Correlation between symptom status, health perception, and spiritual well-being in heart failure patients: A structural equation modeling approach


EROĞLU H., Metin Z. G.

Journal of Nursing Scholarship, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2024
  • Doi Number: 10.1111/jnu.12961
  • Journal Name: Journal of Nursing Scholarship
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, ASSIA, CINAHL, MEDLINE, Psycinfo
  • Keywords: health perception, heart failure, nurse, spirituality, structural equation modeling, symptom burden
  • Hacettepe University Affiliated: Yes

Abstract

Aim: To explore predictors of spiritual well-being behaviors among heart failure patients based on Wilson and Cleary's conceptual model of health-related quality of life and to clarify the interrelationships among these variables. Design: A descriptive and correlational study design was used. Methods: This study included 202 heart failure patients treated between October 2020 and July 2021. Data were collected using the Symptom Status Questionnaire-Heart Failure, Perception of Health Scale, and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale. Descriptive analysis, correlation, and structural equation modeling were performed. Results: Characteristic factors positively affected spiritual well-being both directly (β = 0.19, p = 0.007) and indirectly (β = 0.19; CI (0.106; 0.311)). The direct relationship between health perception and spiritual well-being was significant (β = 0.83, p < 0.05). Symptom status acted as an essential mediator between model variables and spiritual well-being (β = −0.28; CI (−0.449; −0.133)). Comorbidity and symptom status also influence spiritual well-being through health perceptions. These variables explain 77% of the variance in spiritual well-being. Conclusion: The modified structural equation modeling based on Wilson and Cleary's conceptual model fits well in predicting spiritual well-being in patients with heart failure. Spiritual well-being was reported to be poor, and changes in spiritual well-being were predicted by age, educational level, marital status, comorbidity, symptom status, and health perception. The results can be applied to patients with heart failure and may serve as a guide for assessment and interventions for improving spiritual well-being. Clinical Relevance: This study mainly concludes that symptom status and perceived health status affect spiritual well-being in heart failure patients. Symptom relief and improvement in perceived health status interventions may help enhance spiritual well-being in this population. Future studies are needed to investigate the different predictor's effects on spiritual well-being and examine whether symptom management and health status-enhancing interventions result in improved spiritual well-being in the heart failure population. Reporting Method: This study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. Patient or Public Contribution: No patient or public contribution.