Spiritual support in end stage heart failure (ESHF): a randomised controlled feasibility study

People with ESHF experience significant spiritual needs and would value spiritual support. Research is needed to determine if spiritual support enhances spiritual wellbeing (SWB) and quality of life (QOL) and mitigates against depression and anxiety in ESHF, but information is needed to inform the design of such a study.

Research Questions:
1. What is the effect of spiritual support on SWB (WHO-SRPB), anxiety/depression (HAD), and QOL (EQ5D)?
2. Is such a study feasible in terms of cost, recruitment, drop-out, time?

Method
Prospective random allocation over 18 months of ESHF patients in ABUHB (n=47 from possible 270) to receive standard care only (control group n=25) or standard care plus spiritual support (experimental group n=22). Spiritual support was provided by trained volunteers in patients’ homes at 2 monthly intervals over 6 months (4 visits). Measures of study outcomes were completed at 0, 2, 4, 6 months by both groups.

Analysis
Descriptive statistics and Repeated Measures ANOVA to explore within and between group differences.

Selected Results with follow-on questions
1. No significant effect of spiritual support on SWB, anxiety/depression or QOL was found. The study was limited by its small sample size but the following trends are worthy of further exploration:
-The control group showed a marked worsening in SWB, anxiety and QOL between months 0 and 2, whilst the experimental group showed a marked improvement in QOL and anxiety at this time. Depression scores increased in experimental patients and decreased in control patients at the end of the study, so is there a group allocation effect?
-SWB decreased in patients reporting deterioration of symptoms between months 0-2, so is there a link between SWB and symptoms?
2. Recruitment and data collection took much longer than expected making the feasibility of conducting research with this very ill patient group questionable.