Yejin Lee, PhD, is Postdoctoral Research Associate, Program in Occupational Therapy, School of Medicine, Washington University, St. Louis, MO;
Erin R. Foster, PhD, OTD, OTR/L, is Associate Professor, Program in Occupational Therapy, Department of Neurology and Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO.
Am J Occup Ther. 2024 Nov 1;78(6). doi: 10.5014/ajot.2024.050742.
Because depressive symptoms are momentarily associated with lower levels of participation poststroke, it is crucial to investigate what moderates such associations to identify a potential intervention target to reduce the momentary links between depressive symptoms and participation poststroke. Self-regulation seems to be a potential moderator of such associations.
To investigate the extent to which difficulties in self-regulation moderate the momentary associations between depressive symptoms and participation poststroke.
This study uses a real-time, repeated-measures design using smartphone-based ecological momentary assessment surveys five times a day for 10 days. We performed multilevel modeling to uncover the momentary associations among the study variables.
Community.
39 people with stroke.
We obtained real-time data for difficulties in self-regulation (total, cognitive, behavioral, and emotion regulation), depressive symptoms, and participation in daily activities (performance in daily activities and satisfaction with performing daily activities).
We included 1,612 survey responses in the analysis. Higher depressive symptoms were momentarily associated with lower levels of performance (β = -0.05 to -0.07, p < .001) and satisfaction (β = -0.04 to -0.06, p < .05), regardless of adjusting for self-regulation variables and other covariates. Difficulties in total self-regulation (β = -0.01, p < .001) and emotion regulation (β = -0.02, p < .001) magnified the negative associations between depressive symptoms and satisfaction with performing daily activities.
Using self-regulation and emotion regulation strategies may be a target for just-in-time intervention for reducing the momentary associations between depressive symptoms and satisfaction with performing daily activities poststroke. Plain-Language Summary: Depressive symptoms have immediate and real-time associations with lower levels of participation in daily activities in people with stroke. Self-regulation, including cognitive regulation (e.g., goal setting, planning strategies), behavioral regulation (e.g., controlling impulsive behaviors), and emotion regulation (e.g., managing negative feelings), may be an intervention target for reducing the immediate associations between depressive symptoms and lower levels of participation poststroke. Thus, we investigated whether difficulties in self-regulation variables magnify the negative real-time associations between depressive symptoms and participation poststroke. To obtain real-time data on difficulties in self-regulation variables, depressive symptoms, and participation (i.e., performance and satisfaction), we asked 39 community-dwelling people with stroke to answer smartphone surveys. The results showed that difficulties in total self-regulation and emotion regulation magnified the negative associations between depressive symptoms and satisfaction with performing daily activities. Our findings suggest that self-regulation and emotion regulation strategies may be a target for real-time intervention for reducing the momentary associations between depressive symptoms and satisfaction with performing daily activities poststroke.
由于抑郁症状与中风后参与度的降低有瞬时关联，因此研究什么因素可以调节这种关联以确定潜在的干预目标，从而减少中风后抑郁症状与参与度之间的瞬时联系至关重要。自我调节似乎是这种关联的一个潜在调节因素。
研究自我调节困难在多大程度上调节了抑郁症状与中风后参与度之间的瞬时关联。
本研究采用基于智能手机的实时、重复测量设计，每天进行五次、持续 10 天的生态瞬时评估调查。我们进行了多层次建模，以揭示研究变量之间的瞬时关联。
社区。
39 名中风患者。
我们实时获取了自我调节困难（总体、认知、行为和情绪调节）、抑郁症状和日常活动参与度（日常活动表现和对日常活动表现的满意度）的数据。
我们对 1612 次调查回复进行了分析。较高的抑郁症状与日常活动表现（β=-0.05 至-0.07，p<0.001）和满意度（β=-0.04 至-0.06，p<0.05）水平较低有瞬时关联，无论是否调整自我调节变量和其他协变量。总自我调节（β=-0.01，p<0.001）和情绪调节（β=-0.02，p<0.001）困难加剧了抑郁症状与对日常活动表现的满意度之间的负向关联。
使用自我调节和情绪调节策略可能是针对中风后抑郁症状与对日常活动表现的满意度之间瞬时关联的即时干预目标。
抑郁症状与中风患者日常活动参与度的降低有即时和实时的关联。自我调节，包括认知调节（例如，设定目标、制定策略）、行为调节（例如，控制冲动行为）和情绪调节（例如，管理负面情绪），可能是减少抑郁症状与中风后参与度降低之间即时关联的干预目标。因此，我们研究了自我调节变量的困难是否会放大抑郁症状与参与度之间的负实时关联。为了实时获取自我调节变量、抑郁症状和参与度（即表现和满意度）的数据，我们要求 39 名居住在社区的中风患者回答智能手机调查。结果表明，总自我调节和情绪调节困难加剧了抑郁症状与日常活动表现满意度之间的负相关。我们的研究结果表明，自我调节和情绪调节策略可能是减少中风后抑郁症状与日常活动表现满意度之间瞬时关联的实时干预目标。
