Association between Spirituality and Adherence to Management in Outpatients with Heart Failure

Abstract Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.

Proceedings of the National Shellfisheries Association.

v. 62 (1972)

I. Supplement to the flora of Barro Colorado island, Panama [by] Leslie A. Kenoyer and Paul C. Standley.

v.4:no.6(1929)

Report of the British Association for the Advancement of Science.

Index (1831-1860)

Proceedings of the Dublin University Zoological and Botanical Association.

1-2

Seasonal variability on the structure of sublittoral macrozoobenthic association in the Patos Lagoon estuary, southern Brazil

The aim of this study is to analyze and relate the spatial-temporal variability of macrozoobenthic assemblages to bottom characteristics and salinity fluctuations, in an estuarine shallow water region of Patos Lagoon. Monthly samples, between September 2002 and August 2003, were taken on six sampling stations (distant 90 m). Three biological samples with a 10 cm diameter corer, one sample for sediment analysis, fortnightly bottom topography measurements, and daily data of temperature and salinity were taken from each station. Two biotic and environmental conditions were identified: the first corresponding to spring and summer months, with low macrozoobenthos densities, low values of salinity, small variations in bottom topographic level and weak hydrodynamic activity. A second situation occurred in the months of fall and winter, which showed increased salinity, hydrodynamics and macrobenthos organisms. These results which contrast with previous studies carried out in the area, were attributed to failure in macrozoobenthos recruitments during summer period, especially of the bivalve Erodona mactroides Bosc, 1802 and the tanaid Kalliapseuses schubartii Mañe-Garzón, 1949. This results showed that recruitments of dominant species were influenced by salinity and hydrodynamic conditions.

A new turtle from the Paleocene of Colorado / Karl P. Schmidt --

v.10:no.1(1945)

A new species of the fossorial mammal Arctoryctes from the Oligocene of Colorado / Charles A. Reed --

v.10:no.24(1956)

Proceedings of the National Shellfisheries Association.

v. 64 (1974)

Proceedings of the National Shellfisheries Association.

v. 61 (1971)

Proceedings of the National Shellfisheries Association.

v. 56 (1965)

Proceedings of the National Shellfisheries Association.

v. 65 (1975)

Addresses delivered at the convention of the National Shellfisheries Association.

1949

Proceedings of the National Shellfisheries Association.

v. 68 (1978)