Factors Associated with Post-Stroke Depression in Chinese Stroke Survivors

Abstract

Objectives: To explore the relationship between participation self-efficacy, sociodemographic and clinical characteristics, and post-stroke depression in stroke survivors and provide insights into the development of rehabilitation programmes.

Materials and methods: A cross-sectional descriptive study was conducted with 336 participants recruited from five hospitals in Kunming, China. Measures included the Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES-C), Geriatric Depression Scale (GDS), modified Barthel Index, Rivermead Mobility Index (RMI), Reintegration to Normal Living Index (RNLI), and the Social Support Questionnaire (SSQ6). Logistic regression analyses were performed using SPSS 25.0.

Results: Nearly half (44.6%) of the sample was found to have depression. The mean participation self-efficacy score of stroke survivors with depression was significantly lower than that of those without depression. Logistic regression analyses suggested that participation self-efficacy is a constant and major factor negatively associated with depression, with every 10-pt increase in the PS-SES-C score associated with decreased odds of depression (p<0.001). Other features associated with depression prevalence to varying degrees included education level, marital status, pre-morbid financial role in family, stroke symptom severity, history of heart disease, frequency of stroke, lesion side, stroke type, and use of assistive aids.

Conclusions: Participation self-efficacy is negatively associated with depression in stroke survivors. Rehabilitation programmes might consider incorporating interventions aimed at boosting participation self-efficacy in order to promote positive recovery outcomes among survivors.

Keywords: Depression; Participation self-efficacy; Post-stroke depressive symptoms; Stroke; Stroke rehabilitation.