Background: Heart failure, a condition predominantly affecting the elderly, represents an ever-increasing clinical and financial burden for the NHS. Cardiac rehabilitation, a service that incorporates patient education, exercise training and lifestyle modification, requires further evaluation in heart failure management. Aim: The aim of this study was to determine whether a cardiac rehabilitation programme improved on the outcomes of an outpatient heart failure clinic (standard care) for patients, over 60 years of age, with chronic heart failure. Methods: Two hundred patients (60–89 years, 66% male) with New York Heart Association (NYHA) II or III heart failure confirmed by echocardiography were randomised. Both standard care and experimental groups attended clinic with a cardiologist and specialist nurse every 8 weeks. Interventions included exercise prescription, education, dietetics, occupational therapy and psychosocial counselling. The main outcome measures were functional status (NYHA, 6-min walk), health-related quality of life (MLHF and EuroQol) and hospital admissions. Results: There were significant improvements in MLHF and EuroQol scores, NYHA classification and 6-min walking distance (meters) at 24 weeks between the groups (p<0.001). The experimental group had fewer admissions (11 vs. 33, p<0.01) and spent fewer days in hospital (41 vs. 187, p<0.001). Conclusions: Cardiac rehabilitation, already widely established in the UK, offers an effective model of care for older patients with heart failure.

Aims and objectives: To map existing evidence about educational interventions or strategies in nursing and allied healthcare concerning students’ and staffs’ spiritual care provision.Background: Spiritual care is an important part of whole person care, but healthcare staff lack competence and awareness of spiritual issues in practice. To rectify this, it is important to identify what educational approaches are most helpful in supporting them to provide spiritual care.Design: A scoping review using the PRISMA‐ScR checklist.Method: Searches in the databases CINAHL, MEDLINE, ATLA and ERIC were conducted for papers spanning January 2009–May 2020. Search terms were related to spirituality, spiritual care, education and clinical teaching. Appraisal tools were used.Results: From the 2128 potentially relevant papers, 36 were included. The studies were from 15 different countries and involved nurses, physicians and other health‐related professions, and both quantitative, qualitative and mixed methods were used. The results are presented in three themes: Understanding of spirituality, Strategies in educational settings, and Strategies in practice settings. The review points to great diversity in the content, lengths and setting of the educational interventions or strategies.Conclusions: Courses in spiritual care should be implemented in curricula in both undergraduate and postgraduate education, and several studies suggest it should be mandatory. Courses should also be available for healthcare staff to raise awareness and to encourage the integration of spiritual care into their everyday practice. There is a need for greater consensus about how spirituality and spiritual care are described in healthcare settings.Relevance to clinical practice: Spiritual care must be included both in monodisciplinary and multidisciplinary educational settings. The main result of spiritual care courses is in building awareness of spiritual issues and self‐awareness. To ensure the provision of spiritual care for patients in healthcare practices, continuing and multidisciplinary education is recommended.