MODERATING ROLE OF POSITIVE RELIGIOUS COPING, ENGAGEMENT COPING, AND PERCEIVED AVAILABILITY OF SOCIAL SUPPORT AMONG CHRONICALLY- ILL PATIENTS

Abstract

The present research was carried out to investigate the moderating role of positive religious coping, engagement coping, and perceived availability of social support in stress-distress relationship among chronically-ill patients (HIV/AIDS & cancer). This study also investigated the role of gender, locale, type of disease and stages of disease in the appraisal of stressors (poor physical well-being, disease-related discrimination & barriers to care), and different coping strategies (positive religious coping & engagement coping) as well as perceived availability of social support among chronically-ill patients. Present research comprised two separate studies, Study-I and Study-II. The Study-I was further conducted in two phases. Phase-I aimed at translation of the Physical Well-being Scale, Disease-related discrimination Scale, Barriers to Care Scale, Positive Religious Coping Scale, Engagement Coping Scale, and Interpersonal Support Evaluation List into Urdu language. Whereas, phase-II of the study-I aimed at investigating the psychometric properties of the translated instruments. The translated versions were administered to a sample of 90 chronically- ill patients, comprising HIV/AIDS (n = 35) and cancer (n = 55) patients. Convergent and discriminant validity of the instruments were addressed and the scales exhibited good internal consistency reliability. For study-II (main study) data were collected from 330 chronically-ill patients comprising 252 cancer patients and 78 HIV/AIDS patients. A total of 63% (n = 208) were symptomatic patients whereas, 37% (n = 122) were asymptomatic. Participants were administered Urdu version of the seven scales (Physical Well-being scale, Disease-related Discrimination, Barriers to Care scale, Positive Religious Coping Scale, Engagement Coping Scale, Perceived Availability of Social Support and Beck Depression Inventory). Multiple regression and hierarchical moderated regression analyses were used to test the hypothesized relationships. Poor physical well-being and disease-related discrimination have significant main effects on depression. All the three moderating variables (positive religious coping, engagement coping and perceived availability of social support) were found significantly related to the depression. Positive religious coping and engagement coping was found significantly moderating poor physical well-being and depression relationship as well as disease-related discrimination and depression relationship. Whereas, moderating role of perceived availability of social support was found for poor physical well-being and depression as well as barriers to care and depression. Finally, t-test were conducted to explain the differences on stress appraisal, perceived availability of social support and coping strategies with reference to gender, locale, type and stages of disease. Overall, male patients differed from female patients in the appraisal of poor physical well-being, disease-related discrimination and barriers to care, whereas female patients significantly differed from male patients in their use of coping strategies. Patients from rural areas were high in the perception of poor physical well-being and barriers to care as compared to urban patients. HIV/AIDS patients differed from cancer patients in their high use of coping strategies and high perception of availability of social support as compared to cancer patients. Symptomatic patients were high in the appraisal of poor physical well-being, barriers to care and positive religious coping. HIV/AIDS and cancer patients were further compared across disease stages and gender. Symptomatic HIV/AIDS patients were high on the appraisal of poor physical well being and barriers to care as compared to asymptomatic HIV/AIDS patients. However, symptomatic cancer patients differed from asymptomatic cancer patients in their high appraisal of poor physical well- being, barriers to care and their high use of positive religious coping. Male cancer patients were high on the appraisal of poor physical well-being, disease-related discrimination and barriers to care, whereas, female cancer patients were high on positive religious coping, engagement coping, and perceived availability of social support as compared to men cancer patients. Male HIV/AIDS patients differed from female HIV/AIDS patients in their high perception of availability of social support. Further research may test the role of negative religious coping and disengagement coping strategies among chronically-ill patients.