Despite of regional variations, congenital heart disease (CHD) is the most prevalent congenital abnormality, worldwide. It is described as a chronic disorder in the cardiovascular structure or function that are reveal at birth, with a live born prevalence of about 5–8 per 1000 in western countries. With advances in palliative and corrective surgery ,the numbers of children with CHD surviving to adulthood has increased significantly. Due to these advances, 85% of patients are survived to the adult age.
Management of CHD at different stages of patient’s life is a challenging task for patient and his/her parents. Parents of children with CHD face a variety of stressors that are related to the nature of the disease and its treatment. They continue to have concerns about how their child’s illness and treatment affect their child’s daily functioning, development, and overall wellbeing. Therefore, parents of child who suffered from a chronic disorder such as CHD are at risk for lower quality of life and higher distress in advance.
Accordingly, regular monitoring of the quality of life and mental functions of parents of children with a chronic illness and subsequent interventions to improve their mental status have been encouraged.
In many communities, mothers are taking primary responsibility for the care and support of children and families. Studies have shown that, in developing countries such as Iran, mothers play a key role in providing care for sick children and Fathers are usually responsible for the payment of costs and expenses. Therefore, psychological and mental support of these mothers is one of the main duties of medical care providers.
There are studies which show the positive long term effects of religious beliefs on individual depression, anxiety and stress in different settings. Moreover, in Islamic point of view, religious beliefs play fundamental role in individual inner peace mainly based on the holy Quran statement: “Now surely in Allah’s remembrance do hearts find rest”. Muslims believes that whole-hearted Allah’s remembrance (In Islamic terms: Zikr) leads to peace, even at the moment of remembrance. Therefore, they usually remember Allah when exposed to anxiety and stress and want to help from Him.
We designed and conducted a quasi-experimental study to investigate immediate short term effect of Allah’s remembrance (in Islamic terms: Zikr) on anxiety, stress, and depression of the mothers of the children with CHD undergoing treatment.
A quasi-experimental study was conducted to compare pre-test and post-test measures of anxiety, depression and stress in one group. All CHD patients who admitted into two referral canters in Kerman, Iran during six months (July to December, 2014) were listed. The study’s inclusion criteria’es were Patients’ mothers who had no history of mental disorders, use of psychiatric medication or any drug abuse, who were Muslim, literate (At least passing elementary-school) and older than 20 years (to be mature enough to understand the meanings of Zikr) were eligible to participate in the study.
Study aims and procedures were described for enrolled mothers and ask them if they can participate in the study. They were assured that their acceptance or rejection to participate in the study had no effect on their children’s treatment. If a mother accepts verbally to participate in the study a written consent was obtained.
Depression, anxiety, and stress were measured using short- form version of the Depression, Anxiety, and Stress Scales (DASS-21). Its reliability in Iranian populations has been confirmed in a study. Study participants were asked to fill the DASS-21 two times. First time, at the start of the intervention (Before Allah’s remembrance) and second at the end of it (After Allah’s remembrance).
In an Islamic point of view, Allah’s remembrance (Zikr) could be done verbally (Verbal Zikr) or non- verbally (Non-verbal Zikr). Non-verbal Allah’s remembrance means remembering God in heart without any verbal statement. Regardless of the type of Zikr, one of the most common Islamic Zikrs is “Salavat”, an ultimate spiritual remedy, which means sending salutation on the prophet Mohammad. It is an ordered Zikr in Holy Quran.
Participants were trained and asked to use non- verbal Salavat for 12 times and then request health of their child from God and be hopeful to meet God their desire.