Religious and Spiritual Appraisals and Coping Strategies among Patients in Medical Rehabilitation

This longitudinal investigation examined the prevalence of religious and spiritual appraisals and coping strategies and their associations with anxiety, depression, and posttraumatic growth among 70 medical rehabilitation inpatients who sustained a major unanticipated physical health event. Questionnaires were administered to participants within 48 hours of admission to medical rehabilitation and again 6-8 weeks following discharge. Religious and spiritual appraisals were common; 85.7% and 81.4% endorsed some degree of benevolent religious appraisals, 71.4% and 58.6% endorsed some degree of sacred loss, and 42.9% and 40.0% endorsed some degree of desecration at admission and follow-up, respectively. Hierarchical regression analyses revealed that sacred loss and desecration added unique variance in the prediction of symptoms of anxiety, depression, and posttraumatic growth. Benevolent religious appraisals added unique variance in the prediction of posttraumatic growth. Positive and negative religious coping acted as significant partial mediators linking sacred loss and desecration to positive and negative outcomes, respectively. The results of this longitudinal study suggest that, although important, religious and spiritual appraisals do not influence outcomes in isolation. Instead, how individuals respond to, or cope with, their initial religious and spiritual appraisals may be fundamental to predicting psychological outcomes following inpatient medical rehabilitation. Practical directions for spiritually-sensitive and integrated approaches for facilitating the health and well-being of patients who are undergoing medical rehabilitation are discussed.