Abstract Background and purpose: Results from a number of research show that patients having heart surgery require focused therapies to manage their anxiety and enhance their quality of life and life satisfaction. Overall surgical outcomes for these patients can be greatly enhanced by addressing patient expectations, implementing structured psychosocial support, and implementing educational programs based on spiritual aspects. Thus, the current study sought to determine the impact of problem-solving skills training grounded in enhancing one's relationship with God on anxiety, life satisfaction, and quality of life in patients referred to the Tehran Heart Center in 2023 who were candidates for open heart surgery. Materials and Methods: One hundred patients (50 in the experimental group and 50 in the control group) were chosen at random for this quasi-experimental investigation. The researcher's Human-God Interaction Inventory (a reconstruction of Lawrence's 1997 God Conception Scale), Diener's Life Satisfaction Inventory, the World Health Organization Quality of Life Inventory, and Beck's Anxiety Inventory were used to measure quality of life, life satisfaction, anxiety, and the interactive relationship with God, respectively. Participants in the intervention group got six group discussion sessions, instruction in spiritually oriented problem-solving techniques, and a strengthening of their relationship with God in addition to drug treatment. SPSS software was used to evaluate the data from the pre-test, post-test, and one-month follow-up. Findings: The findings of the above study showed that the decrease in the mean anxiety in the experimental group had a more severe downward trend than in the control group, especially in the follow-up phase (pv < 0.0001). Also, the mean of the dimensions of acceptance, benevolence, learning, and quality of life in the post-test in the experimental group (especially in the follow-up phase) increased more than in the control group, although this increase did not lead to a statistically significant result. Also, the mean of the variables of presence, influence, divine providence, self-actualization, commitment, mental focus, faith, the full score of the interactive relationship between man and God, and life satisfaction in the post-test in the experimental group (especially in the follow-up phase) increased more than in the control group, and this increase led to a statistically significant result (p<0001). Conclusion: Designing and implementing group problem-solving educational interventions based on strengthening the relationship with God can be an effective approach to reducing preoperative anxiety and increasing subscales of the interactive relationship between man and God and life satisfaction. Keywords: problem-solve, relationship with God, anxiety, quality of life, life satisfaction, open heart surgery