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Transcript
The relationship between subjective cognitive complaints and mental health in stroke patients, as assessed by iPad administered self-report measures. Francesca Holden, Submitted for iBSc research project, 2015 Background: Assessing self-reported mental health in stroke remains a huge challenge due to the overlap of cognitive and affective symptoms. Past literature describes an association between Subjective Cognitive Complaints (SCCs) and affective symptoms. This study aims to (1) identify a self-report measure of cognitive function, which can be administered via an iPad, (2) establish the acceptability of measuring self-reported cognitive function in stroke patients, via an iPad and (3) explore the relationship between SCCs and affective symptoms. Method: Design. (1) Literature review, (2) Content analysis and (3) Cross-sectional observation. Sample. 15 patients previously discharged from a Hyper-Acute Stroke Unit (HASU) at King’s College Hospital. Patients completed an iPad-administered, carefully selected self-report measure of SCCs, the Checklist for Cognitive and Emotional Consequences following Stroke (CLCE-24). Patients were asked questions about the iPad administered CLCE-24 to assess its acceptability. CLCE-24 scores were analysed with scores from the routinely administered Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder Assessment (GAD-7) to examine the association between SCCs and depression/anxiety levels in HASU patients. Results: A moderately strong positive correlation was found between depression and CLCE-24 scores (.51), however this did not reach a level of statistical significance (p<.053). There was no association between anxiety and CLCE-24 scores (p<.64). Multiple regression analysis revealed no significant association between additional predictor variables, such as age, gender and Stroke Impact Scale scores, and depression/anxiety scores. However, after controlling for the effects of these additional variables, CLCE-24 score was a statistically significant predictor of depression (p<.011), but not a statistically significant predictor of anxiety (p<.659). Conclusion: Overall, results suggest that SCCs are associated with higher levels of depression in HASU patients. There was no statistically significant association between SCCs and anxiety levels in these patients. Replication with a larger sample size is required to strengthen the confirmation of these findings, as the small sample size in this study (N=15) is likely to have limited levels of significance. Post-stroke mood disorders are a major concern and have a high impact on patient’s quality of life and therefore effective screening is vital. IPads may improve screening for post-stroke affective disorders to provide earlier diagnosis. Page 1 of 1