Narayanan Santhosshi, Milbury Kathrin, Wagner Richard, Cohen Lorenzo
Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Pain Symptom Manage. 2020 Oct;60(4):737-745.e3. doi: 10.1016/j.jpainsymman.2020.04.029. Epub 2020 May 6.
Past religiosity/spirituality (R/S) research has mainly relied on self-report instruments, which may result in self-presentation and defensive biases.
To address these limitations, we reviewed the writing samples that were generated as part of an expressive writing (EW) trial, coded the samples for R/S content, and examined cross-sectional and prospective associations between R/S content and symptom and psychosocial outcomes.
Participants diagnosed with renal cell carcinoma who were randomized to the EW arm completed a standard writing protocol. Before randomization, they completed validated measures of R/S, depressive symptoms, social support, fatigue, and sleep disturbances and one, four, and 10 months after completing the intervention. Writing samples were coded for positive and negative religious coping (RC), and personal (e.g., private prayer) and collective (e.g., church attendance) religious engagement (RE).
Of the 138 patients, 117 provided at least one writing sample, and 89% of participants made at least one R/S reference with 70% including at least one positive RC statement, and 45.3% revealed personal and 42.3% collective RE. Negative RC was rare (8%). Although positive RC and RE were significantly associated with the R/S Index (P < 0.01), negative RC was not. In prospective analyses, RE was associated with reduced cancer-related symptoms over time (P = 0.04), and negative RC was associated with increased psychological distress over time (P = 0.004).
Behavioral coding of EW samples supported the literature suggesting that positive RC is common among patients with cancer. Although negative RC may be relatively rare, it may be associated with psychological distress.
过去关于宗教信仰/精神性（R/S）的研究主要依赖自我报告工具，这可能导致自我呈现和防御性偏差。
为解决这些局限性，我们回顾了作为一项表达性写作（EW）试验一部分所生成的写作样本，对样本中的R/S内容进行编码，并研究R/S内容与症状及心理社会结果之间的横断面和前瞻性关联。
被诊断为肾细胞癌并随机分配到EW组的参与者完成了一份标准写作方案。在随机分组前，他们完成了关于R/S、抑郁症状、社会支持、疲劳和睡眠障碍的有效测量，在完成干预后的1个月、4个月和10个月也进行了测量。写作样本被编码为积极和消极的宗教应对（RC），以及个人（如私人祈祷）和集体（如参加教堂活动）的宗教参与（RE）。
在138名患者中，117名提供了至少一个写作样本，89%的参与者至少提及一次R/S，70%的参与者至少包含一条积极的RC陈述，45.3%的参与者显示有个人RE，42.3%的参与者显示有集体RE。消极RC很少见（8%）。尽管积极RC和RE与R/S指数显著相关（P<0.01），消极RC则不然。在前瞻性分析中，RE与随时间推移癌症相关症状的减轻相关（P=0.04），消极RC与随时间推移心理困扰的增加相关（P=0.004）。
EW样本的行为编码支持了文献表明积极RC在癌症患者中很常见。尽管消极RC可能相对少见，但它可能与心理困扰有关。
