Associations Between Religiosity, Symptoms, and the Quality of End of Life for Cardiovascular Disease Patients.

Abstract

Background: Religiosity is a well-described core component of palliative care in the end-of-life (EOL) care of cancer patients. However, studies examining associations between religiosity, physical symptoms, quality of care (QOC), and quality of death (QOD) in cardiovascular disease (CVD) patients at EOL are lacking.

Methods and results: This nationwide cross-sectional mortality follow-back survey sent a questionnaire to bereaved caregivers of patients who had died of CVD in 2017. Responses to the Memorial Symptom Assessment Scale (MSAS), Care Evaluation Scale (CES), and Good Death Inventory (GDI) were assessed, stratified by the presence of religiosity. Responses regarding religiosity were analyzed for 4,436 of 15,047 questionnaires. In all, 795 (17.9%) caregivers reported the patient was supported by religiosity in the 1 month before death. The group with religiosity was older (mean [±SD] age 88.9±8.7 vs. 86.7±9.4 years; P<0.001), more likely to be female (70.9% vs. 60.3%; P<0.001), less likely to have been hospitalized before death (15.8% vs. 24.0%; P<0.001), reported significantly fewer symptoms on the MSAS, and had better QOC and QOD according to CES and GDI subscores. Total CES and GDI scores were significantly better in the group with than without religiosity (CES: 69.2±21.9 vs. 63.6±24.2, respectively [P<0.001]; GDI: 65.4±17.0 vs. 53.7±22.1, respectively [P<0.001]).

Conclusions: Religiosity may contribute to reduced physical symptoms and improved QOC and QOD among CVD patients at EOL.