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  • 标题:Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke
  • 本地全文:下载
  • 作者:Inken Padberg ; Benjamin Hotter ; Andrea Liebenau
  • 期刊名称:Risk Management and Healthcare Policy
  • 印刷版ISSN:1179-1594
  • 电子版ISSN:1179-1594
  • 出版年度:2020
  • 卷号:13
  • 页码:285-293
  • DOI:10.2147/RMHP.S228265
  • 出版社:Dove Medical Press Ltd
  • 摘要: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.
  • 关键词:health;care quality; social;care; risk management; stroke; depression
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