[Show abstract][Hide abstract] ABSTRACT: Marriage has long been linked to lower risk for adult mortality in population and clinical studies. In a regional sample of patients (n = 569) undergoing cardiac surgery, we compared 5-year hazards of mortality for married persons with those of widowed, separated or divorced, and never married persons using data from medical records and psychosocial interviews. After adjusting for demographics and pre- and postsurgical health, unmarried persons had 1.90 times the hazard of mortality of married persons; the disaggregated widowed, never married, and divorced or separated groups had similar hazards, as did men and women. The adjusted hazard for immediate postsurgical mortality was 3.33; the adjusted hazard for long-term mortality was 1.71, and this was mediated by married persons' lower smoking rates. The findings underscore the role of spouses (both male and female) in caregiving during health crises and the social control of health behaviors.
Journal of Health and Social Behavior 03/2012; 53(1):33-49. DOI:10.1177/0022146511432342 · 2.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Research in religion and health has spurred new interest in measuring religiousness. Measurement efforts have focused on subjective facets of religiousness such as spirituality and beliefs, and less attention has been paid to congregate aspects, beyond the single item measuring attendance at services. We evaluate some new measures for religious experiences occurring during congregational worship services. Respondents (N=576) were religiously-diverse community-dwelling adults interviewed prior to cardiac surgery. Exploratory factor analysis of the new items with a pool of standard items yielded a readily interpretable solution, involving seven correlated but distinct factors and one index variable, with high levels of internal consistency. We describe religious affiliation and demographic differences in these measures. Attendance at religious services provides multifaceted physical, emotional, social, and spiritual experiences that may promote physical health through multiple pathways.
International Journal for the Psychology of Religion 02/2009; 19(1):1-20. DOI:10.1080/10508610802471096 · 1.64 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Distress and low perceived social support were examined as indicators of psychosocial vulnerability in patients about to undergo heart surgery. Design: A total of 550 study patients underwent heart surgeries, including bypass grafting and valve procedures. Psychosocial interviews were conducted about five days before surgery, and biomedical data were obtained from hospital records.
Sociodemographic, personality, religious, and biomedical factors were evaluated as predictors of psychosocial vulnerability, and all five sets of variables were evaluated as contributors to hospital length of stay (LOS).
Patients scoring higher on one or more indicator of presurgical psychosocial vulnerability were younger, more likely to be female, less likely to be married, less well educated, lower in dispositional optimism, higher in trait anger, and lower in religiousness. Older age, depression, low support, and low trait anger each showed an independent, prospective association with greater LOS, and several other predictors had prospective relationships with LOS that were statistically mediated by depression or perceived support.
Evidence that multiple psychosocial factors may influence adaptation to heart surgery has implications for understanding and ameliorating presurgical distress and for improving postsurgical recovery.
Health Psychology 06/2008; 27(3):309-19. DOI:10.1037/0278-6220.127.116.119 · 3.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to examine the dimensionality, stability, and course of depressive symptoms over the 12-month period beginning approximately 1 week before heart surgery.
The Center for Epidemiological Studies Depression Scale (CES-D) was administered to 570 patients before heart surgery and 1, 3.5, 6.5, and 12.5 months later.
Confirmatory factor analysis rejected a four-factor model as a result of small variances for two interpersonal items. With their elimination, a three-factor solution (negative affect, low positive affect, somatic/vegetative symptoms) showed good psychometric properties. Except for the somatic/vegetative factor at the 1-month follow up, there was a high degree of stability in the factor pattern over a 12-month period beginning approximately 1 week before heart surgery. Latent mean structure analysis indicated that, apart from elevations in several somatic/vegetative symptoms during the month after surgery, means for all three depressive symptoms declined over time. The recovery of positive affect showed a steeper trajectory toward the end of the follow-up period by comparison with the rates of decline for depressed affect and somatic/vegetative symptoms.
These findings support using 18 CES-D items to measure three depressive symptom dimensions in heart patients and may reflect a normative pattern of adjustment to heart surgery.
Psychosomatic Medicine 12/2006; 68(6):922-30. DOI:10.1097/01.psy.0000244391.56598.10 · 3.47 Impact Factor