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Broomfield NM, Blake J, Gracey F, Steverson T. Post-stroke emotionalism: Diagnosis, pathophysiology, and treatment. Int J Stroke 2024; 19:857-866. [PMID: 38503711 PMCID: PMC11408949 DOI: 10.1177/17474930241242952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND Post-stroke emotionalism affects one in five stroke sufferers 6 months after their stroke, but despite its frequency remains a poorly understood stroke symptom. The literature is limited, especially compared to other frequently observed neurological conditions such as aphasia and visual neglect. AIM AND METHODS This narrative review presents a summary of the post-stroke emotionalism literature, to inform clinical practice and future research. We cover discussion of definitions, prevalence, neurobiology, predisposing and precipitating factors, and treatment. RESULTS Increasing evidence suggests that damage to specific areas functionally linked to emotion expression or regulation processes, disruption to structural pathways and those related to serotonin production and modulation individually or in concert give rise to emotionalism-type presentations. A range of emotionalism measurement tools have been used in research contexts making between study comparisons difficult. Testing for Emotionalism after Recent Stroke-Questionnaire (TEARS-Q) has recently been developed to allow standardized assessment. Treatment options are limited, and there have been few adequately powered treatment trials. Antidepressants may reduce severity, but more trial data are required. There have been no randomized-controlled trials of non-pharmacological interventions. CONCLUSIONS More research is needed to improve recognition and treatment of this common and disabling symptom. We conclude with research priorities and recommendations for the field.
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Affiliation(s)
- Niall M Broomfield
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
| | - Joshua Blake
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom Steverson
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
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Xian X, Niu T, Zhang Y, Zhou X, Wang X, Du X, Qu L, Mao B, He Y, Chen X, Ye M. The relationship between appearance anxiety and depression among students in a medical university in China: a serial multiple mediation model. PeerJ 2024; 12:e17090. [PMID: 38563007 PMCID: PMC10984188 DOI: 10.7717/peerj.17090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
Background Appearance anxiety and depression have become common and global public health problems worldwide, especially among adolescents. However, few studies have revealed the mechanisms between them. This study aimed to explore the multiple mediating roles of interpersonal sensitivity and social support between appearance anxiety and depression among medical college students. Methods With 13 invalid samples excluded, 724 college students participated in our survey and completed questionnaires. The average age of 724 samples was 19.8 ± 2.02 including freshman to senior year and graduate school and above; 31.9% of the participants were male and 68.1% were female. SPSS 25.0 and Hayes' PROCESS macro were used for statistical description, correlation analysis and built multiple mediation models. Results Appearance anxiety can not only directly affect depression, but also indirectly affect depression through three significant mediating pathways: (1) IS (B = 0.106, 95% CI [0.082-0.132]), which accounted for 49.77% of the total effect, (2) SS (B = 0.018, 95% CI [0.008-0.031]), which accounted for 8.45% of the total effect, and (3) IS and SS (B = 0.008, 95% CI [0.003-0.014]), which accounted for 3.76% of the total effect. And the total mediating effect was 61.97%. Limitations It is a cross-sectional research method and the causal relationship is unclear. Conclusions This study found that lower interpersonal sensitivity and higher social support can effectively reduce depression caused by appearance anxiety among college students. The schools and relevant departments should take measures to reduce the interpersonal sensitivity of college students and establish reliable social support, so as to reduce the occurrence of depression.
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Affiliation(s)
- Xiaobing Xian
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Tengfei Niu
- Department of Basic Courses, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Yu Zhang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xilin Zhou
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xinxin Wang
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Xin Du
- The Second Clinical College, Chongqing Medical University, Chongqing, China
| | - Linhan Qu
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Binyi Mao
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Ying He
- The Second Clinical College, Chongqing Medical University, Chongqing, China
| | - Xiyu Chen
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Mengliang Ye
- School of Public Health, Chongqing Medical University, Chongqing, China
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Zhang W, Ye M, Zhou W, Gao Y, Zhou L. Trajectory and predictors of family function in caregivers of stroke survivors: A longitudinal study of the first 6 months after stroke. J Adv Nurs 2024; 80:264-274. [PMID: 37395440 DOI: 10.1111/jan.15749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 05/04/2023] [Accepted: 06/10/2023] [Indexed: 07/04/2023]
Abstract
AIMS This study aimed to investigate the trajectory and predictors of family function in caregivers of stroke survivors during the first 6 months after the first episode of stroke. DESIGN Longitudinal study. METHODS A total of 288 primary caregivers of patients with first-time stroke were recruited from seven tertiary hospitals in China between July 2020 and March 2021. The following characteristics were assessed by caregivers at hospitalization (T0) and at 1 month (T1), 3 months (T2) and 6 months (T3) after the stroke: family function, general self-efficacy, social support, coping style, caregiver burden, and sociodemographic and clinical data. RESULTS Family function scores among caregivers of stroke survivors were highest in the resolve dimension and lowest in the growth and adaptation dimensions within the first 6 months. The percentages of families with low functioning were 34.7%, 33.3%, 24.8% and 17.7% at T0, T1, T2 and T3, respectively. The generalized estimating equation model revealed that family function in caregivers increased over the first 6 months (Exp(B) = 1.415-2.689, p < .05). The following factors were identified as predictors of family functioning: caregiver's age, education, residential district, self-efficacy, social support utilization and caregiver burden. CONCLUSIONS Family function of caregivers of stroke survivors gradually increased during the first 6 months after stroke. However, some families demonstrated poor functioning. Caregivers' age, education, caregiver burden, self-efficacy and social support utilization could predict family function over time. IMPACT Empirical data on family function in families of stroke survivors are important for developing psychosocial interventions that can help families adapt to stroke. This study found that families of stroke survivors were likely to be dysfunctional in the first 6 months after stroke, particularly in family growth and adaptation. Therefore, reducing caregiver burden and promoting self-efficacy and social support utilization can help restore family functioning early after stroke. PATIENT OR PUBLIC CONTRIBUTION Stroke caregivers from seven hospitals in China were involved in this study and had the right to be informed of the main findings. A few patients were informed of the research results, who contributed to the dissemination.
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Affiliation(s)
- Wei Zhang
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Mingming Ye
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Wanqiong Zhou
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Yitian Gao
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Lanshu Zhou
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
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Lo SHS, Chau JPC, Lau AYL, Choi KC, Shum EWC, Lee VWY, Hung SS, Mok VCT, Siow EKC, Ching JYL, Mirchandani K, Lam SKY. Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial. Stroke 2023; 54:2482-2490. [PMID: 37551588 PMCID: PMC10519295 DOI: 10.1161/strokeaha.123.043605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Stroke survivors constantly feel helpless and unprepared after discharge from hospitals. More flexible and pragmatic support are needed for their optimized recovery. We examined the effects of a virtual multidisciplinary stroke care clinic on survivors' health and self-management outcomes. METHODS A randomized controlled trial was conducted. Survivors were recruited from 10 hospitals and randomized at 1:1 ratio into the intervention or the control groups. Intervention group participants received the Virtual Multidisciplinary Stroke Care Clinic service (monthly online consultations with a nurse, follow-up phone calls, and access to an online platform). Control group participants received the usual care. Outcomes of self-efficacy (stroke self-efficacy questionnaire; primary), self-management behaviors (Stroke Self-Management Behaviors Performance Scale), social participation (reintegration to normal living index), and depression (Geriatric Depression Scale; secondary) were measured at baseline, and 3 and 6 months after commencing the intervention (post-randomization). A generalized estimating equations model was used to compare the differential changes in outcomes at 3 and 6 months with respect to baseline between 2 groups. RESULTS Between July 2019 and June 2022, 335 eligible participants were enrolled in the study. Participants (intervention group; n=166) showed significantly greater improvements in outcomes of self-efficacy (group-by-time interaction regression coefficient, B=4.60 [95% CI, 0.16 to 9.05]), social participation (B=5.07 [95% CI, 0.61 to 9.53]), and depression (B=-2.33 [95% CI, -4.06 to -0.61]), and no significant improvement in performance of self-management behaviors (B=3.45, [95% CI, -0.87 to 7.77]), compared with the control group (n=169) right after the intervention (6 months after its commencement). Hedges' g effect sizes of the intervention on outcomes: 0.19 to 0.36. CONCLUSIONS The results provide some positive evidence on the usefulness of the Virtual Multidisciplinary Stroke Care Clinic service. The effect sizes are regarded as small to medium, which may not be of clinical relevance. The baseline levels in outcomes were in favor of the control group, the intervention effects might be overestimated. The service must be tested further to determine its effectiveness. REGISTRATION URL: https://www.chictr.org.cn; Unique identifier: ChiCTR1800016101.
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Affiliation(s)
- Suzanne Hoi Shan Lo
- The Nethersole School of Nursing (S.H.S.L., J.P.C.C., K.C.C., K.M., S.K.Y.L.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing (S.H.S.L., J.P.C.C., K.C.C., K.M., S.K.Y.L.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Alexander Yuk Lun Lau
- Department of Medicine and Therapeutics (A.Y.L.L.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kai Chow Choi
- The Nethersole School of Nursing (S.H.S.L., J.P.C.C., K.C.C., K.M., S.K.Y.L.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Vivian Wing Yan Lee
- Centre for Learning Enhancement And Research, The Chinese University of Hong Kong, Hong Kong SAR (V.W.Y.L.)
| | - Sheung Sheung Hung
- Hong Kong Institute of Integrative Medicine (S.S.H.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Vincent Chung Tong Mok
- Division of Neurology, Department of Medicine and Therapeutics (V.C.T.M.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Jessica Yuet Ling Ching
- Department of Medicine and Therapeutics (J.Y.L.C.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kashika Mirchandani
- The Nethersole School of Nursing (S.H.S.L., J.P.C.C., K.C.C., K.M., S.K.Y.L.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Simon Kwun Yu Lam
- The Nethersole School of Nursing (S.H.S.L., J.P.C.C., K.C.C., K.M., S.K.Y.L.), Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
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Wang G, Liu X, Lei J. Mental health latent profiles and emotion regulation in women with polycystic ovary syndrome: A cross-sectional study. J Health Psychol 2023; 28:1172-1185. [PMID: 37492985 DOI: 10.1177/13591053231186916] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
This cross-sectional study aimed to identify latent mental health subgroups of reproductive-aged women with polycystic ovary syndrome (PCOS) and examine differences in emotion regulation and social support. A total of 477 samples (age = 27.22 ± 5.37) diagnosed with PCOS were included in this study, all of whom were of the same ethnicity. Latent profile analysis (LPA) was conducted in Mplus version 8.3 to identify mental health latent profiles in women with PCOS based on the dual-factor approach. The current study identified three distinct mental health profiles within women with PCOS: High-Symptom and High-Well-being Profile, Low-Symptom and High-Well-being Profile, and High-Symptom and Low-Well-being Profile, with group proportions of 52.3%, 35.7%, and 11.1%, respectively. This study revealed that cognitive reappraisal and social support are important protective factors for the mental health of women with PCOS, whereas expressive suppression is a negative factor for their mental health.
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Affiliation(s)
- Guangpeng Wang
- The Third Xiangya Hospital of Central South University, China
- Xiangya School of Nursing, Central South University, China
| | - Xueyan Liu
- School of Nursing, Shandong University, China
| | - Jun Lei
- The Third Xiangya Hospital of Central South University, China
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Hu Y, Qiu X, Ji C, Wang F, He M, He L, Chen L. Post-stroke experiences and health information needs among Chinese elderly ischemic stroke survivors in the internet environment: a qualitative study. Front Psychol 2023; 14:1150369. [PMID: 37663326 PMCID: PMC10471187 DOI: 10.3389/fpsyg.2023.1150369] [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: 01/26/2023] [Accepted: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
Background Elderly stroke survivors are encouraged to receive appropriate health information to prevent recurrences. After discharge, older patients seek health information in everyday contexts, examining aspects that facilitate or impair healthy behavior. Objectives To explore the experiences of older stroke patients when searching for health information, focusing on search methods, identification of health information, and difficulties faced during the search process. Methods Using the qualitative descriptive methodology, semi-structured interviews were conducted with fifteen participants. Results Participants associated the health information they sought with concerns about future life prospects triggered by perceived intrusive changes in their living conditions. Based on the participants' descriptions, four themes were refined: participants' motivation to engage in health information acquisition behavior, basic patterns of health information search, source preferences for health information, and difficulties and obstacles in health information search, and two search motivation subthemes, two search pattern subthemes, four search pathway subthemes, and four search difficulty subthemes were further refined. Conclusion Older stroke patients face significant challenges in searching for health information online. Healthcare professionals should assess survivors' health information-seeking skills, develop training programs, provide multichannel online access to health resources, and promote secondary prevention for patients by improving survivors' health behaviors and self-efficacy.
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Affiliation(s)
- Yufan Hu
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Xichenhui Qiu
- Health Science Center, Shenzhen University, Shenzhen, China
| | - Cuiling Ji
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Fang Wang
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Manlan He
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Lei He
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Lu Chen
- Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
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Lee Y, Won M. Mediating Effects of Rehabilitation Motivation between Social Support and Health-Related Quality of Life among Patients with Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215274. [PMID: 36429992 PMCID: PMC9690434 DOI: 10.3390/ijerph192215274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 05/28/2023]
Abstract
Post-stroke health-related quality of life (HRQoL) is poor, which is related to low social support levels and lack of rehabilitation motivation. However, there are limited studies that have systematically analyzed the mechanisms underlying this relationship in stroke patients. This study aimed to identify the mediating effects of rehabilitation motivation on the relationship between social support and HRQoL among stroke patients. A cross-sectional descriptive study was conducted on 176 Koreans aged ≥19 years who were admitted for rehabilitation treatment after stroke at three general hospitals in Jeonbuk. Data collection was conducted from September to December 2020 through face-to-face interviews using structured questionnaires and review of medical records. The significance of the mediation model was tested using SPSS 25.0 and the PROCESS macro for SPSS v3.5. Significant associations were identified between social support and HRQoL. Our findings revealed an indirect effect, suggesting that the effects of social support on HRQoL are mediated by rehabilitation motivation (B = 0.004, 95% bias-corrected bootstrap confidence interval = 0.002, 0.006). Social support for stroke patients had a positive effect on HRQoL, and rehabilitation motivation was found to have a partial mediating effect on this relationship. This study suggests that social support from healthcare professionals and families for post-stroke can improve patients' HRQoL by inducing positive rehabilitation motivation. Therefore, developing intervention strategies to motivate rehabilitation could improve the HRQoL of patients with stroke.
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Affiliation(s)
| | - Mihwa Won
- Correspondence: ; Tel.: +82-63-850-6045
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