School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
BMC Psychiatry. 2024 Jun 14;24(1):448. doi: 10.1186/s12888-024-05906-w.
The incidence of Post Stroke Depression (PSD) in the Rehabilitation Stage is high, which can bring serious physical and psychological disorders to patients. However, there is still a lack of targeted tools for screening PSD in the rehabilitation stage. Therefore, the aim of this study was to evaluate the factor structure and reliability of a measurement instrument to screen for PSD in the rehabilitation stage.
A cross-sectional study was conducted on 780 hospitalized stroke patients who were within the rehabilitation stage from May to August 2020. Exploratory factor analysis (EFA) as well as first- and second-order confirmatory factor analysis (CFA) were performed to evaluate the factor structure of the newly developed Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS). The reliability and validity of the SMPSD-RS were also verified using several statistical methods.
EFA extracted a 24-item, five-factor (cognition, sleep, behavior, emotion, and obsession) model that can clinically explain the symptoms of PSD during the rehabilitation stage. A first-order CFA confirmed the EFA model with good model fit indices, and the second-order CFA further confirmed the five-factor structure model and showed acceptable model fit indices. Acceptable reliability and validity were also achieved by the corresponding indicators.
The SMPSD-RS was proven to have a stable factor structure and was confirmed to be reliable and valid for assessing PSD symptoms in stroke patients during the rehabilitation stage.
康复阶段脑卒中后抑郁（PSD）的发病率较高，会给患者带来严重的身心障碍。但是，目前康复阶段 PSD 的筛查尚缺乏针对性工具。因此，本研究旨在评估一种用于筛查康复阶段 PSD 的测量工具的结构和信度。
采用横断面研究，对 2020 年 5 月至 8 月期间在康复阶段的 780 例住院脑卒中患者进行研究。采用探索性因子分析（EFA）和一阶、二阶验证性因子分析（CFA），对新开发的康复阶段脑卒中后抑郁症状测量工具（SMPSD-RS）的因子结构进行评价。采用多种统计方法对 SMPSD-RS 的信度和效度进行验证。
EFA 提取出一个 24 项、五因子（认知、睡眠、行为、情绪和困扰）模型，可从临床角度解释康复阶段 PSD 的症状。一阶 CFA 验证了 EFA 模型，拟合指数良好，二阶 CFA 进一步验证了五因子结构模型，拟合指数可接受。相应指标也达到了可接受的信度和效度。
SMPSD-RS 具有稳定的因子结构，用于评估康复阶段脑卒中患者 PSD 症状具有良好的信度和效度。
