Hopeful thinking, participation, and depressive symptoms three months after stroke

Abstract

This study was designed to examine hopeful thinking, depressive symptoms, and participation in meaningful activities and roles for survivors 3 months after stroke. It was predicted that: (a) participation would predict lower depressive symptoms; (b) higher hopeful thinking (i.e., beliefs in one's goal pursuit abilities) would predict lower depressive symptoms; and (c) higher hopeful thinking would predict better participation. Three months after stroke, 110 participants completed measures of disability, participation, depressive symptoms, and hopeful thinking. Contrary to the first hypothesis, participation did not independently predict depressive symptoms after controlling for more basic activity limitations (physical, memory, communication). As predicted, hopeful thinking was the strongest predictor of depressive symptoms. Hopeful thinking did not directly predict participation, but it moderated relationships of activity functioning to participation. Results suggest that participation and hopeful thinking may contribute to the understanding of post-stroke depressive symptoms, although additional research is needed to further elucidate such contributions.

Keywords:

• Stroke
• depressive symptoms
• disability
• participation
• hope

Acknowledgements

This project was supported by the American Heart Association Patient Care and Outcomes Research Program Award (9970089N) and the Claude D. Pepper Older Americans Independent Center Grant (AG-96-003). The following health facilities in the greater Kansas City area collaborated with us for patient recruitment: Baptist Medical Center, Bethany Hospital, Department of Veterans Affairs Medical Center at Kansas City, Independence Regional Health Center, John Knox Village Care Center, Liberty Hospital, Life Care Center of Grandview, Menorah Medical Center, Mid-America Rehabilitation Hospital, Overland Park Regional Medical Center, Rehabilitation Institute, Research Medical Center, Shawnee Mission Medical Center, Saint Luke's Medical Center, Saint Joseph Health Center, Trinity Lutheran Hospital, and University of Kansas Medical Center. The efforts of Denise Tyler, M.A., in data collection and management are greatly appreciated.

At the time this study was conducted, Amber Gum was in the Department of Psychology, University of Kansas, and Pamela W. Duncan was in the Center on Aging, University of Kansas Medical Center. Amber Gum is now at Department of Aging and Mental Health, University of South Florida, and Pamela Duncan is now at Brooks Center for Rehabilitation Studies, University of Florida. This project is based on the dissertation of Amber Gum, under the supervision of C.R. Snyder, PhD, at the University of Kansas.