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Current Status of Spirituality in Cardiac Rehabilitation Programs: A REVIEW OF LITERATURE

Nadarajah, Sheeba PhD, RN; Berger, Ann M. MSN, MD; Thomas, Sue Ann PhD, RN

Journal of Cardiopulmonary Rehabilitation and Prevention: May/June 2013 - Volume 33 - Issue 3 - p 135–143
doi: 10.1097/HCR.0b013e318291381e
Scientific Review

PURPOSE: Strong spiritual experiences in life are a protective, positive, prognostic factor in cardiovascular diseases. However, spirituality is often neglected in cardiac rehabilitation (CR) programs. The purpose of this article was to review studies that investigated spirituality in CR programs.

METHODS: The electronic databases PubMed, CINHAL, PsycINFO, and Cochrane Library of Systematic Reviews were searched for studies that measured spirituality in a CR population. The search included studies with and without spiritual interventions in CR settings.

RESULTS: Five quantitative studies and 1 qualitative study that enrolled a total of 1636 patients in phase 2 CR programs were reviewed. The spiritual interventions found were relaxation responses and spiritual classes. Two studies showed preliminary evidence that supports the further exploration of spiritual interventions in CR programs.

CONCLUSIONS: Evidence supporting the use of spiritual interventions for medical and psychological outcomes in CR programs is very limited because of a lack of controlled clinical trials. However, the descriptive and observational studies provide some empirical support to further explore spiritual interventions in CR programs, with the goal of enhancing the psychosocial and emotional status of CR participants. Further rigorous research design and procedures are needed to establish the contribution of spirituality in CR programs for cardiac patients.

Addressing spirituality is rarely included in cardiac rehabilitation (CR). A systematic review was conducted to identify the current status of spirituality in CR programs. The evidence for using spiritual interventions in CR programs is limited because of a lack of controlled clinical trials. Further research with rigorous design is needed.

Pain and Palliative Care, Clinical Center, National Institutes of Health (Drs Nadarajah and Berger), Bethesda, Maryland; and University of Maryland School of Nursing, Baltimore (Dr Thomas)

Correspondence: Sheeba Nadarajah, PhD, RN, Clinical Center, National Institutes of Health, 10 Center Dr, MSC 1517 2-1733, Bethesda, MD 20892 (

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.