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Roles of Religious Commitment, Emotion Regulation and Social Support in Preoperative Anxiety

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Abstract

Surgery is a relatively commonplace medical procedure in healthcare settings. The mental health status of the person undergoing surgery is vital, but there is dearth of empirical studies on the mental health status of surgery patients, particularly with regard to the factors associated with anxiety in surgical conditions. This study investigated the roles of religious commitment, emotion regulation (cognitive reappraisal and expressive suppression) and social support in preoperative anxiety in a sample of 210 surgical inpatients from a Nigerian tertiary healthcare institution. A cross-sectional design was adopted. Before the surgery, respondents completed the state anxiety subscale of State-Trait Anxiety Inventory, Religious Commitment Inventory, Emotion Regulation Questionnaire and Multidimensional Scale of Perceived Social Support. After controlling for relevant demographic factors, regression results showed that cognitive reappraisal, social support and interpersonal religious commitment were negatively associated with preoperative anxiety, while expressive suppression was positively associated with preoperative anxiety. The emotion regulation strategies made robust and significant explanation of variance in preoperative anxiety. Appropriate interventions to promote interpersonal religious commitment, encourage cognitive reappraisal and enhance social support quality may improve mental health outcomes in surgery.

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References

  • Aldao, A., Nolen-Hoeksoma, S., & Schweizer, S. (2010). Emotion regulation strategies across psychopathology: A meta-analysis. Clinical Psychology Review,30, 217–237.

    Article  PubMed  Google Scholar 

  • Bergin, A. E., Masters, K. S., & Richards, P. S. (1987). Religiousness and psychological well-being re-considered: A study of an intrinsically religious sample. Journal of Psychiatry,34, 197–204.

    Google Scholar 

  • Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behavioural Research Therapy,44, 1251–1263.

    Article  Google Scholar 

  • Caumo, W., Schmidt, A. P., Schneider, C. N., Bergmann, J., Iwamoto, C. W., Bandeir, D., et al. (2001). Risk factors for preoperative anxiety in adults. Acta Anaesthesiological Scandinavia,45(3), 298–307.

    Article  CAS  Google Scholar 

  • Chukwuorji, J. C., Ituma, E. A., & Ugwu, L. E. (2017). Locus of control and academic engagement: Mediating role of religious commitment. Current Psychology. https://doi.org/10.1007/s12144-016-9546-8.

    Article  Google Scholar 

  • Clements, A. D., Fletcher, T. R., Cyphers, N. A., Ermakova, A. V., & Bailey, B. (2015). RSAS-3: Validation of a very brief measure of religious commitment for use in health research. Journal of Religion and Health,54(1), 134–152. https://doi.org/10.1007/s10943-013-9791-1.

    Article  PubMed  Google Scholar 

  • Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine,38(5), 300–314.

    Article  CAS  PubMed  Google Scholar 

  • Cohen, S., & Wills, T. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin,98(2), 310–357.

    Article  CAS  PubMed  Google Scholar 

  • Dangel, T., & Webb, J. R. (2017). Spirituality and psychological pain: The mediating role of social support. Mental Health, Religion and Culture,3, 246–259. https://doi.org/10.1080/13674676.2017.1345880.

    Article  Google Scholar 

  • de Souza, J., Magalhaes, R. C., Arnault, D. M. S., de Oliveira, J. L., Assad, F. B., et al. (2017). The role of social support for patients with mental disorders in primary care in Brazil. Issues in Mental Health Nursing,38(5), 425–434. https://doi.org/10.1080/01612840.2016.1271483.

    Article  PubMed  Google Scholar 

  • DeFiguereido, J. M., & Lemkau, P. V. (1978). The prevalence of psychosomatic symptom in a rapidly changing bilingual culture: An exploratory study. Social Psychiatry,13, 125–133.

    Article  Google Scholar 

  • Dodds, F. (1993). Access to the coping strategies managing anxiety in elective surgical patients. Professional Nurse,10, 45–52.

    Google Scholar 

  • Frazier, S. K., Moser, D. K., Daley, L. K., McKinley, S., Riegel, B., et al. (2003). Critical care nurses’ beliefs about and reported management of anxiety. American Journal of Critical Care,12(1), 19–27.

    Article  PubMed  Google Scholar 

  • Garnefski, N., Kraaij, V., & Spinhoven, P. (2002). Manual for the use of the cognitive emotion regulation questionnaire. Leiderdorp: Datec.

    Google Scholar 

  • Gartner, J., Larsen, D. B., & Allen, G. D. (1991). Religious commitment and mental health: A review of the empirical literature. Journal of Psychology and Theology,19(1), 6–25.

    Article  Google Scholar 

  • Goulet, C., Henrie, J., & Szymanski, L. (2017). An exploration of the associations among multiple aspects of religiousness, body image, eating pathology, and appearance investment. Journal of Religion and Health,56(2), 493–506. https://doi.org/10.1007/s10943-016-0229-4.

    Article  PubMed  Google Scholar 

  • Gross, J. J. (1998). Antecedent and response-focused emotion regulation: Divergent consequences for experience, expression, and physiology. Journal of Personality and Social Psychology,74, 224–237.

    Article  CAS  PubMed  Google Scholar 

  • Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology,39, 281–291.

    Article  PubMed  Google Scholar 

  • Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology,85, 348–362.

    Article  PubMed  Google Scholar 

  • Guo, P. (2015). Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: A review of randomised controlled trials. Journal of Clinical Nursing,24(1–2), 34–46.

    Article  PubMed  Google Scholar 

  • Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York, NY: Guilford Press.

    Google Scholar 

  • Hayes, J. P., Morey, R. A., Petty, C. M., Seth, S., Smoski, M. J., McCarthy, G., et al. (2010). Staying cool when things get hot: Emotion regulation modulates neural mechanisms of memory encoding. Frontiers in Human Neuroscience,4, 230–238. https://doi.org/10.3389/fnhum.2010.00230.

    Article  PubMed  PubMed Central  Google Scholar 

  • Heilmann, C., Stotz, U., Burbaum, C., Feuchtinger, J., Leonhart, R., et al. (2016). Short-term intervention to reduce anxiety before coronary artery bypass surgery—A randomised controlled trial. Journal of Clinical Nursing,25(3–4), 351–361.

    Article  PubMed  Google Scholar 

  • Hohn, H. G. (1972). Operationskatalog fur Betriebswergleiche [Operation Catalog for Betriebswergleiche]. Krankenhausumschau,2, 134–146.

    Google Scholar 

  • Isaacs, K. B., & Hall, A. (2011). A psychometric analysis of the functional social support questionnaire in low-income pregnant women. Issues in Mental Health Nursing,32(12), 766–773. https://doi.org/10.3109/01612840.2011.610561.

    Article  PubMed  Google Scholar 

  • Kalkhoran, M. A., & Karimollahi, M. (2007). Religiousness and preoperative anxiety: A correlational study. Annals of General Psychiatry,6, 17–21. https://doi.org/10.1186/1744-859X-6-17.

    Article  PubMed  Google Scholar 

  • Karanci, A. (2003). Predictors of pre- and postoperative anxiety in emergency surgery patients. Journal of Psychosomatic Research,55, 363–369.

    Article  CAS  PubMed  Google Scholar 

  • Kelly, M. E., Duff, H., Kelly, S., Power, J. E. M., Brennan, S., Lawlor, B. A., et al. (2017). The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: A systematic review. BMC Systematic Reviews,6, 659–674. https://doi.org/10.1186/s13643-017-0632-2.

    Article  Google Scholar 

  • Koivula, M., Paunonen-Ilmonen, M., Tarkka, M. T., Tarkka, M., & Laippala, P. (2002). Social support and its relation to fear and anxiety in patients awaiting coronary artery bypass grafting. Journal of Clinical Nursing,11(5), 622–633.

    Article  PubMed  Google Scholar 

  • Kulkarni, M. R. (2010). Childhood violence exposure on emotion regulation and PTSD in adult survivors. Ph. D thesis. Department of Psychology, University of Michigan.

  • Larson, D. B., Sherrill, K. A., Lyons, J. S., Craigie, E. F., Jr., Thielman, S. B., Greenwold, M. A., et al. (1992). Associations between dimensions of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry: 1978–1989. American Journal of Psychiatry,149, 557–559.

    Article  CAS  PubMed  Google Scholar 

  • Lavrič, M., & Flere, S. (2010). Trait anxiety and measures of religiosity in four cultural settings. Mental Health, Religion & Culture,13(7–8), 667–682.

    Article  Google Scholar 

  • Litman, L., Robinson, J., Weinberger-Litman, S. L., & Finkelstein, R. (2017). Both intrinsic and extrinsic religious orientation are positively associated with attitudes toward cleanliness: Exploring multiple routes from godliness to cleanliness. Journal of Religion and Health. https://doi.org/10.1007/s10943-017-0460-7.

    Article  Google Scholar 

  • Marroquín, B., & Nolen-Hoeksema, S. (2015). Emotion regulation and depressive symptoms: Close relationships as social context and influence. Journal of Personality and Social Psychology,109, 836–855. https://doi.org/10.1037/pspi0000034.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mccrone, S., Lenz, E., Tarzian, A., & Perkins, S. (2001). Anxiety and depression: Incidence and patterns in patients after coronary artery bypass graft surgery. Applied Nursing Research,14(3), 155–164.

    Article  CAS  PubMed  Google Scholar 

  • McMurray, A., Johnson, P., Wallis, M., Patterson, E., & Griffiths, S. (2007). General surgical patients’ perspectives of the adequacy and appropriateness of discharge planning to facilitate health decision-making at home. Journal of Clinical Nursing,16(9), 1602–1609.

    Article  PubMed  Google Scholar 

  • McNally, R. J. (1994). Panic disorder: A critical analysis. New York: Guilford Press.

    Google Scholar 

  • Meara, J. G., Leather, A. J., Hagander, L., Alkire, B. C., Alonso, N., Ameh, E. A., et al. (2015). Global surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Lancet,158, 3–6.

    Google Scholar 

  • Mitchell, M. (2004). Methodological challenges in the study of psychological recovery from modern surgery. Nurse Research,12(1), 64–77.

    Article  Google Scholar 

  • Mitchell, M. (2013). Anaesthesia type, gender and anxiety. Journal of Perioperative Practice,23(3), 41–47. https://doi.org/10.1177/175045891302300301.

    Article  PubMed  Google Scholar 

  • Mitchinson, A. R., Kim, H. M., Geisser, M., Rosenberg, J. M., & Hinshaw, D. B. (2007). Social connectedness and patient recovery after major operations. Journal of American College of Surgery,206(2), 292–300. https://doi.org/10.1016/j.jamcollsurg.2007.08.017.

    Article  Google Scholar 

  • Mouch, C. A., & Sonnega, A. J. (2012). Spirituality and recovery from cardiac surgery: A review. Journal of Religion and Health,51(4), 1042–1060. https://doi.org/10.1007/s10943-012-9612-y.

    Article  PubMed  Google Scholar 

  • Nadeem, M., Ali, A., & Buzdar, M. A. (2017). The association between Muslim religiosity and young adult college students’ depression, anxiety, and stress. Journal of Religion and Health,56(4), 1170–1179. https://doi.org/10.1007/s10943-016-0338-0.

    Article  PubMed  Google Scholar 

  • Nigussie, S., Belachew, T., & Wolancho, W. (2014). Predictors of preoperative anxiety among surgical patients in Jimma university specialized teaching hospital, South Western Ethiopia. BMC Surgery,14(67), 1–10. https://doi.org/10.1186/1471-2482-14-67.

    Article  Google Scholar 

  • Parent, N., & Fortin, F. (2000). A randomized, controlled trial of vicarious experience through peer support for male first-time cardiac surgery patients: Impact on anxiety, self-efficacy expectation, and self-reported activity. Heart and Lung,29(6), 389–400.

    Article  CAS  PubMed  Google Scholar 

  • Perks, A., Chakravarti, S., & Manninen, P. (2009). Preoperative anxiety in neurosurgical patients. Journal of Neurosurgery and Anesthesiology,21(2), 127–130. https://doi.org/10.1097/ANA.0b013e31819a6ca3.

    Article  Google Scholar 

  • Peterman, J. S., LaBelle, D. R., & Steinberg, L. (2014). Devoutly anxious: The relationship between anxiety and religiosity in adolescence. Psychology of Religion and Spirituality,6(2), 113–122. https://doi.org/10.1037/a0035447.

    Article  Google Scholar 

  • Phipps, W., Long, B., & Woods, N. F. (2004). Medical surgical nursing. St Louis: CV Mosby Co.

    Google Scholar 

  • Ping, G., Linda, E., & Antony, A. (2012). A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: A randomized controlled trial. International Journal of Nursing Studies,49(2), 129–137.

    Article  Google Scholar 

  • Power, J. M., Carney, S., Hannigan, C., Brennan, S., Wolfe, H., Lynch, M., et al. (2016). Systemic inflammatory markers and sources of social support among older adults in the memory research unit cohort. Journal of Health Psychology. https://doi.org/10.1177/1359105316676331.

    Article  PubMed  Google Scholar 

  • Pressman, P. (2000). Religious belief, depression, and ambulation status in elderly women with broken hips. American Journal of Psychiatry,147(6), 758–760.

    Google Scholar 

  • Rami, S. (2013). Social support, emotional well-being, and emotion regulation: A mediation model. A thesis submitted in partial fulfillment of the requirements for the degree of Bachelor of Science with honors in Biopsychology, Cognition, and Neuroscience at the University of Michigan.

  • Reis, S., & McNally, R. J. (1985). The expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy. New York: Academic Press.

    Google Scholar 

  • Reiss, S. (1991). The expectancy model of fear, anxiety, and panic. Clinic Psychology Review,11, 141–153.

    Article  Google Scholar 

  • Richards, J. M., Butler, E. A., & Gross, J. J. (2003). Emotion regulation in romantic relationships: The cognitive consequences of concealing feelings. Journal of Social and Personal Relationships,20, 599–620.

    Article  Google Scholar 

  • Richards, J. M., & Gross, J. J. (2000). Emotion regulation and memory: The cognitive costs of keeping one’s cool. Journal of Personality and Social Psychology,79, 410–424.

    Article  CAS  PubMed  Google Scholar 

  • Schroder, K. E., Schwarzer, R., & Endler, N. S. (1997). Predicting cardiac patients’ quality of life from the characteristics of their spouse. Journal of Health Psychology,2(2), 231–244.

    Article  CAS  PubMed  Google Scholar 

  • Shiah, Y. J., Chang, F., Chiang, S. K., Lin, I.-M., & Tam, W. C. (2015). Religion and health: Anxiety, religiosity, meaning of life and mental health. Journal of Religion and Health,54(1), 35–45. https://doi.org/10.1007/s10943-013-9781-3.

    Article  PubMed  Google Scholar 

  • Spielberger, C. D., Gorsuch, R., Lushene, P., Vagg, P., & Jacobs, A. (1983). Manual for the state-trait anxiety inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Swindale, J. E. (2004). The nurse’s role in giving pre-operative information to reduce anxiety in patients admitted to hospital for elective minor surgery. Journal of Advanced Nursing,14, 899–905.

    Article  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Boston: Pearson Education.

    Google Scholar 

  • Taylor, S. E. (2011). Social support: A review. In M. S. Friedman (Ed.), The handbook of health psychology. New York: Oxford University Press.

    Google Scholar 

  • Van Olphen, J., Schulz, A., Israel, B., Chatters, L., Klem, L., Parker, E., et al. (2003). Religious involvement, social support, and health among African-American Women on the East Side of Detroit. Journal of General and Internal Medicine,18(7), 549–557. https://doi.org/10.1046/j.1525-1497.2003.21031.x.

    Article  Google Scholar 

  • Vizehfar, F., & Jaberi, A. (2017). The relationship between religious beliefs and quality of life among patients with multiple sclerosis. Journal of Religion and Health,56(5), 1826–1836. https://doi.org/10.1007/s10943-017-0411-3.

    Article  PubMed  Google Scholar 

  • Watson, M., Haviland, J. S., Greer, S., Davidson, J., & Bliss, J. M. (2011). Influence of psychological response on survival in breast cancer: A population-based cohort study. Lancet,354(13), 31–37.

    Google Scholar 

  • Wirth, A. G., & Büssing, A. (2016). Utilized resources of hope, orientation, and inspiration in life of persons with multiple sclerosis and their association with life satisfaction, adaptive coping strategies, and spirituality. Journal of Religion and Health,55(4), 1359–1380. https://doi.org/10.1007/s10943-015-0089-3.

    Article  PubMed  Google Scholar 

  • Worthington, E., Wade, N., Hight, T., Ripley, J., McCullough, M., Berry, J., et al. (2003). The religious commitment inventory-10: Development, refinement, and validation of a brief scale for research and counseling. Journal of Counseling Psychology,50(1), 84–96.

    Article  Google Scholar 

  • Yilmaz, M., Sezer, H., Gürler, H., & Bekar, M. (2011). Predictors of preoperative anxiety in surgical inpatients. Journal of Clinical Nursing,21(78), 956–964.

    PubMed  Google Scholar 

  • Zhou, X., Wu, X., & Zhen, R. (2016). Understanding the relationship between social support and posttraumatic stress disorder/posttraumatic growth among adolescents after Ya’an earthquake: The role of emotion regulation. Psychological Trauma: Theory, Research Practice, and Policy,9(2), 214–221. https://doi.org/10.1037/tra0000213.

    Article  Google Scholar 

  • Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment,52, 30–41.

    Article  Google Scholar 

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  1. Department of Psychology, University of Nigeria, Nsukka, 41000, Enugu state, Nigeria

    Joseph Chinenye Aliche, Chuka Mike Ifeagwazi, JohnBosco Chika Chukwuorji & John E. Eze

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  1. Joseph Chinenye Aliche
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  2. Chuka Mike Ifeagwazi
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Correspondence to JohnBosco Chika Chukwuorji.

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Aliche, J.C., Ifeagwazi, C.M., Chukwuorji, J.C. et al. Roles of Religious Commitment, Emotion Regulation and Social Support in Preoperative Anxiety. J Relig Health 59, 905–919 (2020). https://doi.org/10.1007/s10943-018-0693-0

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