1
|
Babkair LA, Huri H, Alharbi W, Turkistani Y, Alaslani R, Alandijani N, Hakami FH. The Association between Sleep Quality and Depressive Symptoms among Stroke Survivors and Caregivers. Healthcare (Basel) 2023; 12:58. [PMID: 38200962 PMCID: PMC10779400 DOI: 10.3390/healthcare12010058] [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: 11/06/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Stroke is a serious health problem that can lead to the development of depressive symptoms, sleep disturbances, and functional dependence in stroke survivors. The change in stroke survivors' quality of life results in negative health outcomes for stroke survivors and caregivers. This study aims to investigate the association between sleep quality and depressive symptoms among stroke survivors and caregivers in Saudi Arabia. METHODS A cross-sectional design was used to collect data from 100 stroke survivors and 80 caregivers using the patient health questionnaire and Pittsburgh Sleep Quality Index. RESULTS 43% of the stroke survivors reported depressive symptoms and 65% had poor sleep quality; 21% of the caregivers reported depressive symptoms and 46% reported poor sleep quality. A strong association between sleep quality and depressive symptoms was detected for the stroke survivors and caregivers: (r = 0.885, p < 0.001); (r = 0.669, p < 0.001), respectively. A strong association was found between caregivers' depressive symptoms and patient post-stroke depressive symptoms (r = 0.502, p < 0.001). A moderate association was found between stroke survivors' sleep quality and caregivers' sleep quality (r = 0.407, p < 0.001). There was a moderate association between stroke survivors' depressive symptoms and caregivers' sleep quality (r = 0.456, p < 0.001). Moreover, there was a moderate association between stroke survivors' sleep quality and caregivers' depressive symptoms (r = 0.492, p < 0.001). CONCLUSION Poor sleep quality and depressive symptoms are common among stroke survivors and caregivers. This study found an association between the two variables. Therefore, depressive symptoms and sleep disturbances in stroke survivors and caregivers should receive more attention. Future research should focus on an interventional study to enhance sleep quality and decrease the risk of depressive symptoms.
Collapse
Affiliation(s)
- Lisa A. Babkair
- Faculty of Nursing, King AbdulAziz University, Jeddah 21589, Saudi Arabia; (H.H.); (W.A.); (Y.T.); (R.A.)
| | - Hanadi Huri
- Faculty of Nursing, King AbdulAziz University, Jeddah 21589, Saudi Arabia; (H.H.); (W.A.); (Y.T.); (R.A.)
| | - Walaa Alharbi
- Faculty of Nursing, King AbdulAziz University, Jeddah 21589, Saudi Arabia; (H.H.); (W.A.); (Y.T.); (R.A.)
| | - Yara Turkistani
- Faculty of Nursing, King AbdulAziz University, Jeddah 21589, Saudi Arabia; (H.H.); (W.A.); (Y.T.); (R.A.)
| | - Ruba Alaslani
- Faculty of Nursing, King AbdulAziz University, Jeddah 21589, Saudi Arabia; (H.H.); (W.A.); (Y.T.); (R.A.)
| | | | | |
Collapse
|
2
|
Hasan F, Vidyanti AN, Tsai PS, Wu D, Lee HC, Yuliana LT, Romadlon DS, Marta OFD, Chiu HY. Psychometric properties of Indonesian version of sleep condition indicator for screening poststroke insomnia. Sleep Breath 2023; 27:2013-2020. [PMID: 36854859 DOI: 10.1007/s11325-023-02797-1] [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: 10/06/2022] [Revised: 12/22/2022] [Accepted: 02/20/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND No study has examined the psychometric properties of the sleep condition indicator (SCI) for screening poststroke insomnia in the Indonesian population. We aimed to develop the Indonesian version of the sleep condition indicator (ISCI) and to examine its psychometric properties for screening adult patients in late sub-acute and chronic periods after stroke. METHODS This was a cross-sectional study with two stages. In the first stage, the English version of the SCI was translated into the ISCI using standard procedures. The psychometric properties of the ISCI were tested in the second stage. Internal consistency and test-retest reliability of ISCI were used to evaluate reliability. A confirmatory factor analysis (CFA) was performed to test construct validity. To test concurrent and convergent validity, the Indonesian version of the insomnia severity index (ISI-INA), generalized anxiety disorder questionnaire (IGAD-7), and patient health questionnaire (IPHQ-9) were used. A receiver operating characteristic (ROC) analysis was conducted to calculate the optimal cutoff score of the ISCI on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for insomnia. RESULTS A total of 160 adults with a diagnosis of stroke for more than 3 months were included (median age of 58.5 years, 31% met the DSM-5 criteria for insomnia). The ISCI had a satisfactory Cronbach's alpha of 0.89 and test-retest reliability of 0.78. The CFA revealed that the ISCI exhibited a satisfactory model fit and was associated with the ISI-INA, IGAD-7, and IPHQ-9 (r = -0.81, -0.32, and -0.52, respectively; all P < .001). The ROC test revealed that the optimal cutoff point of ≤23 yielded the highest sensitivity (94%) and specificity (97%). CONCLUSION The study results revealed that the 8-item ISCI is a reliable and valid screening tool for detecting insomnia symptoms according to the DSM-5 criteria in the chronic period after stroke.
Collapse
Affiliation(s)
- Faizul Hasan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Amelia Nur Vidyanti
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Dean Wu
- Department of Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, 23561, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
| | - Hsin-Chien Lee
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | | | | | | | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
| |
Collapse
|
3
|
Nguyen TTP, Nguyen TX, Nguyen TC, Nguyen HTT, Nguyen TN, Nguyen TTH, Nguyen HTT, Hoang HB, Vu HTT. Post-stroke depression in Vietnamese patients is associated with decreased sleep quality and increased fatigue: a one-institution cross-sectional analysis. Sleep Breath 2023; 27:1629-1637. [PMID: 36434377 PMCID: PMC9702659 DOI: 10.1007/s11325-022-02745-5] [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: 05/21/2022] [Revised: 10/18/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aimed to determine the prevalence of post-stroke depression (PSD) during the first year and its associated factors, especially focusing on sleep quality and fatigue severity. METHODS A cross-sectional study was conducted among stroke patients in Vietnam's National Geriatric Hospital. Data were collected by using standardized questionnaires for interviewing and evaluating patients at the research site. Several covariables were presented including demographics, stroke-related characteristics, activities of daily living, post-stroke fatigue, and sleep quality (Pittsburgh Sleep Quality Index [PSQI] scale). PSD was assessed as an outcome variable through the Patient Health Questionnaire-9 scale. To summarize sociodemographic and clinical variables, descriptive statistics were performed. A logistic regression model was used to explore the factors related to PSD. RESULTS Of 157 patients with stroke, mean age 73.1 (± 9.6), PSD was present in 60 patients (38%). The global score and all PSQI components of participants with PSD showed worse levels than those without depression. Furthermore, the prevalence of PSD was higher in patients with low IADL scores and functional disability at high levels. In the multivariate logistic regression analysis, the patients with PSD showed higher Fatigue Severity Scale (FSS) scores (OR = 4.11; 95% CI = 1.39; 12.19) and higher scores in two domains of the PSQI scale including subjective sleep quality (OR = 3.03; 95% CI = 1.21; 7.58) and sleep disturbance (OR = 5.22; 95% CI = 1.33; 20.47). CONCLUSION There is a significant prevalence of depression following stroke. Furthermore, post-stroke fatigue and two PSQI scale components (subjective sleep quality and sleep disturbance) were shown to be associated with PSD. This finding may guide early screening and intervention strategies to address depression following stroke.
Collapse
Affiliation(s)
- Thao Thi Phuong Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thanh Xuan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Tat Cuong Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Thu Thi Hoai Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Huong Thi Thanh Nguyen
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
- Physiology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Hai Bui Hoang
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Vietnam
- Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam
| | - Huyen Thi Thanh Vu
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam.
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam.
| |
Collapse
|
4
|
Polese JC, da Silva SLA, Lacerda CSA, Roza EA, Torriani-Pasin C. Community ambulation after chronic stroke: A cross-sectional study. J Bodyw Mov Ther 2022. [DOI: 10.1016/j.jbmt.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
5
|
Ecker S, Lord A, Gurin L, Olivera A, Ishida K, Melmed K, Torres J, Zhang C, Frontera J, Lewis A. Psychological Outcome after Hemorrhagic Stroke is Related to Functional Status. J Stroke Cerebrovasc Dis 2022; 31:106492. [PMID: 35594604 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106492] [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: 12/20/2021] [Revised: 03/07/2022] [Accepted: 04/03/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To identify opportunities to improve morbidity after hemorrhagic stroke, it is imperative to understand factors that are related to psychological outcome. DESIGN/METHODS We prospectively identified patients with non-traumatic hemorrhagic stroke (intracerebral or subarachnoid hemorrhage) between January 2015 and February 2021 who were alive 3-months after discharge and telephonically assessed 1) psychological outcome using the Quality of Life in Neurological Disorders anxiety, depression, emotional and behavioral dyscontrol, fatigue and sleep disturbance inventories and 2) functional outcome using the modified Rankin Scale (mRS) and Barthel Index. We also identified discharge destination for all patients. We then evaluated the relationship between abnormal psychological outcomes (T-score >50) and discharge destination other than home, poor 3-month mRS score defined as 3-5 and poor 3-month Barthel Index defined as <100. RESULTS 73 patients were included; 41 (56%) had an abnormal psychological outcome on at least one inventory. There were 41 (56%) patients discharged to a destination other than home, 44 (63%) with poor mRS score and 28 (39%) with poor Barthel Index. Anxiety, depression, emotional and behavioral dyscontrol and sleep disturbance were all associated with a destination other than home, poor mRS score, and poor Barthel Index (all p<0.05). Fatigue was related to poor mRS score and poor Barthel Index (p=0.005 and p=0.006, respectively). CONCLUSION Multiple psychological outcomes 3-months after hemorrhagic stroke are related to functional status. Interventions to improve psychological outcome and reduce morbidity in patients with poor functional status should be explored by the interdisciplinary team.
Collapse
Affiliation(s)
- Sarah Ecker
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York
| | - Aaron Lord
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York; NYU Langone Medical Center, Department of Neurosurgery, NY 10016, New York
| | - Lindsey Gurin
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York; NYU Langone Medical Center, Department of Psychiatry, NY 10016, New York; NYU Langone Medical Center, Department of Rehabilitation Medicine, NY 10016, New York
| | - Anlys Olivera
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York; NYU Langone Medical Center, Department of Psychiatry, NY 10016, New York
| | - Koto Ishida
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York
| | - Kara Melmed
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York; NYU Langone Medical Center, Department of Neurosurgery, NY 10016, New York
| | - Jose Torres
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York
| | - Cen Zhang
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York
| | - Jennifer Frontera
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York; NYU Langone Medical Center, Department of Neurosurgery, NY 10016, New York
| | - Ariane Lewis
- NYU Langone Medical Center, Department of Neurology, NY 10016, New York; NYU Langone Medical Center, Department of Neurosurgery, NY 10016, New York.
| |
Collapse
|
6
|
Fleming MK, Smejka T, Henderson Slater D, Chiu EG, Demeyere N, Johansen-Berg H. Self-Reported and Objective Sleep Measures in Stroke Survivors With Incomplete Motor Recovery at the Chronic Stage. Neurorehabil Neural Repair 2021; 35:851-860. [PMID: 34196598 PMCID: PMC8442123 DOI: 10.1177/15459683211029889] [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] [Indexed: 01/04/2023]
Abstract
Background. Stroke survivors commonly complain of difficulty sleeping. Poor sleep is associated with reduced quality of life and more understanding of long-term consequences of stroke on sleep is needed. Objective. The primary aims were to (1) compare sleep measures between chronic stroke survivors and healthy controls and (2) test for a relationship between motor impairment, time since stroke and sleep. Secondary aims were to explore mood and inactivity as potential correlates of sleep and test the correlation between self-reported and objective sleep measures. Methods. Cross-sectional sleep measures were obtained for 69 chronic stroke survivors (mean 65 months post-stroke, 63 years old, 24 female) and 63 healthy controls (mean 61 years old, 27 female). Self-reported sleep was assessed with the sleep condition indicator (SCI) and sleep diary ratings, objective sleep with 7-nights actigraphy and mood with the Hospital Anxiety and Depression Scale. Upper extremity motor impairment was assessed with the Fugl-Meyer assessment. Results. Stroke survivors had significantly poorer SCI score (P < .001) and higher wake after sleep onset (P = .005) than controls. Neither motor impairment, nor time since stroke, explained significant variance in sleep measures for the stroke group. For all participants together, greater depression was associated with poorer SCI score (R2adj = .197, P < .001) and higher age with more fragmented sleep (R2adj = .108, P < .001). There were weak correlations between nightly sleep ratings and actigraphy sleep measures (rs = .15-.24). Conclusions. Sleep disturbance is present long-term after stroke. Depressive symptoms may present a modifiable factor which should be investigated alongside techniques to improve sleep in this population.
Collapse
Affiliation(s)
- Melanie K Fleming
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, 6396University of Oxford, Oxford, UK.,552380NIHR Oxford Biomedical Research Centre, UK.,212787Oxford Centre for Enablement, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Tom Smejka
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, 6396University of Oxford, Oxford, UK.,552380NIHR Oxford Biomedical Research Centre, UK.,212787Oxford Centre for Enablement, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - David Henderson Slater
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, 6396University of Oxford, Oxford, UK.,212787Oxford Centre for Enablement, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Nele Demeyere
- Department of Experimental Psychology, 6396University of Oxford, Oxford, UK
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, 6396University of Oxford, Oxford, UK.,552380NIHR Oxford Biomedical Research Centre, UK
| |
Collapse
|