Valores humanos e crescimento pós-traumático: papel mediador da resiliência familiar em pessoas com doença renal crônica

Abstract

This work aimed to test the mediating role of family resilience on the relationship between human values and posttraumatic growth in people with chronic kidney disease. Thus, it was decided to perform four studies articles format. Article 1 aimed to perform a theoretical review of the contributions of human values, family resilience and posttraumatic growth in facing with adverse situations. The review indicated that the constructs presented are important variables to analyze how people with chronic kidney disease deal with adversity and provide explanations for better understanding of family relationships that take place in the context of mental health of these people and how family support can contribute to the personal growth and acceptance of the disease. Article 2 aimed to adapt to the Brazilian context the scale Family Resilience Assessment Scale (FRAS) gathering evidence of validity and precision. To this end, two studies were carried out with participants from different Brazilian states. 314 people participated in the first study (Mage = 31.87; SD = 10.58), being 56.4% female, 48.4% from Paraíba and São Paulo (20.4%). In study 1, an exploratory factor analysis was carried out, which suggested a tetrafactorial structure, with an adequate reliability index (CFI = 0.84, TLI = 0.83, RMSEA = 0.06). Study 2 included 336 people with chronic kidney disease (Mage = 41.44; SD = 11.02), the majority (54.1%) were female, São Paulo (33.1%) and Rio de Janeiro (14.5%) and undergoing hemodialysis (46.4%). The confirmatory factor analysis confirmed the structure composed of four factors by means of a reduced version of the scale (CFI = 0.96, TLI = 0.95, RMSEA = 0.07). Therefore, the results showed that the reduced version of FRAS can be an alternative to assess family resilience and its correlates in Brazil. Article 3 aimed to verify the influence of sociodemographic variables on family resilience in people with chronic kidney disease. 210 patients with chronic kidney disease participated in the research (Mage = 42.1; SD = 10.80), the majority of whom were from São Paulo (29.5%), women (68.6%), Catholic (44.3%). There were positive and significant relationships between the degree of religiosity and the family resilience factor: family spirituality (r = 0.62; p = 0.01). Furthermore, in order to verify whether the type of religion influences family resilience, a MANOVA was carried out, which indicated that there are significant differences only in relation to the type of religion in the family spirituality factor [Wilks Lambda = 0.668, F (24.618) = 3.164, p = 0.01, η² (effect size) = 0.09]. The results suggest that religiosity can help to overcome traumatic situations because, through religious teachings, people socialize, join groups and participate in social activities that happen regularly in the context of religious communities, contributing as an adaptation strategy to level of structuring family resilience. Finally, article 4, aimed to test the mediating role of family resilience on the relationship between human values and posttraumatic growth in people with chronic kidney disease. There were 342 people with Chronic Kidney Disease (Mage = 41.37; SD = 11.06; range 19 to 72 years), from 24 Brazilian states, most of São Paulo (32.7%), Rio de Janeiro (14.6%) and women (54.7%). Of these 46.2% undergoing hemodialysis and 29.5% kidney transplantation. They were applied to FRAS, Posttraumatic Growth Inventory (PTGI), Basic Values Questionnaire (QVB), and demographic issues. Correlations were performed, followed by regressions. Mediation models demonstrated the contribution of social values, seeking to verify the predictive power of posttraumatic growth, mediated by family resilience in people with chronic kidney disease. Thus, it is concluded that improving family resilience levels can be a way to minimize the symptoms of the disease and promote growth in people with chronic kidney disease.