School of Nursing, Oregon Health & Science University, Portland, OR, USA.
Child Development and Rehabilitation Center (CDRC), Portland, OR, USA.
J Adv Nurs. 2020 Jul;76(7):1627-1637. doi: 10.1111/jan.14374. Epub 2020 May 2.
To investigate the relationships between spirituality, somatic symptom distress/severity, depressive symptoms and quality of life (QOL) for adolescents diagnosed with spina bifida (SB).
Exploratory, cross-sectional design.
Fifty-eight adolescents with SB in southern California were recruited during routine visits to a multidisciplinary clinic at a healthcare university from January 2016-January 2017. Each adolescent completed a series of self-report measures, including the System of Belief Inventory, Somatic Symptom Scale, Patient Health Questionnaire and Pediatric Quality of Life Inventory. Path analysis was performed to examine regression coefficients for each direct and indirect effect.
The mediation-moderation analysis showed that depressive symptoms fully mediated the relationship between symptom distress and QOL (B = 0.029 [0.014], CI [0.007, 0.061]) and higher levels of spirituality moderated the relationship between depressive symptoms and QOL (B = 0.052, p = .018). Spirituality was higher for adolescents with greater symptom severity; including shunt status Welch's F(1, 53.689) = 4.174, p = .046, level of lesion F(2,57) = 3.382, p = .041, and ambulation status F(3, 57) = 2.920, p = .042.
Adolescents with SB who had greater levels of symptom distress experienced significantly higher levels of depressive symptoms and a lower QOL. Contrary to our expectations, adolescents with greater levels of spirituality had a lower QOL when depressive symptoms were mild/moderate, but no differences were noted when depressive symptoms were severe.
This study examined the relationship between spirituality and quality of life (QOL) in adolescents with spina bifida, who were experiencing different levels of depressive symptoms and symptom distress/severity. Depressive symptoms appeared to have a more profound effect on QOL than spirituality. Accordingly, we recommend that healthcare professionals actively screen for depressive symptoms when assessing these adolescents and their physical symptoms/distress levels.
调查精神信仰与躯体症状困扰/严重程度、抑郁症状和生活质量（QOL）之间的关系，研究对象为被诊断患有脊柱裂（SB）的青少年。
探索性、横截面设计。
2016 年 1 月至 2017 年 1 月，从南加州一家医疗保健大学的多学科诊所的常规就诊中招募了 58 名患有 SB 的青少年。每位青少年都完成了一系列自我报告量表，包括信仰系统量表、躯体症状量表、患者健康问卷和儿科生活质量量表。进行路径分析以检验各直接和间接效应的回归系数。
中介调节分析表明，抑郁症状完全中介了症状困扰与 QOL 之间的关系（B=0.029[0.014]，CI[0.007，0.061]），更高水平的精神信仰调节了抑郁症状与 QOL 之间的关系（B=0.052，p=0.018）。躯体症状越严重，青少年的精神信仰越高；包括分流状态 Welch 检验 F(1,53.689)=4.174，p=0.046，损伤水平 F(2,57)=3.382，p=0.041，以及步行状态 F(3,57)=2.920，p=0.042。
躯体症状困扰程度较高的 SB 青少年经历了更严重的抑郁症状和更低的 QOL。与我们的预期相反，当抑郁症状轻度/中度时，精神信仰程度较高的青少年 QOL 较低，但当抑郁症状严重时，两者之间没有差异。
本研究调查了精神信仰与脊柱裂青少年生活质量（QOL）之间的关系，这些青少年经历了不同程度的抑郁症状和躯体症状困扰/严重程度。抑郁症状对 QOL 的影响似乎比精神信仰更大。因此，我们建议医疗保健专业人员在评估这些青少年及其身体症状/困扰水平时，积极筛查抑郁症状。
