1
|
Zeng Y, Chen J, Liu J, Zhang Y, Wang H, Jiang Y, Ding W, Li Y, Li J. Factor structure and reliability of the symptom measurement of post-stroke depression in the rehabilitation stage. BMC Psychiatry 2024; 24:448. [PMID: 38877421 PMCID: PMC11179195 DOI: 10.1186/s12888-024-05906-w] [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: 02/14/2023] [Accepted: 06/10/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSION 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.
Collapse
Affiliation(s)
- Yawei Zeng
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junya Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jing Liu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yi Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hongxia Wang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanhong Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weiwei Ding
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yun Li
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Jufang Li
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
2
|
Lin Y, Jia G, Zhao Z, Li M, Cao G. The association between family adaptability and adolescent depression: the chain mediating role of social support and self-efficacy. Front Psychol 2024; 15:1308804. [PMID: 38596336 PMCID: PMC11002239 DOI: 10.3389/fpsyg.2024.1308804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
Objective Previous research has shown a correlation between family adaptability and adolescent depression. However, there is a lack of studies that have investigated the underlying mechanism between family adaptability and adolescent depression. Based on the Ecological Systems Theory, this study aims to investigate the link between family adaptability and depression in adolescents, mediated by the sequential roles of social support and self-efficacy. Methods The sample consisted of 1086 students randomly selected from seven public middle schools in Shandong Province, Eastern China. All the participants filled in the structured self-report questionnaires on family adaptability, social support, self-efficacy, and depression. The data were analyzed using SPSS 25.0 and Structural Equation Modeling (SEM) in AMOS 24.0. Results The findings of this study are as follows: (1) Family adaptability is negatively associated with adolescent depression; (2) Social support plays a mediating role between family adaptability and adolescent depression; (3) Self-efficacy plays a mediating role between family adaptability and adolescent depression; (4) Social support and self-efficacy play a chain mediation role between family adaptability and adolescent depression. Conclusion It is suggested that early interventions and support should be provided to facilitate adolescents' family adaptability, social support, and self-efficacy, thus reducing their depression and improving mental health of adolescents.
Collapse
Affiliation(s)
- Yanyan Lin
- College of Teacher Education, Jining University, Qufu, China
| | | | - Zirong Zhao
- College of Teacher Education, Jining University, Qufu, China
| | - Meng Li
- College of Teacher Education, Jining University, Qufu, China
| | - Guanghai Cao
- College of Teacher Education, Jining University, Qufu, China
- College of Education, Qufu Normal University, Qufu, China
| |
Collapse
|
3
|
Furnham A, Cheng H. The Big-Five personality factors, cognitive ability, health, and social-demographic indicators as independent predictors of self-efficacy: A longitudinal study. Scand J Psychol 2024; 65:53-60. [PMID: 37525487 DOI: 10.1111/sjop.12953] [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: 04/07/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/02/2023]
Abstract
This study set out to examine to what extent a set of psychological, health and socio-demographic factors are associated with self-efficacy (SE) in a large sample of over 12,000 participants over a two-year period. We were interested in the correlates of self-efficacy (criterion variable) with gender, age, education and occupation, the Big-Five personality factors and cognitive ability, as well as mental and physical health (predictor variables). Regression analyses showed that four of the Big-Five personality factors (extraversion, neuroticism, conscientiousness, and openness), cognitive ability, mental and physical health, gender, education and occupation were all significant and independent predictors of self-efficacy, accounting for 23% of the variance of the outcome variable. Personality variables, particularly Neuroticism and Conscientiousness, were the most powerful predictors of SE two years later. The implications for encouraging SE in individuals are discussed.
Collapse
Affiliation(s)
| | - Helen Cheng
- Department of Psychology, University College London, London, UK
- ESRC Centre for Learning and Life Chances in Knowledge Economies and Societies, Institute of Education, University College London, London, UK
| |
Collapse
|
4
|
Volz M, Mundiyanapurath S, Schauenburg H, Meuth SG, Wild B, Werheid K, Barber JP, Schäfer R, Beerbaum L, Dinger U. Integrative-interpersonal dynamic therapy for poststroke depression (INID): study protocol of a randomised controlled pilot trial. BMJ Open 2023; 13:e077656. [PMID: 37553187 PMCID: PMC10414082 DOI: 10.1136/bmjopen-2023-077656] [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: 07/11/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Depression is the most frequent psychiatric disorder following stroke, affecting about one-third of stroke survivors. Patients experience poorer recovery, lower quality of life and higher mortality compared with stroke survivors without depression. Despite these well-known malign consequences, poststroke depression (PSD) is regarded underdiagnosed and undertreated. Evidence of beneficial effects of psychotherapy to treat PSD remains scarce and inconclusive and is limited by heterogeneity in design, content and timing of the intervention. This pilot study aims to assess the feasibility of a newly developed integrative-interpersonal dynamic PSD intervention in an outpatient setting and provide a first estimation of the potential effect size as basis for the sample size estimation for a subsequent definite trial. METHOD AND ANALYSIS Patients will be recruited from two German stroke units. After discharge from inpatient rehabilitation, depressed stroke survivors will be randomised to short-term psychotherapy (12 weeks, ≤16 sessions) or enhanced treatment as usual. The manualised psychotherapy integrates key features of the Unified Psychodynamic and Cognitive-Behavioural Unified Protocol for emotional disorders and was adapted for PSD. Primary endpoints are recruitment feasibility and treatment acceptability, defined as a recruitment rate of ≥20% for eligible patients consenting to randomisation and ≥70% completion-rate of patients participating in the treatment condition. A preliminary estimation of the treatment effect based on the mean difference in Patient Health Questionnaire-9 (PHQ-9) scores between intervention and control group six months poststroke is calculated. Secondary endpoints include changes in depression (PHQ-9/Hamilton Depression Scale) and anxiety (Generalised Anxiety Disorder 7) of all participants across all follow-ups during the first year poststroke. ETHICS AND DISSEMINATION The INID pilot study received full ethical approval (S-321/2019; 2022-2286_1). Trial results will be published in a peer-reviewed journal in the first half of 2025. One-year follow-ups are planned to be carried out until summer 2025. TRIAL REGISTRATION NUMBER DRKS00030378.
Collapse
Affiliation(s)
| | | | - Henning Schauenburg
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sven Guenther Meuth
- Department of Neurology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Beate Wild
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Katja Werheid
- Department of Psychology, Clinical Neuropsychology and Psychotherapy, University of Bielefeld, Bielefeld, Germany
| | - Jacques P Barber
- Adelphi University, Gordon F Derner School of Psychology, New York City, New York, USA
| | - Ralf Schäfer
- Department of Psychosomatic Medicine and Psychotherapy, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Luisa Beerbaum
- Department of Psychosomatic Medicine and Psychotherapy, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Ulrike Dinger
- Department of Psychosomatic Medicine and Psychotherapy, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| |
Collapse
|
5
|
Liu H, Cheng Z, Wang S, Jia Y. Effects of virtual reality-based intervention on depression in stroke patients: a meta-analysis. Sci Rep 2023; 13:4381. [PMID: 36928345 PMCID: PMC10020160 DOI: 10.1038/s41598-023-31477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
As one of the most common neuropsychiatric complications after stroke, post-stroke depression can significantly affect the initiative of rehabilitation exercise and the rehabilitation of neurological function of patients. Virtual reality (VR) has been widely used in health-related fields in recent years. There is some evidence that VR-based interventions have benefits for depression. The aim of this study was to assess the effectiveness of VR-based intervention on depression in stroke patients. A total of 752 patients with stroke from 11 randomized controlled trials (RCTs) studies were included in this meta-analysis and the studies derived from seven electronic databases searched from database inception to August 2021. Different tools were used to measure depression. For continuous results, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to synthesize the effects. We assessed the risk of bias by using the Cochrane Collaboration criteria. The results showed that compared to the control group, VR-based interventions significantly decreased the depression scale score (SMD = - 0.75, 95% CI - 1.35, - 0.15). The meta-analysis indicated that VR-based intervention had a moderate effect on depression in stroke patients compared to control group. There was no evidence of potential publication bias as assessed by visual inspection of funnel plots in Egger and Begg tests. Substantial heterogeneity between studies was observed, meta-regression analysis showed that mean age might be the source of heterogeneity.
Collapse
Affiliation(s)
- Hebing Liu
- The Second Hospital, Jilin University, No. 218 Ziqiang Street, Changchun, 130021, Jilin, China
| | - Zhaohua Cheng
- The Second Hospital, Jilin University, No. 218 Ziqiang Street, Changchun, 130021, Jilin, China
| | - Shuo Wang
- School of Nursing, Xuzhou Medical University, Tongshan Road, Xuzhou, 221004, Jiangsu, China
| | - Yong Jia
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, 130021, Jilin, China.
| |
Collapse
|
6
|
Massarwe A, Cohen N. Understanding the benefits of extrinsic emotion regulation in depression. Front Psychol 2023; 14:1120653. [PMID: 37179872 PMCID: PMC10172593 DOI: 10.3389/fpsyg.2023.1120653] [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: 12/10/2022] [Accepted: 03/31/2023] [Indexed: 05/15/2023] Open
Abstract
Depression is a serious psychiatric illness that negatively affects people's feelings, thoughts, and actions. Providing emotion regulation support to others, also termed Extrinsic Emotion Regulation (EER), reduces depressive symptoms such as perseverative thinking and negative mood. In this conceptual review paper, we argue that EER may be especially beneficial for individuals with depression because it enhances the cognitive and affective processes known to be impaired in depression. Behavioral studies have shown that EER recruits processes related to cognitive empathy, intrinsic emotion regulation (IER), and reward, all impaired in depression. Neuroimaging data support these findings by showing that EER recruits brain regions related to these three processes, such as the ventrolateral prefrontal cortex which is associated with IER, the ventral striatum, which is associated with reward-related processes, and medial frontal regions related to cognitive empathy. This conceptual review paper sheds light on the mechanisms underlying the effectiveness of EER for individuals with depression and therefore offers novel avenues for treatment.
Collapse
Affiliation(s)
- Atheer Massarwe
- Department of Special Education, Faculty of Education, University of Haifa, Haifa, Israel
- *Correspondence: Atheer Massarwe,
| | - Noga Cohen
- Department of Special Education, Faculty of Education, University of Haifa, Haifa, Israel
- The Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa, Israel
| |
Collapse
|
7
|
Dharma KK, Nurbani N, Wardhani P, Rangkuti WF, Rahayu H, Kapadia R. The factors that influence the adaptation process 6 months after a stroke: A path analysis. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:30-37. [PMID: 35760357 DOI: 10.1016/j.enfcle.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/22/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The purpose of this study was to identify the determinant factors that influence the adaptation process and quality of life after a stroke. METHODS This study is an observational study using a cross-sectional design. Respondents were patients who were 6 months post-discharge after non-hemorrhagic strokae and their family caregivers. Information about respondents was taken from medical record data at two regional general hospitals in West Kalimantan Province, Indonesia. A total of 80 patients were selected using a consecutive sampling method. Theoretical models of patient and caregiver factors that influence adaptation responses and post-stroke quality of life were tested using path analysis. RESULT Caregiver coping, self-efficacy, and illness acceptance had a direct effect on the post-stroke psychosocial adaptation response by 58.1%, with self-efficacy contributing the most (β = 0.668, P < .0001). Self-efficacy, illness acceptance, and healthy behavior had a direct effect on the physiological adaptation response by 24.3%, where self-efficacy also contributed the most (β = 0.272, P < .014). Psychosocial adaptation and physiological adaptation had a direct effect on the quality of life by 54.6%, where psychosocial adaptation showed the largest contribution (β = 0.63, P < .0001). CONCLUSION Self-efficacy contributes the most to both psychosocial and physiological adaptations 6 months after stroke. Psychosocial adaptation and self-efficacy have been proven to be the determinant factors that contribute the most to the quality of life of patients 6 months after stroke.
Collapse
Affiliation(s)
- Kelana Kusuma Dharma
- School of Nursing, Politeknik Kesehatan Kementerian Kesehatan, Pontianak, Indonesia.
| | - Nurbani Nurbani
- School of Nursing, Politeknik Kesehatan Kementerian Kesehatan, Pontianak, Indonesia
| | - Puspa Wardhani
- School of Nursing, Politeknik Kesehatan Kementerian Kesehatan, Pontianak, Indonesia
| | | | - Halina Rahayu
- School of Nursing, Politeknik Kesehatan Kementerian Kesehatan, Pontianak, Indonesia
| | - Raju Kapadia
- School of Nursing, Politeknik Kesehatan Kementerian Kesehatan, Pontianak, Indonesia
| |
Collapse
|
8
|
Błaszcz M, Prucnal N, Wrześniewski K, Pasiut S, Mika P, Kucia M, Stach B, Woźniak M, Mirek E. Physical Activity, Psychological and Functional Outcomes in Non-Ambulatory Stroke Patients during Rehabilitation-A Pilot Study. J Clin Med 2022; 11:jcm11247260. [PMID: 36555878 PMCID: PMC9781234 DOI: 10.3390/jcm11247260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Despite the extensive literature on stroke rehabilitation, there are few studies that comprehensively show non-ambulatory stroke patients. The aim of the study was to explore the dynamics of the change in physical activity (PA), psychological and functional outcomes, and the correlation between them in non-ambulatory patients during early in-patient post-stroke rehabilitation. Measurements were taken on 21 participants at the beginning of and 6 weeks post-conventional rehabilitation with the Barthel Index (BI), Berg Balance Scale (BBS), Trunk Control Test (TCT), Stroke Impact Scale (SIS), General Self-Efficacy Scale, Stroke Self-Efficacy Questionnaire (SSEQ), the original scale of belief in own impact on recovery (BiOIoR), Hospital Anxiety and Depression Scale, Acceptance of Illness Scale and when the patient could walk—Time Up & Go and 6 Minute Walk Test. Daily PA was assessed over 6 weeks using a Caltrac accelerometer. Only outcomes for BI, BBS, TCT, SIS, and SSEQ significantly improved 6 weeks post-rehabilitation. PA energy expenditure per day significantly increased over time (p < 0.001; effect size = 0.494), but PA only increased significantly up to the third week. PA change was correlated with BiOIoR post-treatment. Self-efficacy in self-management mediated improvement in SIS. The BiOIoR and confidence in self-management could be important factors in the rehabilitation process.
Collapse
Affiliation(s)
- Marcin Błaszcz
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
- Non-Public Healthcare Facility “Pasternik”, 32-085 Modlniczka, Poland
- Correspondence: (M.B.); (N.P.); (E.M.); Tel.: +48-604-249-436 (M.B.)
| | - Nina Prucnal
- Emotion and Perception Lab, Institute of Psychology, Faculty of Philosophy, Jagiellonian University, Ingardena 6, 30-060 Krakow, Poland
- Correspondence: (M.B.); (N.P.); (E.M.); Tel.: +48-604-249-436 (M.B.)
| | - Krzysztof Wrześniewski
- Department of Psychology, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Szymon Pasiut
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Piotr Mika
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Małgorzata Kucia
- Musculoskeletal Rehabilitation Centre in “Krzeszowice”, 32-065 Krzeszowice, Poland
| | - Beata Stach
- Musculoskeletal Rehabilitation Centre in “Krzeszowice”, 32-065 Krzeszowice, Poland
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, 31-126 Krakow, Poland
| | - Marcin Woźniak
- Non-Public Healthcare Facility “Pasternik”, 32-085 Modlniczka, Poland
| | - Elżbieta Mirek
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
- Correspondence: (M.B.); (N.P.); (E.M.); Tel.: +48-604-249-436 (M.B.)
| |
Collapse
|
9
|
Los factores que influyen en el proceso de adaptación 6 meses después de un ictus:un análisis de trayectoria. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
Han L, Zhang J, Yang J, Yang X, Bai H. Between Personality Traits and Postpartum Depression: The Mediated Role of Maternal Self-Efficacy. Neuropsychiatr Dis Treat 2022; 18:597-609. [PMID: 35342292 PMCID: PMC8942121 DOI: 10.2147/ndt.s346327] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Postpartum depression is related to many factors, which affect the health of mothers and infants. The purpose of this study is to test the mediated effect of self-efficacy in the relationship between vulnerable personality and postpartum depression. PATIENTS AND METHODS A cross-sectional survey was conducted with pregnant women aged ≥20 years from February to April 2021 in Zhengzhou, China. We recruited 587 pregnant women, and 429 pieces of data were available. The demographic characteristics questionnaire, General Self efficacy Scale (GSES) and Vulnerable Personality Style Questionnaire (VPSQ) were distributed in the prenatal survey. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen postpartum depression symptoms at one month through WeChat and telephone follow-up. A mediated model was constructed to explain the relationship of variables and test the mediated effect of self-efficacy. RESULTS The valid questionnaires were 429 (effective response rate: 90.7%). The vulnerable personality and low self-efficacy were related to postpartum depression (all P< 0.01). The self-efficacy of pregnant women was inversely associated with vulnerable personality (β= -0.415) and postpartum depression (β= -0.216). The vulnerable personality and self-efficacy can explain 29.0% of the variation in postpartum depression. It was confirmed that a partial mediating effect of self-efficacy accounted for 18.0% (0.090/0.501) of the total effect. CONCLUSION Maternal self-efficacy partly mediates the relationship between vulnerable personality traits and postpartum depression. The study implies the importance of targeted interventions to improve self-efficacy for women with vulnerable personality traits to reduce the risk of postpartum depression.
Collapse
Affiliation(s)
- Lingli Han
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ji Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, Henan, People's Republic of China
| | - Jingxuan Yang
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xiaoyu Yang
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hua Bai
- The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| |
Collapse
|
11
|
Ladwig S, Werheid K. Determinants of Antidepressant Treatment and Outpatient Rehabilitation Within the First Year After Stroke. J Geriatr Psychiatry Neurol 2022; 35:135-144. [PMID: 33233997 DOI: 10.1177/0891988720973749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aims to identify individual determinants of antidepressant treatment and outpatient rehabilitation after stroke. People with ischemic stroke (N = 303) recruited at 2 inpatient rehabilitation clinics were included into a prospective longitudinal study with follow-up telephone interviews 6 and 12 months later. Participants reported on their use of antidepressant medication and psychotherapy as well as physical, occupational, speech, and neuropsychological therapy. The use of antidepressants at discharge (n = 65, 23.8%) was predicted by the severity of depressive symptoms, severity of stroke, history of depression, and use of antidepressants at admission (all p < .05, R2= .55). The number of outpatient rehabilitation services used at follow-ups was predicted by higher functional and cognitive impairment, higher education, younger age, severity of depressive symptoms, and lower self-efficacy (all p < .05; R26M = .24, R212M = .49). The relevance of identified determinants for the improvement of treatment rates after stroke is discussed.
Collapse
Affiliation(s)
- Simon Ladwig
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.,Clinic of Neurology, Hospital Ernst von Bergmann, Potsdam, Germany
| | - Katja Werheid
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.,Clinic of Neurology, Hospital Ernst von Bergmann, Potsdam, Germany
| |
Collapse
|
12
|
Okoye EC, Onwuakagba IU, Akile CC, Okonkwo UP, Akosile CO, Mgbeojedo UG, Oyewumi TJ, Kubeyinje OS. Social Support, General Self-Efficacy, Fear of Falling, and Physical Activity Among Older Adults in a Middle-Income Country. Gerontol Geriatr Med 2022; 8:23337214221097750. [PMID: 35478850 PMCID: PMC9036325 DOI: 10.1177/23337214221097750] [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: 01/27/2022] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives: To investigate the levels and interrelationships between fear of falling (FOF), physical activity (PA), social support (SS), and general self-efficacy (GSE) among older adults in a Nigerian community. Methods: This was a cross-sectional survey involving 100 older adults (65.0% females; mean age = 74.25 ± 8.01 years) consecutively recruited from Nnewi community. Participants’ FOF, PA, GSE, and SS were assessed using standardized questionnaires. Data were analyzed using descriptive statistics, Spearman rank order correlation, and structural equation modeling at a 0.05 level of significance. Results: The participants’ mean FOF, PA, GSE, and SS scores were 15.22 ± 7.43 (fearful), 114.76 ± 90.18 (low), 21.64 ± 8.25 (low) and 5.72 ± 1.19 (high) respectively. There were significant correlations between each pair of FOF, PA, GSE, and SS scores of the participants (p < .05). FOF and GSE were significant predictors of PA while GSE and SS were significant predictors of FOF. Conclusion: FOF and SS were high while PA and GSE were low in this sample of Nigerian older adults. Significant correlations existed between FOF, SS, GSE, and PA, with FOF and GSE being predictors of PA while GSE and SS significantly predicted FOF. Measures should be geared towards reducing FOF and improving PA, GSE, and SS in this group.
Collapse
Affiliation(s)
- Emmanuel C Okoye
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Ifeoma U Onwuakagba
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Cynthia C Akile
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Uchenna P Okonkwo
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Christopher O Akosile
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Ukamaka G Mgbeojedo
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu, Nigeria
| | - Taiwo J Oyewumi
- Department of Physiotherapy, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Oluwaseun S Kubeyinje
- Department of Physiotherapy, University of Benin Teaching Hospital, Benin City, Nigeria
| |
Collapse
|
13
|
Remes O, Mendes JF, Templeton P. Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci 2021; 11:1633. [PMID: 34942936 PMCID: PMC8699555 DOI: 10.3390/brainsci11121633] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Depression is one of the leading causes of disability, and, if left unmanaged, it can increase the risk for suicide. The evidence base on the determinants of depression is fragmented, which makes the interpretation of the results across studies difficult. The objective of this study is to conduct a thorough synthesis of the literature assessing the biological, psychological, and social determinants of depression in order to piece together the puzzle of the key factors that are related to this condition. Titles and abstracts published between 2017 and 2020 were identified in PubMed, as well as Medline, Scopus, and PsycInfo. Key words relating to biological, social, and psychological determinants as well as depression were applied to the databases, and the screening and data charting of the documents took place. We included 470 documents in this literature review. The findings showed that there are a plethora of risk and protective factors (relating to biological, psychological, and social determinants) that are related to depression; these determinants are interlinked and influence depression outcomes through a web of causation. In this paper, we describe and present the vast, fragmented, and complex literature related to this topic. This review may be used to guide practice, public health efforts, policy, and research related to mental health and, specifically, depression.
Collapse
Affiliation(s)
- Olivia Remes
- Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK
| | | | - Peter Templeton
- IfM Engage Limited, Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK;
- The William Templeton Foundation for Young People’s Mental Health (YPMH), Cambridge CB2 0AH, UK
| |
Collapse
|
14
|
Havaei N, Lotfalinezhad E, Nadrian H, Papi S, Goljarian S, Ahmadi A, Nazaripanah N, Mohammadi M, Asghari Jafarabadi M, Badeleh MT, Bhalla D. Evaluation of a Persian version of the Adelaide driving self-efficacy scale among Iranian older adults. TRAFFIC INJURY PREVENTION 2021; 22:611-615. [PMID: 34582299 DOI: 10.1080/15389588.2021.1965998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Our aim in the present study was to estimate the psychometric properties of the full-length Adelaide driving self-efficacy scale (ADSES) for use among community-based resident older adults in Tehran, Iran. METHODS We recruited older adults (60+ years) from various sampling units nested in the Tehran district's general urban population (20 subjects/questionnaire-item). The questionnaire was translated and back-translated by using recommended pathways. Multiple forms of validity and reliability, including Cronbach alpha, were estimated. Also, we measured intra-class correlation coefficient, and did confirmatory factor analysis (CFA). RESULTS A total of 243 participants (mean age: 65.8, 95%CI 65.4-66.3) met our inclusion criteria. For ADSES, the alpha coefficient was 0.77, the intraclass correlation coefficient was 0.97 (95% CI: 0.95-0.98), and the average item-test correlation was 0.67. Upon CFA, we found a 0.95 comparative fit index, a coefficient of determination = 92.6%, and standardized size of the residual = 0.04. CONCLUSION Our Persian language ADSES was found to have adequate validity and factor structure parameters for evaluating driving self-efficacy among community-based older adults in a non-western context. Our questionnaire is an essential first step toward evaluating driving self-efficacy among older adults, especially where no such tool is available, to help develop driving self-efficacy as a healthy aging measure.
Collapse
Affiliation(s)
- Naser Havaei
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Lotfalinezhad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
- Aging Research Institute, Tabriz University of medical sciences, Tabriz, Iran
| | - Haidar Nadrian
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahab Papi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Goljarian
- School of Rehabilitation Sciences, Physiotherapy Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Ahmadi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Nazaripanah
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojtaba Mohammadi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohamad Asghari Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
- Center for the Development of Interdisciplinary Research in Islamic Science and Health Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Devender Bhalla
- Pôle Universitaire euclide Intergovernmental UN Treaty, Bangui, Central African Republic
| |
Collapse
|
15
|
Whitehall L, Rush R, Górska S, Forsyth K. The General Self-Efficacy of Older Adults Receiving Care: A Systematic Review and Meta-Analysis. THE GERONTOLOGIST 2021; 61:e302-e317. [PMID: 32373938 PMCID: PMC8361502 DOI: 10.1093/geront/gnaa036] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives General self-efficacy (GSE) encourages health-promoting behaviors in older adults. It is unsurprising then that older adults receiving health care services are reported to have a greater risk of low GSE than older adults who are not. Despite this, there is currently limited evidence investigating whether the effect differs based on the environment in which care is received. This review aims to determine whether the GSE of older adults is affected by the receipt of health care services and whether GSE varies based on the setting in which care is received. Research Design and Methods In accordance with PRISMA guidelines (PROSPERO registration number CRD42018092191), a systematic search was undertaken across 7 databases. Standardized mean differences (SMD) and mean General Self-Efficacy Scale scores, with 95% confidence intervals (CI), were pooled for meta-analysis. Results A total of 40 studies were identified, they consisted of 33 population cohorts that were included in the meta-analysis. Older adults receiving health care services were found to be at greater risk of having lower GSE than those who do not (SMD = −0.62; 95% CI: −0.96 to −0.27, p < .0001). Following identification of sources of heterogeneity, older adults receiving acute inpatient care were more likely to have lower GSE than those receiving care in other health care settings. Discussion and Implications Older adults receiving inpatient care have a greater risk of lower GSE, and consequently, poorer health-promoting behaviors. Further research is recommended that focuses on the GSE of older adults and health outcomes following discharge from inpatient care.
Collapse
Affiliation(s)
- Lucy Whitehall
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Robert Rush
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Sylwia Górska
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| |
Collapse
|
16
|
Dong L, Williams LS, Brown DL, Case E, Morgenstern LB, Lisabeth LD. Prevalence and Course of Depression During the First Year After Mild to Moderate Stroke. J Am Heart Assoc 2021; 10:e020494. [PMID: 34184539 PMCID: PMC8403325 DOI: 10.1161/jaha.120.020494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/19/2021] [Indexed: 01/18/2023]
Abstract
Background This study examined the prevalence and longitudinal course of depression during the first year after mild to moderate stroke. Methods and Results We identified patients with mild to moderate ischemic stroke or intracerebral hemorrhage (National Institutes of Health Stroke Scale score <16) and at least 1 depression assessment at 3, 6, or 12 months after stroke (n=648, 542, and 533, respectively) from the Brain Attack Surveillance in Corpus Christi project (2014-2016). Latent transition analysis was used to examine temporal profiles of depressive symptoms assessed by the 8-item Patient Health Questionnaire between 3 and 12 months after stroke. Mean age was 65.6 years, 49.4% were women, and 56.7% were Mexican Americans. The prevalence of depression after stroke was 35.3% at 3 months, decreased to 24.9% at 6 months, and remained stable at 25.7% at 12 months. Approximately half of the participants classified as having depression at 3 or 6 months showed clinical improvement at the next assessment. Subgroups with distinct patterns of depressive symptoms were identified, including mild/no symptoms, predominant sleep disturbance and fatigue symptoms, affective symptoms, and severe/all symptoms. A majority of participants with mild/no symptoms retained this symptom pattern over time. The probability of transitioning to mild/no symptoms was higher before 6 months compared with the later period, and severe symptoms were more likely to persist after 6 months compared with the earlier period. Conclusions The observed dynamics of depressive symptoms suggest that depression after stroke tends to persist after 6 months among patients with mild to moderate stroke and should be continually monitored and appropriately managed.
Collapse
Affiliation(s)
- Liming Dong
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMI
| | - Linda S. Williams
- Health Services Research and Development Center for Health Information and CommunicationRoudebush VA Medical CenterIndianapolisIN
- Department of NeurologyIndiana University School of MedicineIndianapolisIN
- Regenstrief Institute, Inc.IndianapolisIN
| | - Devin L. Brown
- Stroke ProgramUniversity of Michigan Medical SchoolAnn ArborMI
| | - Erin Case
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMI
| | - Lewis B. Morgenstern
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMI
- Stroke ProgramUniversity of Michigan Medical SchoolAnn ArborMI
| | - Lynda D. Lisabeth
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMI
| |
Collapse
|
17
|
Fraser T, Karon L, Lund A, Sveen U, Kessler D. Examining components of community psychosocial stroke interventions using concept mapping. Scand J Occup Ther 2021; 29:325-336. [PMID: 34181505 DOI: 10.1080/11038128.2021.1933172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Stroke impacts psychosocial well-being and engagement in occupation. Psychosocial interventions reduce depression and anxiety but may not impact occupation. Knowledge of key processes and components of community psychosocial stroke interventions can inform future intervention development. AIM/OBJECTIVE(S) To determine the essential elements common to three psychosocial interventions for stroke survivors. MATERIAL(S) AND METHOD(S) Concept maps were created for three community psychosocial stroke interventions based on published literature and communication with researchers who tested the intervention with stroke survivors. The concept maps were then compared to identify common elements. Ongoing communication with researchers ensured accurate representation of each respective intervention. RESULTS Similarities in intervention processes and components included support for autonomy; individualized information exchange; coping, life skill development and adaptation support; competence development; and the incorporation of goals. Differences included intervention delivery (individual versus group), and the avenues in which psychosocial needs are addressed (occupation versus dialogue). CONCLUSIONS Concept mapping identified similarities among the three interventions that can be best understood using self-determination theory. Clinicians may utilize findings revealed in the process to inform evidence-based psychosocial stroke interventions. SIGNIFICANCE Knowledge of key 'active ingredients' for psychosocial community stroke interventions, can be used to guide clinical reasoning and inform development of interventions.
Collapse
Affiliation(s)
- Theresa Fraser
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
| | - Leora Karon
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
| | - Anne Lund
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
| |
Collapse
|
18
|
Chen J, Li Y, Liu J, Zhang Y, Zeng Y, Chen M, Ding W, Lu Z, Xu H, Li J. Symptom clusters of early-stage poststroke depression: A mixed-methods study. Nurs Open 2021; 8:2488-2497. [PMID: 33471441 PMCID: PMC8363377 DOI: 10.1002/nop2.772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/20/2020] [Accepted: 12/17/2020] [Indexed: 12/15/2022] Open
Abstract
Aim To identify the symptom clusters of early‐stage poststroke depression (PSD) and provide an in‐depth understanding of the symptoms. Design A mixed‐methods study with a convenient sampling method was used. Methods A cross‐sectional questionnaire survey in 231 stroke patients and semi‐structured interviews in 14 stroke patients were conducted in the neurological department of a comprehensive hospital in Southeast China. Data from the questionnaire survey were analysed through descriptive and exploratory factor analyses; data from the semi‐structured interview were transcribed verbatim and analysed through inductive content analysis. This study adheres to the GRAMMS checklist. Results Exploratory factor analysis revealed six symptom clusters of early‐stage PSD that accounted for an ideal variance in PSD: nervous, wakefulness, emotional, dull, guilt and low mood. Further, inductive content analysis revealed five themes that were like the above symptom clusters, except for the dull symptom cluster.
Collapse
Affiliation(s)
- Junya Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yun Li
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Liu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yi Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yawei Zeng
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Mengjiao Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Weiwei Ding
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Zhongqiu Lu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hongbo Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Jufang Li
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
19
|
Iwanowicz-Palus G, Mróz M, Bień A. Quality of life, social support and self-efficacy in women after a miscarriage. Health Qual Life Outcomes 2021; 19:16. [PMID: 33413432 PMCID: PMC7791812 DOI: 10.1186/s12955-020-01662-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 12/23/2020] [Indexed: 02/25/2023] Open
Abstract
Background Pregnancy loss is typically experienced as a traumatic, critical event, which may lead to secondary psychological health disorders. Its burden involves both the experience of loss and related medical issues, which are associated with pain, hospitalization, limitation in one’s social roles, decreased sense of security, and changes in one’s perceived quality of life. The purpose of the present study was to evaluate levels of quality of life (QoL), social support and self-efficacy among women who had suffered a miscarriage. Methods The study was performed using a diagnostic survey method with questionnaires administered to 610 patients hospitalized due to spontaneous pregnancy loss in hospitals in Lublin (Poland). The instruments used were: the Berlin Social Support Scales (BSSS), the Generalized Self-Efficacy Scale (GSES), the WHOQoL–BREF questionnaire, and a standardized interview questionnaire. Results Respondents rated their overall quality of life (3.90 points) higher than their overall perceived health (3.66). In terms of social support, the highest scores were noted for perceived available instrumental support (M = 3.78), perceived available emotional support (M = 3.68) and actually received support (M = 3.60). The mean generalized self-efficacy score among the women after pregnancy loss was 30.29. Respondents’ QoL was significantly correlated with multiple social support subscales and self-efficacy (p < 0.05). Conclusions Women after a miscarriage perceive their overall quality of life as better than their overall health, while reporting the poorest QoL in the psychological domain. They also have a high level of self-efficacy. Regarding the types of social support, perceived available support, both instrumental and emotional, and actually received support was rated highly. Social support and self-efficacy contributed to better perceived QoL among the respondents.
Collapse
Affiliation(s)
- Grażyna Iwanowicz-Palus
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Mariola Mróz
- Obstetrics and Gynecology Department and Clinic, Cardinal S. Wyszyński Regional Specialist Hospital, Lublin, Poland.
| | - Agnieszka Bień
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| |
Collapse
|
20
|
Cong L, Ju Y, Gui L, Zhang B, Ding F, Zou C. The Mediating Role of Self-Efficacy in Sleep Disorder and Depressive Symptoms Among Chinese Caregivers of Stroke Inpatients: A Structural Equation Modeling Analysis. Neuropsychiatr Dis Treat 2021; 17:3635-3643. [PMID: 34934316 PMCID: PMC8684603 DOI: 10.2147/ndt.s338241] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/01/2021] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Caregivers of stroke inpatients are at high risk of sleep disorder, which may lead to depressive symptoms. Self-efficacy has always been regarded as a protective factor against psychological disorders such as depressive symptoms. This study aims to investigate the sleep disorder and depressive symptoms of caregivers of stroke inpatients in China and explore the mediating effect of self-efficacy between sleep disorder and depressive symptoms among Chinese caregivers of stroke inpatients. PATIENTS AND METHODS In this cross-sectional study, a total of 305 caregivers who were hospitalized with stroke patients completed the PROMIS Sleep Disorder Short Form Scale, General Self-Efficacy Scale and Patient Health Questionnaire-9 in two general public hospitals in northeast and southeast China. A structural equation model with bootstrap method was performed to determine the mediation of self-efficacy between sleep disorder and depressive symptoms. RESULTS Among the participants, 55.4% of caregivers reported depressive symptoms. Sleep disorder and self-efficacy were significant predictors of depressive symptoms. The direct impact of sleep disorder on depressive symptoms was positive, and the path coefficient of sleep disorder with depressive symptoms was decreased from 0.45 to 0.38 (P < 0.01) after addition of self-efficacy in the model. This indicated that self-efficacy played as mediator. CONCLUSION The caregivers of stroke inpatients were in poor physical and psychological health, and more than half of the caregivers (55.4%) suffered from depressive symptoms. Our research revealed the mediation of self-efficacy between sleep disorder and depressive symptoms, and emphasized the importance of enhancing self-efficacy to reduce depressive symptoms among caregivers of stroke inpatients. These results demonstrate that focusing on self-efficacy interventions can enhance mental health and reduce depressive symptoms effectively.
Collapse
Affiliation(s)
- Longjuan Cong
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yanhong Ju
- Section of Statistics, 4th People's Hospital of Shenyang, Shenyang, Liaoning, People's Republic of China
| | - Ling Gui
- Department of Health Service Management, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Bo Zhang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Fangyan Ding
- Department of Health Service Management, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Changqing Zou
- School of Health Humanities, China Medical University, Shenyang, Liaoning, People's Republic of China
| |
Collapse
|
21
|
Moss-Pech SA, Southward MW, Cheavens JS. Hope attenuates the negative impact of general psychological distress on goal progress. J Clin Psychol 2020; 77:1412-1427. [PMID: 33216377 DOI: 10.1002/jclp.23087] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/26/2020] [Accepted: 10/31/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Symptoms of general psychological distress disrupt goal pursuit; however, not everyone is equally impacted by distress when pursuing goals. We tested whether hope, self-efficacy, and/or grit buffered the impact of symptoms of general psychological distress on longitudinal goal progress. METHOD Undergraduate students reported on these constructs and, 2 months later, their progress toward five personal goals (N = 117). RESULTS Although greater levels of baseline psychological distress predicted less goal progress, the impact of psychological distress on goal progress was moderated by hope, β = .20, SE = 0.07, p < .01. More specifically, at higher hope, participants reported similar goal progress regardless of baseline distress symptoms, while at lower hope, baseline distress was negatively associated with goal progress. CONCLUSION Hope may function as a buffer against the association between general psychological distress and impaired goal progress.
Collapse
Affiliation(s)
- Sara A Moss-Pech
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | | | | |
Collapse
|
22
|
Szczepańska-Gieracha J, Mazurek J. The Role of Self-Efficacy in the Recovery Process of Stroke Survivors. Psychol Res Behav Manag 2020; 13:897-906. [PMID: 33177896 PMCID: PMC7649225 DOI: 10.2147/prbm.s273009] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/29/2020] [Indexed: 01/13/2023] Open
Abstract
Introduction Belief in one’s personal capabilities are conducive to achieving success and provides additional energy for action. The stronger the conviction of one’s self-efficacy, the higher the self-goals and the stronger the commitment to achieving them, despite any adversities. Our knowledge regarding the role of self-efficacy in post-stroke rehabilitation is still scarce. Aim of the Study The study aimed to analyze characteristics related to high self-efficacy levels before and after rehabilitation and to determine the role of self-efficacy in this process. Materials and Methods The study involved 99 stroke survivors. Participants’ mental and functional state were assessed using Generalized Self-Efficacy Scale (GSES), Barthel Index (BI), Acceptance of Illness Scale (AIS), Geriatric Depression Scale (GDS), Visual Analogue Scale for Pain (VAS), Instrumental Activities of Daily Living (IADL) and Rivermead Mobility Index (RMI). Patients were evaluated twice: on admission (T1) and 3 weeks into rehabilitation (T2). Results Patients without self-efficacy improvement after 3 weeks of rehabilitation, on discharge from the ward demonstrated poorer well-being (p = 0.002, Hedges’ g = 0.63, 95% CI [0.24–1.08]), lower illness acceptance levels (p < 0.001, Hedges’ g = −0.78, 95% CI [−1.25 – −0.41]), poorer functional status in basic activities of daily living (p = 0.003, Hedges’ g = −0.62, 95% CI [−1 – −0.25]), locomotive abilities (p = 0.004, Hedges’ g = −0.58, 95% CI [−1.12 – −0.15]) and instrumental activities of daily living (p = 0.001, Hedges’ g = −0.71, 95% CI [−1.15 – −0.34]). Conclusion Self-efficacy level is significantly related to rehabilitation outcomes. A routine self-efficacy assessment during the rehabilitation process seems very important. Patients whose initial self-efficacy is low or remains unchanged despite rehabilitation require special attention. Close cooperation between all members of the therapeutic team is essential to strengthen, at each stage, the sense of self-efficacy in stroke survivors.
Collapse
Affiliation(s)
| | - Justyna Mazurek
- Department and Division of Medical Rehabilitation, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
23
|
Medeiros GC, Roy D, Kontos N, Beach SR. Post-stroke depression: A 2020 updated review. Gen Hosp Psychiatry 2020; 66:70-80. [PMID: 32717644 DOI: 10.1016/j.genhosppsych.2020.06.011] [Citation(s) in RCA: 214] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Post-stroke depression (PSD) is common and associated with higher mortality, poorer recovery, more pronounced cognitive deficits, and lower quality of life than is stroke without depression. This manuscript will conduct an updated, comprehensive and clinically-useful review of the risk factors, pathophysiology, assessment, prevention, and treatment of PSD. METHODS This narrative review summarizes articles obtained on PubMed, Medline, EMBase, Google Scholar and the Cochrane Database. This review prioritized articles with a more robust level of evidence, such as original articles with longitudinal data and/or larger samples, randomized controlled trials, systematic reviews, and metaanalyses. RESULTS One hundred twenty-four articles were reviewed, of which 44 (35%) were published before 2016 and 80 (65%) that were published since 2016. DISCUSSION Rates of PSD range from 18 to 33%, yet it is vastly underdiagnosed and undertreated. Risk factors for PSD include female sex, history of psychiatric illness, large or multiple strokes, injuries in frontal/anterior areas or in the basal ganglia, stroke occurrence within the past year, poor social support, and pronounced disability. The pathophysiology of PSD is multifactorial and likely involves decreased levels of monoamines, abnormal neurotrophic response, increased inflammation with dysregulation of hypothalamic-pituitary-adrenal axis, and glutamate-mediated excitotoxicity. The evidence for preventive interventions for PSD is somewhat inconsistent and modest. The best treatment for PSD consists of the combination of pharmacological, psychosocial and stroke-focused interventions. CONCLUSION PSD is a common, treatable condition that is associated with several negative outcomes. Early detection and proper management are critical to obtain better outcomes in individuals with PSD.
Collapse
Affiliation(s)
- Gustavo C Medeiros
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Durga Roy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas Kontos
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Scott R Beach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
24
|
Freire C, Ferradás MDM, Regueiro B, Rodríguez S, Valle A, Núñez JC. Coping Strategies and Self-Efficacy in University Students: A Person-Centered Approach. Front Psychol 2020; 11:841. [PMID: 32508707 PMCID: PMC7248269 DOI: 10.3389/fpsyg.2020.00841] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/06/2020] [Indexed: 11/13/2022] Open
Abstract
In daily academic life, students are exposed to a wide range of potentially stressful situations which could negatively affect their academic achievement and their health. Among the factors that could be weakened by academic stress, attention has been paid to expectations of self-efficacy, which are considered one of the most important determinants for student engagement, persistence, and academic success. From a proactive perspective, research on academic stress has emphasized the importance of coping strategies in preventing harmful consequences. In recent years, there has been a growing interest in discovering the extent to which individuals are able to combine different coping strategies and the adaptive consequences this flexibility entails. However, studies using this person-centered approach are still scarce in the academic context. On that basis, this current study had two objectives: (a) to examine the existence of different profiles of university students based on how they combined different approach coping strategies (positive reappraisal, support seeking, and planning) and (b) to determine the existence of differences in general expectations of self-efficacy between those coping profiles. A total of 1,072 university students participated in the study. The coping profiles were determined by latent profile analysis (LPA). The differences in the self-efficacy variable were determined using ANCOVA, with gender, university year, and degree type as covariates. Four approach coping profiles were identified: (a) low generalized use of approach coping strategies; (b) predominance of social approach coping approaches; (c) predominance of cognitive approach coping approaches; and (d) high generalized use of approach coping strategies. The profile showed that a greater combination of the three strategies was related to higher general self-efficacy expectations and vice versa. These results suggest that encouraging flexibility in coping strategies would help to improve university students’ self-efficacy.
Collapse
Affiliation(s)
- Carlos Freire
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | | | - Bibiana Regueiro
- Department of Pedagogy and Didactics, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Susana Rodríguez
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Antonio Valle
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | | |
Collapse
|
25
|
Volz M, Ladwig S, Werheid K. Gender differences in post-stroke depression: A longitudinal analysis of prevalence, persistence and predictive value of known risk factors. Neuropsychol Rehabil 2019; 31:1-17. [PMID: 31379275 DOI: 10.1080/09602011.2019.1648301] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Post-stroke depression (PSD) is the most frequent psychiatric condition after stroke with a prevalence of approximately 33%. In the general population, depression is consistently reported to be more frequent in women than in men. Evidence about gender differences in PSD remains inconclusive and it is unknown if established risk factors exert gender-specific influence. The authors examined gender differences in PSD prevalence, persistence and influence of established risk factors using χ 2- and Welch's t-tests and continuous-time structural equation modelling (CT-SEM). Patients (N = 301) from the longitudinal Berlin-PSD-study were assessed six weeks (baseline), and up to four times during the first 2.5 years post-stroke using DSM-5 depression criteria and the Geriatric Depression Scale (GDS). Established risk factors were assessed at baseline. Women showed higher PSD prevalence and severity at baseline (p < .01) but not thereafter (p ≥ .43). CT-SEM analysis revealed that known risk factors predicted depression, yet predictive value and persistence did not differ between genders. Our results showed that established PSD risk factors influence both genders to a similar extent and that in contrast to depression in the general population, gender differences in PSD prevalence and severity disappeared within six months post-stroke. Thus, for reasons yet to be deciphered, gender differences in PSD appear to be time-dependent after stroke.
Collapse
Affiliation(s)
- Matthias Volz
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Simon Ladwig
- Department of Psychology, Humboldt University Berlin, Berlin, Germany.,Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Katja Werheid
- Department of Psychology, Humboldt University Berlin, Berlin, Germany.,Klinikum Ernst von Bergmann, Potsdam, Germany
| |
Collapse
|
26
|
Torrisi M, De Cola MC, Buda A, Carioti L, Scaltrito MV, Bramanti P, Manuli A, De Luca R, Calabrò RS. Self-Efficacy, Poststroke Depression, and Rehabilitation Outcomes: Is There a Correlation? J Stroke Cerebrovasc Dis 2018; 27:3208-3211. [PMID: 30078760 DOI: 10.1016/j.jstrokecerebrovasdis.2018.07.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/05/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The sudden live changes of stroke survivors may lead to negative psychological and behavioral outcomes, including anxiety and depressive mood, which may compromise the rehabilitation process. Some personality features, such as self-efficacy, could play an important role in mediating the degree of post-stroke depression. Aim of this study is to investigate the possible correlation between specific psychological dimensions, such as poststroke depression and self-efficacy, and rehabilitation outcomes. MATERIALS AND METHODS Thirty-eight patients, affected by stroke, completed a four-hour-daily training lasting up to 8 weeks, including traditional and robotic-assisted physiotherapy. Patients were assessed at admission (T0) and at the end (T1) of the motor training, by means of the Montgomery-Asberg Depression Scale, the General Self-Efficacy Scale, and the Functional Independent Measure. RESULTS We observed a significant T0-T1 difference in MADRS scores in patients with a better functional recovery (t = 5.76; P < .0001) and higher self-efficacy (t = 4.74; P < .001), but no significant T0-T1 difference in individuals without functional recovery (t = 1.21; P = .239) and low self-efficacy (t = 1.72; P = .103). CONCLUSIONS Our study shows that rehabilitation outcomes and self-efficacy may influence mood, but not vice versa. Thus, to potentiate self-efficacy in the rehabilitation setting may help clinicians in obtaining better functional outcomes, including depression reduction.
Collapse
Affiliation(s)
| | | | - Antonio Buda
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Luigi Carioti
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | | | | | | | | | | |
Collapse
|