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

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, socio-economic complications and lack of sub-optimal car...

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Autores principales: Padberg, Inken, Hotter, Benjamin, Liebenau, Andrea, Knispel, Petra, Lehnerer, Sophie, Heel, Sabine, Wellwood, Ian, Meisel, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7131991/
https://www.ncbi.nlm.nih.gov/pubmed/32280291
http://dx.doi.org/10.2147/RMHP.S228265
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author Padberg, Inken
Hotter, Benjamin
Liebenau, Andrea
Knispel, Petra
Lehnerer, Sophie
Heel, Sabine
Wellwood, Ian
Meisel, Andreas
author_facet Padberg, Inken
Hotter, Benjamin
Liebenau, Andrea
Knispel, Petra
Lehnerer, Sophie
Heel, Sabine
Wellwood, Ian
Meisel, Andreas
author_sort Padberg, Inken
collection PubMed
description 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, socio-economic 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 out-patient 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 socio-economic 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 out-patient screening for depression is lacking in stroke aftercare. Furthermore, the high rate of unmet emotional needs, the poor socio-economic situation and the higher rates of recommendations for social counselling and application for benefits suggest an undersupply of care in the out-patient setting that is more prominent in patients with depression and warrants further studies to investigate the underlying causes.
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spelling pubmed-71319912020-04-10 Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke Padberg, Inken Hotter, Benjamin Liebenau, Andrea Knispel, Petra Lehnerer, Sophie Heel, Sabine Wellwood, Ian Meisel, Andreas Risk Manag Healthc Policy Original Research 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, socio-economic 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 out-patient 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 socio-economic 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 out-patient screening for depression is lacking in stroke aftercare. Furthermore, the high rate of unmet emotional needs, the poor socio-economic situation and the higher rates of recommendations for social counselling and application for benefits suggest an undersupply of care in the out-patient setting that is more prominent in patients with depression and warrants further studies to investigate the underlying causes. Dove 2020-04-01 /pmc/articles/PMC7131991/ /pubmed/32280291 http://dx.doi.org/10.2147/RMHP.S228265 Text en © 2020 Padberg et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Padberg, Inken
Hotter, Benjamin
Liebenau, Andrea
Knispel, Petra
Lehnerer, Sophie
Heel, Sabine
Wellwood, Ian
Meisel, Andreas
Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke
title Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke
title_full Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke
title_fullStr Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke
title_full_unstemmed Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke
title_short Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke
title_sort unmet need for social and emotional support and lack of recalled screening is associated with depression in the long-term course after stroke
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7131991/
https://www.ncbi.nlm.nih.gov/pubmed/32280291
http://dx.doi.org/10.2147/RMHP.S228265
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