Advertisement
Archives of Physical Medicine and Rehabilitation
Advanced searchSave search
Research Article|Articles in Press

The moderating role of motivation in the real-time associations of fatigue, cognitive complaints, and pain with depressed mood among stroke survivors: An ecological momentary assessment study

  • Stephen C.L. Lau
    Correspondence
    Corresponding author: Stephen C.L. Lau, PhD, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, 100 Technology Drive, Suite 350, Pittsburgh, PA 15219, USA, Phone: 412-383-6620.
    Affiliations
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA

    Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
    Search for articles by this author
  • Lisa Tabor Connor
    Affiliations
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA

    Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
    Search for articles by this author
  • Elizabeth R. Skidmore
    Affiliations
    Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
    Search for articles by this author
  • Allison A. King
    Affiliations
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA

    Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

    Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA

    Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Department of Education, Washington University School of Medicine, St. Louis, MO, USA
    Search for articles by this author
  • Jin-Moo Lee
    Affiliations
    Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
    Search for articles by this author
  • Carolyn M. Baum
    Affiliations
    Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA

    Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA

    Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
    Search for articles by this author
Published:December 16, 2022DOI:https://doi.org/10.1016/j.apmr.2022.11.012
The moderating role of motivation in the real-time associations of fatigue, cognitive complaints, and pain with depressed mood among stroke survivors: An ecological momentary assessment study
Previous ArticleLetter to the Editor on “Effects of Electrical Stimulation Training on Body Composition Parameters After Spinal Cord Injury: A Systematic Review”
Next ArticleTactile Perception of the Hand in Children with an upper Neonatal Brachial Plexus Palsy

      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 seven days of ecological momentary assessment (EMA), during which participants completed eight EMA surveys per day. Multilevel modeling was used to analyze data.

      Setting

      Community.

      Participants

      Forty community-dwelling stroke survivors.

      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<0.001). Within-person autonomous motivation significantly buffered the momentary associations of physical fatigue (B=-0.06, p<0.001), mental fatigue (B=-0.04, p=0.032), and pain (B=-0.21, p<0.001) 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

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      Article info

      Publication history

      Accepted: November 17, 2022
      Received in revised form: October 19, 2022
      Received: August 17, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Acknowledgements: This study was supported by the Program in Occupational Therapy Dissertation Fund, Washington University in St. Louis.

      Conflict of interest: 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.

      Reprints are not available from the authors.

      Identification

      DOI: https://doi.org/10.1016/j.apmr.2022.11.012

      Copyright

      © 2022 by the American Congress of Rehabilitation Medicine.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX