Spiritual assessment in heart failure: The blind spot that shattered person-centered care

Background : Heart failure is a chronic syndrome with serious physical, psychosocial, and spiritual burdens. The symptoms and life-threatening nature of the disease may give rise to spiritual needs and lead to spiritual distress. Caregivers should address spiritual issues with the goal of enhancing quality of life and spiritual well-being. Spiritual needs should therefore be included in person-centered care approaches, especially in more advanced stages of the disease. Methods : The aim of this study was to describe the propensity of Quebec cardiologists to assess the spiritual well-being and spiritual needs of heart failure patients and identify factors that limit or facilitate this assessment. A descriptive exploratory study was carried out with 26 cardiologists working in three main cities of the province of Quebec in Canada. The data collected through online surveys were statistically analyzed and discussed by expert committees. Results : The assessment of spiritual well-being is weak. Spiritual needs assessment is more common. Overall, the needs for inner peace and relationality are more frequently assessed than those related to meaning, purpose and wholeness. Cardiologists affirm that spirituality is different than religion and can be a valid coping mechanism for patients. The vast majority also think that the patient’s spiritual state can influence HF physical symptoms. Among other factors, the clinical context, lack of time and lack of training are barriers to spiritual evaluation. Conclusion : Despite HF patients’ desire to discuss spiritual issues related to their disease, spiritual assessment is not well addressed in the context of a primarily biomedical model of health. Education on spiritual needs and spiritual assessment tools should be offered to cardiologists, as well as to any health professional taking care of seriously ill patients.