COMMENTARY

Can Spirituality Overcome Negative Emotions in Heart Disease?

Tom G. Bartol, NP

Disclosures

January 08, 2015

Viewpoint

What the authors of this study refer to as negative emotions (anxiety, depression, and anger) have been found to be associated with future CHD.[1] In a review of epidemiologic evidence, Kubzansky[2] explores the role of negative emotions in CHD while trying to explain some of the mechanisms involved. Patients with CHD and other chronic diseases also often suffer from depression and other negative emotions. The question of cause or effect of these negative emotions on CHD is a bit less clear. Are these negative emotions markers or causes of CHD or both?

This study looks at people with existing CHD and the effects of seven dimensions of spirituality on patients and their effects on the negative emotions of anxiety, depression, and anger. Although I found the details and results of this study a challenge to follow, I find the concepts explored in it very intriguing and important in our care of patients with CHD.

The 293 individuals with stable CHD were evaluated for their spiritual attitudes and their levels of negative emotions of anger, depression, and anxiety. The working definition of spirituality was "the personal quest for answers to ultimate questions about life, meaning, and relationships"[3] including connecting with the essence of life, which consists of connectedness with oneself, connectedness with others and nature, and connectedness with the transcendent.[4] It was far more than simply looking at religion and religious practices as spirituality. The SAIL questionnaire has much more to do with how people perceive themselves in the world around them.

This study is far from conclusive about which elements of spirituality are the most important in having an impact on negative emotions in patients with CHD. From this and other research, psychosocial factors, including negative emotions, clearly play a role in the development of CHD and many other diseases. Some studies indicate that psychosocial distress is a greater risk factor for CHD than such conventional risk factors as hypertension, diabetes, and abdominal obesity.[5]

More research is needed to fully ascertain the role of negative emotions in causing, or being caused by, CHD. This study points out, however, that nursing interventions are important in helping people cope with CHD, but the spiritual needs of patients receive little attention. Nurses have the skills, empathy, and capacity to take a lead in a process that could potentially have a huge impact on CHD. Facilitating connectedness, trust, and relationships can be key interventions, but they often get lost in the midst of monitoring blood pressures and lipid levels. Nurses can help patients find hope, meaning, and purpose in life what I like to call building a "relationship of hope" with their patients.[6]

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