Identifying depression and suicidality in people with post-stroke aphasia

Schlesinger, Hope (2021) Identifying depression and suicidality in people with post-stroke aphasia. Doctoral thesis, University of East Anglia.

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Background: Stroke is associated with increased risk of depression and suicidality. People with acquired communication disorder after stroke, or aphasia (PwA) are at even greater risk of low mood and suicidality. Screening mood after stroke with methods appropriate for use with PwA, is recommended by clinical guidelines. Previous research found PwA were frequently excluded from studies assessing post-stroke depression however and it is unclear to what extent this exclusion is mirrored in staff screening practises.

Method: A systematic review was conducted on the level and method of inclusion of PwA in poststroke depression (PSD) research to test if inclusivity has improved with the development of new measures. A Theory of Planned Behaviour (TPB) study of UK stroke professionals explored current rates, methods, and predictors of staff screening for mood and suicidality in PwA.

Results: Of 997 studies assessing post-stroke depression, only 70 did not exclude PwA and were included in the systematic review, demonstrating the continued exclusion of PwA from most research on PSD. When included, assessment practises frequently raised issues of accessibility or use of unvalidated measures. One hundred and eighteen stroke clinicians completed the TPB questionnaire. A striking discrepancy was found between high reported likelihood to screen PwA for low mood (Mode: 100%, M: 71%, SD: 34.54) but low likelihood to screen PwA for suicidality (Mode: 0%, M:43%, SD: 38.96). TPB variables accounted for 48% of variance in intention to screen for depression in PwA (R2=.48, F (3,101) =30.60, p<.001) with normative beliefs found to be the only significant predictor (β= .62, p<.001).

Conclusions: More effort is needed to ensure PwA are included in post-stroke depression research and to help stroke professionals detect depression and suicidality in PwA. Screening rates may be improved by communicating a clear expectation that staff should screen all stroke survivors for depression and suicidality.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Chris White
Date Deposited: 23 Nov 2021 12:20
Last Modified: 23 Nov 2021 12:20


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