Babkair Lisa A, Chyun Deborah, Dickson Victoria Vaughan, Almekhlafi Mohammed A
PhD, RN, FAHA, FAAN, Professor, School of Nursing, University of Connecticut, USA.
PhD, RN, FAAN, FAHA, FHFSA, Associate Professor, Pless Center for Research, Rory Meyers College of Nursing, New York University, USA.
J Nurs Res. 2021 Oct 22;30(1):e189. doi: 10.1097/JNR.0000000000000464.
Stroke is the second leading cause of death and a major cause of serious, long-term disability worldwide. The approximately 15 million people each year who experience stroke are at risk of developing depression. Poststroke depressive symptoms affect one third of survivors of stroke. Patients who develop poststroke depressive symptoms experience decreased functional independence, poor cognitive recovery, decreased quality of life, and increased mortality. Survivors of stroke use social support to deal with stress and defend against the adverse effects of negative stroke outcomes.
This study was designed to examine the influence of perceived social support (emotional and informational, tangible, affectionate, and positive social interaction), stress level, and functional independence on depressive symptoms in survivors of stroke.
A cross-sectional observational study design in outpatient settings and rehabilitation centers was conducted. A convenience sample of 135 survivors of stroke completed the psychometrically valid instruments.
Most of the sample had mild or moderate depressive symptoms (26% and 29%, respectively). The mean score for perceived social support was 77.53 (SD = 21.44) on the Medical Outcomes Study Social Support Survey. A negative association was found between depressive symptoms and the social support total score (r = -.65, p < .01). All of the social support subcategories were negatively associated with depressive symptoms. Hierarchical multiple linear regression showed that social support, stress level, and literacy were associated with depressive symptoms (β = -.31, p < .001; β = .45, p < .001; and β = .16, p = .01, respectively) and partially mediated the association between depressive symptoms and functional independence.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Poststroke depressive symptoms are common among survivors of stroke. Social support may improve health by protecting these individuals from the negative outcomes of stroke and enhance their recovery. Future research is required to examine how related interventions improve social support in caregivers and reduce depressive symptoms in stroke survivors.
中风是全球第二大致死原因，也是严重长期残疾的主要原因。每年约有1500万人中风，他们有患抑郁症的风险。中风后抑郁症状影响三分之一的中风幸存者。出现中风后抑郁症状的患者功能独立性下降、认知恢复不佳、生活质量降低且死亡率增加。中风幸存者利用社会支持来应对压力并抵御中风负面结果的不利影响。
本研究旨在探讨感知社会支持（情感和信息、实际、亲情及积极社会互动）、压力水平和功能独立性对中风幸存者抑郁症状的影响。
在门诊和康复中心进行了一项横断面观察性研究设计。135名中风幸存者的便利样本完成了心理测量有效的工具。
大多数样本有轻度或中度抑郁症状（分别为26%和29%）。在医学结局研究社会支持调查中，感知社会支持的平均得分为77.53（标准差 = 21.44）。抑郁症状与社会支持总分之间存在负相关（r = -0.65，p < 0.01）。所有社会支持子类别均与抑郁症状呈负相关。分层多元线性回归显示，社会支持、压力水平和识字能力与抑郁症状相关（β = -0.31，p < 0.001；β = 0.45，p < 0.001；β = 0.16，p = 0.01），并部分介导了抑郁症状与功能独立性之间的关联。
结论/实践意义：中风后抑郁症状在中风幸存者中很常见。社会支持可能通过保护这些个体免受中风负面结果的影响来改善健康，并促进他们的康复。未来需要进行研究，以探讨相关干预措施如何改善照顾者的社会支持并减少中风幸存者的抑郁症状。
