470
Views
20
CrossRef citations to date
0
Altmetric
Research Papers

Forgiveness and health among people in outpatient physical therapy

&
Pages 383-392 | Received 14 Oct 2010, Accepted 19 Jul 2011, Published online: 21 Oct 2011
 

Abstract

Purpose: Forgiveness is associated with a variety of health-related outcomes; however much of this work has been in the context of forgiveness of others, direct associations and otherwise healthy samples. This study examined associations involving multiple dimensions of forgiveness, including indirect effects through health behavior, among outpatients receiving physical therapy. Methods: Participants from southern Appalachia (n = 141) completed cross-sectional self-report measures of forgiveness, lifetime religiousness, health behavior, health status and pain. Mediation analysis was employed to examine the direct and indirect relationships between forgiveness and health. Results: Forgiveness of self was associated with: (i) overall health status, physical health status and current pain in an indirect-only fashion and (ii) mental health status and chronic pain in a direct-only fashion. Feeling forgiven by God was associated with health-related social functioning in a direct-only fashion. Forgiveness of others was not associated with the health-related outcomes. Conclusions: Forgiveness of self appears to be the most important to health, yet the most difficult to achieve. Religious culture may influence whether feeling forgiven by God is also important. Forgiveness-based intervention may be useful in the context of rehabilitation, in general, and physical therapy, in particular.

Implications for Rehabilitation

  • Forgiveness may be particularly helpful for people seeking physical therapy and its effect may be direct and/or operate through association with better health behavior or self-care.

  • Direct associations were observed for forgiveness of self with mental health status and chronic pain and for feeling forgiven by God with health-related social functioning.

  • Forgiveness of self was indirectly associated with overall health status, physical health status and current pain through its association with health behavior.

  • Clinicians may be able to facilitate the benefits of forgiveness through explicit forgiveness-based interventions.

Acknowledgments

This paper is based on the undergraduate Psychology Honors-in-Discipline Thesis of the first author, who entered the ETSU Doctor of Physical Therapy program in January 2011. Portions of this paper were presented in a symposium at the 8th Annual Mid-Year Research Conference on Religion and Spirituality of Division 36 (Society for the Psychology of Religion and Spirituality) of the American Psychological Association, sponsored by the Department of Pastoral Counseling at Loyola University Maryland. The authors would like to thank the administrator, physical therapists and patients of Watauga Orthopedics for allowing the study to be conducted at their facility.

Declaration of interest: This research was sponsored by a Student–Faculty Collaborative Grant from the ETSU Honors College. Otherwise, this research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Notes

1Nearly all the participants reported Caucasian ethnicity (i.e. 143 of 150 or 95.33%) and/or an education level of High School graduate or above (i.e. 147 of 150 or 98%). Seven participants reported one of four additional ethnicities and three participants reported having not graduated from High School. Incorporating these additional participants into the existing otherwise applicable categories (too few for one or more additional respective categories) would lead to an inadequate description and make interpretation of results based on ethnicity and education more difficult. As such, we chose to exclude these participants from the analyses.

2While the coefficient of determination (r2) indicates the proportion of variance shared among two variables, standard guidelines for assessing the strength of association or effect size of r suggest that values equal to 0.10, 0.30 and 0.50 reflect magnitudes of small, medium, and large, respectively [Citation37]. For example, if r = 0.30 then r2 = 0.09. As such, both would be considered to reflect a medium effect size. As the guidelines provided by Cohen [Citation37] are in the context of r, we only present r, rather than r2, at the bivariate level of analysis.

3Preacher and Hayes’ techniques allow for more accurate analysis of indirect effects associated with MVs [Citation44,Citation71,Citation72]. Baron and Kenny’s [Citation73] techniques derive mediation from a sequential series of significant direct effects among an IV, MV and DV and are restricted by assumptions of normally distributed data. Preacher and Hayes’ techniques allow for indirect effects without requiring direct effects and do not require normally distributed data, as bootstrap resampling is used.

4Attributional style is defined as: “a person’s characteristic tendencies when inferring the cause of behavior or events. … the internal–external dimension [refers to] whether they tend to attribute events to the self or to other factors” [Citation74].

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.