The roles of spirituality, hope and social support as predictors of psychological well-being and life satisfaction in adults with cystic fibrosis

Increased life expectancy for individuals with cystic fibrosis (CF) has led to interest in the role of resources adults with CF use in coping with their illness. The role of spirituality and hope in adults with CF has received little attention in the literature. In recent years a number of clinical advances such as lung transplantation and gene therapy may have served to increase hope in adults with CF (Gotz & Gotz, 2000). However, policies and protocols surrounding infection control measures at CF out-patient clinics and hospitals treating CF in-patients have necessarily altered the extent of direct contact individuals with CF have with other patients with CF. Given that prior social networks for adults with CF have been altered, further research regarding the role of social support for adults with CF and its relationship to psychological well-being is therefore timely. The present study examined the relationships between spirituality, hope, social support, psychological well-being and life satisfaction in adults with CF. Participants (64 males; 68 females) provided responses to an on-line self-report instrument which consisted of demographic items, self-ratings of health status and spirituality, and scales assessing spirituality, hope, social support, coping, psychological well-being, and life satisfaction. Results revealed a significant positive relationship between one of the measures of spirituality, namely, spiritual well-being - meaning, peace and purpose in life, and hope, psychological well-being, and life satisfaction. It was concluded that hope in adults with CF operates through this particular aspect of spirituality. Number of close friends and relatives perceived to be supportive was significantly positively correlated with all types of social support as measured by the MOS Social Support Survey (emotional/informational, tangible, positive social interaction, affectionate support) but was unrelated to social support from a spiritual community. Findings revealed that social support was negatively and moderately associated with depression as well as to a lesser extent, with stress but surprisingly, unrelated to anxiety. All aspects of social support as measured by the MOS Social Support Survey, were positively and significantly associated with life satisfaction as it related to living with CF. Way of coping as measured by the CF Coping Scale, had significant implications for psychological wellbeing and life satisfaction. Optimistic Acceptance was moderately, negatively associated with depression, negatively and weakly significantly related to stress, and moderately, positively and highly significantly correlated with life satisfaction as measured by the FLZM-CF. Coping by way of either hopefulness or distraction was positively associated with anxiety and stress. Avoidance was positively correlated with depression and stress, and weakly, negatively correlated with life satisfaction as it related to living with CF. Qualitative information gained from participants on what they perceived to be significant medical advances in treating CF may have implications for providing hope. A wide range of sources upon which participants relied for providing inner strength (e.g., selfreliance, support from family, partner and others, cognitive strategies, life style measures, spiritual dimensions/hope, and health/medical support) were reported. The breadth and number of responses reported were consistent with the findings of Rustoen, Wahl, Hanestad, Gjengedal, & Moum (2004) that adults with CF have high levels of inner strength. It was concluded that spirituality, hope, and social support, were resources that contributed positively to the psychological well-being of adults with CF. Meaning, peace and purpose in life, hope, and social support, were all clearly associated with life satisfaction for adults with CF. It was also concluded that interventions with a focus on promoting hope and social support could well be instrumental in preventing depression and stress in this patient group. Such results necessarily have implications for clinicians providing psychological treatment and support to adults with CF.