Spirituality Self-Care Practices as a Mediator between Quality of Life and Depression

The purpose of this study was to develop a midrange theory, building on Orem’s self-care deficit nursing theory (SCDNT) to include constructs of religion, spirituality, and spiritual self-care practices. This mid-range theory, White’s theory of spirituality and spiritual self-care (WTSSSC), was developed and tested as part of a larger study of African American patients with heart failure (HF). The aim of the study was to determine if spiritual self-care practices were mediating the relationship between depression and quality of life for African Americans diagnosed with heart failure. Participants in this study included 142 African Americans diagnosed with HF who were recruited at the clinic where they were being treated. Four instruments were used to measure spiritual self-care practices (White’s Spiritual Self-Care Practice Scale (WSPSCPC)), depression symptomology (Patient Health Questionnaire-9 (PHQ-9)), quality of life (World Health Organization QOL (WHOQOL-Bref)), and personal characteristics. Results of the analysis were statistically significant, indicating that spirituality self-care practices were mediating the relationship between depression and quality of life for African American individuals diagnosed with HF. As the population ages and chronic illness becomes more common, nurses need to promote the use of spirituality self-care practices to help patients maintain their well-being.