The role of gratitude in spiritual wellbeing in asymptomatic heart failure patients

Citation

Mills PJ, Redwine L, Wilson K, Pung MA, Chinh K, Greenberg BH, Lunde O, Maisel A, Raisinghani A, Wood AM & Chopra D (2015) The role of gratitude in spiritual wellbeing in asymptomatic heart failure patients. Spirituality in Clinical Practice, 2 (1), pp. 5-17. https://doi.org/10.1037/scp0000050

Abstract
Spirituality and gratitude are associated with well-being. 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 between gratitude, spiritual well-being, 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 < .01), less depressed mood (r = −.41, p < .01), less fatigue (r = −.46, p < .01), and better self-efficacy to maintain cardiac function (r = .42, p < .01). Patients expressing more gratitude also had lower levels of inflammatory biomarkers (r = −.17, p < .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 well-being and sleep quality (z = −2.35, SE = .03, p = .02) and also the relationship between spiritual well-being and depressed mood (z = −4.00, SE = .075, p < .001). Gratitude also partially mediated the relationships between spiritual well-being and fatigue (z = −3.85, SE = .18, p < .001) and between spiritual well-being and self-efficacy (z = 2.91, SE = .04, p = .003). In sum, we report that gratitude and spiritual well-being 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 well-being on these endpoints. Efforts to increase gratitude may be a treatment for improving well-being in HF patients’ lives and be of potential clinical value.

Keywords
heart failure; gratitude; spiritual well-being; inflammation

Journal
Spirituality in Clinical Practice: Volume 2, Issue 1