Development and initial validation of a clinical measure to assess symptoms of post-stroke depression in stroke patients at the rehabilitation stage

Abstract

BackgroundThe high incidence of post-stroke depression (PSD) during rehabilitation exerts a negative effect on the treatment and functional recovery of patients with stroke and increases the risk of mortality. It is necessary to screen PSD in the rehabilitation stage and thus provide effective intervention strategies. However, existing measurements used to assess PSD in the rehabilitation stage in patients with stroke lack specificity. This study aimed to develop a clinical measure to assess symptoms of PSD in the rehabilitation stage.MethodsThe research team created the initial items through a literature review and semi-structured interviews of patients with stroke. Then, the symptom-related items were estimated by three panels: healthcare professionals (N = 41), Delphi experts (N = 15), and patients with stroke in the rehabilitation stage (N = 30).ResultsThe literature review and semi-structured interview produced 51 symptom-related items including six domains, and the items were reduced to 47 by the healthcare professionals. The symptom-related items were further reduced to 33 items by a two-round Delphi consultation. The initiative coefficients of the two Delphi rounds were 71.4 and 100%, the expert authority coefficients were both 0.85, Kendall’s W were 0.152 and 0.408 (p < 0.01), and the coefficient of variation (CV) were 0.05–0.32 and 0.00–0.18, respectively. The item-level content validity index (I-CVI) was 0.53–1.00, the scale-level CVI/universal agreement (S-CVI/UA) was 0.26, and the S-CVI/average (S -CVI/Ave) was 0.85 for the first found Delphi consultation; the I-CVI was 0.67–1.00, the S-CVI/UA was 0.61, and the S-CVI/Ave was 0.97 for the second round Delphi consultation. All content validity indicators have been significantly improved compared with the first round. Using mean ≥ 4 and full score ≥ 0.5, combined with CV ≤ 0.16 as the item criteria, a clinical measure of PSD with 33 items and 6 dimensions (cognition, sleep, behavior, emotion, body, and guilt) was finally formed after two rounds. The patients with stroke made no further revisions after evaluation.ConclusionThe research team developed a specific tool with good content validity to assess the symptoms of PSD in the rehabilitation stage.

Research on patient-centered design for post-stroke depression patients based on SEM and comprehensive evaluation

“…were evaluated significantly higher than humanistic landscapes in both experiments. This may be due to the common negativity of PSD patients in interpersonal communication (32), while previous conventional psychotherapy for PSD would guide patients to participate in socialization and establish dialogues to relieve psychological stress (7,10,33,34), compared to the experiments in VRTL which did not provide sufficient guidance and had potential for upgrading.…”

Factor structure and reliability of the symptom measurement of post-stroke depression in the rehabilitation stage

“…The SMPSD-RS includes 33 items with 6 dimensions (cognition, sleep, behavior, emotion, body, and guilt). The SMPSD-RS showed acceptable content validity as evidenced by the following indicators: the item-level content validity index = 0.780–1.000, the scale-level content validity index/universal agreement = 0.610, and the scale-level content validity index/ average = 0.970 [ 23 ]. Participants were required to complete the survey based on the frequency of their symptoms during the previous week.…”

“…Due to the shortcomings of the current tools for assessing PSD in the rehabilitation stage and the lack of a screening tool specifically developed to assess PSD symptoms in the rehabilitation stage after stroke, it was a good idea to develop a measurement instrument to screen for PSD in the rehabilitation stage [ 17 ]. The present research aimed to test the psychometric properties of the Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS), a new scale specifically developed to screen for PSD in Chinese stroke patients who are in the rehabilitation stage [ 23 ].…”