ArticleSpirituality in clinical practice (Washington, D.C.)2015
The Role of Gratitude in Spiritual Well-being in Asymptomatic Heart Failure Patients.
Article in Spirituality in clinical practice (Washington, D.C.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- The impact of gratitude interventions on patients with cardiovascular disease: a systematic review.Frontiers in psychology · 2023Pooled it
- Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology - 2019.Arquivos brasileiros de cardiologia · 2019Guideline
- A pilot study of a gratitude journaling intervention to enhance spiritual well-being and exercise self-efficacy in Black breast cancer survivors.BMC psychiatry · 2024Trial
- Do People Become More or Less Materialistic during Disasters? The Mediating Roles of Mortality Salience and Gratitude.International journal of environmental research and public health · 2021Trial
- Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure.Psychosomatic medicineTrial
- Religiousness-happiness links in Türkiye and Jordan: the role of gratitude and envy.BMC psychology · 2026Article
- Can Gratitude Ease the Burden of Fibromyalgia? A Systematic Review.Behavioral sciences (Basel, Switzerland) · 2025Review
- The relationship of religiosity, spirituality and health in Spanish cancer patients: testing underlying psychological, social and behavioral pathways.BMC psychology · 2025Article
- Gratitude and sleep disturbance in primary care patients: the mediating roles of health self-efficacy, health behaviors, and psychological distress.Frontiers in sleep · 2025Article
- Development and Validation of Hindu Gratitude Scale (HGS-15): A Rnas Perspective.Journal of religion and health · 2023Article
- Religion/Spirituality and Prevalent Hypertension among Ethnic Cohorts in the Study on Stress, Spirituality, and Health.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2023Article
- Exploring the relationship between gratitude and depression among older adults with chronic low back pain: a sequential mediation analysis.Frontiers in pain research (Lausanne, Switzerland) · 2023Article
- Spirituality as a protective factor for chronic and acute anxiety in Brazilian healthcare workers during the COVID-19 outbreak.PloS one · 2022Article
- Positive religious coping acts through perception of nature and silence in its association with well-being and life satisfaction among Polish Catholics.Frontiers in public health · 2022Article
- Gratitude Questionnaire (GQ-6)-Exploring Psychometric Properties in India.Journal of religion and health · 2021Article
- The Use of Prayer During Life-Threatening Illness: A Connectedness to God, Inner-Self, and Others.Journal of religion and health · 2020Article
- Longitudinal associations between gratitude and depression 1 year later among adult cystic fibrosis patients.Journal of behavioral medicine · 2020Article
- The Relationship Between Spiritual Health and Quality of Life of Heart Transplant Candidates.Journal of religion and health · 2020Article
- Is Belonging to a Religious Organization Enough? Differences in Religious Affiliation Versus Self-ratings of Spirituality on Behavioral and Psychological Variables in Individuals with Heart Failure.Healthcare (Basel, Switzerland) · 2020Article
- Spirituality, Religious Attendance and Health Complaints in Czech Adolescents.International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
Abstract
Spirituality and gratitude are associated with wellbeing. Few if any studies have examined the role of gratitude in heart failure (HF) patients or whether it is a mechanism through which spirituality may exert its beneficial effects on physical and mental health in this clinical population. This study examined associations bet ween gratitude, spiritual wellbeing, sleep, mood, fatigue, cardiac-specific self-efficacy, and inflammation in 186 men and women with Stage B asymptomatic HF (age 66.5 years ±10). In correlational analysis, gratitude was associated with better sleep (r=-.25, p<0.01), less depressed mood (r=-.41, p<0.01), less fatigue (r=-.46, p<0.01), and better self-efficacy to maintain cardiac function (r=.42, p<0.01). Patients expressing more gratitude also had lower levels of inflammatory biomarkers (r=-.17, p<0.05). We further explored relationships among these variables by examining a putative pathway to determine whether spirituality exerts its beneficial effects through gratitude. We found that gratitude fully mediated the relationship between spiritual wellbeing and sleep quality (z=-2.35, SE=.03, p=.02) and also the relationship between spiritual wellbeing and depressed mood (z=-4.00, SE=.075, p<.001). Gratitude also partially mediated the relationships between spiritual wellbeing and fatigue (z=-3.85, SE=.18, p<.001), and between spiritual wellbeing and self-efficacy (z=2.91, SE=.04, p=.003). In sum, we report that gratitude and spiritual wellbeing are related to better mood and sleep, less fatigue, and more self-efficacy, and that gratitude fully or partially mediates the beneficial effects of spiritual wellbeing on these endpoints. Efforts to increase gratitude may be a treatment for improving wellbeing in HF patients' lives and be of potential clinical value.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.