Spirituality and heart failure: a systematic review

Abstract

Objectives: Heart failure (HF) is a frequent chronic disease with disturbing symptoms and complex treatments, associated with depression and lower quality of life. Some studies have shown that spirituality and religiosity may be relevant in these patients. We aimed to systematically review the medical literature on spirituality and religiosity in patients with HF. Methods: Major databases for studies investigating the effect of spirituality and religiosity in people affected by HF were searched from inception until 26th April 2023. Studies with clear definition of spirituality or religiosity, validated diagnosis of HF, and reporting outcomes of interest (i.e., incidence of mortality, cardiovascular outcomes, and quality of life) were included. Results: Among 810 non-duplicate records, we screened the full texts of 25 works. After excluding 18 studies, we included 7 studies (3 observational and 4 interventional) comprising 1234 HF patients followed up over a median of 3 months. Definitions of spirituality and religiosity were heterogeneous among the studies. The intervention studies showed improvements in quality-of-life parameters, some cardiovascular outcomes, or mortality, and the observational studies showed significant associations with these outcomes. Conclusions: Despite the extreme heterogeneity of the populations included, of the definition of spirituality and religiosity, and of the interventions in the few studies that included it, all the studies reported some positive associations with the outcomes examined. Spirituality/religiosity is an aspect not generally taken into account in the usual practice of medicine and can potentially contribute to improving the conditions of patients with HF, a chronic disease with unfavorable prognosis.