Symptom clusters of early-stage poststroke depression: A mixed-methods study

Abstract

Aim: To identify the symptom clusters of early-stage poststroke depression (PSD) and provide an in-depth understanding of the symptoms.

Design: A mixed-methods study with a convenient sampling method was used.

Methods: A cross-sectional questionnaire survey in 231 stroke patients and semi-structured interviews in 14 stroke patients were conducted in the neurological department of a comprehensive hospital in Southeast China. Data from the questionnaire survey were analysed through descriptive and exploratory factor analyses; data from the semi-structured interview were transcribed verbatim and analysed through inductive content analysis. This study adheres to the GRAMMS checklist.

Results: Exploratory factor analysis revealed six symptom clusters of early-stage PSD that accounted for an ideal variance in PSD: nervous, wakefulness, emotional, dull, guilt and low mood. Further, inductive content analysis revealed five themes that were like the above symptom clusters, except for the dull symptom cluster.

Keywords: exploratory factor analysis; inductive content analysis; mixed methods; poststroke depression; symptom cluster.