A study of whether individual and dyadic relations between spirituality and resilience contribute to psychological adjustment among individuals with spinal cord injuries and their family members

Abstract

Objective: To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members. Design: Prospective cross-sectional observational data were analyzed by structural equation modelling. Setting: Inpatient and community services at one rehabilitation hospital. Subjects: Individual with spinal cord injury ( n = 50) and family member ( n = 50) dyads. Interventions: Standard rehabilitation, both inpatient and community. Main measure(s): Functional assessment of chronic illness therapy – spiritual well-being scale – expanded, Connor–Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale–21, satisfaction with life scale. Results: Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members. Conclusion: Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.

Spirituality and resilience among family caregivers of survivors of stroke: A scoping review

“…In terms of the quantitative observational studies, the one finding of note was a weak positive association between spirituality and depression (Qiu & Li, 2018), and the authors speculated that this link might indicate that religion was a temporary escape mechanism but without providing long-term relief from the stresses of caregiving. However, observational studies among caregivers with SCI and TBI have found the opposite, with spirituality acting as a buffer or protective factor, either in direct association with depression (Simpson et al, 2020) or as mediated through resilience (Jones, Simpson, Briggs et al, 2019). So further research will be required to help clarify this issue among caregivers of people with stroke.…”

“…At a theoretical level, Smith and colleagues (2012) have asserted that healthy spirituality can contribute to better health out-comes, and this is supported by reviews of patient studies across the general health literature (Koenig, 2012). In the field of neurologic insult, initial studies that investigated the applicability of this research to the lives of family caregivers (after spinal cord injury (SCI) or traumatic brain injury (TBI)), found that spirituality had a protective (inverse) association to negative affect, depression and burden, and a positive association with positive affect (Jones et al, 2019;Simpson et al, 2020). These results reflect findings from studies among people with SCI or TBI which have found a positive association between spirituality and better life satisfaction, quality of life, and positive mental health (Jones et al, 2016;Jones et al, 2018).…”

“…Resilience can be defined as "a dynamic process encompassing positive adaptation within the context of significant adversity" (Luthar, Cicchetti, & Becker, 2000, p. 543), and can also play an important role in mediating outcomes for family caregivers after neurologic insult (Anderson, Daher, & Simpson, 2019). Empirical evidence for the relationship between spirituality and resilience among caregivers has been found in two recent observational studies of family caregivers after SCI and TBI (Jones et al, 2019;Simpson et al, 2020). Therefore, the span of the proposed review was broadened to include resilience.…”

Spinal cord injury and aging: an exploration of the interrelatedness between key psychosocial factors contributing to the process of resilience

“…Re-affirming relationship strength was found to mutually benefit both the individual with SCI, and the social support, founded by the ‘deepening of relationships’ (Jones et al, 2018 , p. 527). However, this finding is inconclusive as a later study by Jones, Simpson, Briggs, Dorsett, and Anderson ( 2019 ) found that no intercorrelation exists between spirituality and resilience of the individual with SCI, and their social supports. While an explanation for the lack of mutual dyadic benefits is not given, the authors note that this finding is inconsistent with similar studies employing qualitative methods (Jones et al, 2019 ).…”

“…However, this finding is inconclusive as a later study by Jones, Simpson, Briggs, Dorsett, and Anderson ( 2019 ) found that no intercorrelation exists between spirituality and resilience of the individual with SCI, and their social supports. While an explanation for the lack of mutual dyadic benefits is not given, the authors note that this finding is inconsistent with similar studies employing qualitative methods (Jones et al, 2019 ). Spirituality, as an inconclusive psychosocial contributor of resilience warrants further empirical examination.…”