Spiritual growth, weight loss, and medical and psychological outcomes among participants of a mind-body cardiac program

Objectives:

Relaxation response (RR) practice has been found to improve spiritual quality of life in various patient populations including cardiac patients. In this study, we examined the relationship among RR, spirituality, weight loss, and medical and psychological outcomes of patients with coronary artery disease who participated in a mind-body Cardiac Wellness Program (CWP). We tested a conceptual model to examine the associations among RR practice, spiritual growth, weight loss and medical and psychological outcomes.

Methods:

RR training is a major component in the CWP, along with exercise, diet, and cognitive/behavioral training. Data were collected at baseline and after the 3-month program from 526 patients who completed the CWP between 1997 and 2005. Spirituality was measured using the Spiritual Growth (SG) subscale of the Health-Promoting Lifestyle Profile II. A path analysis was conducted to test the conceptual model.

Results:

Patients reported significant increases in SG score (p<.0001) after completing the CWP. A regression model indicated that increases in RR practice time predicted increases in SG score after adjusting for the SG baseline score (p=.048). Another regression model indicated that increases in SG score predicted improvements in psychological outcomes: depression, anxiety, and hostility (all with P<.001). Increases in SG score also predicted weight loss (p=.047), which in turn predicted improvements in medical outcomes of systolic (p=0.0008) and diastolic blood pressure (p=0.0068), total cholesterol (p=0.0035), and LDL (p=0.028).

Conclusions:

Our data support the conceptual model that increased RR practice leads to increased SG, which in turn directly leads to reduced psychological distress levels, and indirectly leads to improved medical outcomes through weight loss.