Higher spirituality linked to better quality of life for stroke survivors and their caregivers

Reviewed by James Ives, M.Psych. (Editor)May 26 2020

Higher spirituality among stroke survivors was strongly linked to better quality of life for them and their caregivers who may also feel depressed, according to new research published today in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal. May is American Stroke Month.

For many stroke survivors, a caregiver, often a family member or close friend, may help with daily tasks, making the survivor and the caregiver prone to depression. Depression can impact quality of life for both.

Roughly 200 stroke survivors in Italy, with low-to-medium disabilities and no other major health issues, and their caregivers completed questionnaires measuring spirituality, depression and quality of life between 2016 and 2018. Women and men were nearly equally represented among the stroke survivors, and their average age was 71 years. Among the caregivers, women comprised nearly two-thirds, and their average age was 52.

Spirituality is defined by the World Health Organization (WHO) as an 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.

Research shows that spirituality may help some patients cope with illness, yet few studies have looked at its effects on quality of life among stroke survivors and their long-term care partners, who are at increased risk for depression."

Gianluca Pucciarelli, Ph.D., FAHA, lead study author, research fellow at the University of Rome in Italy

Quality of life was measured with a 26-item WHO questionnaire on physical, psychological, social and environmental aspects.

In this analysis, those who scored one-standard deviation above average were considered to have "higher spirituality."

Researchers noted at baseline:

• A strong relationship between the degree of spirituality and quality of life even if caregivers were depressed.
• Stroke survivors who scored above average on the spirituality questionnaire reported higher psychological quality of life even when their caregivers reported symptoms of depression.
• Similarly, the caregivers with above-average spirituality scores reported better physical and psychological quality of life.
• In contrast, stroke survivors who scored below average on the spirituality questionnaire had lower quality of life, overall, as did their caregivers with depression symptoms.

"In summary, when care partners feel depressed, something that is common for stroke caregivers, the survivor's spirituality made the difference in whether this was associated with better or worse quality of life. This demonstrates the important protective role of spirituality in illness, and why we must study it more," Pucciarelli said.

He noted that the findings call for greater awareness on the importance of spirituality among health professionals.

"Our study emphasizes the importance of viewing stroke survivors holistically, as a patient with symptoms and disabilities, and as an individual with emotional needs and part of an interdependent unit with their care partner," Pucciarelli said.

The predominant religion in Italy is Roman Catholicism, which could have affected the results. Also, the study included only stroke survivors with low-to-medium disabilities and no other major health issues, so the study's findings may not apply to survivors with more severe disabilities or other underlying illnesses.