{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:49:55Z","timestamp":1772160595669,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T00:00:00Z","timestamp":1588377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate the relationships between spirituality, somatic symptom distress\/severity, depressive symptoms and quality of life (QOL) for adolescents diagnosed with spina bifida (SB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Exploratory, cross\u2010sectional design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010eight adolescents with SB in southern California were recruited during routine visits to a multidisciplinary clinic at a healthcare university from January 2016\u2013January 2017. Each adolescent completed a series of self\u2010report 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mediation\u2013moderation analysis showed that depressive symptoms fully mediated the relationship between symptom distress and QOL (\n                      <jats:italic>B<\/jats:italic>\n                      \u00a0=\u00a00.029 [0.014], CI [0.007, 0.061]) and higher levels of spirituality moderated the relationship between depressive symptoms and QOL (\n                      <jats:italic>B<\/jats:italic>\n                      \u00a0=\u00a00.052,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.018). Spirituality was higher for adolescents with greater symptom severity; including shunt status Welch's\n                      <jats:italic>F<\/jats:italic>\n                      (1, 53.689)\u00a0=\u00a04.174,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.046, level of lesion\n                      <jats:italic>F<\/jats:italic>\n                      (2,57)\u00a0=\u00a03.382,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.041, and ambulation status\n                      <jats:italic>F<\/jats:italic>\n                      (3, 57)\u00a0=\u00a02.920,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.042.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.14374","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T11:55:59Z","timestamp":1585914959000},"page":"1627-1637","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The moderating role of spirituality on quality of life and depression among adolescents with spina bifida"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1911-2753","authenticated-orcid":false,"given":"Asma A.","family":"Taha","sequence":"first","affiliation":[{"name":"School of Nursing Oregon Health &amp; Science University Portland OR USA"},{"name":"Child Development and Rehabilitation Center (CDRC) Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron M.","family":"Eisen","sequence":"additional","affiliation":[{"name":"Child Development and Rehabilitation Center (CDRC) Portland OR USA"},{"name":"Helfgott Research Institute National University of Natural Medicine Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hana Q.","family":"Abdul\u2010Rahman","sequence":"additional","affiliation":[{"name":"School of Nursing Oregon Health &amp; Science University Portland OR USA"},{"name":"Portland State University Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Zouros","sequence":"additional","affiliation":[{"name":"St. Luke\u2019s Children\u2019s Hospital St. Luke\u2019s Idaho Elk\u2019s Children\u2019s Pavilion Boise ID USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Norman","sequence":"additional","affiliation":[{"name":"School of Nursing Oregon Health &amp; Science University Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,2]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","first-page":"42","article-title":"Spirituality and quality of life in chronic illness","volume":"10","author":"Adegbola M.","year":"2006","journal-title":"The Journal of Theory Construction & Testing"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/22.5.707"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12367"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11456"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2019.01.007"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsp094"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-240X(200010)23:5<415::AID-NUR8>3.0.CO;2-H"},{"key":"e_1_2_9_9_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J. E.","year":"1988"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-032511-143108"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.78.1.98"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2006.00642.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/20.1.109"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0193208"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.12179"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198606000-00022"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1611(199811\/12)7:6<460::AID-PON328>3.0.CO;2-R"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/20.6.817"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/24.6.499"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-017-3691-8"},{"issue":"4","key":"e_1_2_9_22_1","first-page":"291","article-title":"Adolescent development and family functioning in youth with spina bifida","volume":"1","author":"Kelly L. M.","year":"2008","journal-title":"Journal of Pediatric Rehabilitation Medicine"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2005.07.003"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2005.03.026"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep443"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ajp.0000210929.43192.5d"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2012.09.007"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2016.1159142"},{"issue":"6","key":"e_1_2_9_30_1","first-page":"1016","article-title":"System of belief inventory (SBI\u201015R): A validation study in Italian cancer patients on oncological, rehabilitation, psychological and supportive care settings","volume":"96","author":"Ripamonti C.","year":"2010","journal-title":"Tumori Journal"},{"issue":"2","key":"e_1_2_9_31_1","first-page":"144","article-title":"Assessing health\u2010related quality of life in children with spina bifida","volume":"15","author":"Rocque B. G.","year":"2015","journal-title":"Journal of Neurosurgery"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-8454-3-S1-S36"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-312307"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2015.09.027"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2002.02417.x"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1367\/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199902000-00003"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/01612840500436941"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-11-98"}],"container-title":["Journal of Advanced Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjan.14374","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.14374","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jan.14374","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.14374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T06:03:48Z","timestamp":1693980228000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jan.14374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,2]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/jan.14374"],"URL":"https:\/\/doi.org\/10.1111\/jan.14374","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/JAN.14374\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v3\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.14374\/v3\/decision1","asserted-by":"object"}]},"ISSN":["0309-2402","1365-2648"],"issn-type":[{"value":"0309-2402","type":"print"},{"value":"1365-2648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,2]]},"assertion":[{"value":"2019-10-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}