Vansimaeys Camille, Zuber Mathieu, Pitrat Benjamin, Join-Lambert Claire, Tamazyan Ruben, Farhat Wassim, Bungener Catherine
Laboratory of Psychopathology and Health Processes, Psychology Institute, Université Paris Descartes-Sorbonne Paris CitéParis, France.
Neurology and Neurovascular Department, Saint Joseph Hospital Group, Université Paris Descartes-Sorbonne Paris CitéParis, France.
Front Psychol. 2017 Jul 12;8:1172. doi: 10.3389/fpsyg.2017.01172. eCollection 2017.
Stroke has several consequences on survivors' daily life even for those who experience short-lasting neurological symptoms with no functional disability. Depression and anxiety are common psychological disorders occurring after a stroke. They affect long-term outcomes and quality of life but they are difficult to diagnose because of the neurobiological consequences of brain lesions. Current research priority is given to the improvement of the detection and prevention of those post-stroke psychological disorders. Although previous studies have brought promising perspectives, their designs based on retrospective tools involve some limits regarding their ecological validity. Ecological Momentary Assessment (EMA) is an alternative to conventional instruments that could be a key in research for understanding processes that underlined post-stroke depression and anxiety onset. We aim to evaluate the feasibility and validity of anxiety, depression and coping EMA for minor stroke patients. Patients hospitalized in an Intensive Neuro-vascular Care Unit between April 2016 and January 2017 for a minor stroke is involved in a study based on an EMA methodology. We use a smartphone application in order to assess anxiety and depression symptoms and coping strategies four times a day during 1 week at three different times after stroke (hospital discharge, 2 and 4 months). Participants' self-reports and clinician-rates of anxiety, depression and coping are collected simultaneously using conventional and standard instruments. Feasibility of the EMA method will be assessed considering the participation and compliance rate. Validity will be the assessed by comparing EMA and conventional self-report and clinician-rated measures. We expect this study to contribute to the development of EMA using smartphone in minor stroke population. EMA method offers promising research perspective in the assessment and understanding of post-stroke psychological disorders. The development of EMA in stroke population could lead to clinical implications such as remotely psychological follow-ups during early supported discharge. European Clinical Trials Database Number 2014-A01937-40.
中风对幸存者的日常生活会产生多种影响，即使是那些仅经历短暂神经症状且无功能残疾的患者。抑郁和焦虑是中风后常见的心理障碍。它们会影响长期预后和生活质量，但由于脑损伤的神经生物学后果，这些心理障碍很难诊断。当前的研究重点是改善中风后心理障碍的检测和预防。尽管先前的研究带来了有前景的观点，但基于回顾性工具的研究设计在生态效度方面存在一些局限性。生态瞬时评估（EMA）是传统工具的一种替代方法，可能是理解中风后抑郁和焦虑发作过程的研究关键。我们旨在评估针对轻度中风患者的焦虑、抑郁和应对EMA的可行性和有效性。2016年4月至2017年1月期间因轻度中风入住重症神经血管护理病房的患者参与了一项基于EMA方法的研究。我们使用一款智能手机应用程序，以便在中风后的三个不同时间（出院时、2个月和4个月），在1周内每天4次评估焦虑和抑郁症状以及应对策略。同时使用传统和标准工具收集参与者的焦虑、抑郁和应对的自我报告及临床医生评分。将通过考虑参与率和依从率来评估EMA方法的可行性。将通过比较EMA与传统自我报告及临床医生评分的测量结果来评估效度。我们期望这项研究能为在轻度中风人群中使用智能手机进行EMA的发展做出贡献。EMA方法在中风后心理障碍的评估和理解方面提供了有前景的研究视角。在中风人群中开发EMA可能会带来临床意义，例如在早期支持出院期间进行远程心理随访。欧洲临床试验数据库编号2014 - A01937 - 40。
