Defining Spiritual Wellbeing in Survivors of Stroke: A Convergent Parallel Mixed Methods Study

 You blithering idiots wouldn't need this if you just created 100% recovery protocols! I don't think any stroke medical 'professionals' have two neurons to rub together for a spark of intelligence!

Defining Spiritual Wellbeing in Survivors of Stroke: A Convergent Parallel Mixed Methods Study

Devanshi Choksi, MBBS, MPH https://orcid.org/0009-0009-6312-5621, 

Mary Craven, MSc, 

Taylor McVeigh, BS, 

Akashleena Mallick, MBBS https://orcid.org/0000-0001-9805-7985, 

Tanzeela Ranman, MBA, 

Christina Kourkoulis, BS https://orcid.org/0000-0001-6330-9169, 

Sofia Constantinescu, BS, … Show All … , and 

Nirupama Yechoor, MD, MSc https://orcid.org/0000-0001-6479-9155 nyechoor@mgh.harvard.eduAuthor Info & Affiliations

 

Abstract

Background

Stroke recovery involves adapting to physical impairments, emotional distress(Provide 100% recovery protocols and you remove that distress about not recovering. CAN'T YOU IDIOTS THINK AT ALL?), and uncertainty about the future. Survivors of stroke may rely on spirituality and spiritual wellbeing practices to cope with illness. However, how survivors of stroke experience spiritual wellbeing remains unexplored. This study aimed to explore spiritual wellbeing in survivors of stroke and identify associated practices.

Methods

A convergent parallel mixed methods study using virtual focus groups with survivors of stroke and caregivers and survey data on spirituality using the All of Us research database was completed from October 2023 to February 2025. The framework method was used for qualitative data analysis and a 7‐item spirituality survey completed by survivors of stroke was analyzed from the All of Us research database using descriptive statistics. Data sets were integrated through joint displays to assess coherence.

Results

A total of 41 participants completed 6 focus groups. In this context, spirituality was defined as trust in a higher power and maintaining emotional balance. Focus groups identified spiritual wellbeing practices, including mindfulness, prayer, and spending time in nature. These findings converged with survey data (n=5428), with 70% of respondents endorsing connection with god/higher power. Spiritual practices extended beyond religious services, as 51.7% of respondents reported they did not attend religious services as a practice. Spending time in nature was a common practice, with 90.4% of respondents feeling spiritually touched by nature at least occasionally.

Conclusions

Spiritual wellbeing and its practices are important to survivors of stroke and can serve as a foundation for targeted interventions in poststroke care(NOT RECOVERY!). Future research should investigate spiritual wellbeing in diverse populations to develop tailored interventions for survivors of stroke.

The Personality Trait Linked To Good Mental Health

I have almost no spiritual beliefs, nothing outside of myself and my friends will improve my already great mental health.

The Personality Trait Linked To Good Mental Health

This type of people are less likely to be neurotic.

People who are more spiritual have better mental health, psychological, research finds.

Spiritual people feel a greater connection with the rest of the universe.

Being spiritual may boost people’s mental health because it reduces self-centredness.

Dr Dan Cohen, the study’s first author, said:

“In many ways, the results of our study support the idea that spirituality functions as a personality trait.

With increased spirituality people reduce their sense of self and feel a greater sense of oneness and connectedness with the rest of the universe.

What was interesting was that frequency of participation in religious activities or the perceived degree of congregational support was not found to be significant in the relationships between personality, spirituality, religion and health.”

Three surveys asked people about their personality, spirituality and mental and physical health.

The study included Protestants, Catholics, Jews, Muslims and Buddhists.

The results showed that people with faith had lower levels of neuroticism, which indicates better mental health.

Spiritual people were also more likely to be extraverted.

Dr Cohen said:

“Our prior research shows that the mental health of people recovering from different medical conditions, such as cancer, stroke, spinal cord injury and traumatic brain injury, appears to be related significantly to positive spiritual beliefs and especially congregational support and spiritual interventions.

Spiritual beliefs may be a coping device to help individuals deal emotionally with stress.”

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

Not for me.  Don't let your doctor use this as a get out of jail free card for not getting you 100% recovered.  A statement from my parents that 'God doesn't give you anything more than you can handle'. A God that is that evil tipped me completely into atheism and I relied on my own internal strengths to get where I am today.

 

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

Gianluca Pucciarelli

,

Ercole Vellone

,

Tatiana Bolgeo

,

Silvio Simeone

,

Rosaria Alvaro

,

Christopher S. Lee

,

Karen S. Lyons

Originally published26 May 2020https://doi.org/10.1161/CIRCOUTCOMES.119.006129Circulation: Cardiovascular Quality and Outcomes. ;0

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.

Footnotes

Gianluca Pucciarelli, PhD, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. Email gianluca.pucciarelli@uniroma2.it

Stroke survivors, caregivers may benefit from spirituality

Not me.  Don't let your doctor use this as a get out of jail free card for not getting you 100% recovered.  A statement from my parents that 'God doesn't give you anything more than you can handle'. A God that is that evil tipped me completely into atheism and I relied on my own internal strengths to get where I am today.

Stroke survivors, caregivers may benefit from spirituality

Pucciarelli G, et al. Circ Cardiovasc Qual Outcomes. 2020;doi:10.1161/CIRCOUTCOMES.119.006129.

May 26, 2020

Spirituality improved quality of life for patients who survived stroke and for their caregivers who reported depressive symptoms, according to a study published in Circulation: Cardiovascular Quality and Outcomes.

“The results of this study highlight the protective role of spirituality understood not as religiosity, but as the individual’s perception of life within the context of the culture and value systems of the society and in relation to the individual’s goals, expectations, standards and concerns,” Gianluca Pucciarelli, PhD, FAHA, research fellow at the University of Rome, told Healio. “Spirituality seems to be a coping variable that ‘moderates’ the effect of psychological variables (ie, depression) on individual variables (ie, quality of life). Being a coping variable, spirituality may alter the meaning of the events, making them less stressful in nature, moderate the negative associations leading to problems or manage the level of emotional response to stressors.”

See Also

• PTSD increases long-term MI, stroke risk in World Trade Center response crews
• Midlife fitness helps prevent later depression, CVD mortality
• Parent-child psychotherapy effective for early childhood depression

Researchers analyzed data from 213 dyads of stroke survivors (mean age, 71 years; 49% women) and their care partners (mean age, 52 years; 66% women) who were enrolled at discharge from 10 rehabilitation hospitals in Italy. Care partners were defined as those who provided most of the informal care for the stroke survivor. Dyads were followed up every 3 months for 1 year.
Several measures were taken during the study for the stroke survivor and care partner, including anxiety, depression and spirituality. Researchers also assessed physical, environmental, social and psychological quality of life.
The spirituality of the stroke survivor significantly weakened the link between a care partner’s depressive symptoms and the psychological quality of life of the survivor (beta = 0.05; P < .001). This specifically focused on the significant interaction between depressive symptoms of the care partner and the survivor’s spirituality (effect size = 0.24). A similar effect related to spirituality was also observed for the care partner’s baseline psychological quality of life (beta = 0.04; P < .001), with a significant interaction between depressive symptoms of the care partner and the spirituality of the survivor (effect size = 0.24).
Spirituality of the care partner was linked to their physical quality of life at baseline (beta = 0.28; P < .001).

“Our study emphasizes the importance for clinicians to view survivors holistically; not just as a patient with symptoms and disabilities, but also as an individual made up of emotional needs, suffering, hopes, faith, religious beliefs and desires, and also part of an interdependent unit with their caregivers,” Pucciarelli said in an interview. “Usually in the international context, there is a tendency to put the patient at the center of care, but it would be advisable to change the thinking strategy. We should start developing projects that may put the dyad at the center of care and not only the patient, because as we have seen, stroke does not impact only on the survivors’ life.” – by Darlene Dobkowski

For more information:

Gianluca Pucciarelli, PhD, FAHA, can be reached at gianluca.pucciarelli@uniroma2.it.

The Type of Spirituality Linked to Healthier Mind And Body

I'm an outlier then because I have no spiritual belief. One of my psychologists in the hospital tried to get me to answer whether I believed my body failed me by having the stroke. I said no and the more I thought about it the more it became obvious that my body is what saved my life. My excellent physical condition, my brain reserve from learning new programming languages often. My mental health is excellent.
http://www.spring.org.uk/2015/10/the-type-of-spirituality-linked-to-healthier-mind-and-body.php?
People who believe God loves them and forgives them have better mental health, a new study finds.
In contrast, those who hold negative spiritual beliefs tend to have worse mental health.
Negative spiritual beliefs include believing that God is punishing you or feeling abandoned.
Professor Brick Johnstone, one of the study’s authors, said:

“In general, the more religious or spiritual you are, the healthier you are, which makes sense. ( I see no reason for why this statement should be assumed true.)
But for some individuals, even if they have even the smallest degree of negative spirituality — basically, when individuals believe they’re ill because they’ve done something wrong and God is punishing them — their health is worse.”

More at link.

“I Should Be Closer To God Because of This”—A Case Study of Embodied Narratives and Spiritual Reconstruction in Spinal Cord Injury and Stroke Rehabilitation

Well they could write up a case study on me and it would come to the complete opposite conclusion. A statement from my parents that 'God doesn't give you anything more than you can handle'. A God that is that evil tipped me completely into atheism and I relied on my own internal strengths to get where I am today.

“I Should Be Closer To God Because of This”—A Case Study of Embodied Narratives and Spiritual Reconstruction in Spinal Cord Injury and Stroke Rehabilitation

DOI:

10.1080/23312521.2014.990551

Robert Mundle^a*

pages 30-49

Publishing models and article dates explained

• Published online: 12 Mar 2015

Article Views: 1

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Abstract

This instrumental case study demonstrates the need for patients to be able to draw upon their own spiritual and religious vocabularies in order to reconstruct narrative self-continuity in the wake of debilitating illness. Through the presentation of case material taken from a series of semi-structured interviews with a 77-year-old female Roman Catholic patient who suffered a crisis of faith following a spinal cord injury and a stroke, the author illustrates key aspects of life history and religious beliefs and practices—such as lives of the saints, devotions, mystical experiences, sacred time, sacred symbols, and sacred space—to engage narrative ethics around typologies and therapeutic plots supplied by others. Narrative analysis of such discursive resources from the perspective of spiritual health can help inter-professional healthcare teams understand more fully patient needs and holistic best practices within rehabilitation environments.

The University leads research and teaching into spirituality in health care to give people “hope, meaning and purpose”

For us stroke survivors hope is pretty much out of reach since only 10% get to full recovery. I most definitely am not a spiritual person, yet I have a definite meaning and purpose. I really dislike this focus because it seems to focus on  just another version of getting better at breaking bad news            rather than getting people to 100% recovery. 'We don't know anything about how to get you recovered, but look over here, you can still have a meaning and purpose to life'. Man I hate that type of condescending tripe.

The University leads research and teaching into spirituality in health care to give people “hope, meaning and purpose”

The term ‘spirituality’ is now widely used to describe the qualities that give people hope, meaning and purpose.  In the case of patients, it can aid their recovery.  The University of Huddersfield has become a key centre for research into spirituality and how it can be integrated into health care teaching and practice.
Articles, overseas conference presentations and now close links with an NHS trust are among the recent outputs and activities of the University’s Spirituality Special Interest Group, based in the School of Human and Heath Sciences.  Established for ten years, the group has also run a series of master classes for health and social care practitioners.
Spirituality is embedded in a wide range of undergraduate courses – covering subject areas such as psychology, social work, nursing, physiotherapy and occupational therapy – and four PhD students are currently carrying out research on spirituality in health care.  Also, plans are being made for a 2015 conference on the subject.
Melanie Rogers is a Senior Lecturer and Advanced Nurse Practitioner at the University and one of the leaders of the special interest group, alongside Professor John Wattis and Senior Lecturer Janice Jones. She admits that many people regard spirituality as a nebulous term, or one that is often conflated with religion. However, she says, spirituality is intensely practical.
“It helps to sustain health care workers and patients by recognising and supporting a sense of meaning and purpose in life.  It can improve resilience in patients and practitioners alike, in addition to improving the experience of illness and crisis in patients.”
She acknowledges that for some people, spirituality derives from religious beliefs. But for many others it stems from factors such as their relationships, community connections and special interests.
The University’s special interest group is now a “spiritual partner” of the South West Yorkshire Partnership NHS Foundation Trust, which provides community, mental health and learning disability services in Barnsley, Calderdale, Kirklees and Wakefield.  It has embedded spirituality into its work.
“Spirituality and the practitioners approach to their patients play a huge part in recovery from illness,” said Melanie Rogers, whose recent co-authored articles include an evaluation of therapeutic optimism, dealing with the role played by a practitioner’s belief in a patient’s recovery.
“Patients can lose optimism, but the practitioner needs to try and facilitate it.  One way is to spend time listening to the patient – being fully present and engaged in the relationship. Spirituality is about the patient being the focus and it is very practical, not at all airy fairy, and we know it sustains health care workers and patients,” said Ms Rogers, who has been invited to join the executive of the British Association for the Study of Spirituality.
Her most recent article is ‘Health care lecturers’ perceptions of spirituality in education’, in the leading journal Nursing Standard presenting research carried out at the University originally led by Dr Sharon Prentis, a former member of staff.  Her co-authors were University of Huddersfield colleagues Professor Wattis, Dr John Stephenson and Janice Jones.  Also, Melanie Rogers and Janice Jones have presented at conferences on spirituality that have taken place in the UK and overseas.
Although spirituality is gaining increasing recognition, it is still not spread evenly across the spectrum of health care.
“Occupational therapy has taken a lead, and there is growing amount of evidence in the fields of mental health and palliative care, but many of the other disciplines struggle to know how to integrate it into their care,” said Melanie Rogers.  Research and teaching at the University of Huddersfield aims to correct this imbalance.
http://www.hud.ac.uk/news/2014/november/spiritualityplayshugepartinpatientsrecoveryfromillness.php

Does Spirituality and Religion Guard Against Depression?

I doubt I've been depressed a day in my life. My parents comments during my hospital stay, ' God doesn't give you anything more than you can handle', pretty much completely tipped me into atheism. And I would never consider myself spiritual.

Does Spirituality and Religion Guard Against Depression?

This line will make Amy happy or mad depending on how clinicians listen to her insights on Kundalini yoga mediatation.
A 2005 study suggests that a daily meditation practice can increase cortical thickness, which is in line with Miller’s findings regarding depression.