1
|
Ayasrah SM, Ahmad MM, Abuadas FH, Abu-Snieneh HM, Basheti IA. Health-Related Quality of Life Among Patients With Stroke: A Cross-Sectional Study. Arch Clin Neuropsychol 2024; 39:659-668. [PMID: 38364311 DOI: 10.1093/arclin/acae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 02/18/2024] Open
Abstract
PURPOSE To assess levels and predictive factors of health-related quality of life (HRQOL) among stroke patients. METHODS The study employed a cross-sectional predictive correlational design. Levels of HRQOL were assessed using the Stroke-Specific Quality of Life (SS-QOL) scale, and the Hospital Anxiety and Depression Scale was employed to assess psychological aspects among 209 Saudi stroke patients. The analysis included demographic and medical variables to comprehensively explore influencing factors. RESULTS A two-step hierarchical multiple regression analysis was performed. The overall SS-QOL summary score (49 items) showed a mean score of 94.4 (SD = 8.1), indicating poor functioning. Nine predictor variables were found to significantly predict HRQOL levels, including age (β = -0.212, p ≤ .001), female (β = -5.33, p ≤ .001), unmarried (β = 2.48, p ≤ .001), low gross monthly income (GMI) (β = -9.02, p ≤ .001), medium GMI (β = -8.36, p ≤ .001), having a medical history of hypertension (β = 2.7, p ≤ .01), time since stroke (β = 3.26 p ≤ .001), and being a probable case of anxiety (β = -4.29, p ≤ .001) and/or depression (β = -2.75, p ≤ .001). These variables collectively explained ~76% of the variance in HRQOL scores (adjusted R2 = .762, F (16,192) = 42.6, p ≤ .001). CONCLUSIONS Stroke patients exhibited poor HRQOL levels influenced by various factors. Clinicians should consider these predictors and intervene early to enhance HRQOL among patients at risk, emphasizing the importance of optimizing patient outcomes.
Collapse
Affiliation(s)
- Shahnaz M Ayasrah
- Department of Applied Science/Nursing, Al-Balqa Applied University, Al-Salt, Jordan
| | - Muayyad M Ahmad
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Fuad H Abuadas
- College of Nursing, Community Health Nursing Department, Jouf University, Sakaka, Saudi Arabia
| | | | | |
Collapse
|
2
|
Horn J, Simpson KN, Simpson AN, Bonilha LF, Bonilha HS. The Relationship Between Poststroke Dysphagia and Poststroke Depression and Its Risk Factors. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-13. [PMID: 39088240 DOI: 10.1044/2024_ajslp-23-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE A diagnosis of dysphagia and/or depression after stroke can impact the physical, psychological, and social welfare of stroke survivors. Although poststroke depression (PSD) and poststroke dysphagia are known to occur concurrently, there is a paucity of research that has specifically investigated their association. Therefore, we aimed to study the relationship between PSD and poststroke dysphagia during acute inpatient hospitalization and within 90 days after discharge. Furthermore, we aimed to evaluate the odds and hazard of being diagnosed with depression after stroke and estimate the time to depression diagnosis from the initial stroke diagnosis in patients with and without a diagnosis of dysphagia. METHOD Using the acute inpatient hospital data set from our previous work, we pulled additional postdischarge administrative claims data from the 2017 Medicare 5% Limited Data Set and conducted a retrospective, cross-sectional study of patients diagnosed with poststroke dysphagia and PSD. RESULTS Patients diagnosed with poststroke dysphagia had 2.7 higher odds of being diagnosed with PSD and had an approximately 1.75-fold higher hazard for PSD diagnosis in the 90 days after discharge compared to patients not diagnosed with dysphagia. Risk factors for PSD included having dysphagia, being female, and having dual eligibility. CONCLUSIONS Our results demonstrated a significant association between PSD and poststroke dysphagia. Additional research should further explore the impact of PSD on poststroke dysphagia.
Collapse
Affiliation(s)
- Janet Horn
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston
| | - Kit N Simpson
- Department of Healthcare Leadership & Management, College of Health Professions, Medical University of South Carolina, Charleston
| | - Annie N Simpson
- Department of Healthcare Leadership & Management, College of Health Professions, Medical University of South Carolina, Charleston
| | - Leonardo F Bonilha
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston
- Department of Neurology, School of Medicine, University of South Carolina, Columbia
| | - Heather S Bonilha
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia
| |
Collapse
|
3
|
Liu Z, Zhang Z, Wang J, Ge S, Zhang W, Xiang D, Liu Q, Budu JT, Lin B, Chen S, Xue L, Mei Y. Depressive Symptoms in Young and Middle-Aged Stroke Patients: A Transition Analysis. Nurs Res 2024; 73:149-157. [PMID: 37916850 DOI: 10.1097/nnr.0000000000000703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND There is heterogeneity in depressive symptoms. However, latent classes of depressive symptoms and the transition and influences of these in young and middle-aged stroke patients are unclear. OBJECTIVES The aim of this study was to identify the latent classes of depressive symptoms and their transition patterns over time and the influencing factors in young and middle-aged stroke patients from stabilization to 6 months after discharge. METHODS This is a longitudinal study following the Strengthening the Reporting of Observational Studies in Epidemiology checklist. A total of 272 young and middle-aged stroke participants were recruited from a hospital neurology ward in Henan Province, China. Participants completed a questionnaire on sociodemographic and health information. Latent transition analysis was used to evaluate the transition pattern of latent classes from stabilization to 6 months after discharge and its influencing factors. RESULTS One hundred seventy-nine participants were included in the analysis. Three latent classes of depressive symptoms were identified as "mild symptoms," "grief-sleep-fatigue symptoms," and "severe symptoms." Most participants remained in the original latent class from stabilization to 6 months after discharge (probability of 83.8%, 83.8%, and 88.8%). From 3 to 6 months after discharge, the participants with fewer complications were more likely to transition into the mild symptom class. DISCUSSION The findings indicate that from stabilization to 6 months after discharge, depressive symptoms in young and middle-aged stroke patients in China transitioned gradually from the severe symptom class to the mild symptom. Patients with fewer numbers of poststroke complications were more likely to transition to the mild symptoms class. Future research should focus on depressive symptoms in early-stage stroke patients and provide sufficient psychological support to patients with a high number of complications.
Collapse
|
4
|
Wang B, Ding XX, Zhang H, Liu ZM, Duan PB, Dong YF. Predictors of post-stroke depression: the perspective from the social convoy model. Psychogeriatrics 2023; 23:864-875. [PMID: 37464888 DOI: 10.1111/psyg.13011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Post-stroke depression (PSD) as one of the most common neuropsychiatric disorders after a stroke and is caused by many factors. However, the relationships among different factors and their potential contributions to PSD remain unclear. METHODS Two hundred and seventy-six patients were recruited into this study. The general information questionnaire, the Patient Health Questionnaire-9, the Perceived Social Support Scale, the Family Assessment Device, the General Well-Being Scale, the Barthel Index, and the modified Rankin Scale were used to assess the condition of patients. Subsequently, we identify the main causes associated with the PSD and then performed a path analysis to clarify the direct, indirect and total effects among the variables. RESULTS We found that age, stroke with coronary heart disease, neurological function, family function, social support, and general well-being had a significant impact on PSD (P < 0.05). Of these, neurological function had the largest total effect on PSD (β = 0.451), social support contributed the most as a direct effect (β = -0.306), and family function showed the largest indirect effect (β = -0.264). CONCLUSION Individual, disease, and social-psychological factors all contributed to the development of PSD. We should pay more attention to comprehensive assessment, especially for those with poor neurological function, and lacking family or social support. In addition, it would be preferable to provide them with necessary support and care strategies to reduce the incidence of PSD.
Collapse
Affiliation(s)
- Bin Wang
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing-Xing Ding
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Heng Zhang
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-Min Liu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Pei-Bei Duan
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yin-Feng Dong
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| |
Collapse
|
5
|
Yin S, Li N, Wang Y. Prognostic value of Type D personality for post-stroke depression in ischemic stroke patients. J Affect Disord 2023; 333:172-176. [PMID: 37086794 DOI: 10.1016/j.jad.2023.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Depression in patients with stroke has been a risk factor for adverse outcomes. Type D personality as a significant predictor of negative psychological status. However, the relationship with post-stroke depression (PSD) is still unclear. METHODS A prospective observational study of 533 patients with first-ever ischemic stroke was conducted between November 2020 and March 2021. Type D personality was assessed at baseline. The presence of depression was measured 3-month after discharge. RESULTS During 3-month follow-up, a total of 141 patients developed PSD. On multivariate logistic analysis, the main effect of negative affectivity (OR = 1.28, 95%CI = 1.03-1.61, p = 0.030) and social inhibition (OR = 1.25, 95%CI = 1.01-1.54, p = 0.039) showed significant correlation with PSD when Type D analyzed as continuous variables. Furthermore, positive effects were found for the negative affectivity and social inhibition interaction (OR = 1.31, 95 % CI =1.11-1.55, p = 0.001) on PSD. CONCLUSIONS Our findings suggest that Type D personality is high risk group of PSD. These findings highlight the importance of personalized interventions management in Type D individuals.
Collapse
Affiliation(s)
- Shi Yin
- Department of neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Na Li
- Office of administration of the Public Health Institute of Harbin Medical University, Harbin, China
| | - Yini Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
| |
Collapse
|
6
|
Lin HL, Sung FC, Muo CH, Chen PC. Depression Risk in Post-Stroke Aphasia Patients: A Nationwide Population-Based Cohort Study. Neuroepidemiology 2023; 57:162-169. [PMID: 36972565 DOI: 10.1159/000530070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/22/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION Depression and aphasia impair the quality of life after a stroke. Studies linking depression risk to post-stroke aphasia (PSA) lacked confirmation using a large database. METHODS Using Taiwan's National Health Insurance claims data, we identified ≥18-year-old patients hospitalized for stroke from 2005 to 2009, and those diagnosed with aphasia during hospitalization or within 3 months after discharge were selected to form the aphasic group. We estimated depression incidence by December 31, 2018, and used the Cox proportional hazards model to estimate aphasia group to non-aphasia group hazard ratios (HRs). RESULTS With a median follow-up period of 7.91 and 8.62 years for aphasia (n = 26,754) and non-aphasia groups (n = 139,102), respectively, the incidence of depression was higher in the aphasia group than in the non-aphasia group (9.02 vs. 8.13 per 1,000 person-years), with an adjusted HR (95% confidence intervals [CI]) of 1.21 (1.15-1.29) for depression. The adjusted HRs (95% CI) of depression were homogenous for females, 1.26 (1.15-1.37); for males, 1.18 (1.09-1.27); for hemorrhagic stroke, 1.22 (1.09-1.37); and for ischemic stroke, 1.21 (1.13-1.30). Results in analyzing 25,939 propensity score-matched pairs demonstrated an equivalent effect. CONCLUSION Patients with PSA are at an increased risk of developing depression, regardless of sex or stroke type.
Collapse
Affiliation(s)
- Hui-Lin Lin
- Program for Aging, China Medical University, Taichung, Taiwan,
- Department of Physical Medicine and Rehabilitation, Lin Shin Hospital, Taichung, Taiwan,
- Taichung Hospital of the Ministry of Health and Welfare, Taichung, Taiwan,
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Chih-Hsin Muo
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Pei-Chun Chen
- Department of Public Health, China Medical University, Taichung, Taiwan
| |
Collapse
|
7
|
Ke X, Deng M, Wu Z, Yu H, Yu D, Li H, Lu Y, Shu K, Pei L. miR-34b-3p Inhibition of eIF4E Causes Post-stroke Depression in Adult Mice. Neurosci Bull 2023; 39:194-212. [PMID: 35802246 PMCID: PMC9905405 DOI: 10.1007/s12264-022-00898-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022] Open
Abstract
Post-stroke depression (PSD) is a serious and common complication of stroke, which seriously affects the rehabilitation of stroke patients. To date, the pathogenesis of PSD is unclear and effective treatments remain unavailable. Here, we established a mouse model of PSD through photothrombosis-induced focal ischemia. By using a combination of brain imaging, transcriptome sequencing, and bioinformatics analysis, we found that the hippocampus of PSD mice had a significantly lower metabolic level than other brain regions. RNA sequencing revealed a significant reduction of miR34b-3p, which was expressed in hippocampal neurons and inhibited the translation of eukaryotic translation initiation factor 4E (eIF4E). Furthermore, silencing eIF4E inactivated microglia, inhibited neuroinflammation, and abolished the depression-like behaviors in PSD mice. Together, our data demonstrated that insufficient miR34b-3p after stroke cannot inhibit eIF4E translation, which causes PSD by the activation of microglia in the hippocampus. Therefore, miR34b-3p and eIF4E may serve as potential therapeutic targets for the treatment of PSD.
Collapse
Affiliation(s)
- Xiao Ke
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- The Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Manfei Deng
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- The Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhuoze Wu
- Department of Pathophysiology, Basic Medical School, North Sichuan Medical College, Nanchong, 637100, China
| | - Hongyan Yu
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- The Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dian Yu
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- The Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hao Li
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- The Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Youming Lu
- The Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Physiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kai Shu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lei Pei
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- The Institute for Brain Research, Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
8
|
Almhdawi KA, Jaber H, Alghwiri A, Arabiat A, Alazrai A, Tariah HA, Obeidat D, Alrabbaie H. Health-related quality of life and its correlates among individuals with stroke during the COVID-19 pandemic. Neuropsychol Rehabil 2023; 33:69-84. [PMID: 34663187 DOI: 10.1080/09602011.2021.1984256] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Strict safety procedures including lockdowns were adopted during the Corona virus (COVID-19) pandemic worldwide which might have influenced mental and physical health in affected communities. This study aimed to investigate the level of Health-related quality of life (HRQoL) and its correlates among individuals with stroke in Jordan during the COVID-19 pandemic. This was a cross-sectional study with a self-administered questionnaire, which included demographics, 12-item Short Form (SF-12) health survey, Depression Anxiety Stress Scale (DASS 21), and The Stroke Impact Scale 16 (SIS-16). Descriptive analyses were used to summarize study data. Factors significantly correlated with HRQoL were determined using Pearson correlation. A total of 97 individuals successfully completed the study with a mean age of 57.9 years (±57.9). The level of HRQoL (measured by SF-12) was significantly and negatively associated with mental health symptoms (depression, anxiety, and stress) and the stroke recovery subscale of the SIS-16. Furthermore, participants' HRQoL level was significantly and positively associated with participants' age, stroke chronicity, receiving rehabilitation, and amount of help asked from caregivers. Jordanians with stroke demonstrated a relatively low level of HRQoL and high levels of mental health symptoms during the COVID-19 pandemic. Healthcare administrators should carefully consider individuals with stroke HRQoL and its correlates while planning for future crises.
Collapse
Affiliation(s)
- Khader A Almhdawi
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid - Jordan
| | - Hanan Jaber
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid - Jordan
| | - Alia Alghwiri
- Department of Physical Therapy, The University of Jordan, Amman, Jordan
| | - Alaa Arabiat
- Department of Family Medicine, The Jordanian Ministry of Health, Amman, Jordan
| | - Alza Alazrai
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid - Jordan
| | - Hashem Abu Tariah
- Department of Occupational Therapy, The Hashemite University, Zarqa, Jordan
| | - Donia Obeidat
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid - Jordan
| | - Hassan Alrabbaie
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid - Jordan
| |
Collapse
|
9
|
Alwledat K, Al-Amer R, Ali AM, Abuzied Y, Adnan Khudeir F, Alzahrani NS, Alshammari SR, AlBashtawy M, Thananayagam T, Dehghan M. Creative Art Therapy for Improving Depression, Anxiety, and Stress in Patients with Stroke: A Quasi-Interventional Study. SAGE Open Nurs 2023; 9:23779608231160473. [PMID: 36895711 PMCID: PMC9989432 DOI: 10.1177/23779608231160473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/12/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Creative art therapy is a psychotherapeutic approach used to enhance the mental health status of patients. Objectives This study aimed to evaluate the effect of creative art therapy on the levels of depression, anxiety, and stress in Jordanian patients following stroke. Methods One-group pretest-posttest design was used; it included four sessions of creative art therapy which were conducted as two sessions for two weeks. This study recruited 85 participants who were within three months poststroke diagnosis. The Depression, Anxiety, and Stress Scale was used to assess the levels of psychological reactions pre and post creative art therapy intervention. Results The data showed that there was a statistically significant improvement in the levels of depression (t = 37.98; p < .001), anxiety (t = 20.59, p < .001), and stress (t = 35.52, p < .001) post-intervention. There was a statistically significant improvement in the study-related psychological aspects following creative art therapy. Conclusion The findings of this study suggest that creative art therapy is a valuable method to complement other types of treatments among patients with stroke, resulting in positive patient mental health outcomes. Creative art therapy could be used as a psychotherapeutic approach to manage mental health complexities among patients with stroke. Health policymakers are invited to use the findings of this study to establish tailored counselor services using this new psychotherapeutic approach.
Collapse
Affiliation(s)
| | - Rasmieh Al-Amer
- Faculty of Nursing, Isra University, Amman, Jordan.,Western Sydney University, School of Nursing and Midwifery, Penrith South, Australia
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Smouha, Egypt
| | - Yacoub Abuzied
- Department of Nursing, Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Naif S Alzahrani
- Department of Medical-Surgical Nursing, College of Nursing, Taibah University, Medina, Saudi Arabia
| | - Saleh R Alshammari
- Department of Nursing, Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed AlBashtawy
- Nursing Community Health, Prince Salma Faculty of Nursing, Al-Bayt University, Mafraq, Jordan
| | | | - Mahlagha Dehghan
- Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
10
|
Abuadas FH, Ayasrah SM, Ahmad MM, Abu‐Snieneh H, Obiedallah HF, Basheti IA. Prevalence of depression and its associated factors among stroke survivors in Saudi Arabia. Nurs Open 2022; 10:1629-1638. [PMID: 36266745 PMCID: PMC9912400 DOI: 10.1002/nop2.1417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/06/2022] [Accepted: 10/02/2022] [Indexed: 02/11/2023] Open
Abstract
AIM The purpose of this study was to investigate the prevalence of poststroke depression (PSD) in Saudi Arabia and its association with socio-demographic and clinical factors. DESIGN A predictive correlational cross-sectional study. METHODS The study adopted a non-probability convenience sampling method to recruit 211 stroke survivors between April and October 2021 from the neurology outpatient departments of two main governmental hospitals in Saudi Arabia. PSD was measured using a self-assessment reliable and valid scale (The Hospital Anxiety and Depression Scale [HADS]). RESULTS More than two-thirds (70.6%) of the study sample (Mean age = 53 years, SD = 8.5, 51.2% were males) experienced some degree of depression (Score ≥8); of these, approximately half (48.8%) were in severe depression. The final prediction model was statistically significant (χ2 [15] = 31.39, p ˂ .01). PSD is a statistically significant health issue and requires immediate attention by healthcare providers to improve the health outcomes of stroke survivors.
Collapse
Affiliation(s)
- Fuad H. Abuadas
- College of Nursing, Community Health Nursing DepartmentJouf UniversitySakakaSaudi Arabia
| | - Shahnaz M. Ayasrah
- Department of Applied Science/NursingAl‐Balqa Applied UniversityAl‐SaltJordan
| | - Muayyad M. Ahmad
- Clinical Nursing Department, School of NursingUniversity of JordanAmmanJordan
| | | | - Hayyaf F. Obiedallah
- College of Nursing, Nursing Administration & Education DepartmentJouf UniversitySakakaSaudi Arabia
| | - Iman A. Basheti
- Dean ‐ Faculty of PharmacyApplied Science Private UniversityAmmanJordan
| |
Collapse
|
11
|
Ayasrah S, Ahmad M, Basheti I, Abu-Snieneh HM, Al-Hamdan Z. Post-stroke Anxiety Among Patients in Jordan: A Multihospital Study. J Geriatr Psychiatry Neurol 2022; 35:705-716. [PMID: 34933575 DOI: 10.1177/08919887211060015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the prevalence, correlates, and significant associated factors of anxiety among patients with stroke. A cross-sectional, correlation design was utilized. The Hospital Anxiety and Depression scale was used to detect and assess the severity of anxiety and depression among mentally well patients at general hospital settings. Among the 226 patients with stroke, 45.6% had clinically significant levels of anxiety to be considered as a definite case. Having a short duration since the stroke onset, being a definite case of depression, being unable to perform self-care activities, having an insufficient monthly income, and having visual problems due to stroke were the significantly associated factors. The high prevalence of anxiety among patients with stroke highlights the need for interventions of early detection and management to enhance recovery. Patients who have any of the significant traits predicted post-stroke anxiety required special attention.
Collapse
Affiliation(s)
| | | | - Iman Basheti
- 59177Applied Science Private University, Amman, Jordan
| | - Hana M Abu-Snieneh
- Faculty of Nursing, 84977Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Zaid Al-Hamdan
- 37251Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
12
|
Al Qawasmeh M, Aldabbour B, Abuabada A, Abdelrahman K, Elamassie S, Khweileh M, Zahran M, El-Salem K. Prevalence, Severity, and Predictors of Poststroke Depression in a Prospective Cohort of Jordanian Patients. Stroke Res Treat 2022; 2022:6506326. [PMID: 35035872 PMCID: PMC8759919 DOI: 10.1155/2022/6506326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 01/01/2023] Open
Abstract
Poststroke depression (PSD) is common and remains a significant risk factor for poor outcomes. This prospective study is aimed at assessing the prevalence, severity, and predictors of PSD among Jordanian stroke survivors. A total of 151 patients who were consequently admitted to a tertiary teaching hospital with ischemic or hemorrhagic strokes were enrolled. Participants were screened on admission for premorbid depression using the PHQ-9 questionnaire; then, screening for PSD was repeated one and three months after stroke using the same tool. Depression prevalence at each screening was reported, and logistic regression analysis was conducted to evaluate for significant predictors. PHQ-9 scores suggestive of depression were reported by 15%, 24.83%, and 17.39% of respondents on admission and after one and three months, respectively. Scores suggesting severe depression were reported by 0.71%, 2.13%, and 6.52% of respondents, respectively. Significant predictors of PSD were having chronic kidney disease, current smoking status, moderate or severe disability (mRS score) at stroke onset, and severe dependence (BI) after one month (p values 0.007, 0,002, 0.014, and 0.031, respectively). Patients with secondary and high school education levels were less likely to get depression compared with illiterate patients (p 0.042). This study showed that nearly one in four Jordanian stroke survivors experienced PSD after one month. In contrast, while the overall PSD prevalence declined towards the end of follow-up period, patients who remained depressed showed a tendency towards higher PSD severity.
Collapse
Affiliation(s)
- Majdi Al Qawasmeh
- Neurology Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Belal Aldabbour
- Neuroscience Department, Faculty of Medicine, Islamic University of Gaza, P.O. Box 108, Gaza, State of Palestine
| | - Amal Abuabada
- Psychiatry Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid Abdelrahman
- Psychiatry Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Samah Elamassie
- Health Services, United Nations Relief and Works Agency (UNRWA), Gaza, State of Palestine
| | - Mays Khweileh
- Neurology Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Zahran
- Psychiatry Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid El-Salem
- Neurology Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
13
|
Mahadevan S, Chan MF, Moghadas M, Shetty M, Burke DT, Al-Rasadi K, Al-Adawi S. Post-Stroke Psychiatric and Cognitive Symptoms in West Asia, South Asia and Africa: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:3655. [PMID: 34441951 PMCID: PMC8397184 DOI: 10.3390/jcm10163655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 11/17/2022] Open
Abstract
Recent research has shown that the prevalence of stroke incidents and the number of survivors in developing countries surpass those from developed countries. This study aimed to enumerate the prevalence of post-stroke psychiatric and cognitive symptoms among stroke survivors from West and South Asia and Africa through a systematic review and meta-analysis. Data from each country was systematically acquired from five major databases (PsycINFO, Web of Science, Scopus, PubMed/Medline, and Google Scholar (for any missing articles and grey literature)). Meta-analytic techniques were then used to estimate the prevalence of various post-stoke psychiatric and cognitive symptoms. A total of 36 articles were accrued from 11 countries, of which 25 were evaluated as part of the meta-analysis. The pooled prevalence of post-stroke depression as per the Hospital Anxiety and Depression Scale (HADS), Hamilton Depression Rating Scale, Patient Health Questionnaire, Schedules for Clinical Assessment in Neuropsychiatry (SCAN), Geriatric Depression Scale, and the Montgomery-Asberg Depression Rating Scale ranged from 28.00 to 50.24%. Pooled prevalence of post-stroke anxiety based on the HADS and SCAN was 44.19% and 10.96%, respectively. The pooled prevalence of post-stroke cognitive impairment as per the Mini-Mental Status Examination was 16.76%. This present review has suggested that both psychiatric and cognitive symptoms are common among stroke survivors. Concerted efforts are needed to institute robust studies using culturally sensitive measures to contemplate mechanisms that address the unmet needs of this vulnerable population.
Collapse
Affiliation(s)
- Sangeetha Mahadevan
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (M.M.); (M.S.)
| | - Moon Fai Chan
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman;
| | - Marzieh Moghadas
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (M.M.); (M.S.)
| | - Maithili Shetty
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (M.M.); (M.S.)
| | - David T. Burke
- Department of Rehabilitation Medicine in the Emory University School of Medicine, 1441 Clifton Road N.E., Atlanta, GA 30322, USA;
| | - Khalid Al-Rasadi
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman;
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman; (S.M.); (M.M.); (M.S.)
| |
Collapse
|
14
|
Liu F, Yang Y, Wang S, Zhang XL, Wang AX, Liao XL, Fang HJ, Qu Y, Ma WG, Zhang N, Wang CX, Wang YJ. Impact of Sleep Duration on Depression and Anxiety After Acute Ischemic Stroke. Front Neurol 2021; 12:630638. [PMID: 33841304 PMCID: PMC8032928 DOI: 10.3389/fneur.2021.630638] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Abnormal sleep duration predicts depression and anxiety. We seek to evaluate the impact of sleep duration before stroke on the occurrence of depression and anxiety at 3 months after acute ischemic stroke (AIS). Methods: Nationally representative samples from the Third China National Stroke Registry were used to examine cognition and sleep impairment after AIS (CNSR-III-ICONS). Based on baseline sleep duration before onset of stroke as measured by using the Pittsburgh Sleep Quality Index (PSQI), 1,446 patients were divided into four groups: >7, 6-7, 5-6, and <5 h of sleep. Patients were followed up with the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) for 3 months. Poststroke anxiety (PSA) was defined as GAD-7 of ≥5 and poststroke depression (PSD) as PHQ-9 of ≥5. The association of sleep duration with PSA and PSD was evaluated using multivariable logistic regression. Results: The incidences of PSA and PSD were 11.2 and 17.6% at 3 months, respectively. Compared to a sleep duration of >7 h, 5-6 h, and <5 h of sleep were identified as risk factors of PSA [odds ratio (OR), 1.95; 95% confidence interval (CI), 1.24-3.07; P < 0.01 and OR, 3.41; 95% CI, 1.94-6.04; P < 0.01) and PSD (OR, 1.47; 95% CI, 1.00-2.17; P = 0.04 and OR, 3.05; 95% CI, 1.85-5.02; P < 0.01), while 6-7 h of sleep was associated with neither PSA (OR, 1.09; 95% CI, 0.71-1.67; P = 0.68) nor PSD (OR, 0.92; 95% CI, 0.64-1.30; P = 0.64). In interaction analysis, the impact of sleep duration on PSA and PSD was not affected by gender (P = 0.68 and P = 0.29, respectively). Conclusions: Sleep duration of shorter than 6 h was predictive of anxiety and depression after ischemic stroke.
Collapse
Affiliation(s)
- Fei Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yang Yang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuo Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Li Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - An-Xin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Ling Liao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hong-Juan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yue Qu
- Independent Researcher, Ithaca, NY, United States
| | - Wei-Guo Ma
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chun-Xue Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Yong-Jun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
15
|
Post-stroke depression: frequency, risk factors, and impact on quality of life among 103 stroke patients—hospital-based study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00199-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
16
|
Efficacy and safety of modified Sini San for treating poststroke depression: A meta-analysis of randomized controlled trials. Explore (NY) 2020; 17:162-169. [PMID: 32527684 DOI: 10.1016/j.explore.2020.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 05/01/2020] [Accepted: 05/08/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to evaluate the efficacy and safety of modified Sini San (MSS) for poststroke depression (PSD). METHODS Randomized controlled trials of MSS for PSD were identified in the Web of science, PsycINFO, World Cat, CNKI, VIP, Wanfang, DuXiu, and Embase databases according to the inclusion and exclusion criteria. RESULTS In total, 7 trials with 548 patients were included in the review. The meta-analysis showed that MSS had superior effects to fluoxetine hydrochloride in terms of response rate in patients with PSD (relative risk (RR): 1.19, 95% confidence interval (CI) [1.10, 1.28], Z = 4.31, P < 0.0001). MSS may be more effective at reducing Hamilton depression rating scale (HAMD) scores and modified Edinburgh-Scandinavia stroke scale (SSS) scores than fluoxetine hydrochloride after 4 and 8 weeks of treatment. CONCLUSIONS Our meta-analysis demonstrated that MSS appears to have excellent therapeutic effects on PSD and no serious adverse effects. However, due to the small sample sizes and low quality of the literature, studies with higher methodological quality, larger sample sizes, and placebo controls are recommended in future research on MSS in patients with PSD to enhance the strength of the evidence. Therefore, clinicians should be cautious in using this evidence to make clinical decisions.
Collapse
|
17
|
Almhdawi KA, Alazrai A, Kanaan S, Shyyab AA, Oteir AO, Mansour ZM, Jaber H. Post-stroke depression, anxiety, and stress symptoms and their associated factors: A cross-sectional study. Neuropsychol Rehabil 2020; 31:1091-1104. [PMID: 32419606 DOI: 10.1080/09602011.2020.1760893] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Individuals post-stroke are subject to increased levels of mental health symptoms. This is a cross-sectional study explored levels of depression, anxiety, and stress symptoms and identified their predictors among Jordanian individuals with stroke. Outcome measures included Depression Anxiety Stress Scale, Fugl-Meyer assessment, goniometry, hand-held dynamometry, nine-hole peg test, Ashworth scale, Motor Activity Log, ten-meter walk test, and 12-item Short-Form health survey (SF-12). Descriptive analyses were used to describe prevalence of mental health symptoms and multiple variable linear regression models were used to identify their predictors. A total of 153 individuals participated in the study. Proportions of participants with mental health symptoms were 74.5% for depression, 52.9% for anxiety, and 68% for stress. Significant predictors of post-stroke mental health symptoms were SF-12 Mental Composite Score and grip strength for depression, anxiety, and stress. Depression and stress symptoms were significantly associated with discontinuation of rehabilitation services. Furthermore, self-reports of fewer sleep hours was significantly associated with anxiety and stress. Finally, Gender and self-reported physical diseases other than stroke were significantly associated with depression symptoms. We conclude that high proportions of Jordanian individuals' post-stroke have suffered mental health symptoms. Future studies are required to design effective interventions to improve post-stroke mental health.
Collapse
Affiliation(s)
- Khader A Almhdawi
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alza Alazrai
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saddam Kanaan
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Awni A Shyyab
- Division of Neurology, King Hussein Centre, Amman, Jordan
| | - Alaa O Oteir
- Department of Allied Health Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Zaid Modhi Mansour
- Department of Physical and Occupational Therapy, Hashemite University, Zarqa, Jordan
| | - Hanan Jaber
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
18
|
Ghaffari A, Akbarfahimi M, Rostami HR. Discriminative factors for post-stroke depression. Asian J Psychiatr 2020; 48:101863. [PMID: 31901586 DOI: 10.1016/j.ajp.2019.101863] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/26/2019] [Accepted: 10/31/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Depression is the most common mood disorder following stroke. It can negatively affects different domains of patient's life. The present study aimed to explore demographic and clinical predictors of post stroke depression and determine discriminative cognitive, motor, and functional factors in stroke patients with and without depression. METHODS In a cross sectional study, 100 patients with stroke were investigated. Measurements consisted of Beck Depression Inventory-II, Trail Making Test A & B, Digit Span Subtest of Wechsler Memory Scale, Motricity Index (arm and leg motor), Trunk Control Test, Barthel Index, and Lawton Instrumental Activities of Daily Living. Demographics and clinical data including educational level, marital status, limb affected, cigarette smoking habits, diabetes mellitus, cardiac diseases, and blood pressure were also collected. RESULTS Multivariate logistic regression revealed that college level of education (OR = 8.78, 95% CI: 2.65-29.11, P < 0.001) and cardiac diseases (OR = 3.11, 95% CI: 1.19-8.13, P < 0.001) were significant demographic and clinical predictors of post stroke depression. Using stepwise discriminant function analysis, basic activities of daily living and trunk control with 88.0% classification accuracy, 81.1% sensitivity, and 95.7% specificity were as the best discriminators of post stroke depression. CONCLUSIONS Rehabilitation experts working with patients with stroke should pay special attention to trunk control and basic activities of daily living for preventing consequences of PSD particularly in those with higher educational level and cardiac diseases.
Collapse
Affiliation(s)
- Amin Ghaffari
- Department of Occupational therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Malahat Akbarfahimi
- Department of Occupational therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Hamid Reza Rostami
- Department of Occupational therapy, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
19
|
Basheti IA, Ayasrah SM, Ahmad M. Identifying treatment related problems and associated factors among hospitalized post-stroke patients through medication management review: A multi-center study. Saudi Pharm J 2018; 27:208-219. [PMID: 30766431 PMCID: PMC6362176 DOI: 10.1016/j.jsps.2018.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/16/2018] [Indexed: 11/03/2022] Open
Abstract
Background Stroke is a major cause of disability and one of the leading causes of death among the elderly. Treatment related problems can lead to undesirable consequences. The Medication Management Review (MMR) service is aimed at identifying, resolving and preventing TRPs, subsiding the undesirable outcomes associated with TRPs. Objectives To explore the types, frequencies and severity of TRPs amongst post-stroke patients recruited through hospitals via conducting the MMR service by clinical pharmacists in Jordan. Associations between patient factors and the identified TRPs were explored. Methods This cross-sectional descriptive study was conducted over three months in 2017 in different geographical areas throughout Jordan. Randomly recruited patients were interviewed at the hospitals to collect their demographic data and clinical characteristics. Types/frequencies/severity of TRPs for each stroke patient were identified by a clinical pharmacist. Associations between the identified TRPs and patient's factors were explored through multiple regression analysis.Key findings:Out of 198 stroke patients (mean age: 56.6 ± 14.2) who completed the study, 110 (55.6%) were males. Many of the patients (82 (41.6%)) were smokers and 61 (69.2%) had hypertension and/or diabetes. The mean number of TRPs per patient was 2.5 ± 1.1. The most common TRP categories involved efficacy issues (198 (40.6%)), inappropriate drug adherence (136 (27.9%)) and inappropriate patient knowledge (114 (23.4%)). More than 70.0% (342/487) of the identified TRPs were of major severity. Higher number of TRPs was found to be associated with being a male, having a lower educational level, being a current smoker, having a higher number of drugs and a poorer quality of life. Conclusion Lack of drug efficacy, inappropriate drug adherence and patient knowledge were the major TRPs identified via delivering the MMR service to post-stroke patients. The identified TRPs highlights the importance of the MMR service, and supports planning future strategies aimed at decreasing the incidence of strokes.
Collapse
Affiliation(s)
- Iman A Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | | | | |
Collapse
|