Predictors of depressive symptoms among community-dwelling stroke survivors

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19 Citations (Scopus)

Abstract

Background: Depression is a common yet often unrecognized consequence of stroke, affecting between 25% and 70% of all survivors. Untreated depression post-stroke leads to a poorer prognosis and increased mortality. However, the pattern and profile of post-stroke depression in chronic stroke are poorly understood. Objective: The aim of this study was to examine the independent predictors of depressive symptoms in chronic stroke. Methods: Community-dwelling stroke survivors (n = 100) completed the Center for Epidemiological Studies-Depression (CES-D) scale, Multidimensional Scale of Perceived Social Support, Medical Outcomes Study Short Form-36, and the Pittsburgh Sleep Quality Index. Functional disability and cognitive impairment were assessed using standardized procedures. Multiple linear regression was conducted to explore potential independent predictors of depressive symptoms. Results: Subjects were, on average, 70 ± 10 years old and 39 ± 49 months post-stroke. The majority were white/European-American (78%), college educated (79%), and retirees (77%). Annual income was $50 000 or greater for 32%. Hemiparesis was common (right side, 39%; left side, 42%); 35% had a Center for Epidemiological Studies-Depression scale score of 16 or higher, and 21% had a history of major depression. Approximately 64% of the variance in depressive symptoms could be explained by the independent variables in the model: quality of life, sleep quality, social support, cognitive impairment, functional disability, months post-stroke, age, gender, history of major depression, and lesion location (R = 0.64, F12,87 = 12.97, P < .01). Only poor quality of life (t1,87 =-6.99, P < .01) and low social support (t1,87 =-2.14, P = .04) contributed uniquely and significantly to the severity of depressive symptoms among these stroke survivors. Conclusion: Depressive symptoms are prevalent in chronic stroke survivors, even among an educated and economically advantaged population. Our findings are similar to reports by others that poor quality of life and low social support are major contributors to depressive symptoms in chronic stroke and should be routinely assessed and monitored to improve long-term rehabilitation efforts and promote wellness and community reintegration.

Original languageEnglish (US)
Pages (from-to)460-467
Number of pages8
JournalJournal of Cardiovascular Nursing
Volume28
Issue number5
DOIs
StatePublished - Sep 2013

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Independent Living
Survivors
Stroke
Depression
Social Support
Quality of Life
Epidemiologic Studies
Sleep
Paresis

Keywords

  • chronic stroke
  • depressive symptoms
  • long-term rehabilitation
  • quality of life
  • social support

ASJC Scopus subject areas

  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

@article{b49cac76f9584ee985c23ebf981d2eea,
title = "Predictors of depressive symptoms among community-dwelling stroke survivors",
abstract = "Background: Depression is a common yet often unrecognized consequence of stroke, affecting between 25{\%} and 70{\%} of all survivors. Untreated depression post-stroke leads to a poorer prognosis and increased mortality. However, the pattern and profile of post-stroke depression in chronic stroke are poorly understood. Objective: The aim of this study was to examine the independent predictors of depressive symptoms in chronic stroke. Methods: Community-dwelling stroke survivors (n = 100) completed the Center for Epidemiological Studies-Depression (CES-D) scale, Multidimensional Scale of Perceived Social Support, Medical Outcomes Study Short Form-36, and the Pittsburgh Sleep Quality Index. Functional disability and cognitive impairment were assessed using standardized procedures. Multiple linear regression was conducted to explore potential independent predictors of depressive symptoms. Results: Subjects were, on average, 70 ± 10 years old and 39 ± 49 months post-stroke. The majority were white/European-American (78{\%}), college educated (79{\%}), and retirees (77{\%}). Annual income was $50 000 or greater for 32{\%}. Hemiparesis was common (right side, 39{\%}; left side, 42{\%}); 35{\%} had a Center for Epidemiological Studies-Depression scale score of 16 or higher, and 21{\%} had a history of major depression. Approximately 64{\%} of the variance in depressive symptoms could be explained by the independent variables in the model: quality of life, sleep quality, social support, cognitive impairment, functional disability, months post-stroke, age, gender, history of major depression, and lesion location (R = 0.64, F12,87 = 12.97, P < .01). Only poor quality of life (t1,87 =-6.99, P < .01) and low social support (t1,87 =-2.14, P = .04) contributed uniquely and significantly to the severity of depressive symptoms among these stroke survivors. Conclusion: Depressive symptoms are prevalent in chronic stroke survivors, even among an educated and economically advantaged population. Our findings are similar to reports by others that poor quality of life and low social support are major contributors to depressive symptoms in chronic stroke and should be routinely assessed and monitored to improve long-term rehabilitation efforts and promote wellness and community reintegration.",
keywords = "chronic stroke, depressive symptoms, long-term rehabilitation, quality of life, social support",
author = "Taylor-Piliae, {Ruth E} and Joseph Hepworth and Coull, {Bruce M}",
year = "2013",
month = "9",
doi = "10.1097/JCN.0b013e318258ad57",
language = "English (US)",
volume = "28",
pages = "460--467",
journal = "Journal of Cardiovascular Nursing",
issn = "0889-4655",
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T1 - Predictors of depressive symptoms among community-dwelling stroke survivors

AU - Taylor-Piliae, Ruth E

AU - Hepworth, Joseph

AU - Coull, Bruce M

PY - 2013/9

Y1 - 2013/9

N2 - Background: Depression is a common yet often unrecognized consequence of stroke, affecting between 25% and 70% of all survivors. Untreated depression post-stroke leads to a poorer prognosis and increased mortality. However, the pattern and profile of post-stroke depression in chronic stroke are poorly understood. Objective: The aim of this study was to examine the independent predictors of depressive symptoms in chronic stroke. Methods: Community-dwelling stroke survivors (n = 100) completed the Center for Epidemiological Studies-Depression (CES-D) scale, Multidimensional Scale of Perceived Social Support, Medical Outcomes Study Short Form-36, and the Pittsburgh Sleep Quality Index. Functional disability and cognitive impairment were assessed using standardized procedures. Multiple linear regression was conducted to explore potential independent predictors of depressive symptoms. Results: Subjects were, on average, 70 ± 10 years old and 39 ± 49 months post-stroke. The majority were white/European-American (78%), college educated (79%), and retirees (77%). Annual income was $50 000 or greater for 32%. Hemiparesis was common (right side, 39%; left side, 42%); 35% had a Center for Epidemiological Studies-Depression scale score of 16 or higher, and 21% had a history of major depression. Approximately 64% of the variance in depressive symptoms could be explained by the independent variables in the model: quality of life, sleep quality, social support, cognitive impairment, functional disability, months post-stroke, age, gender, history of major depression, and lesion location (R = 0.64, F12,87 = 12.97, P < .01). Only poor quality of life (t1,87 =-6.99, P < .01) and low social support (t1,87 =-2.14, P = .04) contributed uniquely and significantly to the severity of depressive symptoms among these stroke survivors. Conclusion: Depressive symptoms are prevalent in chronic stroke survivors, even among an educated and economically advantaged population. Our findings are similar to reports by others that poor quality of life and low social support are major contributors to depressive symptoms in chronic stroke and should be routinely assessed and monitored to improve long-term rehabilitation efforts and promote wellness and community reintegration.

AB - Background: Depression is a common yet often unrecognized consequence of stroke, affecting between 25% and 70% of all survivors. Untreated depression post-stroke leads to a poorer prognosis and increased mortality. However, the pattern and profile of post-stroke depression in chronic stroke are poorly understood. Objective: The aim of this study was to examine the independent predictors of depressive symptoms in chronic stroke. Methods: Community-dwelling stroke survivors (n = 100) completed the Center for Epidemiological Studies-Depression (CES-D) scale, Multidimensional Scale of Perceived Social Support, Medical Outcomes Study Short Form-36, and the Pittsburgh Sleep Quality Index. Functional disability and cognitive impairment were assessed using standardized procedures. Multiple linear regression was conducted to explore potential independent predictors of depressive symptoms. Results: Subjects were, on average, 70 ± 10 years old and 39 ± 49 months post-stroke. The majority were white/European-American (78%), college educated (79%), and retirees (77%). Annual income was $50 000 or greater for 32%. Hemiparesis was common (right side, 39%; left side, 42%); 35% had a Center for Epidemiological Studies-Depression scale score of 16 or higher, and 21% had a history of major depression. Approximately 64% of the variance in depressive symptoms could be explained by the independent variables in the model: quality of life, sleep quality, social support, cognitive impairment, functional disability, months post-stroke, age, gender, history of major depression, and lesion location (R = 0.64, F12,87 = 12.97, P < .01). Only poor quality of life (t1,87 =-6.99, P < .01) and low social support (t1,87 =-2.14, P = .04) contributed uniquely and significantly to the severity of depressive symptoms among these stroke survivors. Conclusion: Depressive symptoms are prevalent in chronic stroke survivors, even among an educated and economically advantaged population. Our findings are similar to reports by others that poor quality of life and low social support are major contributors to depressive symptoms in chronic stroke and should be routinely assessed and monitored to improve long-term rehabilitation efforts and promote wellness and community reintegration.

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KW - long-term rehabilitation

KW - quality of life

KW - social support

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