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抑郁改善与卒中后社会角色功能有关。

Depression improvement is related to social role functioning after stroke.

机构信息

Roudebush Veterans Administration Medical Center, Health Services Research and Development Center on Implementing Evidence-Based Practice, Indianapolis, IN 46202, USA.

出版信息

Arch Phys Med Rehabil. 2012 Jun;93(6):978-82. doi: 10.1016/j.apmr.2011.12.012. Epub 2012 Mar 20.

Abstract

OBJECTIVES

To (1) examine the relationships between baseline demographic, clinical, and psychological characteristics and social role functioning (SRF) at 4 months after stroke, and (2) assess whether depression improvement is associated with 4-month SRF.

DESIGN

We completed a secondary data analysis using data from a completed cohort study including people with stroke with or without depression. We used multiple linear regression to identify variables independently associated with 12-week SRF.

SETTING

Hospital and patients' homes. The intervention was via phone calls.

PARTICIPANTS

People with a new stroke recruited during the inpatient stay (N=371, depressed only n=176). All survived an ischemic stroke, were 18 years and older, spoke and understood English, owned a telephone, had no severe language or cognitive impairments, and were expected to live at least 6 months.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

We measured depression with the Patient Health Questionnaire-9 (PHQ-9), and depression improvement was defined by a 50% decrease in PHQ-9 scores from baseline to 12 weeks or a 12-week PHQ-9 score <10. SRF was measured with the social domain of the Stroke-Specific Quality of Life Scale.

RESULTS

Depression and comorbidities were found to be independently associated with 12-week SRF. Importantly, depression response (or depression improvement) was the only variable to independently predict SRF in the depressed-only group.

CONCLUSIONS

Among stroke survivors with depression, improvement of that depression was independently associated with improved SRF. This is a reminder of the importance for rehabilitation providers to screen for and treat poststroke depression.

摘要

目的

(1)考察基线人口统计学、临床和心理特征与卒中后 4 个月社会角色功能(SRF)之间的关系,(2)评估抑郁改善是否与 4 个月的 SRF 相关。

设计

我们对一项完成的队列研究的数据进行了二次数据分析,其中包括有或没有抑郁的卒中患者。我们使用多元线性回归来确定与 12 周 SRF 独立相关的变量。

设置

医院和患者家中。干预措施是通过电话进行。

参与者

在住院期间招募的新发卒中患者(N=371,仅抑郁患者 n=176)。所有患者均经历过缺血性卒中,年龄在 18 岁及以上,能说且能理解英语,拥有电话,无严重语言或认知障碍,预计至少能存活 6 个月。

干预措施

不适用。

主要观察指标

我们使用患者健康问卷-9(PHQ-9)来衡量抑郁程度,抑郁改善定义为 PHQ-9 评分从基线到 12 周时下降 50%或 12 周 PHQ-9 评分<10。SRF 用卒中特定生活质量量表的社会领域来衡量。

结果

发现抑郁和合并症与 12 周 SRF 独立相关。重要的是,抑郁反应(或抑郁改善)是仅抑郁组中唯一能独立预测 SRF 的变量。

结论

在有抑郁的卒中幸存者中,抑郁的改善与 SRF 的改善独立相关。这提醒康复提供者筛查和治疗卒中后抑郁的重要性。

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