Heart Failure Self-Care and Spirituality: An Integrative Review

Heart failure (HF) is on the rise worldwide, and the economic burden is gradually increasing. Spirituality positively impacts mental and physical health of people with HF through regaining purpose, meaning, and self-transcendence.

In this study, our aim was to identify gaps in knowledge by analyzing and synthesizing evidence related to benefits, barriers, definition, and measurement of spirituality and its relationship to HF self-care.

For this integrative review, we searched CINAHL, MEDLINE, PubMed, APA PsycINFO, Web of Science, and manual search between January 2013 and August 2024. Search terms included combinations of HF, self-care, and spirituality-related keywords. Hawker and colleagues' critical appraisal tool was utilized to analyze the quality of this review.

We analyzed 15 studies and derived 3 themes: Heterogeneous and interconnected, spirituality as a predictor of self-care, and social and cultural consideration. Most define spirituality as seeking meaning and connection to a transcendent being, and the FACIT-Sp scale was the most commonly used. In 20% of studies, the influence of spirituality was examined using self-care measurements in people with HF. The facilitating factors to integrating spirituality into care included social support, resilience, gratitude, approach coping, prayer, meditation, and religious affiliation, while the barriers included disease severity, burden, and cultural differences.

Spirituality serves as an inner resource that enhances HF self-care by providing personal meaning and self-transcendence, extending beyond traditional religious practices. Healthcare providers should assess the spiritual needs of individuals with HF and provide individualized self-care support that considers the social and cultural backgrounds that can enhance spirituality.