Article

We explored the factors that predicted psychological distress in the
first six months post stroke in a sample including people with aphasia.
Prospective longitudinal observational study. SUBJECTS: Participants
with a first stroke from two acute stroke units were assessed while still in
hospital (baseline) and at three and six months post stroke. MAIN
Distress was assessed with the General Health Questionnaire-12. Other measures
included: NIH Stroke Scale, Barthel Index, Frenchay Aphasia Screening Test,
Frenchay Activities Index, MOS Social Support Scale and social network
indicators. Logistic regression was used to identify predictors of distress at
each stage post stroke; and to determine what baseline factors predicted distress
at six months. RESULTS: Eighty-seven participants were able to self-report on
measures used, of whom 32 (37%) had aphasia. 71 (82%) were seen at six months,
including 11 (16%) with aphasia. Predictors of distress were: stroke severity at
baseline; low social support at three months; and loneliness and low satisfaction
with social network at six months. The baseline factors that predicted distress
at six months were psychological distress, loneliness and low satisfaction with
social network (Nagelkerke R(2) = 0.49). Aphasia was not a predictor of distress
at any time point. Yet, at three months post stroke 93% of those with aphasia
experienced high distress, as opposed to 50% of those without aphasia (chi(2) (1)
= 8.61, P<0.01). CONCLUSIONS: Factors contributing to distress after stroke vary
across time. Loneliness and low satisfaction with one's social network are
particularly important and contribute to long-term psychological distress.

Langue : ANGLAIS