Emotions and spiritual needs also interrelate on a
clinical level: Spirituality has been shown to be associated
with decreased anxiety and depression.2732 Increased
use of spiritual practices among persons with AIDS has
been associated with a decrease in psychological distress
and depression and an increase in emotional coping
ability.33,34 The Systems of Beliefs Inventory,
developed to measure spirituality and religious practices
in medical populations, recognizes the overlapping emotional,
cognitive, behavioral, and social elements of spirituality.
35 Furthermore, emotions and spiritual needs are
consistent with patients perceptions of a single self
where all needs intermingle.36
The notion that caring for
emotional and spiritual needs employs behaviors and
interventions of a similar naturesupport, sensitivity,
empathy, comfort, affirmation, and attentiveness to
patients unique needsis supported by the literature
and in the data analysis of the survey results.
Impact on Health Outcomes.
Poor psychological and emotional health damages physical health
outcomes. A review of emotional distress and coronary
heart disease reported that depression, stress, anger, and
negative emotions in general were strongly associated
with increased cardiac death and reinfarction, independently
of disease severity.37 For example, Pratt et al.38
confirmed that depression increases the risk of myocardial
infarction (MI), and Anda et al.39 found that depression
and feelings of hopelessness were associated with
increased mortality from ischemic heart disease.
Conversely,
emotional well-being has been shown to
be predictive of survival and functional independence
among older patients.40 The widely accepted causal relationship
between social support and physical health41
could be the product of reduction in emotional distress.42
In a vicious cycle of decline between psychological distress
and perceived health, psychological distress would
lead to increased negative health perceptions, which, in
turn, would lead to increased distress and further deterioration
in perceived health.43
Health outcomes can be positively affected by attempts
to address emotional and psychosocial needs. Two studies
noted positive physiological responses resulting from the
emotional comfort of spirituality.44,45 Through in-depth
patient interviews,
Kent et al.46 found anxiety, depression,
and other poor outcomes to be common among patients
with unmet emotional needs. Three studies found that
psychosocial interventions reduced mortality rates among
cancer patients.4749 Appropriate, well-considered responses
to emotional distress in cancer patients have been
found to reduce psychological morbidity.50,51
Psychosocial interventions benefit patients through
improved quality of life, emotional adjustment, functional
adjustment, and psychosocial functioning.52,53 Metaanalyses
indicate positive clinical effects and decreased
anxiety from preemptive psychological interventions
that target patients at risk of psychological distress.53
Studies by Blumenthal et al.54,55 have found that stress
management interventions reduce cardiac morbidity.
Reducing emotional distress in patients with coronary
heart disease improves long-term prognosis.56 Numerous
literature reviews confirm that psychoeducational interventions
improve clinical outcomes (for example, anxiety,
depression, pain) while reducing length of stay.5762
Finally, spiritual and psychosocial interventions have
been shown to help patients cope with disease and the
effects of hospitalization.6365
In summary, these studies suggest that
emotional and
spiritual needs have a profound effect on patients health
outcomes and deserve the attention of health care professionals.
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