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Living with heart failure: Psychosocial resources, meaning, gratitude and well-being

Published:February 07, 2014DOI:https://doi.org/10.1016/j.hrtlng.2014.01.012

      Abstract

      Objectives

      The present study explored the experiences of people living with advanced heart failure (HF) to determine the extent to which (1) psychosocial resources relevant to HF patients were qualitatively reported, and (2) to determine the extent to which psychosocial resources were correlates of subsequent well-being as assessed by validated quantitative measures.

      Background

      HF is a serious life-limiting illness that involves impaired heart functionality. Patients commonly face severe physical fatigue and frequently endure disabling depression. Individuals with HF often report the use of social support and religion/spirituality (R/S) as helpful, but little work has systematically linked their reliance on these resources and well-being.

      Methods

      111 participants completed four open-ended questions to assess aspects of living with HF. Open-ended questions were coded to identify psychosocial resources: positive meaning, gratitude, R/S, social support, and medical resources. Data were collected once and then again 3 months later. Participants also completed measures of well-being, including religious meaning, life meaning, satisfaction with life, depressive symptoms, death anxiety, and health-related quality of life. Bivariate correlations were used to relate psychosocial resources and well-being.

      Results

      Patients reported many psychosocial resources, particularly positive meaning, R/S, social support, and medical resources. Positive meaning and R/S were inversely linked with depressive symptoms. R/S was also related to less death anxiety, while social support was related to higher anxiety about death three months later.

      Conclusions

      Findings advance our understanding of the struggles HF patients experience and the roles of psychosocial resources such as meaning and gratitude in alleviating these struggles. Results may help explain how resources like R/S and social support may influence well-being.

      Keywords

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      References

        • McCall D.
        Congestive heart failure.
        in: Stein J.H. Hutton J.J. Kohler P.O. Internal Medicine. 4th ed. Mosby, St. Louis, MO1994: 116-131
        • American Heart Association
        Heart Disease and Stroke Statistics 2012 Update.
        American Heart Association, Dallas, TX2012
        • American Heart Association
        Heart Disease and Stroke Statistics 2011 Update.
        American Heart Association, Dallas, TX2011
        • Rogers A.E.
        • Addington-Hall J.M.
        • Abery A.J.
        • et al.
        Knowledge and communication difficulties for patients with chronic heart failure: qualitative study.
        BMJ. 2000; 321: 605-607
        • Rohrbaugh M.
        • Cranford J.
        • Shoham V.
        • Nicklas J.
        • Sonnega J.
        • Coyne J.
        Couples coping with congestive heart failure: role and gender differences in psychological distress.
        J Fam Psychol. 2002; 16: 3-13
        • Freeland K.E.
        • Carney L.M.
        Psychosocial considerations in elderly patients with heart failure.
        Clin Geriatr Med. 2002; 16: 649-661
        • MacMahon K.M.A.
        • Lip G.Y.H.
        Psychosocial factors in heart failure.
        Arch Intern Med. 2002; 162: 73-93
        • Nierenberg A.
        • Rapaport M.
        • Schettler P.
        • et al.
        Deficits in psychological well-being and quality-of-life in minor depression: implications for DSM-V.
        CNS Neurosci Ther. 2010; 16: 208-216
        • Jiang W.
        • Alexander J.
        • Christopher E.
        • et al.
        Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure.
        Arch Intern Med. 2001; 161: 1849-1856
        • Murray S.A.
        • Kendall M.
        • Boyd K.
        • Worth A.
        • Benton T.F.
        Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their careers.
        Palliat Med. 2004; 18: 39-45
        • Europe E.
        • Tyni-Lenné R.
        Qualitative analysis of the male experience of heart failure.
        Heart Lung. 2004; 33: 227-234
        • Bosworth H.
        • Steinhauser K.
        • Orr M.
        • Lindquist J.
        • Grambow S.
        • Oddone E.
        Congestive heart failure patients' perceptions of quality of life: the integration of physical and psychosocial factors.
        Aging Ment Health. 2004; 8: 83-91
        • Murray M.
        • Morrow D.
        • Weiner M.
        • et al.
        A conceptual framework to study medication adherence in older adults.
        Am J Geriatr Pharmacother. 2004; 2004: 36-43
        • Gualco A.
        • Opasich C.
        The complex symptom burden of the aged heart failure population.
        Curr Opin Support Palliat Care. 2007; 1: 255
        • Folkman S.
        • Moskowitz J.T.
        Stress, positive emotion, and coping.
        Curr Dir Psychol Sci. 2000; 9: 115-118
        • Folkman S.
        • Moskowitz J.T.
        • Ozer E.M.
        • Park C.
        Positive meaningful events and coping in the context of HIV/AIDS.
        in: Gottlieb B.H. Coping With Chronic Stress. Plenum Press, New York1997: 293-314
        • Meyerowtz B.E.
        • Watkins I.K.
        • Spark F.C.
        Quality of life breast cancer patients receiving adjuvant chemotherapy.
        Am J Nurs. 1983; 83: 232-235
        • Zambroski C.H.
        • Moser D.K.
        • Bhat G.
        • Ziegler C.
        Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure.
        Eur J Cardiovasc Nurs. 2005; 4: 198-206
        • Griffin M.T.Q.
        • Lee Y.H.
        • Salman A.
        • et al.
        Spirituality and well-being among elders: differences between elders with heart failure and those without heart failure.
        Clin Interv Aging. 2007; 2: 669-675
        • Dekker R.
        • Peden A.
        • Lennie T.
        • Schooler M.
        • Moser D.
        Living with depressive symptoms: patients with heart failure.
        Am J Crit Care. 2009; 18: 310-318
        • Fetzer Institute and National Institute on Aging
        Multidimensional measurement of religion/spirituality for use in health research.
        (Kalamazoo, MI: A report of a national working group supported by the John E. Fetzer Institute and The National Institute on Aging)1999
        • Idler E.L.
        • Ory M.
        • Musick M.
        • et al.
        Measuring multiple dimensions of religion and spirituality for health research.
        Res Aging. 2003; 25: 327-365
        • Ryan M.
        • Farrelly M.
        Living with an unfixable heart: a qualitative study exploring the experience of living with advanced heart failure.
        Eur J Cardiovasc Nurs. 2009; 8: 223-231
        • Wong P.T.P.
        Implicit theories of meaningful life and the development of the Personal Meaning Profile.
        in: Wong P.T.P. Fry P.S. The Human Quest for Meaning: A Handbook of Psychological Research and Clinical Application. Erlbaum, London, UK1998: 111-140
        • Ware J.E.
        • Kosinski M.
        • Keller S.D.
        SF-12: an even shorter health survey.
        Med Outcomes Trust Bull. 1996; 4: 2
        • Ware Jr., J.E.
        • Kosinski M.
        • Keller S.D.
        A 12-Item Short-Form Health Survey: construction of scales and preliminary test of reliability and validity.
        Med Care. 1996; 34: 220-233
        • Radloff L.
        The CES-D Scale: a self-report depression scale for research in the general population.
        Appl Psychol Meas. 1977; 1: 385-401
        • Sheehan T.J.
        • Fifield J.
        • Reisine S.
        • Tennen H.
        The measurement structure of the Center for Epidemiologic Studies Depression Scale.
        J Pers Assess. 1995; 64: 507-521
        • Santor D.A.
        • Zuroff D.C.
        • Ramsay J.O.
        • Cervantes P.
        • Palacios J.
        Examining scale discriminability in the BDI and CES-D as a function of depressive severity.
        Psychol Assess. 1995; 7: 131-139
        • Diener E.
        • Emmons R.
        • Larsen R.
        • Griffin S.
        The Satisfaction with Life Scale.
        J Pers Assess. 1985; 49: 71-75
        • Pavot W.
        • Diener E.
        • Colvin C.R.
        • Sandvik E.
        Further validation of the Satisfaction with Life Scale: evidence for the cross-method convergence of well-being measures.
        J Pers Assess. 1991; 57: 149-161
        • Harper A.
        • Power M.
        Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment.
        Psychol Med. 1998; 28: 551-558
        • Baumeister R.F.
        • Leary M.R.
        The need to belong: desire for interpersonal attachments as fundamental human motivation.
        Psychol Bull. 1995; 3: 497-529
        • Bekelman D.B.
        • Havranek E.P.
        • Becker D.M.
        • et al.
        Symptoms, depression, and quality of life in patients with heart failure.
        J Card Fail. 2007; 13: 643-648
        • Thornhill K.
        • Lyons A.
        • Nouwen A.
        • Lip G.
        Experiences of living with congestive heart failure: a qualitative study.
        Br J Health Psychol. 2008; 13: 155-175
        • Park C.
        • Fenster J.
        • Suresh D.
        • Bliss D.
        Social support, appraisals, and coping as predictors of depression in congestive heart failure patients.
        Psychol Health. 2006; 21: 773-789
        • Artinian N.
        The psychosocial aspects of heart failure: depression and anxiety can exacerbate the already devastating effects of the disease.
        Am J Nurs. 2003; 103: 32-42
        • Gallangher R.
        • Luttik M.L.
        • Jaarsma T.
        Social support and self-care in heart failure.
        J Cardiovasc Nurs. 2011; 26: 439-445
        • Hill P.C.
        • Pargament K.I.
        Advances in the conceptualization and measurement of religion spirituality: implications for physical and mental health research.
        Am Psychol. 2003; 58: 64-74
        • Wortmann J.H.
        • Park C.L.
        Religion and spirituality in adjustment following bereavement: an integrative review.
        Death Stud. 2008; 32: 703-736
        • Hackney C.H.
        • Sanders G.S.
        Religiosity and mental health: a meta-analysis of recent studies.
        J Sci Study Relig. 2003; 42: 43-55
        • Ibrahim H.
        • Asmawati D.
        • Chiew-Tong N.K.
        • Ismail R.
        • Zainah A.Z.
        Social support and religious coping strategies in health-related quality of life in end-stage renal disease patients.
        Soc Sci Hum. 2011; 19: 91-97
        • Parkerson G.R.
        • Gutman R.A.
        Health-related quality of life predictors of survival and hospital utilization.
        Healthc Financ Rev. 2000; 21: 171-184