RESUMO
Higher levels of resilience and spirituality are independently linked to better physical and mental health outcomes, within both general and cardiac populations. We investigated the long-term associations of such psychological factors following cardiac surgery. A total of 402 patients undergoing routine cardiac surgery at two large urban hospitals in the Dallas, Texas, area were prospectively enrolled in this study, with completed follow-up data for 364 (90.5%). Data were collected from August 2013 to January 2017. Resilience, spirituality, and secondary measures were assessed at baseline, 1 month, and 1 year via the Connor-Davidson Resilience Scale-10 and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale. Linear regression and correlational analyses assessed associations between resilience and spirituality, as well as other demographic and psychosocial factors. Resilience was significantly associated with every construct except posttraumatic growth. Spirituality was associated with increasing resilience over the ensuing year, whereas never being married was associated with a decrease in resilience. Our findings identify a population that is vulnerable to a decrease in resilience following cardiac surgery, as well as an avenue (i.e., spirituality) for potentially bolstering resilience. Improving resilience via spirituality postoperatively may foster better overall recovery and better mental and physical health outcomes.
RESUMO
OBJECTIVES: Nonpharmacologic pain management strategies are needed because of the growing opioid epidemic. While studies have examined the efficacy of virtual reality (VR) for pain reduction, there is little research in adult inpatient settings, and no studies comparing the relative efficacy of standard animated computer-generated imagery (CGI) VR to Video Capture VR (360 degrees 3D/stereoscopic Video Capture VR). Here, we report on a randomized controlled trial of the relative efficacy of standard CGI VR versus Video Capture VR (matched for content) and also compared the overall efficacy of VR to a waitlist control group. MATERIALS AND METHODS: Participants (N=103 hospitalized inpatients reporting pain) were randomized to 1 of 3 conditions: (1) waitlist control, (2) CGI VR, or (3) Video Capture VR. The VR and waitlist conditions were 10 minutes in length. Outcomes were assessed pretreatment, post-treatment, and after a brief follow-up. RESULTS: Consistent with hypotheses, both VR conditions reduced pain significantly more relative to the waitlist control condition (d=1.60, P<0.001) and pain reductions were largely maintained at the brief follow-up assessment. Both VR conditions reduced pain by â¼50% and led to improvements in mood, anxiety, and relaxation. Contrary to prediction, the Video Capture VR condition was not significantly more effective at reducing pain relative to the CGI VR condition (d=0.25, P=0.216). However, as expected, patients randomized to the Video Capture VR rated their experience as more positive and realistic (d=0.78, P=0.002). DISCUSSION: Video Capture VR was as effective as CGI VR for pain reduction and was rated as more realistic.
