A Scoping Review of Nursing Approaches to Spiritual Care in Cardiovascular Disease: Clinical Practice and Patient Outcomes

https://doi.org/10.53770/medica.v8i7.1170

Authors

  • Aris Citra Wisuda Medical-Surgical Nursing Specialist Program, Faculty of Nursing, Universitas Padjadjaran, West Java, Indonesia and Nursing Profession Study Program, Sekolah Tinggi Ilmu Kesehatan Bina Husada, Palembang, South Sumatera, Indonesia https://orcid.org/0000-0001-7420-1591
  • Masniati Arafah Medical-Surgical Nursing Specialist Program, Faculty of Nursing, Universitas Padjadjaran, West Java, Indonesia and Nursing Profession Study Program, Sekolah Tinggi Ilmu Kesehatan Hesti Wira Sriwijaya, Palembang, South Sumatera, Indonesia
  • Ayu Prawesti Priambodo Faculty of Nursing, Universitas Padjadjaran, Sumedang Regency, West Java, Indonesia
  • Fermata Sari Medical-Surgical Nursing Specialist Program, Faculty of Nursing, Universitas Padjadjaran, West Java, Indonesia and Diploma in Nursing Study Program, Sekolah Tinggi Ilmu Kesehatan Hesti Wira Sriwijaya, Palembang, South Sumatera, Indonesia
  • Neny Nursahaza Diploma in Nursing Study Program, Sekolah Tinggi Ilmu Kesehatan Hesti Wira Sriwijaya, Palembang, South Sumatera, Indonesia
  • Citra Suraya Nursing Study Program, Sekolah Tinggi Ilmu Kesehatan Bina Husada, Palembang, South Sumatera, Indonesia https://orcid.org/0000-0002-4445-6443
  • Wa Ode Nurlina Diploma in Nursing Study Program, Sekolah Tinggi Ilmu Kesehatan RS. Prof. Dr. J.A. Latumeten, Ambon, Maluku, Indonesia
  • Basmalah Harun Diploma in Nursing Study Program, Sekolah Tinggi Ilmu Kesehatan Makassar, South Sulawesi, Indonesia

Keywords

Cardiovascular Disease Cardiovascular Nursing Patient Outcomes Scoping Review Spiritual Care

Abstract

Cardiovascular disease (CVD) remains a leading cause of global morbidity and mortality. Beyond physical symptoms, patients frequently experience psychological distress, existential concerns, and spiritual needs that may influence coping, treatment adherence, and overall well-being. Although spiritual care is increasingly recognized as a component of holistic cardiovascular nursing, evidence regarding nurse-led spiritual care remains heterogeneous in terms of intervention models, implementation strategies, cultural adaptation, and reported outcomes. This scoping review aimed to systematically map nursing approaches to spiritual care for adults with CVD and summarize their implementation across clinical settings. The review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Searches were conducted in PubMed, Scopus, Web of Science, CINAHL, and ScienceDirect for studies published between 2015 and 2025. Quantitative, qualitative, and mixed-methods studies involving nurse-led or nurse-integrated spiritual care interventions were included. Eighteen studies met the eligibility criteria. Thematic synthesis identified four categories of nursing approaches: spiritually supportive communication, faith-based spiritual interventions, mindfulness- and meaning-centered approaches, and holistic spiritually integrated nursing care. These interventions were implemented across acute care, coronary care, cardiac rehabilitation, outpatient, palliative, and community settings. Reported outcomes encompassed psychosocial, spiritual, patient-centered, and selected physiological domains, with anxiety reduction, emotional comfort, coping, spiritual well-being, quality of life, and patient satisfaction being the most frequently described outcomes. This review provides a comprehensive overview of contemporary nursing approaches to spiritual care in cardiovascular practice, highlights important variations in intervention characteristics and outcome assessment, and identifies priorities for developing standardized, culturally responsive, and theory-informed spiritual care frameworks and future cardiovascular nursing research.

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References

Abdoli Nejad, M. R., Bagheri Nesami, M., Jafari, H., Mousavi Nasab, N., & Kahen, S. (2018). Comparing the effect of Qur’an recitation and scheduled visits on hemodynamic status and oxygen saturation of acute myocardial infarction patients. Journal of Nursing and Midwifery Sciences, 5(1), 1–8. https://doi.org/10.4103/jnms.jnms_11_18

Ahmed, F. R., Aburuz, M. E., & Al-Dweik, G. (2023). The effect of listening to Holy Quran recital on pain and length of stay post-CABG: A randomized control trial. Critical Care Research and Practice, 2023, 9430510. https://doi.org/10.1155/2023/9430510

Al-Dwaikat, T., Al-Amer, R., & Khalifeh, A. (2023). The effect of Holy Quran audio therapy on depression and anxiety among Jordanian patients following coronary artery bypass graft surgery: A randomized controlled trial. The Open Nursing Journal, 17, 1–10. https://doi.org/10.2174/0118744346262682230921094004

American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). ANA.

Balboni, T. A., et al. (2022). Spiritual care and patient outcomes in serious illness: A systematic review. JAMA Network Open, 5(4), e228123. https://doi.org/10.1001/jamanetworkopen.2022.8123

Barati, D., Veisani, Y., Heidarzadeh, H., Vasiee, A., & Azadi, A. (2025). Investigating the effectiveness of online system spiritual therapies program on the attitude and competence of intensive care unit nurses in providing spiritual healing: A quasi-experimental study. Journal of Education and Health Promotion, 14, 479. https://doi.org/10.4103/jehp.jehp_1331_24

Bekelman, D. B., Fink, R. M., Sannes, T., Kline, D. M., Borrayo, E. A., Turvey, C., & Fischer, S. M. (2020). Puente para cuidar (bridge to caring): A palliative care patient navigator and counseling intervention to improve distress in Latino/as with advanced cancer. Psycho-Oncology, 29(4), 688–695. https://doi.org/10.1002/pon.5313

Bucciarelli, V., et al. (2023). Psychosocial and spiritual determinants of cardiovascular outcomes. European Heart Journal Supplements, 25(Suppl C), C45–C52. https://doi.org/10.1093/eurheartj/suad012

Caldeira, S., et al. (2021). Spiritual care in nursing practice: A concept analysis. Journal of Advanced Nursing, 77(3), 1034–1045. https://doi.org/10.1111/jan.14612

Celano, C. M., et al. (2021). Depression and anxiety in patients with cardiovascular disease: Mechanisms and treatment. Current Cardiology Reports, 23(9), 120. https://doi.org/10.1007/s11886-021-01558-9

Chen, Y., Li, H., & Wang, X. (2022). Effects of mindfulness-based intervention on quality of life and psychological distress in patients with heart failure: A randomized controlled trial. International Journal of Nursing Studies, 129, 104199. https://doi.org/10.1016/j.ijnurstu.2022.104199

Cohen, B. E., Edmondson, D., & Kronish, I. M. (2021). State of the art review: Depression, stress, anxiety, and cardiovascular disease. American Journal of Hypertension, 34(5), 447–456. https://doi.org/10.1093/ajh/hpab011

Dossey, B. M., & Keegan, L. (2021). Holistic nursing: A handbook for practice (8th ed.). Jones & Bartlett Learning.

Ferreira, V. M., Barbosa, M. H., & Souza, D. F. (2022).

Spiritual care in patients with heart failure: Nurses’ perspectives on therapeutic listening and presence. Journal of Clinical Nursing, 31(15–16), 2345–2354.

https://doi.org/10.1111/jocn.16045

Ferrell, B. R., et al. (2022). Integrating spirituality into patient-centered care. Nursing Outlook, 70(1), 1–10. https://doi.org/10.1016/j.outlook.2021.08.012

Gonçalves, J. P., et al. (2022). Spirituality and quality of life in chronic disease: A systematic review. Journal of Religion and Health, 61(2), 890–910. https://doi.org/10.1007/s10943-021-01363-2

Hosseini, S.-R., Valizad-Hassanloei, M.-A., & Feizi, A. (2018). The effect of using communication boards on ease of communication and anxiety in mechanically ventilated conscious patients admitted to intensive care units. Iranian Journal of Nursing and Midwifery Research, 23(5), 358–362. https://doi.org/10.4103/ijnmr.IJNMR_68_17

Ismail, H., et al. (2023). Religious and spiritual interventions in cardiac care: A clinical review. BMC Cardiovascular Disorders, 23, 112. https://doi.org/10.1186/s12872-023-03112-0

Jarvis, S. S., et al. (2022). Autonomic regulation and cardiovascular outcomes in stress-related conditions. Journal of the American Heart Association, 11(6), e024567. https://doi.org/10.1161/JAHA.121.024567

Jbilou, J., Grenier, J., Chomienne, M.-H., Talbot, F., Tulloch, H., D’Antono, B., & Greenman, P. (2019). Understanding men’s psychological reactions and experience following a cardiac event: A qualitative study from the MindTheHeart project. BMJ Open, 9(9), e029560. https://doi.org/10.1136/bmjopen-2019-029560

Khan, M. A., et al. (2020). Global burden of cardiovascular diseases. The Lancet, 396(10254), 1–10. https://doi.org/10.1016/S0140-6736(20)31031-5

Kim, S. S., Kim-Godwin, Y., Gil, M., Kim, D. E., & Cheon, Y. K. (2021).

The benefits of spiritual diaries: A mixed-method study in Korea. Journal of Religion and Health, 60(6), 3978–3992. https://doi.org/10.1007/s10943-021-01277-8

Koenig, H. G. (2020). Religion, spirituality, and cardiovascular disease. International Journal of Psychiatry in Medicine, 55(3), 123–136. https://doi.org/10.1177/0091217420909487

Levine, G. N., et al. (2021). Psychological factors and cardiovascular risk. Circulation Research, 128(5), 594–609. https://doi.org/10.1161/CIRCRESAHA.120.317403

Lucchese, F. A., & Koenig, H. G. (2023). Spirituality and mental health in chronic disease. Journal of Religion and Health, 62(1), 1–15. https://doi.org/10.1007/s10943-022-01654-9

Lundberg, K., Jong, M., Jong, M. C., & Kristiansen, L. P. (2020).

Patients’ experiences of the caring encounter in health promotion practice: A qualitative study in Swedish primary health care. BMC Family Practice, 21(1), 232. https://doi.org/10.1186/s12875-020-01296-6

Martins, H., et al. (2021). Spiritual care interventions in nursing practice. Journal of Nursing Management, 29(7), 1954–1963. https://doi.org/10.1111/jonm.13357

Mensah, G. A., et al. (2023). Global burden of cardiovascular diseases and risk factors. Circulation, 147(1), 1–10. https://doi.org/10.1161/CIRCULATIONAHA.122.061321

Miles, J., Ross, L., Jarvis, P., & Pickett, S. (2021). Spiritual Support in Advanced Heart Failure: A Randomized Controlled Feasibility Study. Health and Social Care Chaplaincy, 9(2), 191–215. https://doi.org/10.1558/hscc.41171

Mousavizadeh, S. N., & Jandaghian-Bidgoli, M. (2024). The effects of nurse-led spiritual care on psychological well-being in the healthcare services of patients with cardiovascular diseases in Iran: A systematic review. BMC Cardiovascular Disorders, 24, 403. https://doi.org/10.1186/s12872-024-04076-7

Page, M. J., et al. (2021). PRISMA 2020 statement. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

Pargament, K. I., & Exline, J. J. (2022). Working with spiritual struggles in psychotherapy: From research to practice. Guilford Press.

Park, C. L., et al. (2023). Spirituality and stress regulation mechanisms. Psychoneuroendocrinology, 148, 105987. https://doi.org/10.1016/j.psyneuen.2023.105987

Peteet, J. R., & Balboni, M. J. (2022). Spirituality and biopsychosocial health. Harvard Review of Psychiatry, 30(2), 85–95. https://doi.org/10.1097/HRP.0000000000000335

Puchalski, C. M., et al. (2020). Spirituality in healthcare. Journal of Palliative Medicine, 23(1), 1–5. https://doi.org/10.1089/jpm.2019.0410

Rollman, B. L., et al. (2019). Blended collaborative care for treating heart failure and co-morbid depression (Hopeful Heart trial). American College of Cardiology Scientific Session (ACC 2019). https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2019/03/15/13/30/Hopeful-Heart

Rosa, W. E., et al. (2023). Holistic nursing care in chronic disease populations. Nursing Outlook, 71(2), 200–210. https://doi.org/10.1016/j.outlook.2022.10.005

Roth, G. A., et al. (2020). Global burden of cardiovascular diseases and risk factors. Journal of the American College of Cardiology, 76(25), 2982–3021. https://doi.org/10.1016/j.jacc.2020.11.021

Sajadi, M., Niazi, N., Khosravi, S., Yaghobi, A., Rezaei, M., & Koenig, H. G. (2018). Effect of spiritual counseling on spiritual well-being in Iranian women with cancer: A randomized clinical trial. Complementary Therapies in Clinical Practice, 30(February), 79–84. https://doi.org/10.1016/j.ctcp.2017.12.011

Sitzman, K. (2021). Watson’s theory of human caring. Nursing Science Quarterly, 34(2), 145–152. https://doi.org/10.1177/0894318420983445

Steptoe, A., & Kivimäki, M. (2020). Stress and cardiovascular disease. Nature Reviews Cardiology, 17(7), 401–420. https://doi.org/10.1038/s41569-020-0359-7

Sulmasy, D. P. (2021). The biopsychosocial-spiritual model. Theoretical Medicine and Bioethics, 42(3), 145–156. https://doi.org/10.1007/s11017-021-09549-4

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Published

2026-07-30

How to Cite

Wisuda, A. C., Arafah, M., Priambodo, A. P., Sari, F., Nursahaza, N., Suraya, C., Nurlina, W. O. ., & Harun, B. (2026). A Scoping Review of Nursing Approaches to Spiritual Care in Cardiovascular Disease: Clinical Practice and Patient Outcomes. MEDICA (International Medical Scientific Journal), 8(7), 678–696. https://doi.org/10.53770/medica.v8i7.1170