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Article
Relaxation response and spirituality: Pathways to improve psychological outcomes in cardiac rehabilitation
Journal of Psychosomatic Research (2010)
  • Bei-Hung Chang, Boston University
  • Aggie Casey, Massachusetts General Hospital
  • Jeffery A. Dusek, Massachusetts General Hospital
  • Herbert Benson, Harvard Medical School
Abstract
OBJECTIVES: Studies have shown beneficial effects from practicing the relaxation response (RR). Various pathways for these effects have been investigated. Previous small studies suggest that spirituality might be a pathway for the health effects of the RR. In this study, we tested the hypothesis that increased spiritual well-being by eliciting the RR is one pathway resulting in improved psychological outcomes.

METHODS: This observational study included 845 outpatients who completed a 13-week mind/body Cardiac Rehabilitation Program. Patients self-reported RR practice time in a questionnaire before and after the 13-week program. Similarly, data on spiritual well-being, measured by the subscale of Spiritual Growth of the Health-Promoting Lifestyle Profile II, were collected. The psychological distress levels were measured by the Symptom Checklist-90-Revised. We tested the mediation effect of spiritual well-being using regression analyses.

RESULTS: Significant increases in RR practice time (75 min/week, effect size/ES=1.05) and spiritual well-being scores (ES=0.71) were observed after participants completed the program (P<.0001). Patients also improved on measures of depression, anxiety, hostility and the global severity index with medium effect sizes (0.25 to 0.48, P<.0001). Greater increases in RR practice time were associated with enhanced spiritual well-being (beta=.08, P=.01); and enhanced spiritual well-being was associated with improvements in psychological outcomes (beta=-0.14 to -0.22, P<.0001).

CONCLUSION: Our data demonstrated a possible dose-response relationship among RR practice, spiritual and psychological well-being. Furthermore, the data support the hypothesis that spiritual well-being may serve as a pathway of how RR elicitation improves psychological outcomes. These findings might contribute to improved psychological care of cardiac patients.
Publication Date
August, 2010
DOI
10.1016/j.jpsychores.2010.01.007
Citation Information
Chang BH, Casey A, Dusek JA, Benson H. Relaxation response and spirituality: Pathways to improve psychological outcomes in cardiac rehabilitation. J Psychosom Res. 2010 Aug;69(2):93-100. doi: 10.1016/j.jpsychores.2010.01.007. PubMed PMID: 20624507.