Florida State University, FL 2313, University Center Building-C, Tallahassee, FL 32306, USA.
J Behav Med. 2013 Apr;36(2):186-98. doi: 10.1007/s10865-012-9412-6. Epub 2012 Mar 30.
Despite the growing knowledge of posttraumatic growth, only a few studies have examined personal growth in the context of cardiac health. Similarly, longitudinal research is lacking on the implications of religion/spirituality for patients with advanced cardiac diseases. This paper aims to explore the effect of preoperative religious coping on long-term postoperative personal growth and potential mediation in this effect. Analyses capitalized on a preoperative survey and medical indices from the Society of Thoracic Surgeons' National Database of patients undergoing cardiac surgery. Participants in the current follow-up study completed a mailed survey 30 months after surgery. Hierarchical regression analysis was performed to evaluate the extent to which preoperative use of religious coping predicted growth at follow-up, after controlling for key demographics, medical indices, mental health, and protective factors. Predictors of posttraumatic growth at follow-up were positive religious coping and a living status without a partner. Medical indices, optimistic expectations, social support, and other religious factors were unrelated to posttraumatic growth. Including religious factors diminished effects of gender, age, and race. Including perceived spiritual support completely eliminated the role of positive religious coping, indicating mediation. Preoperative positive religious coping may have a long-term effect on postoperative personal growth, explainable by higher spiritual connections as a part of significance-making. These results suggest that spirituality may play a favorable role in cardiac patients' posttraumatic growth after surviving a life-altering operation. The elimination of demographic effects may help explain previously mixed findings concerning the association between these factors and personal growth.
尽管人们对创伤后成长的认识不断增加,但只有少数研究探讨了心脏健康背景下的个人成长。同样,关于宗教/精神信仰对晚期心脏病患者的影响的纵向研究也很缺乏。本文旨在探讨术前宗教应对方式对长期术后个人成长的影响及其潜在的中介作用。分析利用了来自胸外科医师学会国家数据库的心脏手术患者术前调查和医学指数。本研究的随访参与者在手术后 30 个月完成了邮寄调查。采用分层回归分析,在控制关键人口统计学、医学指数、心理健康和保护因素后,评估术前宗教应对方式对随访时成长的预测程度。随访时创伤后成长的预测因素为积极的宗教应对方式和无伴侣的生存状态。医学指数、乐观预期、社会支持和其他宗教因素与创伤后成长无关。纳入宗教因素会降低性别、年龄和种族的作用。纳入感知到的精神支持完全消除了积极宗教应对的作用,表明存在中介作用。术前积极的宗教应对方式可能对术后个人成长产生长期影响,这可以通过更高的精神联系来解释,这是意义建构的一部分。这些结果表明,在经历改变生活的手术后,灵性可能在心脏患者的创伤后成长中发挥有利作用。消除人口统计学效应可能有助于解释先前关于这些因素与个人成长之间关联的混合研究结果。