Many factors can discourage survivors of sexual assault from reporting their assaults. Even those survivors who disclose, their reporting experiences may not leave them feeling empowered or that they have received adequate support to begin the healing process after disclosure. Using a mixed methods approach, we examined the relationship between religious and spiritual coping strategies, the experience of social disclosure, and symptoms of posttraumatic stress disorder (PTSD) and depression using confirmatory factor analysis (CFA) and structural equation modeling (SEM). We further used qualitative data examining the ways that participants used religious/spiritual coping strategies in response to the trauma of sexual assault. In total, 94 female or non-binary participants were enrolled. The CFA showed good model fit for all latent factors except positive religious coping and positive social responses. The SEM path analysis found a significant relationship between the latent factor Distract and PTSD symptoms. No other variables were significant in the SEM model, likely due to the small sample size. Qualitative data themes were identified such as respondent-supported healing, responses promoting shutting down/isolation, and responses affecting self-blame for social disclosure and positive and negative religious coping. Finally, this study substantiates the importance of research assessing the needs and experiences of sexual assault survivors, as this is a population that is particularly vulnerable, and struggles to get adequate support and resources. An increase in understanding about the experiences, needs, and coping strategies of sexual assault survivors will help both informal and formal interventions become more effective.

Submitted by Mariana Dornelles Vargas (marianadv) on 2015-05-19T18:05:23Z No. of bitstreams: 1 deus_nao.pdf: 2237986 bytes, checksum: 8c5a348f59bc16db281c7c5b7dd34d8a (MD5) / Made available in DSpace on 2015-05-19T18:05:23Z (GMT). No. of bitstreams: 1 deus_nao.pdf: 2237986 bytes, checksum: 8c5a348f59bc16db281c7c5b7dd34d8a (MD5) Previous issue date: 2012-02 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta dissertação e composta por três artigos, um de revisão sistemática da literatura e dois empíricos. A pesquisa desenvolvida teve como foco de investigação o coping religioso/espiritual (CRE) em mulheres com câncer de mama e foi estruturada a partir de um delineamento misto. No Estudo 1, buscou-se a) examinar as relações entre o CRE e as variáveis sociodemográficas, clinicas e religiosas de 83 mulheres com câncer de mama (idade media = 52,3 anos, DP = 7,27) e b) conhecer a percepção subjetiva sobre quem e Deus para essas mulheres para, desta forma, compara-las aos estilos de CRE. Para o Estudo 2, selecionou-se as 15 mulheres que obtiveram os maiores índices de CRE positivo no Estudo 1, a fim de que essas participassem de dois grupos focais. Dessas, sete aceitaram o convite para participação (idade media = 51,5 anos, DP = 7,20). O objetivo do Estudo 2 foi o de compreender o lugar que a religiosidade/espiritualidade ocupa na vida dessas mulheres, as formas de coping utilizadas durante o período do diagnostico e tratamento, bem como as possíveis mudanças ocorridas durante a experiência da doença. Todas as participantes pertenciam a grupos de apoio a pacientes com câncer da região metropolitana de Porto Alegre . RS. Os resultados do Estudo 1, obtidos através da aplicação de um questionário de dados sociodemográficos, clínicos e de atividade religiosa/espiritual (incluindo a pergunta aberta: ?\Para você, quem e Deus?.) e da Escala de Coping Religioso-Espiritual, nao permitiram a identificação de nenhuma associação significativa entre as variáveis sociodemográficas e clinicas e o CRE total e positivo, ao passo que a escolaridade apresentou uma associação significativa (r = -0,254; p<0,05) com o fator N3 (Reavaliação negativa do significado) da dimensão CRE negativo. Em contrapartida, foi possível identificar maiores índices de CRE total e positivo entre as mulheres com maior frequência a encontros de natureza religiosa. Uma diferença marginalmente significativa [t(81) =1,749, p<0,10] foi encontrada no fator N1(Reavaliação negativa de Deus) entre mulheres que moravam com filhos (n=45) e aquelas que não moravam (n=38). Mulheres que não moravam com os filhos apresentaram media superior nessa estratégia de CRE (M= 2,11, DP= 1,09) do que aquelas que moravam com os filhos (M=1,73, DP=0,88). A percepção subjetiva das mulheres sobre quem e Deus permitiu a identificação de oito categorias, das quais, três apresentaram associações significativas com os estilos de CRE. Além disso, o Estudo 2 revelou o estabelecimento de uma relação positiva com Deus entre as participantes, capaz de proporcionar forca, esperança e conforto. As crenças religiosas auxiliaram no entendimento da doença, aumentando a confiança de que a enfermidade seria curada. A família e os membros de comunidades religiosas revelaram-se fontes potenciais de apoio social. Além disso, características da personalidade das participantes foram atenuadas, as quais foram decorrentes de um processo de reflexão quando do diagnostico. Contudo, destaca-se que estratégias de CRE negativo também estiveram presentes, merecendo ser observadas e trabalhadas para promover uma melhor adaptação. Os resultados reafirmam a necessidade de uma abordagem na qual os profissionais da saúde contemplem as crenças religiosas/espirituais das pacientes, visando o estimulo das estratégias de CRE positivas e a reavaliação daquelas nocivas. / This dissertation comprises three articles; one on literature review and two on empirical research. The study focused on religious/spiritual coping (RSC) in female breast cancer patients and was structured from a mixed delineation. Study 1 objectives were a) to examine the relation between RSC and sociodemographic, clinical and religious variables of 83 breast cancer patients (average age = 52,3 years, DP = 7,27) and b) to understand these women’s subjective perceptions of God in order to compare such perceptions against RSC styles. In Study 2, the women who had obtained the highest scores of positive RSC in Study 1 were selected to participate in two focal groups. Of these women, seven accepted the invitation to take part in the research (average age= 51,5 years, DP = 7,20).The objective of Study 2 was to understand the place that religiosity/spirituality have in these wom en’s lives, the coping strategies used during diagnosis and treatment period and p ossible changes during the course of the disease. All participants attended support gro ups for cancer patients in the metropolitan region of Porto Alegre - RS. The results of Study 1 were obtained through a questionnaire of sociodemographic, clinical and religious/spiritual data (including the open question: “For you, who is God?”) and the Religious-Spiritual Coping Scale. The results did not identify any significant association between sociodemographic and clinical variables and the total and positive RSC, whereas the education level variable showed significant association with the factor N3 (Negative meaning reappraisal) of the negative RSC dimension. On the other hand, it was possible to identify higher scores of total and positive RSC among women who more frequently attended religious meetings. A marginally significant difference [t(81) =1,749, p<0,10] was found in factor N1 (Negative reappraisal of God) between women who lived with their children (n=45) and those who did not (n=38).Women who did not live with their children showed higher average score on this RSC strategy than those who did. The women’s subjective perception about who God is allowed the identification of eight categories; of these, three showed significant association with the RSC styles. Moreover, Study 2 revealed the establishment, among the patients, of a positive relationship with God, capable of providing strength, hope and comfort. Religious beliefs helped in the understanding of the disease, increasing confidence that the illness would be cured. Family and members of religious groups proved to be potential sources of social support. Personality characteristics of the participants were also attenuated; this happened as a result of a reflection process at the moment of diagnosis. Nonetheless, it is worth point ing out that negative RSC strategies were also present, showing the need for such strategies to be monitored and addressed in order to promote better adaptation. The results endorse the necessity of an approach whereby health-care professionals address the religious/spiritual beliefs of the patients, so as to stimulate the adoption of positive RSC strategies and the reappraisal of negative ones.