<p>Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke</p>

Abstract

Purpose: Details on adequate care and prevalence of depression in long-term stroke aftercare are limited. We aimed to determine long-term depression rates after stroke and to test for an association between depression and inadequate screening, socioeconomic complications and lack of sub-optimal care. Patients and Methods: In this cross-sectional study, 57 patients were re-invited into the clinic 2-3 years after stroke. Patients were interviewed about recalled screening concerning depression and unmet needs. Depression, the patient's social situation, and confounders were assessed by standardized scores. Results: In our study, 20% (n = 11) of patients were classified as depressed by the HDRS-17 score result. However, only 36% of all patients recalled to have been previously screened for depression and only 43% of those patients also recalled outpatient screening. Patients classified as depressed reported significantly lower recalled screening rates (9% vs 43%; p = 0.036) and higher rates of self-reported unmet need with emotional problems (72% vs 18%; p < 0.001). Depression in our study was further associated with a worse socioeconomic situation, fewer social contacts, unmet needs with regard to emotional problems and higher rates of recommendations to apply for additional social support. Conclusion: Our data suggest that systematic outpatient screening for depression is lacking in stroke aftercare. Furthermore, the high rate of unmet emotional needs, the poor socioeconomic situation and the higher rates of recommendations for social counselling and application for benefits suggest an undersupply of care in the outpatient setting that is more prominent in patients with depression and warrants further studies to investigate the underlying causes.

Positionspapier Schlaganfallnachsorge der Deutschen Schlaganfall-Gesellschaft – Teil 1: Nachsorge nach einem Schlaganfall: Status quo der Versorgungsrealität und Versorgungsdefizite in Deutschland

“…Patientenbedürfnisse in der Schlaganfallnachsorge, die im Rahmen von "patients' needs surveys" untersucht werden, werden vornehmlich im englischsprachigen Ausland erfasst. Erstmals für Deutschland hat die MAS-I-Studie Patientenbedarfe erhoben [14] -Depressionen im Krankheitsverlauf des Schlaganfalls werden häufig nicht erkannt oder therapiert [20]. Dabei ist eine Depression als Folge auf den Schlaganfall assoziiert [19].…”

“…Dazu gehört der dringende Wunsch, nach der Erkrankung die Berufstätigkeit wiederaufzunehmen [ 2 ]. Depressionen im Krankheitsverlauf des Schlaganfalls werden häufig nicht erkannt oder therapiert [ 20 ]. Dabei ist eine Depression als Folge auf den Schlaganfall assoziiert [ 19 ].…”

<p>The Influence of Nonpharmacological Complex Therapy Conducted at a Community Day-Care Center on Cognitive function and Mood in Older Adults</p>

“…21,22 A review of research on the impact of physical activity on mental and somatic status of elderly adults has indicated that the physical activity can be an alternative to pharmacological therapy for depressive disorders, and thus, it can affect the reduction of costs related to medical care for older persons. [23][24][25] Furthermore, regular physical exercises, physical therapy, and respiratory exercises cause the reduction of depressive symptoms, mental disorders, and anxiety states. 25 Moreover, the improvement occurs also in the area of social functioning, somatic conditions, and physical performance, as well as cognitive functions, attention span, and memory.…”

Internet Access and Usage Among Stroke Survivors and Their Informal Caregivers: Cross-sectional Study

“…Despite the complex needs of stroke survivors, poststroke care systems are inadequate. Stroke survivors may have limited access to outpatient care because of impaired mobility, limited access to transportation, and lack of support [10]. Most stroke survivors are discharged home from the hospital and receive care provided primarily by unprepared informal caregivers (eg, spouses and family members) [11,12].…”