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Effects of spiritual resilience on psychological distress and health-related quality of life in Chinese people with Parkinson’s disease

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Abstract

Purpose

Health-related quality of life (HRQOL) is an increasingly critical outcome of chronic illness care. However, its disease-independent attributes, particularly its spiritual resilient indicators, for people with Parkinson’s disease (PD) have not been explicitly examined. This study aimed to (i) assess the associations between psychological distress, spiritual resilience and HRQOL, and (ii) examine the mediating effects of spiritual resilience on psychological distress and HRQOL amongst individuals with PD.

Methods

This is a secondary data analysis of the baseline data of a clinical trial that involved 138 individuals with PD. The subjects completed a structured questionnaire assessing psychological distress in terms of anxiety and depression, spiritual resilience in terms of perceived affliction and perceived equanimity, severity of motor symptoms and disease-specific HRQOL.

Results

Analysis by independent t test suggested that distressed individuals with PD demonstrated less spiritual resilience and presented poorer HRQOL than non-distressed individuals with PD. Multiple linear regression models revealed that high emotional distress was associated with low spiritual resilience and poor HRQOL. The mediation analysis found that after simultaneously controlling for the degree of perceived affliction and perceived equanimity, a significant reduction was observed in the direct effect between psychological distress and HRQOL. This result indicated the partially mediating roles of perceived affliction and equanimity in the pathways between psychological distress and HRQOL.

Conclusion

In order to enhance HRQOL, PD interventions should address the spiritual resilience of patients in addition to providing psychological care and physical relief of symptoms.

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Funding

Nil.

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Authors and Affiliations

  1. School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR

    Jojo Yan Yan Kwok, Edmond Pui Hang Choi, Pui Hing Chau, Janet Yuen Ha Wong & Daniel Yee Tak Fong

  2. Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR

    M. Auyeung

Authors
  1. Jojo Yan Yan Kwok
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  2. Edmond Pui Hang Choi
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  3. Pui Hing Chau
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  4. Janet Yuen Ha Wong
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  5. Daniel Yee Tak Fong
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  6. M. Auyeung
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Contributions

JYYK had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: JYYK, EPHC; acquisition, analysis, or interpretation of data: JYYK, EPHC, PHC, JYHW, DYTF, MA; drafting of the manuscript: JYYK; critical revision of the manuscript for important intellectual content: JYYK, EPHC, PHC, JYHW, DYTF, MA; statistical analysis: JYYK, EPHC, PHCl; administrative, technical, or material support: JYYK, MA; study supervision: JYYK, MA.

Corresponding author

Correspondence to Jojo Yan Yan Kwok.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Ethics approval for this study was obtained from the Joint Chinese University of Hong Kong—New Territories East Cluster Clinical Research Ethics Committee (Joint CUHK-NTEC CREC) (Reference code: 2016.323-T).

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Kwok, J.Y.Y., Choi, E.P.H., Chau, P.H. et al. Effects of spiritual resilience on psychological distress and health-related quality of life in Chinese people with Parkinson’s disease. Qual Life Res 29, 3065–3073 (2020). https://doi.org/10.1007/s11136-020-02562-x

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  • DOI: https://doi.org/10.1007/s11136-020-02562-x

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