The Association of Spirituality with Anxiety and Depression in Stroke Survivor-Caregiver Dyads: An Actor-Partner Interdependence Model

J Cardiovasc Nurs. 2021 Feb 28. doi: 10.1097/JCN.0000000000000798. Online ahead of print.


Background: Although several authors have analyzed the effects of spirituality on stroke survivors' physical functioning and on their own caregiver's outcomes, such as quality of life, only few authors have explored the interaction between spirituality and anxiety and depression using a dyadic approach.

Objectives: The aim of this study was to analyze the influence of spirituality in the stroke survivor-caregiver dyad and specifically on anxiety and depression in both parties.

Methods: A total of 217 stroke survivor-caregiver dyads were enrolled at discharge from several rehabilitation hospitals in central and southern Italy. The actor-partner interdependence model was used to analyze the dyadic data. To verify the differences in the effects between survivors and caregivers, comparisons were made between the χ2 values of the model in which actor and partner effects were constrained to be equal.

Results: The average age of stroke survivors and their caregivers at baseline was 71.2 and 52.7 years, respectively. Among the stroke survivors, there were slightly more men than women, whereas 65% of the caregivers were women. Most stroke survivors had had an ischemic stroke. Four statistically significant actor effects were identified. Higher survivors' and caregivers' spirituality was associated with higher survivor and caregiver anxiety. The only significant partner effect that was identified was the association between stroke survivor spirituality and caregiver depression.

Conclusions: This study highlights the importance of studying spirituality in the population with stroke. Spirituality seems to play an important protective role in both stroke survivors' and caregivers' depression but not in anxiety.