struggle to reconcile their values and beliefs with childhood loss.

Caregiver burden and coping strategies in caregivers of older patients with stroke

Background

Coping strategies play a key role in modulating the physical and psychological burden on caregivers of stroke patients. The present study aimed to determine the relationship between the severity of burden of care and coping strategies amongst a sample of Iranian caregivers of older stroke patients. It also aimed to examine the differences of coping strategies used by male and female caregivers.

Methods

A total of 110 caregivers of older patients who previously had a stroke participated in this descriptive and cross-sectional study. The Zarit Burden Interview and Lazarus coping strategies questionnaires were used for data collection. Questionnaires were completed by the caregivers, who were selected using convenience sampling. The collected data were analyzed using Pearson's correlations and independent t-tests.

Results

The mean age of participants was 32.09 ± 8.70 years. The majority of the caregivers sampled reported mild to moderate (n = 74, 67.3%) burden. The most commonly used coping strategies reported were positive reappraisal and seeking social support. Results of the independent t-test showed that male caregivers used the positive reappraisal strategy (t(110) = 2.76; p = 0.007) and accepting responsibility (t(110) = 2.26; p = 0.026) significantly more than female caregivers. Pearson’s correlations showed a significant positive correlation between caregiver burden and emotional-focused strategies, including escaping (r = 0.245, p = 0.010) and distancing (r = 0.204, p = 0.032).

Conclusions

Caregivers with higher burden of care used more negative coping strategies, such as escape-avoidance and distancing. In order to encourage caregivers to utilize effective coping skills, appropriate programs should be designed and implemented to support caregivers. Use of effective coping skills to reduce the level of personal burden can improve caregiver physical health and psychological well-being.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00556-z.

Attachment: the mediating role of hope, religiosity, and life satisfaction in older adults

BACKGROUND

Attachment and support from family and friends are core to the experiences of ageing for older adults. The purpose of this study is to examine the relationships between attachment styles and hope, religiosity, and life satisfaction and provide new knowledge that may assist future planning for a rapidly ageing global population.

METHODS

In this cross-sectional study, 504 Iranian older adult participants from Qazvin province were recruited between December 2015 and April 2016. They completed a questionnaire that included the Revised Adult Attachment Scale, the Life Satisfaction Index-Z, and the Herth Hope Index.

RESULTS

Participants in the study had a mean age of 66.20 years (SD: 5.76) and most of them were women (57.5%). A mediation model testing the direct relationships between attachment, hope, religiosity, and life satisfaction showed a positive relationship between close attachment and religiosity (β = .226, p < .001) and a negative relationship between anxiety attachment and religiosity (β =  - .229, p < .001). Religiosity was positively related to hope (β = .384, p < .01) and hope was related to life satisfaction (β = .448, p < .001). Religiosity and hope mediated the relationship between close attachment (β = .119, p < .001) and anxiety attachment (β =  - .056, p < .01) with life satisfaction. More specifically, while religiosity and hope fully mediated the relationship between close attachment and life satisfaction, they partially mediated the attachment anxiety-life satisfaction link.

CONCLUSIONS

Findings of the study provide insight into only a narrow perspective of life satisfaction and attachment given the many and varied variables that influence these constructs. Future research is needed whereby other related variables are introduced into the model to be examined further.

The effect of spiritual well-being on adaptation to chronic illness among people with chronic illnesses

PURPOSE

This study aimed to identify the effect of spiritual well-being on the adaptation to chronic illness, among people with chronic illnesses.

DESIGN AND METHODS

The study comprised of 466 patients hospitalized in the internal medicine clinics of internal diseases, cardiology, neurology, and chest diseases, at the training and research hospital of a university.

FINDINGS

There was a significant positive relationship between spiritual well-being and adaptation and how spiritual well-being affected patients' adaptation to chronic illness.

PRACTICE IMPLICATION

Study results indicated that adaptation to chronic illness increased in direct relation to an increased level of spiritual well-being, among people with chronic illnesses.

Predictive factors associated with death depression in women with breast cancer

A cross-sectional study with a convenience sample of 241 patients with breast cancer was conducted to investigate death depression and its explanatory factors in Iranian women who were diagnosed and undergoing treatment for breast cancer. Patients with significantly higher death depression were those who were housewives (β = 0.6, p = 0.016), unskilled workers (β = 15.8, p = 0.002), and retired (β = 13.1, p = 0.002) as compared with those who were professionally employed with higher socio-economic status (β = 17.4, p = 0.002); and those receiving combination therapy as compared to surgery only (β = 6.3, p = 0.02). For patients with higher spiritual health scores, death depression was significantly lower (β = -0.2, p < 0.001).

Hope in Iranian mothers of children with cancer: a descriptive correlational study

PURPOSE

This study aims to examine the relationship between the level of hope in mothers who have a child with cancer and its related factors in Iran.

METHOD

A cross-sectional and descriptive correlational design was used in this study. A demographic questionnaire and the Herth Hope Index (HHI) were administered to a sample of 240 mothers who have a child with cancer to assess level of hope. Mothers were also asked to indicate their highest priority hopes such as view of their supportive resources including financial support, psychosocial support, religiosity and spirituality. Data was analysed using descriptive statistics, Spearman's rho, independent sample t test and one-way ANOVA.

RESULTS

The mean HHI score was 35.44 (n = 237). There was a positive correlation between HHI total score and spirituality (r = 0.267, P < 0.001), and psychosocial support (r = 0.281, P < 0.001). No significant differences were found between HHI total score and respondents who saw themselves as a religious person and the family financial support. There was a significant difference in HHI total scores for a mother who has a disabled child (M = 32.92, SD = 2.75; t (235) = 2.00, P = 0.046) and mothers of a child who do not have any disability besides their cancer (M = 35.59, SD = 4.91). No significant differences were found in the HHI total score and different group of the child's diagnoses and the mother's age or/and child's age.

CONCLUSION

Mothers who have a child with cancer with better psychosocial and spiritual support showed a higher level of hope. A thorough knowledge of factors associated with hope in mothers caring for children suffering from cancer could provide a means to further advance the support delivered and the available resources given to the parents, especially the mothers.

Predictors of Quality of Life in Patients with Heart Disease

Individuals with heart disease have been found to have more negative psychological and physical effects that impact their quality of life (QoL) than the general population. Spiritual well-being is considered a protective factor associated with QoL in people with heart disease. Therefore, the current research seeks to evaluate whether sociodemographic factors and spiritual well-being predict QoL among patients with heart disease. A total of 500 patients who were selected through a convenient sampling method from an Iranian hospital participated in this descriptive-correlational study. Data were collected using the McGill QoL Questionnaire, the Spiritual Well-being Scale, and demographic variables. The data analysis included descriptive and inferential statistics powered by SPSS (v. 23). Following multivariate analyses, findings revealed that those participants with their main source of income derived from family or a government pension and with College or intermediate educational levels were more likely to have higher QoL. Those participants with average or poor socioeconomic status reported higher QoL than those who were more affluent. Furthermore, younger patients (- 0.2, 95% CI - 0.3 to - 0.003, p = 0.016) and those with higher social support (0.7, 95% CI 0.2 to 1.3, p = 0.006) and spiritual well-being (0.2, 95% CI 0.1 to 0.3, p < 0.001) had significantly better QoL. In the current study, spiritual well-being and social support led to reduced negative psychological sequelae and improved QoL in cardiac patients.

Perceptions of Clergy Regarding the Provision of Spiritual Care in Lithuanian Hospitals for Cancer Patients

This paper presents an analysis of narratives drawn from research that examined the views of clergy in regard to the provision of spiritual care in Lithuanian hospitals. The purpose of this research was to examine the shared responsibilities between what nurses do in the provision of holistic care and that of the clergy who are employed to provide spiritual care. A thematic analysis was undertaken, guided by questions related to how spirituality was perceived by the clergy; how spiritual care was defined; clergy's perceptions to nurses' provision of spiritual care, and whether there was a delineation between these two roles. Findings showed that although the clergy believed that their role was important in the provision of spiritual care, both nurses and clergy acknowledged that both played a role in spiritual support. However, scope of practice for each role was not yet defined. For nurses and clergy to understand their roles and the boundaries between them, clear standards of practice need to be developed.

Religious beliefs and well-being and distress in congestive heart failure patients

Religiousness (typically assessed as service attendance) is often associated with well-being and psychological distress in persons with life-threatening illnesses, but little of this work has focused explicitly on religious beliefs. We examined the longitudinal relationships of religious beliefs (i.e., in God and in the afterlife) with well-being and distress (assessed 6 months later) in a sample of patients with congestive heart failure, a chronic and progressive disease. After controlling for religious service attendance, belief in God was associated with negative affect and spiritual well-being, while belief in the afterlife was associated with physical health, post-traumatic depreciation, and spiritual well-being. However, after controlling for baseline values of well-being or distress, religious beliefs were not associated with nearly all well-being or distress outcomes at follow-up. Over the 6-month duration of the study, participants increased in belief in afterlife but decreased in their belief in God. Increases in religious beliefs across time were associated with higher levels of distress. These results suggest that religious beliefs are neither positively nor negatively associated with well-being and distress independent of religious attendance among seriously ill patients with CHF. Based on these findings, healthcare providers are encouraged to assess religious belief change at the individual level to better understand and inform spiritual care for patients with late-stage CHF.

Exploring the Relationship Between Spiritual Well-Being and Death Anxiety in Survivors of Acute Myocardial Infarction: Moderating Role of Sex, Marital Status and Social Support

Previous empirical studies have shown that both spiritual well-being (SWB) and death anxiety (DA) significantly affect the mental health of patients with acute diseases. In this regard, our paper contributes to the extant literature by scrutinizing the conditional relationship between SWB and DA as well as the various mechanisms underpinning such a relationship in patients with acute myocardial infraction (AMI). A descriptive, correlational methodology was utilized. Our main sample consisted of 300 patients with acute myocardial infraction who were hospitalized in a specialized medical institution in Iran throughout a two-month period (i.e. August-October 2015). Patients completed Spiritual Well-Being Scale (SWBS) and Templer's Death Anxiety Scale (TDAS). Even though our study showed that the relationship between SWB and DA in patients with AMI is non-significant, we found that (1) single patients with higher SWB have lower DA, (2) single patients with higher SWB as well as social support have significantly lower DA, and (3) for single men/men without social support, there is a negative relationship between SWB and DA. The relationship between SWB and DA is influenced by factors such as sex, marital status and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences. Result revealed that although relationship between SWB and DA is non-significant, this is influenced by factors such as sex and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences.