Denver Spirited Heart: Mixed-Methods Pilot Study of a Psychospiritual Intervention for Heart Failure Patients.
Stephanie A Hooker, Kaile Ross, Kevin S Masters and 4 others
PMID 27076391WHAT IT FOUND
Heart failure patients found a mailed psychospiritual program acceptable, with most reporting benefit.
Preliminary data showed improvements in quality of life and mood, but the small, uncontrolled pilot cannot prove the intervention works.
Key findings
01Most participants rated the intervention as beneficial and worthwhile, with 85.7% saying it was worth their time.
02Participants experienced a moderate, clinically meaningful increase in heart failure-specific quality of life and a decrease in depressive symptoms over 12 weeks.
03Reactions to the spiritual component were mixed; while most thought spirituality should be included, one-third found it the least helpful part and some felt it was too religious.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a small pilot study with no control group, so improvements cannot be attributed to the intervention rather than natural history, regression to the mean, or the Hawthorne effect. The sample was relatively healthy at baseline with high spiritual well-being, limiting the applicability to more distressed or advanced heart failure patients. Attrition was high (36.4% of those with baseline data did not complete), and the study notes that healthier individuals may have been more likely to complete the intervention. The weekly phone calls from research staff added a social component that may have influenced quality of life outcomes, making it difficult to isolate the effect of the mailed modules. The sample was overrepresented by male patients, who may have different coping and depressive symptom profiles than female patients.
Declared interests
No specific funding sources or conflicts of interest are detailed in the provided text, though the study was conducted at a university hospital and a Veterans' Affairs Medical Center.
The easy way to misread this
Do not conclude that the mailed psychospiritual modules caused the improvements in quality of life. The study had no control group, high attrition, and included weekly phone calls from staff, which participants valued for social connection. The observed benefits may be due to the attention and contact rather than the specific content of the modules.