Other Titles
Perceptions of Depressive Symptoms after Stroke: A Mixed-Methods Explanatory Study [Title Slide]
Abstract
The American Psychiatric Association designates the unique relationship between depression and stroke listing it as a medical condition that are is the source of depressive symptoms.1 Poststroke depression (PSD) is a frequently occurring complication of stroke and is associated with adverse outcomes with an estimated prevalence of 27%.2 Prior research has found stroke survivors with PSD experience worse functional recovery than those without PSD.3
Caregiver depression influences stroke recovery and is specifically associated with higher risk 6-month mortality of stroke survivors with moderate to severe stroke.4
Researchers have noted partners of stroke survivors face greater risk for caregiver burden, depressive symptoms and anxiety when taking on the stroke caregiver role due to abrupt change in family dynamics.5
The purpose in Phase I (n=64) of this mixed methods study was to examine the relationship between stroke disability, caregiver burden, distance from stroke center, prior history of depression and depressive symptoms after stroke. In Phase II (n=6 stroke survivors; n=9 stroke caregivers) in 1:1 interview, researchers sought the first hand perspectives of stroke survivors and their caregivers regarding their perceptions of depressive symptoms of PSD and the experience of PSD. PI was influenced to develop study’s Phase II by University of California San Francisco Symptom Management Theory, a middle range theory depicting symptom management as a multidimensional process.6
Phase I results which noted a significant mean difference in depression scores between stroke caregivers who are spouse/significant other and stroke caregivers who are other family member (p-value of 0.0397) and also a significant mean difference in depression scores between stroke caregivers with prior history of depression and stroke caregivers who do not have prior history of depression (p-value = 0.025). Phase II findings validated and illuminated significant Phase I results.
This study contributes to nursing science regarding the experience of post stroke depression in both stroke survivors and stroke caregivers and stroke caregiver burden specifically how male vs female caregivers operationalize their caregiver role. Future research should explore gender differences in perceptions of caregiving for stroke survivors and caregivers. Further nursing implications include focused clinical assessment of depression in stroke survivors and caregivers.
Notes
References:
1. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787
2. Liu, L., Xu, M., Marshall, I. J., Wolfe, C. D., Wang, Y., & O’Connell, M. D. (2023). Prevalence and natural history of depression after stroke: A systematic review and meta-analysis of observational studies. PLOS Medicine, 20(3), e1004200. https://doi.org/10.1371/journal.pmed.1004200
3. Wada, Y., Otaka, Y., Yoshida, T., Takekoshi, K., Takenaka, R., Senju, Y., Maeda, H., Shibata, S., Kishi, T., & Hirano, S. (2023). Effect of Post-stroke Depression on Functional Outcomes of Patients With Stroke in the Rehabilitation Ward: A Retrospective Cohort Study. Archives of Rehabilitation Research and Clinical Translation, 5(4), 100287. https://doi.org/10.1016/j.arrct.2023.100287
4. Zhao, J., Zeng, Z., Yu, J., Xu, J., Chen, P., Chen, Y., Li, J., & Ma, Y. (2021). Effect of main family caregiver’s anxiety and depression on mortality of patients with moderate-severe stroke. Scientific Reports, 11(1), 2747. https://doi.org/10.1038/s41598-021-81596-8
5. Skajaa, N., Farkas, D. K., Laugesen, K., Fuglsang, C. H., Henderson, V. W., Plana-Ripoll, O., Gaist, D., & Sørensen, H. T. (2024). Mental Health Conditions in Partners and Adult Children of Stroke Survivors. JAMA Network Open, 7(3), e243286. https://doi.org/10.1001/jamanetworkopen.2024.3286
6. Dodd, M., Janson, S., Facione, N., Faucett, J., Froelicher, E. S., Humphreys, J., Lee, K., Miaskowski, C., Puntillo, K., Rankin, S., & Taylor, D. (2001). Advancing the science of symptom management. Journal of Advanced Nursing, 33(5), 668–676. https://doi.org/10.1046/j.1365-2648.2001.01697.x
Sigma Membership
Zeta Phi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Stress and Coping, Public and Community Health, Primary Care, Promoting Clinical Outcomes, Poststroke Depression, Caregivers, Caregiver Depression
Recommended Citation
Breckenridge-Trotter, Tanya Leigh; Denny, Dawn; Evanson, Tracy; Ferraro, F. Richard; and O'Malley, Patricia, "Stroke Survivors' and Family Caregivers' Perceptions of Depressive Symptoms After Stroke" (2025). Biennial Convention (CONV). 62.
https://www.sigmarepository.org/convention/2025/presentations_2025/62
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-20
Funder(s)
University of North Dakota, Miami Valley Hospital Magnet Foundation
Stroke Survivors' and Family Caregivers' Perceptions of Depressive Symptoms After Stroke
Indianapolis, Indiana, USA
The American Psychiatric Association designates the unique relationship between depression and stroke listing it as a medical condition that are is the source of depressive symptoms.1 Poststroke depression (PSD) is a frequently occurring complication of stroke and is associated with adverse outcomes with an estimated prevalence of 27%.2 Prior research has found stroke survivors with PSD experience worse functional recovery than those without PSD.3
Caregiver depression influences stroke recovery and is specifically associated with higher risk 6-month mortality of stroke survivors with moderate to severe stroke.4
Researchers have noted partners of stroke survivors face greater risk for caregiver burden, depressive symptoms and anxiety when taking on the stroke caregiver role due to abrupt change in family dynamics.5
The purpose in Phase I (n=64) of this mixed methods study was to examine the relationship between stroke disability, caregiver burden, distance from stroke center, prior history of depression and depressive symptoms after stroke. In Phase II (n=6 stroke survivors; n=9 stroke caregivers) in 1:1 interview, researchers sought the first hand perspectives of stroke survivors and their caregivers regarding their perceptions of depressive symptoms of PSD and the experience of PSD. PI was influenced to develop study’s Phase II by University of California San Francisco Symptom Management Theory, a middle range theory depicting symptom management as a multidimensional process.6
Phase I results which noted a significant mean difference in depression scores between stroke caregivers who are spouse/significant other and stroke caregivers who are other family member (p-value of 0.0397) and also a significant mean difference in depression scores between stroke caregivers with prior history of depression and stroke caregivers who do not have prior history of depression (p-value = 0.025). Phase II findings validated and illuminated significant Phase I results.
This study contributes to nursing science regarding the experience of post stroke depression in both stroke survivors and stroke caregivers and stroke caregiver burden specifically how male vs female caregivers operationalize their caregiver role. Future research should explore gender differences in perceptions of caregiving for stroke survivors and caregivers. Further nursing implications include focused clinical assessment of depression in stroke survivors and caregivers.
Description
The study’s specific research questions were addressed using an explanatory sequential mixed method design to collect and analyze both quantitative and qualitative data in two arms. Priority was given to the qualitative approach to explore stroke survivors’ and their caregivers’ perception of depressive symptoms after stroke and to examine the presence of depressive symptoms post stroke in stroke survivors and their caregivers.