Role of spirituality in adjustment of patients with advanced heart failure.

Heart failure is a chronic and progressive disease often characterized by severe symptoms, frequent hospitalization, and poor prognosis. It may threaten the individual's sense of self and lead to questions related to spirituality. The purpose of this qualitative, phenomenologic study was to describe the role of spirituality in the adjustment of patients to advanced heart failure. Purposive sampling of all patients who presented to two university-affiliated, outpatient heart failure clinics was used. Eighty-seven patients were interviewed using a semistructured questionnaire. Data were subjected to content analysis and thematic coding. Patients described a three-step process where spirituality contributed to their adjustment to advanced heart failure: development of regret regarding past behaviors and lifestyles; the search for meaning within the present experience of heart failure; and the search for hope for the future and reclaiming of optimism. Assessment and interventions that include a spiritual dimension can facilitate the adjustment of patients to advanced heart failure.