Spiritual Support in Advanced Heart Failure: A Randomized Controlled Feasibility Study

Q1 Arts and Humanities Health and Social Care Chaplaincy Pub Date : 2020-07-21 DOI:10.1558/hscc.41171
J. Miles, L. Ross, Paul Jarvis, S. Pickett
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Abstract

Heart failure is a complex, progressive disease with an uncertain trajectory.  Those with advanced heart failure (AHF) experience substantial spiritual needs.  Spiritual interventions may enhance quality of life and reduce anxiety and depression,  but studies are limited and none have focused exclusively on the AHF patient population.  This is the first feasibility randomized controlled trial (RCT) to ascertain the clinical and cost effectiveness of a spiritual intervention (spiritual support) in AHF  patients. A total of 47 AHF patients were randomized to control (standard care, n = 25)  or intervention (standard care plus spiritual support, n = 22) groups. Spiritual support  consisted of a one-hour discussion facilitated by trained volunteers using a “Spiritual  Enquiry Tool” at two-monthly intervals over six months. Participants completed validated  measures of spiritual well-being, depression/anxiety, and health-related quality  of life (QoL). Purpose-designed questionnaires gathered information on demographics,  NHS resource use, confounding factors, and satisfaction with spiritual support. The  new information was to help researchers design an RCT to determine the clinical and  cost effectiveness of spiritual support within a holistic model of care for AHF patients.  Future trends worthy of further investigation include (i) the possible positive effect of  spiritual support on QoL and anxiety, and (ii) possible lower NHS resource use and cost  savings in patients receiving spiritual support. Overall, the key message of this study is  that researchers must evaluate whether the cost of running a well-designed trial of this  nature is justified in the current economic climate, where funding bodies are looking  for value for money.
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晚期心力衰竭患者的精神支持:一项随机对照可行性研究
心力衰竭是一种复杂的进行性疾病,其发展轨迹不确定。那些患有晚期心力衰竭(AHF)的人经历了大量的精神需求。精神干预可以提高生活质量,减少焦虑和抑郁,但研究有限,没有一项专门针对AHF患者群体。这是第一个可行性随机对照试验(RCT),以确定精神干预(精神支持)对AHF患者的临床和成本效益。共有47名AHF患者被随机分为对照组(标准护理,n=25)或干预组(标准治疗加精神支持,n=22)。精神支持包括一个小时的讨论,由受过培训的志愿者使用“精神咨询工具”,在六个月内每两个月进行一次。参与者完成了精神健康、抑郁/焦虑和健康相关生活质量(QoL)的验证测量。专门设计的问卷收集了有关人口统计、NHS资源使用、混杂因素和精神支持满意度的信息。新信息旨在帮助研究人员设计随机对照试验,以确定AHF患者整体护理模式中精神支持的临床和成本效益。值得进一步研究的未来趋势包括(i)精神支持对生活质量和焦虑可能产生的积极影响,以及(ii)接受精神支持的患者可能降低NHS资源使用和成本节约。总的来说,这项研究的关键信息是,研究人员必须评估在当前的经济环境下,进行这种精心设计的试验的成本是否合理,因为资助机构正在寻找物有所值的资金。
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来源期刊
Health and Social Care Chaplaincy
Health and Social Care Chaplaincy Arts and Humanities-Religious Studies
CiteScore
4.80
自引率
0.00%
发文量
19
期刊介绍: Health and Social Care Chaplaincy is a peer-reviewed, international journal that assists health and social care chaplains to explore the art and science of spiritual care within a variety of contexts. The journal was founded in 2013 through the merger of the Journal of Health Care Chaplaincy (issn:1748-801X) and the Scottish Journal of Healthcare Chaplaincy (issn:1463-9920) . It continues to be the official journal of the College of Health Care Chaplains and members of the society receive the journal as part of their annual membership. For more details on membership subscriptions, please click on the ''members'' button at the top of this page. Back issues of both previous journals are being loaded onto this website (see Archives) and online access to these back issues is included in all institutional subscriptions. Health and Social Care Chaplaincy is a multidisciplinary forum for the discussion of a range of issues related to the delivery of spiritual care across various settings: acute, paediatric, mental health, palliative care and community. It encourages a creative collaboration and interface between health and social care practitioners in the UK and internationally and consolidates different traditions of discourse and communication research in its commitment to an understanding of psychosocial, cultural and ethical aspects of healthcare in contemporary societies. It is responsive to both ecumenical and interfaith agendas as well as those from a humanist perspective.
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