Role of Spirituality on the Association Between Depression and Quality of Life in Stroke Survivor–Care Partner Dyads

Abstract

Background: Little is known about the protective effect of spirituality on the association between known risk factors such as depression and quality of life (QOL) in stroke survivor-care partner dyads. Therefore, the aim of this study was to evaluate the moderating role of spirituality on the association between depressive symptomatology and QOL in stroke survivor–care partner dyads. Methods and Results: Longitudinal design with 223 stroke survivor–care partner dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivors’ and care partners’ depression, quality of life, and spirituality. Examining the moderating role of spirituality on the association between depressive symptoms and QOL within survivor-care partner dyads, we used a traditional Actor-Partner-Interdependence Model and a basic Actor-Partner-Interdependence Model moderation model for a mixed variable. Survivors (51% male) and care partners (66% female) were 70.7 and 52.3 years old, respectively. The survivor’s spirituality significantly moderated the association between care partner depressive symptomatology and survivor psychological QOL (B=0.03, P <0.05) and moderated the association between care partner depressive symptoms and care partner physical (B=0.05, P <0.001) and psychological (B=0.04, P <0.001) QOL. The care partner’s own level of spirituality was significantly positively associated with their physical QOL (B=0.28, P <0.001). Conclusions: The findings from this study have broad implications for the role of spirituality in relation to QOL in medical-health contexts and the importance of examining such concepts within a dyadic framework. Greater awareness of the importance of spirituality among clinicians and nurses may improve cultural competence in healthcare services.

Person-centred care in individuals with stroke: a qualitative study using in-depth interviews

“…Personal dimensions, such as daily routines, social obligations and spirituality, should therefore be included [ 18 ]. Spirituality in individuals with stroke should also be considered within the person's globality, as it has direct repercussions on the perception of quality of life of individuals with stroke treated in the health service [ 46 , 47 ].…”

Role of Yoga and Spirituality in Stroke Rehabilitation

“…Meditation is a body-mind exercise that could be a cost-effective and useful technique for poststroke rehabilitation [21,23]. Though spiritual techniques are effective and less labor intensive, there is a lack of evidence-based review to support the claim.…”

“…As such studies relating to spirituality and rehabilitation for neurological illnesses are limited, much research is needed to evaluate their specific role [1,17]. Though higher levels of spirituality are known to be associated with a better quality of life (QOL) for people with neurodisability and their caregivers, most of the medical staff are not well equipped to administer it [20,21].…”

“…Thus, meditation and mind-body exercises are a novel therapeutic approaches to enhance cognitive capabilities and are effective in improving poststroke outcomes [11,21,22,26,39,40].…”

Influence of psychological responses of caregiving on the perceived health of family caregivers to acute stroke survivors

“…[12] Previous studies report that caregiver health is independently related to either signs of psychological distress, such as depressive symptoms and caregiving burdens, or the physical dependency of stroke survivors. [13,14] Nevertheless, the capability of caregiving resources (social support and family functioning) to buffer the influence of caregiving-related stressors on the physical and psychological health of caregivers was rarely considered. [15,16] Regarding social support, immediate family members, including spouses and children, have been identified as the most important individuals in the actual social networks of caregivers to stroke survivors.…”