Abstract
Objective
Stroke symptoms fluctuate during the day as stroke survivors participate in daily
activities. Understanding the real-time associations among stroke symptoms and depressed
mood, as well as the role of motivation for daily activities, informs, and post-stroke
symptom management in the context of everyday living. This study aimed to (1) investigate
the real-time associations of fatigue, cognitive complaints, and pain with depressed
mood and (2) examine the role of motivation for daily activity participation as a
potential moderator of these associations in stroke survivors.
Design
A prospective cohort study involving 7 days of ecological momentary assessment (EMA),
during which participants completed 8 EMA surveys per day. Multilevel modeling was
used to analyze data.
Setting
Community.
Participants
Forty community-dwelling stroke survivors (N=40).
Interventions
Not applicable.
Main Outcome Measures
EMA measures of depressed mood, stroke symptoms (physical and mental fatigue, cognitive
complaints, and pain), and motivation (autonomous motivation, controlled motivation).
Results
Higher levels of within- and between-person physical fatigue, mental fatigue, cognitive
complaints, and pain were momentarily associated with greater depressed mood (Ps<.001). Within-person autonomous motivation significantly buffered the momentary
associations of physical fatigue (B=-0.06, P<.001), mental fatigue (B=-0.04, P=.032), and pain (B=-0.21, P<.001) with depressed mood.
Conclusions
Findings indicate the momentary associations of fatigue, cognitive complaints, and
pain with depressed mood in stroke survivors. Autonomous motivation underpinning daily
activity participation was found to buffer the associations of fatigue and pain with
depressed mood. Promoting autonomous motivation for daily activity participation may
be viable for preventing and mitigating poststroke depression.
Keywords
List of abbreviations:
EMA (ecological momentary assessment), MLM (multilevel modeling), SDT (self-determination theory)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 16, 2022
Accepted:
November 17,
2022
Received in revised form:
October 19,
2022
Received:
August 17,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Disclosures: Elizabeth R. Skidmore received fundings from the National Institutes of Health, Australia National Health and Medical Research Council, National Institute of Disability Independent Living and Rehabilitation Research, Taiwan National Health Research Institute, National Science Foundation, and Canadian Institute of Health Research and payment or honoraria from University of Buffalo and University of Coloardo. Allison A. King received consulting payment from Global Blood Therapeutics planning a clinical trial unrelated to this project. Jin-Moo Lee received fundings from the National Institutes of Health. Other authors declare no conflict of interest.
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© 2022 by the American Congress of Rehabilitation Medicine.
