Roudebush Veterans Administration Medical Center, Health Services Research and Development Center on Implementing Evidence-Based Practice, Indianapolis, IN 46202, USA.
Arch Phys Med Rehabil. 2012 Jun;93(6):978-82. doi: 10.1016/j.apmr.2011.12.012. Epub 2012 Mar 20.
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.
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.
Hospital and patients' homes. The intervention was via phone calls.
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.
Not applicable.
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.
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.
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.
（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。
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。
医院和患者家中。干预措施是通过电话进行。
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。
不适用。
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。
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。
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。
