title: Fatigue of survivors following cardiac surgery: positive influences of preoperative prayer coping.
abstract: OBJECTIVE
  Fatigue symptoms are common among individuals suffering from cardiac diseases, but few studies have explored longitudinally protective factors in this population. This study examined the effect of preoperative factors, especially the use of prayer for coping, on long-term postoperative fatigue symptoms as one aspect of lack of vitality in middle-aged and older patients who survived cardiac surgery.
  
  
  METHODS
  The analyses capitalized on demographics, faith factors, mental health, and on medical comorbidities previously collected via two-wave preoperative interviews and standardized information from the Society of Thoracic Surgeons' national database. The current participants completed a mailed survey 30 months after surgery. Two hierarchical regressions were performed to evaluate the extent to which religious factors predicted mental and physical fatigue, respectively, after controlling for key demographics, medical indices, and mental health.
  
  
  RESULTS
  Preoperative prayer coping, but not other religious factors, predicted less mental fatigue at the 30-month follow-up, after controlling for key demographics, medical comorbidities, cardiac function (previous cardiovascular intervention, congestive heart failure, left ventricular ejection fraction, New York Heart Association Classification), mental health (depression, anxiety), and protectors (optimism, hope, social support). Male gender, preoperative anxiety, and reverence in secular context predicted more mental fatigue. Physical fatigue increased with age, medical comorbidities, and preoperative anxiety. Including health control beliefs in the model did not eliminate this effect.
  
  
  CONCLUSIONS
  Prayer coping may have independent and positive influences on less fatigue in individuals who survived cardiac surgery. However, future research should investigate mechanisms of this association.
authors.affiliation: University of Washington, Seattle, Washington, USA. amyai8@gmail.com
authors.forename: Amy L
authors.initials: AL
authors.lastname: Ai
authors.forename: Paul
authors.initials: P
authors.lastname: Wink
authors.forename: Marshall
authors.initials: M
authors.lastname: Shearer
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001290:Attitude; D006348:Cardiac Surgical Procedures / Q000523:psychology*; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012067:Religion; D012944:Social Support; D017741:Survivors / Q000523:psychology