Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
School of Psychological Sciences, Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
Clin Rehabil. 2024 Jun;38(6):811-823. doi: 10.1177/02692155241232990. Epub 2024 Feb 22.
Post-stroke mental health impairments are common, but under-assessed and under-treated. We aim to describe trends in the provision of mood management to patients with stroke, and describe factors associated with adoption of national mood management recommendations for stroke within Australian hospitals.
Secondary analysis of cross-sectional data from the biennial Stroke Foundation Audit Program.
Participating acute (2011-2021) and rehabilitation hospitals (2012-2020) in Australia.
In the acute audit, 22,937 stroke cases were included from 133 hospitals. In the rehabilitation audit, 15,891 stroke cases were included from 127 hospitals.
Hospital- and patient-level mood management processes.
Among 133 acute hospitals (22,937 stroke episodes), improvements were made between 2011 and 2021 in utilization of mood screening (17% [2011], 33% [2021]; < 0.001) and access to psychologists during hospital stay (18% [2011], 45% [2021]; < 0.001). There was no change in access to a psychologist among those with a mood impairment (= 0.34). Among 127 rehabilitation hospitals (15,891 stroke episodes) improvements were observed for mood screening (35% [2012], 61% [2020]; < 0.001), and access to a psychologist during hospital stay (38% [2012], 68% [2020]; < 0.001) and among those with a mood-impairment (30% [2012], 50% [2020]; < 0.001). Factors associated with receiving mood management processes included: younger age, not requiring an interpreter and longer length of stay.
Adherence to mood management recommendations has improved over 10 years within Australian hospitals. Those aged over 65, requiring an interpreter, or with shorter hospital stays are at risk of missing out on appropriate mood management.
中风后心理健康受损较为常见，但往往评估不足和治疗不足。本研究旨在描述为中风患者提供情绪管理的趋势，并描述澳大利亚医院中风患者采用国家情绪管理建议的相关因素。
对两年一次的中风基金会审计项目的横断面数据进行二次分析。
澳大利亚参与的急性（2011-2021 年）和康复医院（2012-2020 年）。
急性审计中，来自 133 家医院的 22937 例中风病例被纳入研究；康复审计中，来自 127 家医院的 15891 例中风病例被纳入研究。
医院和患者层面的情绪管理流程。
在 133 家急性医院（22937 例中风病例）中，2011 年至 2021 年期间，情绪筛查的使用率（17%[2011 年]，33%[2021 年]；<0.001）和住院期间获得心理学家帮助的机会（18%[2011 年]，45%[2021 年]；<0.001）均有所提高。情绪障碍患者获得心理学家帮助的机会没有变化（=0.34）。在 127 家康复医院（15891 例中风病例）中，情绪筛查（35%[2012 年]，61%[2020 年]；<0.001）和住院期间获得心理学家帮助的机会（38%[2012 年]，68%[2020 年]；<0.001）都有所改善，情绪障碍患者获得帮助的机会也有所改善（30%[2012 年]，50%[2020 年]；<0.001）。与接受情绪管理流程相关的因素包括：年龄较小、不需要口译员和住院时间较长。
在澳大利亚医院，10 年来对情绪管理建议的遵循情况有所改善。65 岁以上、需要口译员或住院时间较短的患者可能会错过适当的情绪管理。
