Spirituality-based palliative care education on quality of life, death anxiety, and resilience of heart failure patients: Randomized controlled clinical trial

Abstract

Background

Heart failure represents the most severe and prevalent form of chronic cardiac disease, significantly impacting patients’ quality of life. Scientific evidence has established palliative care as a crucial component in the treatment of heart failure patients. However, limited research has examined how spirituality-based palliative care education affects these patients’ quality of life, death anxiety, and resilience.

Objectives

This study investigated the effects of spirituality-based palliative care education on quality of life, death anxiety, and resilience among heart failure patients in southern Iran.

Methods

This investigation employed a randomized controlled clinical trial design without blinding, incorporating both experimental and control groups. 80 patients who were randomly assigned to intervention and control groups (40 patients per group). Participants were recruited from patients receiving treatment at a teaching hospital in southern Iran between June and October 2022. Participants in the intervention group received spirituality-based palliative care education through six one-hour sessions. Data were collected using three validated instruments; the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Templer Death Anxiety Scale, and the Connor-Davidson Resilience Scale. Both groups completed these assessments at baseline, immediately post-intervention, and at a three-month follow-up. Data analysis was performed using SPSS version 20, employing descriptive statistics, Chi-square tests, Indipendent sample t test, and Repeated measures ANOVA. Statistical significance was set at P < 0.05.

Results

The mean age of participants was 63.11 ± 12.2 years in the intervention group and 62.14 ± 13.1 years in the control group. In the intervention group, 50 % of participants were married, compared to 30 % in the control group. The majority of patients had completed high school education (50 % in the intervention group and 60 % in the control group). The intervention group showed significant improvements in quality of life, death anxiety, and resilience scores both immediately after the intervention and at the three-month follow-up (p < 0.05). No significant changes were observed in the control group.

Conclusion

The findings demonstrate that spirituality-based palliative care education effectively reduces death anxiety while enhancing quality of life and resilience among heart failure patients. We recommend that healthcare administrators implement this novel educational approach in the care of heart failure patients.