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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This descriptive study was undertaken as a pilot test for several questionnaires designed to examine the well-being of caregivers of persons with stroke. This predominantly female sample was found to have moderately few physical symptoms, but to be in considerable emotional distress. Nearly half the sample had anxiety and depression scores above the level identified as suspicious for clinically relevant distress as indexed by the Symptom Questionnaire. Anger was also a salient finding: 40% of those questioned scored above the cutoff level for hostility and several caregivers expressed anger verbally during data collection. The degree of psychological distress in these individuals is of importance to all health care professionals and deserves increased attention, both from the perspective of the researcher and from the perspective of the clinician.
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PMID:Caregivers of persons with stroke: their physical and emotional wellbeing. 840 57

Psychological status, including depressive symptoms, anxiety, and mastery, was measured in a community-based sample of 3,076 persons aged 55 to 85 with various chronic diseases. Strong, linear associations were found between the number of chronic diseases and depressive symptoms and anxiety, indicating that psychological distress among elderly people is more apparent in the presence of (more) diseases. Furthermore, in contrast to general assumptions that mastery is a relatively stable state, our results indicate that mastery is affected by having chronic diseases. The 8 groups of chronically ill patients (with cardiac disease, peripheral atherosclerosis, stroke, diabetes, lung disease, osteoarthritis, rheumatoid arthritis, or cancer) did differ in their associations with psychological distress. Psychological distress is most frequently experienced by patients with osteoarthritis, rheumatoid arthritis, and stroke, whereas diabetic and cardiac patients appear to be the least psychologically distressed. Differences in disease characteristics, such as functional incapacitation and illness controllability, may partly explain these observed psychological differences across diseases.
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PMID:Psychological status among elderly people with chronic diseases: does type of disease play a part? 880 61

Ultimately, for ventricular assist devices (VADs) to be acceptable as permanent alternatives to heart transplantation, patients' and their families' satisfaction with specific features and risks of VADs must be addressed. Of 42 eligible patients who received VADs between February of 1996 and December of 1998, we interviewed 37 patients (17 Novacor, 18 Thoratec, 2 with both devices) and 20 of their primary family caregivers about device related concerns and reactions. Demographic and health related correlates of respondents' concerns were examined. Eleven patients discharged from the hospital with the VAD in place were then reinterviewed 1 month after discharge. At baseline, patients' general perceptions of the VAD were positive, although 22-52% reported specific concerns, including most often worry about infection (52%), difficulty sleeping due to the position of the driveline (52%), pain at the driveline exit site (46%), worry about device malfunction (40%), and being bothered during the day by device noise (32%). The prevalence of most concerns rose with duration of VAD support. Caregivers' perceptions did not differ significantly from patients' perceptions. Outpatients were somewhat more concerned than inpatients about device noise and risk of stroke, but were markedly less concerned about infection. Across all patients, higher levels of device related concerns were correlated with more physical functional limitations and more psychological distress, and reduced quality of life. Demographic characteristics and device type were not uniformly related to device concerns.
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PMID:Human factors issues in ventricular assist device recipients and their family caregivers. 1082 54

The aim of this study was to determine the effect of mood disorders, including psychological distress and depression, on stroke outcome. Male Fischer rats were exposed to immobilisation stress, an animal paradigm of psychological stress, major depression and post-traumatic stress disorder. Either a subacute (1 h for 7 days) or a chronic (6 h for 21 days) exposure to stress was applied 24 h before permanent middle cerebral artery occlusion (MCAO). Stroke outcome was assessed by measurement of infarct size and behavioural characterisation. Serum glutamate and brain ATP levels as well as brain glutamate transporter function and expression were studied in the search for the molecular mechanisms involved. Subacute stress exposure increased infarct size and decreased behavioural scores after stroke. On the contrary, chronic stress exposure decreased infarct size. Peak serum glutamate levels correlated with infarct size after MCAO. Expression of glutamate transporters was decreased by subacute stress, whereas the expression of EAAT1, a glial glutamate carrier, was increased after the chronic stress protocol. Our results indicate that distinct patterns of stress determine different stroke outcomes, and that expressional changes of brain glutamate transporters, able to affect glutamate release after stroke, are involved.
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PMID:Effect of subacute and chronic immobilisation stress on the outcome of permanent focal cerebral ischaemia in rats. 1285 May 80

This study assessed psychological adjustment and quality of life relative to population-based norms and knowledge about hereditary hemochromatosis in a sample of 101 patients who attended a hemochromatosis clinic. Participants were assessed prior to their clinic visit, and two weeks and 12 months after attendance, using self-administered questionnaires. Mean Mental Health Component Scores from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) (45.3, 95% CI 43.2, 47.4) were as compromised as those found amongst stroke victims (45.9, 95% CI 42.8, 49.0) who had participated in a national health survey. Recall of the genetic testing result was less than optimal, in that only 69.3% of those with genetic testing results knew whether they carried one or two mutations. This study demonstrates that patients would benefit from routine assessment of psychological distress and referral to mental health professionals of those whose levels of distress suggest a need for clinical intervention. Results also show that patients may benefit from strategies aimed at improving recall of genetic testing results.
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PMID:Psychological adjustment and knowledge about hereditary hemochromatosis in a clinic-based sample: a prospective study. 1638 26

This qualitative study describes the effect of exercise on psychological well-being among individuals with chronic illnesses and disabilities such as stroke, cancer, diabetes and arthritis. Eleven users of a physical disability daycentre completed a novel, six-month, group-based programme of seated exercise provided by the first author. Results from grounded analyses of in-depth interviews provide evidence that exercise offers a powerful means to actively manage mood problems associated with disability, to preserve and cultivate personal identity in a positive manner and to connect with others and one's own body in ways which limit the development of illness-related psychological distress. Implications for the development of further research and future provision of similar services are discussed.
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PMID:Physical exercise and psychological well-being among people with chronic illness and disability: a grounded approach. 1842 Jul 52

This study evaluated the psychometric properties of a simple scale for measuring positive interpersonal attitudes of depressed stroke patients, with regard to their cognitive limitations. Two versions of the Attitudes Towards Relationships Scale were developed and administered to depressed stroke (n = 48) and control rheumatic/orthopaedic (n = 45) patients during a study that investigated the relationship between mood state, interpersonal attitudes and psychological distress. Both versions produced homogeneous results and showed acceptable concurrent validity, test-retest reliability, internal consistency and measurement specificity. A principal component analysis produced a three-factor structure highlighting the importance of attitudes towards future interpersonal relationships. These results suggest that the Attitude Towards Relationships Scale may be a psychometrically sound measure that shows some potential as a therapeutic measure of progress in stroke and other comparable samples.
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PMID:Assessing the cognitive regulation of emotion in depressed stroke patients. 1951 47

Informal carers underpin community care policies. An initial cohort of 105 informal live-in carers of new stroke patients from the South Coast of England was followed up before discharge, six weeks after discharge and 15 months after stroke with face-to-face interviews assessing physical and psychological health, and social wellbeing. The carer cohort was compared to a cohort of 50 matched non-carers over the same time period. Carer distress was common (37-54%), started early on in the care-giving experience and continued until 15 months after stroke. Carers were 2.5 times as likely as non-carers to have significant psychological distress. Presence of early distress predicted 90% of those significantly distressed 15 months after stroke. Female carers were likely to develop distress earlier than male carers and in anticipation of the care-giving situation. Male carers developed similar levels of distress but only once the care-giving situation became reality. Further research is needed to establish ways to screen for psychological distress early after onset of caregiving, to find ways to tailor proven support interventions to the individual carer, and to evaluate the effect of early detection and support provision on later carer distress.
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PMID:Cohort study of informal carers of first-time stroke survivors: profile of health and social changes in the first year of caregiving. 1952 Apr 71

This study investigated whether increasing positive mood improved interpersonal attitudes and relieved depression in depressed stroke patients despite levels of cognitive and emotional dysfunction. Depressed stroke (n = 30) and rheumatic/orthopaedic controls (n = 30) were compared on the effect of verbal and nonverbal positive and neutral mood induction on mood state, interpersonal attitudes, psychological distress and related cognitive and emotional processing deficits. Compared with the neutral mood induction condition, the positive mood induction significantly improved mood state, interpersonal attitudes and psychological distress, irrespective of cognitive and emotional processing deficits. The nonverbal material was effective for all patients but was more marked for the left hemisphere stroke group. There was no obvious influence of humour appreciation despite reduced understanding in the right hemisphere stroke group. Although the effect is likely to be short-lived, these results support the trial of positive mood induction within therapy programmes to relieve depression.
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PMID:The relationship between mood state, interpersonal attitudes and psychological distress in stroke patients. 1973 83

Family relationship quality predicts medical outcomes in various health conditions, including stroke, end stage renal disease, and heart failure. Family relationships also influence the onset and course of depression and anxiety disorders. Family may be particularly important in COPD given the high prevalence of depression and anxiety in COPD patients and the association of depression and anxiety with important clinical features of COPD such as dyspnea. The objective of this study was to test three hypotheses in a sample of individuals with COPD: (1) unsupportive family relationships are associated with psychological distress; (2) psychological distress is associated with dyspnea and impairment in health-related quality of life; and (3) unsupportive family relationships are indirectly associated with dyspnea and health-related quality of life via psychological distress. Cross-sectional data were collected via self-report questionnaires completed by 526 individuals with COPD. Structural equation modeling was used to test the hypotheses. All three hypotheses were supported. Unsupportive family relationships were associated with psychological distress, psychological distress was associated with dyspnea and impairment in health-related quality of life, and unsupportive family relationships were indirectly associated with dyspnea and health-related quality of life via psychological distress. If subsequent longitudinal investigations demonstrate that unsupportive family relationships do indeed lead to psychological distress among individuals with COPD, then interventions to improve family relationships of patients with COPD could lead to reductions in psychological distress and, ultimately, to improvements in dyspnea and quality of life.
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PMID:Family relationship quality is associated with psychological distress, dyspnea, and quality of life in COPD. 1986 65


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