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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.
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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.
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Zhang L, Yin J, Sun H, Li J, Zhao X, Liu Y, Yang J. Relationship between mean corpuscular volume and 30-day mortality in patients with intracerebral hemorrhage: Evidence from the MIMIC-III database. Medicine (Baltimore) 2022; 101:e31415. [PMID: 36343042 PMCID: PMC9646635 DOI: 10.1097/md.0000000000031415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Previous studies have shown that mean corpuscular volume (MCV) levels are associated with the prognosis of patients with cardiovascular disease. However, the relationship between MCV levels and mortality in patients with intracerebral hemorrhage (ICH) remains unclear. Patients with ICH were extracted from the Medical Information Mart for Intensive Care-III database. The primary outcome measure was 30-day mortality. Multivariate Cox regression analysis was used to investigate the relationship between MCV at admission and 30-day mortality in ICH patients. We enrolled 1100 patients with ICH. After adjustment for potential confounders, we found that a 1 unit increase in MCV (fl) was associated with a 3% increase in 30-day mortality (HR = 1.03, 95% CI = 1.01-1.05, P = .0015). High MCV (MCV ≥ 92 fl) compared with the low MCV group (MCV < 87 fl) showed a 46% increase of 30-day mortality (HR = 1.46, 95% CI = 1.10-1.92 P = .008). In subgroups analysis's the results remained stable. We demonstrated that MCV at admission was positively associated with 30-day mortality. The Kaplan-Meier (KM) method was used to plot survival curves of three groups with different admission MCV levels.
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Affiliation(s)
- Lu Zhang
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haiyang Sun
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinling Li
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuelian Zhao
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuanxiang Liu
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- * Correspondence: Yuanxiang Liu, Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369 Jingshi Road, Lixia District, Jinan City 250014, Shandong Province, China (e-mail: )
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
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Long J, Wang X, Yuan J, Yang J, Zhou J, Chen Y, Hu E, Zhou Y, Min X. Reference intervals of complete blood count parameters for individuals aged 80 to 89 years in Guizhou, China: A STROBE-compliant retrospective study. Medicine (Baltimore) 2022; 101:e30859. [PMID: 36221361 PMCID: PMC9542839 DOI: 10.1097/md.0000000000030859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The reference intervals of complete blood count (CBC) parameters were commonly based on healthy individuals aged 20 to 79 years. However, these values are not optimal for correct clinical diagnosis in older individuals (e.g., 80-89 years). Although the reference intervals for this age group have been reported in China, there is no population-based report in Guizhou province. A total of 481 healthy adults (238 males and 243 females) aged 80 to 89 years were recruited from Affiliated Hospital of Zunyi Medical University in Guizhou. The CBC parameters were detected by Sysmex XN-9000 automatic hematology analyzer. The reference intervals of the components were analyzed according to the guidelines of International Federation of Clinical Chemistry. This study reported the reference intervals of CBC parameters. There were significant differences were examined in some reference intervals between the different gender groups, especially for RBC-related parameters. Compared with national standards, the most of all conventional reference intervals for CBC parameters were decreased. The present study provided the local reference intervals of CBC parameters for individuals aged 80 to 89 years in Guizhou, China. Some of our results were sex-specific, and most of our results show lower values while comparing with commonly used reference intervals in China. Therefore, more attentions should be paid to these differences, and accurate reference intervals will facilitate clinical diagnosis and decision-making in these populations.
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Affiliation(s)
- Jinlie Long
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiuhong Wang
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jianbo Yuan
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jianru Yang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jie Zhou
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Yuan Chen
- Department of Orthodontics, Affiliated Stomatological Hospital, Zunyi Medical University, Zunyi, Guizhou, China
| | - Enxi Hu
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Yuanzhong Zhou
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xun Min
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
- *Correspondence: Xun Min, Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Dalian Road, Huichuan District, Zunyi 563003, Guizhou, China (e-mail: )
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Liu F, Yang Y, Wang S, Zhang XL, Wang AX, Liao XL, Fang HJ, Qu Y, Ma WG, Zhang N, Wang CX, Wang YJ. Impact of Sleep Duration on Depression and Anxiety After Acute Ischemic Stroke. Front Neurol 2021; 12:630638. [PMID: 33841304 PMCID: PMC8032928 DOI: 10.3389/fneur.2021.630638] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Abnormal sleep duration predicts depression and anxiety. We seek to evaluate the impact of sleep duration before stroke on the occurrence of depression and anxiety at 3 months after acute ischemic stroke (AIS). Methods: Nationally representative samples from the Third China National Stroke Registry were used to examine cognition and sleep impairment after AIS (CNSR-III-ICONS). Based on baseline sleep duration before onset of stroke as measured by using the Pittsburgh Sleep Quality Index (PSQI), 1,446 patients were divided into four groups: >7, 6-7, 5-6, and <5 h of sleep. Patients were followed up with the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) for 3 months. Poststroke anxiety (PSA) was defined as GAD-7 of ≥5 and poststroke depression (PSD) as PHQ-9 of ≥5. The association of sleep duration with PSA and PSD was evaluated using multivariable logistic regression. Results: The incidences of PSA and PSD were 11.2 and 17.6% at 3 months, respectively. Compared to a sleep duration of >7 h, 5-6 h, and <5 h of sleep were identified as risk factors of PSA [odds ratio (OR), 1.95; 95% confidence interval (CI), 1.24-3.07; P < 0.01 and OR, 3.41; 95% CI, 1.94-6.04; P < 0.01) and PSD (OR, 1.47; 95% CI, 1.00-2.17; P = 0.04 and OR, 3.05; 95% CI, 1.85-5.02; P < 0.01), while 6-7 h of sleep was associated with neither PSA (OR, 1.09; 95% CI, 0.71-1.67; P = 0.68) nor PSD (OR, 0.92; 95% CI, 0.64-1.30; P = 0.64). In interaction analysis, the impact of sleep duration on PSA and PSD was not affected by gender (P = 0.68 and P = 0.29, respectively). Conclusions: Sleep duration of shorter than 6 h was predictive of anxiety and depression after ischemic stroke.
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Affiliation(s)
- Fei Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yang Yang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuo Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Li Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - An-Xin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Ling Liao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hong-Juan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yue Qu
- Independent Researcher, Ithaca, NY, United States
| | - Wei-Guo Ma
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chun-Xue Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Yong-Jun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Yao M, Li H, Luo Y, Li L, Yu J. High Prevalence of Post-stroke Anxiety in Elderly Patients Following COVID-19 Outbreak. Front Psychiatry 2021; 12:699869. [PMID: 34248720 PMCID: PMC8264416 DOI: 10.3389/fpsyt.2021.699869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/24/2021] [Indexed: 12/24/2022] Open
Abstract
Objective: Post-stroke anxiety (PSA) is a common affective disorder in patients with ischemic stroke. The elderly are more susceptible to mental health issues, however, few studies have so far focused on PSA in elderly patients, especially in the context of the COVID-19, causing psychological issues in the general population. The aim of the present study was to assess the prevalence and risk factors of PSA in elderly patients following COVID-19 outbreak. Methods: We retrospectively analyzed 206 elderly inpatients with newly diagnosed acute ischemic stroke in the First Affiliated Hospital, Sun Yat-sen University, from January 2020 to December 2020. Patients were categorized into the PSA group and the non-PSA group based on Hamilton Anxiety Scale scores at admission (within 1 week after stroke onset). Demographic and clinical data, mental state by Mini-Mental State Examination, depression by Hamilton Depression Scales (HAMD), and stroke severity and outcome by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to analyze risk factors associated with PSA. We determined the cutoff scores for significant predictors of PSA using the area under the curve (AUC) and receiver operating characteristic. Results: Of the 206 stroke patients, 62 (30.1%) developed anxiety. Binary logistic regression analysis showed that female gender [adjusted odds ratio (aOR): 2.288, 95% confidence interval (CI):1.021-5.128, P = 0.044], high NIHSS scores [aOR: 1.264, 95% CI: 1.074-1.486, P = 0.005] and HAMD scores [aOR: 1.345, 95% CI: 1.215-1.490, P < 0.001] were independent risk factors for PSA. The cutoff threshold for the NIHSS scores was 3.5 points with an AUC of 0.64 and the cutoff threshold for HAMD scores was 5.5 points with an AUC of 0.89. Conclusion: Our results showed a high incidence of PSA in elderly patients after the COVID-19 outbreak. Female gender, high NIHSS and HAMD scores were the independent risk factors for PSA.
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Affiliation(s)
- Meiling Yao
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Hongjie Li
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Ying Luo
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Ling Li
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Jian Yu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
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