Surrey Community Health, Leatherhead, UK.
Disabil Rehabil. 2012;34(13):1114-20. doi: 10.3109/09638288.2011.636137. Epub 2011 Dec 8.
To develop screening protocols to detect depression and anxiety after stroke in a community setting and train therapists to administer them.
Psychologists and a community therapist met to design a system suitable for screening for anxiety and depression in all those with stroke, including people with cognitive and/or communication problems. Other therapists and a local user group were also consulted. Therapists were then trained in the use of the protocols. The ability to enact the protocols was assessed via case vignettes and staff experience, over a month-long trial.
It was considered appropriate for community therapists to screen patients and to do this within 4 weeks of first contact. Two protocols were designed, one for patients without significant communication/cognitive deficits and one for patients with these difficulties. Therapists applied the protocols with accuracy to the case vignettes and rated the training highly. No challenges in applying the protocols in the clinical setting were reported over an initial 1-month trial.
Two protocols to screen for depression and anxiety after stroke have been developed. These appear feasible for use when trialled via case vignette and in clinical practice. Further research might consider the usefulness of the screens in detecting actual clinical disorder and developing better screens to identify anxiety after stroke, particularly in those with a cognitive and/or communication disorder.
制定在社区环境中筛查中风后抑郁和焦虑的方案，并培训治疗师进行实施。
心理学家和社区治疗师共同设计了一个适合所有中风患者（包括认知和/或沟通问题患者）的焦虑和抑郁筛查系统。还咨询了其他治疗师和当地用户群体。然后，治疗师接受了使用方案的培训。在一个月的试验中，通过案例模拟和员工经验评估了治疗师实施方案的能力。
认为社区治疗师筛查患者是合适的，并且可以在首次接触后的 4 周内进行。设计了两个方案，一个适用于没有明显沟通/认知缺陷的患者，另一个适用于有这些困难的患者。治疗师准确地将方案应用于案例模拟，并对培训给予了高度评价。在最初的 1 个月试验中，没有报告在临床环境中应用方案时遇到的挑战。
已经制定了用于筛查中风后抑郁和焦虑的两个方案。通过案例模拟和临床实践的试验，这些方案似乎可行。进一步的研究可能会考虑这些筛查工具在检测实际临床障碍和开发更好的筛查工具以识别中风后焦虑方面的有效性，特别是针对那些存在认知和/或沟通障碍的患者。
