Defense Date

2011

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Health Related Sciences

First Advisor

Diane Dodd-McCue

Abstract

Mechanical Circulatory Support (MCS) improves the health-related quality of life (HRQOL) for patients with end-stage heart failure (HF) (Friedrich & Bohm, 2007). Religious and spiritual practices positively influence health and well-being for cardiac patients (Ai, Park, Huang, Rodgers, & Tice, 2007; Blackhall, & Koenig, 1998). The purpose of this study was to examine the impact of spiritual well-being (SWB) and religious well-being (RWB) and coping styles and methods (CSM) on health related quality of life (HRQOL) of patients with MCS. This exploratory repeated measures study used Spearmans’ rho and Wilcoxons’ Signed Rank tests for correlation and comparison analyses. The study population included patients with left ventricular assist devices (HMII) and total artificial hearts (TAH). Patients were assessed pre and post MCS implant. Patients reported an increase in the use of faith practices for coping (prayer and meditation), providing evidence for spiritual growth after MCS. SWB, RWB, and CSM, and their corresponding subscales were positively related to HRQOL revealing medium to large correlation coefficients and variances. Post MCS, the TAH patients’ mean scores decreased for SWB and RWB (religious comfort) and increased for RWB (religious strain), indicating some spiritual distress. The internal locus of control for TAH patients increased with significance. HMII patients reported a significant increase in adaptive coping and “God” locus of control. The results suggest that early spiritual assessment with MCS patients may promote more timely and effective responses to maladaptive and dysfunctional coping. Patients who use their faith to cope (in distress or not) may also benefit from an increase in emotional and spiritual attention. Spiritual care providers who are knowledgeable about the MCS assessment, surgery, and recovery process could then provide interventions that build resilience and mediate improved outcomes through supportive and directed counseling. The results of this study inform the future development of interdisciplinary plans of spiritual and emotional care for this patient population and for other chronic illness populations. Further examination may reveal how SWB, RWB and CSM improve HRQOL as well as highlight the unique support needs of HMII and TAH patients.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

December 2011

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