The Moderating Role of Motivation in the Real-Time Associations of Fatigue, Cognitive Complaints, and Pain With Depressed Mood Among Stroke Survivors: An Ecological Momentary Assessment Study.
Stephen C L Lau, Lisa Tabor Connor, Elizabeth R Skidmore and 3 others
PMID 36535421WHAT IT FOUND
For stroke survivors, feeling tired, in pain, or mentally slow was linked to feeling depressed in the moment.
However, doing activities because they were personally meaningful, rather than out of pressure or obligation, weakened this link. Clinicians should support autonomous motivation.
Key findings
01Higher levels of physical fatigue, mental fatigue, cognitive complaints, and pain were associated with greater depressed mood.
02Autonomous motivation significantly moderated the associations of physical fatigue, mental fatigue, and pain with depressed mood, making these links weaker when motivation was higher.
03There was no significant interaction between motivation and cognitive complaints on depressed mood in the overall group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Small sample size (40 participants) and recruitment from a single registry. Participants had to own a smartphone and have mild-to-moderate stroke, excluding those with severe impairment, neglect, or significant communication barriers. Single-item EMA measures for mood and symptoms were not validated in stroke survivors. Study design is observational; it shows associations, not that increasing motivation causes a reduction in depressed mood.
Declared interests
Other authors declare no conflict of interest.
The easy way to misread this
Do not assume that simply telling patients to 'stay motivated' will reduce their depression. The study shows an association where autonomous motivation (doing things because you want to) buffers the mood impact of symptoms, but it did not test an intervention to increase motivation. Furthermore, this buffering effect did not hold for cognitive complaints in the main analysis.