The role of gratitude in spiritual well-being in asymptomatic heart failure patients.

Abstract

Spirituality and gratitude are associated with wellbeing. Few if any studies have examined the role of gratitude in heart failure (HF) patients or whether it is a mechanism through which spirituality may exert its beneficial effects on physical and mental health in this clinical population. This study examined associations bet ween gratitude, spiritual wellbeing, sleep, mood, fatigue, cardiac-specific self-efficacy, and inflammation in 186 men and women with Stage B asymptomatic HF (age 66.5 years ±10). In correlational analysis, gratitude was associated with better sleep (r=-.25, p<0.01), less depressed mood (r=-.41, p<0.01), less fatigue (r=-.46, p<0.01), and better self-efficacy to maintain cardiac function (r=.42, p<0.01). Patients expressing more gratitude also had lower levels of inflammatory biomarkers (r=-.17, p<0.05). We further explored relationships among these variables by examining a putative pathway to determine whether spirituality exerts its beneficial effects through gratitude. We found that gratitude fully mediated the relationship between spiritual wellbeing and sleep quality (z=−2.35, SE=.03, p=.02) and also the relationship between spiritual wellbeing and depressed mood (z=−4.00, SE=.075, p<.001). Gratitude also partially mediated the relationships between spiritual wellbeing and fatigue (z=−3.85, SE=.18, p<.001), and between spiritual wellbeing and self-efficacy (z=2.91, SE=.04, p=.003). In sum, we report that gratitude and spiritual wellbeing are related to better mood and sleep, less fatigue, and more self-efficacy, and that gratitude fully or partially mediates the beneficial effects of spiritual wellbeing on these endpoints. Efforts to increase gratitude may be a treatment for improving wellbeing in HF patients’ lives and be of potential clinical value.

Gratitude uniquely predicts lower depression in chronic illness populations: A longitudinal study of inflammatory bowel disease and arthritis.

“…Addressing depression can also have important consequences for medication adherence, as a meta-analysis found that individuals with chronic disease who were depressed were 1.76 times more likely to be non-adherent (Grenard et al, 2011). Importantly, gratitude has also been linked to lower levels of inflammatory biomarkers in individuals with heart failure (Mills et al, 2015), suggesting that gratitude may be particularly relevant for chronic illness characterized by inflammatory processes. Given the current results, and the implications of depression for disease management in IBD and arthritis, further intervention-based and randomized controlled trial research is clearly warranted to more fully investigate the potential benefits of gratitude for these populations.…”

Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure

“…This is a sub-study of a larger observational study examining the relationship among trait gratitude and biological factors linked with HF (14). Participants had a diagnosis of AHA/ACC classification Stage B HF for at least 3 months, were 18 years of age or older and were recruited from the University of California, San Diego (UCSD) Medical Center Cardiology Programs and the Veterans Affairs San Diego Healthcare System (VASDHS).…”

“…The GQ-6 was chosen since it is most often used in gratitude intervention studies (e.g. Emmons & Mccullough) as well as in larger cross-sectional studies measuring physical health (28) including in patients with asymptomatic HF (14). In the present study, the Cronbach's alpha for baseline GQ6 = .83.…”

“…For example, a cross-sectional study from a non-clinical population of 962 individuals ranging in age from 19 to 84 found that gratitude scores positively related with self-reported physical health. However, in a cross-sectional investigation of asymptomatic patients with HF we found a relationship between gratitude levels and an index of inflammatory biomarkers known to be associated with adverse cardiac remodeling and progression to HF (14). There have been even fewer intervention studies examining the effects of increased gratitude on physical health.…”

Resilient to Stress: Proposed a Novel Type E Personality

“…It has been shown that higher expression of gratitude was correlated with reduced inflammation and increased parasympathetic responses (Mills PJ et al 2015, Redwine LS et al 2016. Parasympathetic activation is required to inhibit persistently increased release of stress hormones after stressful stimulus.…”