How is Spirituality Linked to Quality of Life in People with Spinal Cord Injury?
A spinal cord injury (SCI) is damage anywhere along the spinal cord, often due to an accident or other trauma. SCI typically causes a loss of movement and feeling below the damaged part of the spinal cord, often leading to paralysis and other changes in functioning. People with SCI may be more likely to develop depressed mood than members of the general population: Current research shows that up to 25 percent of people with SCI experience depression, and up to 12 percent report major clinical depression.
Spirituality is one resource that people use to cope with a major life change, such as having a SCI. While spirituality means different things to different people, past studies have found that people with stronger spiritual beliefs tend to be happier and less depressed after sustaining a SCI. In a recent NIDILRR-funded study, researchers looked at how two facets spirituality, having the sense of life meaning and inner peace, and having faith in God or a higher power, relate to happiness and quality of life in people with SCI.
Researchers at four SCI Model System Centers in Illinois, Michigan, and Washington surveyed 210 adults with SCI who were being considered for an antidepressant drug trial. The surveys included 12 questions about spiritual beliefs. Some of the questions assessed life meaning and inner peace, such as “I feel a sense of purpose in my life” and “I feel peaceful.” Other questions assessed faith, such as “I find comfort in my faith or spiritual beliefs” and “I know that whatever happens with my illness things will be OK.” Other questions on the survey asked about overall quality of life, mood during the past week, and symptoms of depression.
The researchers found that both dimensions of spirituality, sense of meaning or peace and faith in a higher power, were linked with higher quality of life and lower rates of depression. However, the meaning and peace dimension had a stronger link to quality of life and depression than the faith dimension. People with SCI who reported seeing their lives as more meaningful and having a greater sense of inner peace were happier and less likely to report symptoms of depression. According to the authors, this does not mean that faith is unimportant to well-being because many people could find a sense of meaning and peace through their religious beliefs and practices.
The authors emphasized the importance of spirituality during rehabilitation for people with SCI. A focus on spirituality, especially life meaning and peace, may be one way to help people come to accept a disability and make positive adaptations to it. Spirituality is not limited to one religious tradition, and even those individuals who are not religious can still benefit from a focus on life meaning and inner peace. The authors noted that, while spiritual matters may often be delegated to pastoral counselors, all clinicians can highlight their clients’ spiritual strengths and incorporate them into treatment. Further, a discussion of spiritual matters may be appropriate at all stages of SCI rehabilitation, including after discharge from the hospital setting.
The authors noted that, based on this particular survey, it was not clear whether spirituality causes improvements in mood or happier people tend to be more spiritual. However, the results of this study do highlight the strong relationships between spirituality, quality of life, and mood. Future studies could test the effects of spiritually-oriented programs on mood and quality of life in people with SCI. Clinicians may want to include discussions of spirituality with their patients to help them address issues of meaning and purpose and develop a positive approach to living with a disability.
To Learn More
The Model Systems Knowledge Translation Center (MSKTC) offers a variety of factsheets, videos, and hot topic modules for people with SCI, including a new factsheet on adjusting to life after injury.
Health, Employment, and Longevity Project at the Medical University of South Carolina focuses on promoting health, longevity, and quality of life after injury. More than 13,000 assessments have been conducted with more than 5,000 participants. Check out the research: http://academicdepartments.musc.edu/chp/Health_Employment_Longevity_Project/index.htm
The Paralysis Resource Center provides information, referral, and support resources for people living with paralysis, including spinal cord injury and dysfunction. Their collection of resources for people new to SCI is comprehensive and well-organized: https://www.christopherreeve.org/living-with-paralysis/newly-paralyzed
For professionals interested in incorporating discussions of spirituality and faith, we identified the following resources:
- The Spiritual Assessment from American Family Physician: http://www.aafp.org/afp/2012/0915/p546.html
- Spirituality and Medicine from Ethics in Medicine: https://depts.washington.edu/bioethx/topics/spirit.html
- Discussing Spirituality With Patients: A Rational and Ethical Approach from the Annals of Family Medicine: Discussing Spirituality With Patients: A Rational and Ethical Approach: http://www.annfammed.org/content/2/4/356.long
To Learn More About This Study
Wilson, C.S., Forchheimer, M., Heinemann, A.W., Warren, A.M., and McCullumsmith, C. (2016) Assessment of the relationship of spiritual well-being to depression and quality of life for persons with spinal cord injury . Disability and Rehabilitation, 2016. This article is available from the NARIC collection under Accession Number J73828.