Can Spirituality Overcome Negative Emotions in Heart Disease?

Tom G. Bartol, NP


January 08, 2015

Spirituality and Negative Emotions in Individuals With Coronary Heart Disease

Ginting H, Näring G, Kwakkenbos L, Becker ES
J Cardiovasc Nurs. 2014 Oct 27. [Epub ahead of print]

Studying the Effects of Negative Emotions

Negative emotions can be a risk factor for the outcome of coronary heart disease (CHD), whereas CHD also can result in negative emotions. This study sought to examine the associations between seven dimensions of spirituality and negative emotions in individuals with CHD while controlling for perceived social support. The following seven dimension of spirituality were measured:

  • Meaningfulness;

  • Trust;

  • Acceptance;

  • Caring for others;

  • Connectedness with nature;

  • Transcendent experiences; and

  • Spiritual activities.

The study was conducted in Bandung, Indonesia and included 293 individuals with CHD (211 men and 82 women) aged 33-82 years (mean age, 58 years). Participants were eligible if they had been diagnosed with CHD by a cardiologist, by coronary angiography, echocardiography, treadmill, or electrocardiogram, but had not experienced angina or undergone interventional treatment within the past 6 weeks.

Spirituality was measured with the Spiritual Attitude and Involvement List (SAIL), in which individuals rated 26 statements on a scale of 1-6 in seven areas, including: meaningfulness (eg, I know my position in life), trust (eg, in difficult times, I maintain my inner peace), acceptance (eg, I am aware that each life has its own tragedy), caring for others (eg, I want to mean something to others), connectedness with nature (eg, the beauty of nature moves me), transcendent experiences (eg, I have had experiences where everything seemed perfect), and spiritual activities (eg, I meditate or pray or take time in other ways to find inner peace).

Negative emotions (depression, anxiety, and anger) were also measured, as was perceived social support. The Beck Depression Inventory-II was used to measure depression. Anxiety was assessed using the trait anxiety scale of the State Trait Anxiety Inventory. A 38-item Multidimensional Anger Inventory was used to measure anger, and the Multidimensional Scale of Perceived Social Support was used to measure perceived support from friends, family, and significant others.

Of the seven dimensions of spirituality, a higher level of trust significantly predicted lower levels of depressive symptoms and anxiety. Caring for others and spiritual activities were associated with less anxiety. Less anger was associated with a higher level of connectedness with others. Compared with spirituality, the study found that perceived social support was associated with a larger reduction in depressive symptoms, whereas spirituality had more effect on reducing anxiety and anger.


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