The Effect of a Preoperative Spiritual/Religious Intervention on Anxiety in Shia Muslim Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

Mohammadali Hosseini, Alireza Salehi, Masoud Fallahi Khoshknab, Asghar Rokofian, Patricia Mary Davidson

Research output: Contribution to journalArticle


Background: Coronary artery bypass grafting (CABG) is associated with anxiety. Preoperative anxiety is considered a predictor for a range of suboptimal postsurgical outcomes. Objective: To evaluate the effect of a spiritual/religious training intervention on anxiety in Shia Muslim individuals scheduled for CABG. Methods: A randomized controlled trial of a preoperative spiritual/religious training intervention, congruent with Islamic supplication (Zikr), was administered in five sessions of 45 minutes duration to test the impact on anxiety in comparison with standard care. Seventy participants were selected based on inclusion criteria and randomly allocated to treatment and control groups. Baseline levels of anxiety and the impact of the intervention were assessed using the Persian version of the Hamilton Anxiety Scale. Results: Baseline characteristics were comparable between the intervention and control groups. Following the intervention, there was a statistically significant difference in anxiety mean scores between intervention (19.48 ± 2.03) and control groups (43.27 ± 5.49), p <.001. Conclusions: This study demonstrates that preoperative spiritual/religious training can reduce anxiety in Muslim patients undergoing CABG. Further evaluation of this intervention in other population groups is warranted and the study underscores the importance of culturally appropriate and interventions.

Original languageEnglish (US)
Pages (from-to)164-172
Number of pages9
JournalJournal of Holistic Nursing
Issue number3
StatePublished - Sep 1 2013
Externally publishedYes



  • anxiety
  • coronary artery bypass grafting, CABG
  • religious
  • spiritual

ASJC Scopus subject areas

  • Nursing (miscellaneous)

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