The Relationship Between Positive and Negative Religious Coping, Depressive Symptoms, and Adherence to Health Behaviors in Cardiac Rehabilitation Patients: The Role of Pereceived Control

Abstract

Cardiovascular disease is a diagnosis that requires the use of effective coping strategies to manage the disease itself, as well as the challenges associated with it (e.g., lifestyle changes). Religious and spiritual coping incorporates religious and spiritual beliefs in the coping process and is one strategy commonly used by individuals facing stressful health threats, such as cardiovascular disease. While religiosity is generally associated with better physical and mental health outcomes, different patterns of religious coping may predict disparate outcomes. Limited research exists to explain the mechanisms though which patterns of religious/spiritual coping exert their differential effects, but perceived control is one possibility. Using a moderated mediation model, the purpose of this study was to examine the effect of perceived control on the relationship between positive and negative religious/spiritual (R/S) coping, depressive symptoms, and adherence to health behavior recommendations in individuals with cardiovascular disease. Using a sample of 146 cardiac rehabilitation patients, it was hypothesized that the interaction between low levels of perceived control and positive religious/spiritual coping would be negatively related to depressive symptoms, which would in turn negatively predict adherence to health behavior recommendations. It was further hypothesized that the interaction between low levels of perceived control and negative religious/spiritual coping would be positively related to depressive symptoms, which would in turn negatively predict adherence to health behavior recommendations. Results did not support the proposed hypotheses. Perceived control failed to moderate the relationship between positive R/S coping and depressive symptoms, as well as the relationship between negative R/S coping and depressive symptoms. In addition, depressive symptoms were unrelated to health behavior adherence. Although not specifically predicted, results showed that both forms of R/S coping were positively related to depressive symptoms, and that both forms of perceived control were negatively related to depressive symptoms. Study limitations are discussed, as well as possible implications for practitioners working within a cardiac rehabilitation context.