Relationship of Spiritual Health and Religious Commitment with Anxiety and Depression in Patients with Coronary Heart Diseases Presenting to Fateme Zahra Hospital Clinic in Sari

Anxiety and depression are determinants of the prognosis of coronary artery disease(CAD). Spiritual well-being and religious commitment affect people's mental well-being. Due to the limitations of previous similar studies in the difference in demographic characteristics of participants with CAD patients, it was necessary to repeat these studies in coronary artery disease patients. In this study, the state of spiritual well-being and religious commitment and their relationship with anxiety and depression in coronary artery disease patients referred to Fatemeh Zahra Hospital (Mazandaran Cardiology Center) in 1400 and 1401 were investigated.

In this cross-sectional descriptive-analytical study, 159 heart and CAD patients referred to Fatemeh Zahra Hospital (Mazandaran Cardiology Center) were selected by conventional sampling method. Demographic and well-being variables including age, gender, marital status, education level, employment status, and history of psychiatric diseases and substance abuse were measured using the data collection form. The participants answered the questionnaires of the Hospital Anxiety and Depression Scale (HADS) (with validity in the anxiety component t260=21.32 and depression t260=23.41 and reliability in the anxiety component r=0.75 and depression r=0.71), the scale of the practice of religious beliefs (Mabad) (reliability confirmed with Cronbach's alpha coefficient of 91.0 and criterion-related validity coefficient of .0.84) and Palutzian Ellison's spiritual well-being (validity confirmed by content validity and reliability with Cronbach's alpha coefficient of 0.89). Data were analyzed with the help of Stata 14 statistical software at the significance level of P<0.05. Independent T-test and ANOVA tests were used to compare quantitative scores between study groups, and the Chi-square test was used to compare the frequency of qualitative variables between groups. The relationship between the variables was measured by Pearson's correlation coefficient test.

The average age of the participants was 57.82±14.0 and 33.33% of the sample were men. The religious commitment score of the participants was in the range of 97-10 with an average of 63.73±19.10 (high commitment level). 23% of participants had low religious commitment and 77% had high religious commitment. The religious well-being score of the participants was in the range of 60-34 with an average of 55.28±6.38 and the existential well-being score of the participants was in the range of 60-13 with an average of 43.07±11.24. Also, the spiritual well-being score of the participants was at the average level with a range of 120-54 and an average of 98.35±14.54. 51% of the participants had average spiritual well-being and 49% had high spiritual well-being. The hospital anxiety score of the participants was in the range of 0-21 with an average of 8.23±5.67 (at the level of mild anxiety). 44.2% of the participants had no anxiety, 16% had mild anxiety, 19.2% had moderate anxiety, and 20.5% had severe anxiety. The hospital depression score of the participants was in the range of 0-21 with an average of 7.35±5.06 (at the level of mild depression). 46.4% of the participants had no depression, 14.6% had mild depression, 12.1% had moderate depression, and 26.7% had severe depression. A negative correlation was found between the severity of spiritual well-being and the severity of depression with a Pearson coefficient of -0.62 (P<0.001) and the severity of anxiety (-0.48, P<0.001). The relationship between the intensity of religious commitment with the intensity of anxiety (P=0.87) and the intensity of depression (P=0.12) was not significant.

Considering the reduction of anxiety and depression scores in samples with higher spiritual well-being scores, it is recommended to focus more on improving the spiritual well-being level of CAD patients by medical staff, as well as group training programs and spiritual self-care training programs after discharge. Follow. Psychotherapy sessions with a spiritual approach can also be useful.