a Parkwood Institute , St. Joseph's Health Care London , London , Canada.
b Lawson Health Research Institute , Canada.
Top Stroke Rehabil. 2019 Jan;26(1):6-17. doi: 10.1080/10749357.2018.1536096. Epub 2018 Oct 22.
Post stroke depression (PSD) is common, and the transition home following discharge may be especially challenging for stroke survivors.
This study aimed to determine how well specific Canadian Best Practice Recommendations for PSD screening were adopted within a stroke rehabilitation outpatient clinic before and after the utilization of a standardized clinical form.
Practices were evaluated through retrospective chart review before and after the implementation of the standardized form which cued physicians to administer the Patient Health Questionnaire 9 (PHQ-9) at the first outpatient visit. Participants included those aged ≥18 years with a primary diagnosis of stroke.
One hundred thirty-five subjects' charts were reviewed. Form implementation was associated with increased rates of PSD screening (93.8% versus 0%) and charting regarding mood (55.4% versus 15.7%).
This study highlights the frequency of depressive symptoms in an outpatient cohort and demonstrates how screening rates can be improved by using a standardized form. Routine PHQ-9 completion at the first outpatient visit was associated with more physician-patient discussion and documentation regarding mood.
脑卒中后抑郁（PSD）较为常见，出院后返家期间对脑卒中幸存者来说可能极具挑战性。
本研究旨在评估在使用标准化临床表单前后，一家脑卒中康复门诊对加拿大 PSD 筛查最佳实践推荐的实施情况。
通过回顾性病历审查评估实施前后的实践情况，表单的使用促使医生在首次门诊就诊时使用患者健康问卷 9 项（PHQ-9）进行 PSD 筛查。参与者为年龄≥18 岁、主要诊断为脑卒中的患者。
共审查了 135 名患者的病历。实施表单后，PSD 筛查率（93.8%对 0%）和关于情绪的记录率（55.4%对 15.7%）均显著提高。
本研究凸显了门诊队列中抑郁症状的发生频率，并展示了使用标准化表单如何提高筛查率。首次门诊就诊时常规完成 PHQ-9 可促使医患更多地讨论和记录情绪。
