title: Psychological distress and self-care engagement: healing after a cardiac intervention.
abstract: Silencing the self, a relational concept, occurs when individuals overvalue others' standards, self-sacrifice their needs for others, inhibit self-expression, and experience a sense of dividedness between their inner and outer self. Given the emerging literature highlighting the importance of relational beliefs and experiences in coronary heart disease, the contribution of a concept such as self-silencing to the cardiac healing process is valuable to consider. This study investigated self-silencing dimensions, psychological distress (anxiety and depressive symptoms), and self-care engagement after a serious cardiac event. Forty women and 80 men attending a rehabilitation program completed a series of questionnaires six months post-cardiac intervention. Multivariate regression analyses were performed to examine the role of self-silencing after the influence of cardiac health and sociodemographics were taken into account. Self-silencing was positively associated with anxiety and depressive symptoms for both sexes. For self-care engagement, sex interacted with some of the silencing dimensions. The findings were interpreted in the context of participants' attendance in a rehabilitation program. Women who are self-silencing may benefit from the self-care expectations associated with a cardiac program whereas for men, even engaging in cardiac self-care may be perceived as self-silencing.
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada. medved@cc.umanitoba.ca
authors.forename: Maria I
authors.initials: MI
authors.lastname: Medved
authors.forename: Niva
authors.initials: N
authors.lastname: Piran
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D001294:Attitude to Health; D003327:Coronary Disease / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012046:Rehabilitation / Q000523:psychology; D012648:Self Care; D012737:Sex Factors; D012927:Social Control, Informal; D013315:Stress, Psychological; D011795:Surveys and Questionnaires