Correlation between symptom status, health perception, and spiritual well-being in heart failure patients: A structural equation modeling approach

AimTo explore predictors of spiritual well-being behaviors among heart failure patients based on Wilson and Cleary's conceptual model of health-related quality of life and to clarify the interrelationships among these variables. DesignA descriptive and correlational study design was used. MethodsThis study included 202 heart failure patients treated between October 2020 and July 2021. Data were collected using the Symptom Status Questionnaire-Heart Failure, Perception of Health Scale, and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale. Descriptive analysis, correlation, and structural equation modeling were performed. ResultsCharacteristic factors positively affected spiritual well-being both directly (beta = 0.19, p = 0.007) and indirectly (beta = 0.19; CI (0.106; 0.311)). The direct relationship between health perception and spiritual well-being was significant (beta = 0.83, p < 0.05). Symptom status acted as an essential mediator between model variables and spiritual well-being (beta = -0.28; CI (-0.449; -0.133)). Comorbidity and symptom status also influence spiritual well-being through health perceptions. These variables explain 77% of the variance in spiritual well-being. ConclusionThe modified structural equation modeling based on Wilson and Cleary's conceptual model fits well in predicting spiritual well-being in patients with heart failure. Spiritual well-being was reported to be poor, and changes in spiritual well-being were predicted by age, educational level, marital status, comorbidity, symptom status, and health perception. The results can be applied to patients with heart failure and may serve as a guide for assessment and interventions for improving spiritual well-being. Clinical RelevanceThis study mainly concludes that symptom status and perceived health status affect spiritual well-being in heart failure patients. Symptom relief and improvement in perceived health status interventions may help enhance spiritual well-being in this population. Future studies are needed to investigate the different predictor's effects on spiritual well-being and examine whether symptom management and health status-enhancing interventions result in improved spiritual well-being in the heart failure population. Reporting MethodThis study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. Patient or Public ContributionNo patient or public contribution.