The Effect of Psychosocial Factors and Functional Independence on Poststroke Depressive Symptoms: A Cross-Sectional Study

The Association between Sleep Quality and Depressive Symptoms among Stroke Survivors and Caregivers

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.

Social Support and Depression among Stroke Patients: A Topical Review

Research has shown a protective association between social support and depression, depression among stroke patients, and health impacts of depression. Despite this, not much is known about the effect of social support on depression among stroke patients. This review aims to summarize the current research examining the association between social support and depression among stroke patients. A literature search was performed in PubMed to find original peer-reviewed journal articles from 2016 to 12 March 2023 that examined the association between social support and depression among stroke patients. The search terms were depression and "social support" and stroke, which lead to 172 articles. After abstract review, seven observational studies that studied the target association among stroke patients were selected. One additional study was found using PsycINFO as a complementary source with the same search strategy and criteria. Overall, a negative association was found between social support and depression among stroke patients in eight studies, with more social support leading to lower rates of depression post-stroke. The other study did not find a statistically significant association. Overall, the results of recent studies suggest that social support is negatively associated with depression among stroke patients. In most studies, this association was statistically significant. The findings suggest the importance of improving social support perceived by stroke patients in the prevention of depression after the occurrence of stroke.

Nursing Care for Stroke Patients: Current Practice and Future Needs

BACKGROUND

Stroke is the second leading cause of death and the third leading cause of disability worldwide. Stroke nurses play an important role in the care of patients living with stroke by using best practices and adhering to stroke-management guidelines. This study aims at examining the current nursing practice for stroke patients in Saudi Arabia.

METHOD

A cross-sectional descriptive design was used to collect data from nurses working in the stroke unit and intensive care unit between the period of February and June 2022 using electronic self-administered questionnaires.

RESULTS

A convenience sample of 131 nurses who provided care for stroke patients was enrolled. Significant differences in nursing practice were found between the stroke units and the intensive care units regarding the activation of the stroke code, X2 (4, N = 131) = 48.34, p < 0.001; transferring stroke patients to a designated bed, X2 (4, N = 131) = 48.74, p = 0.002; applying the NIHSS, X2 (4, N = 131) = 70.11, p < 0.001; using the modified Rankin scale, X2 (4, N = 131) = 61.24, p < 0.001; providing intervention for neglect syndrome, X2 (4, N = 131) = 44.72, and hemianopsia, X2 (4, N = 131) = 39.22; screening for poststroke depression, X2 (4, N = 131) = 101.59, p < 0.001; assessing for psychosocial needs, X2 (4, N = 131) = 74.44, p < 0.001, and encouraging patients to express their feelings, X2 (4, N = 131) = 58.64, p < 0.001; educating patients and families about stroke prevention, X2 (4, N = 131) = 40.51, p < 0.001.

CONCLUSION

As per the results of the study, there is an urgent need for stroke units run by specialized stroke nurses to provide early stroke management and improve survivors' outcomes. Structured stroke-care programs are needed to improve nursing practice and meet the international standard of stroke care.

The mediating effect of post-stroke depression between social support and quality of life among stroke survivors: A meta-analytic structural equation modeling

OBJECTIVES

The aim was to confirm the relationship between social support (SS), post-stroke depression (PSD), and quality of life (QOL) and determine the mediating effect of PSD in stroke survivors. Additionally, we tested the impact of economic development level (in developed or developing countries) on the relationship between SS, PSD, and QOL.

METHODS

This study utilized meta-analytic structural equation modeling on systematically searched articles from PubMed, MEDLINE, Cochrane Library, Scopus, PsycINFO, Web of Science, China National Knowledge Infrastructure, and WanFang data published from inception to February 2022. Collect the sample size (n) of each study and the associations of observed variables, and conduct meta-analysis path analysis using AMOS 23.0 to assess the relationships. Concurrently, the effects of the national economic development level were extracted for moderator analysis.

RESULTS

A total of 28 studies (N = 3967) were included for analysis. SS and PSD were significant predictors of QOL (both p < 0.01). PSD mediated the relationship between SS and QOL (β = 0.31; 95% confidence interval 0.273-0.345; p < 0.01). Furthermore, in developed countries, SS was not statistically correlated with PSD (p = 0.811) compared to developing countries.

CONCLUSIONS

Improving SS may help improve the QOL of stroke patients. PSD should be addressed using a comprehensive approach that includes interventions to enhance the QOL. Additionally, people have different psychological reactions to SS at different stages of economic development; thus, further research is needed to develop different measurement standards for patients according to the country's level of economic development.