Monique R Pappadis1,2,3, Shilpa Krishnan2,4, Catherine C Hay1, Beata Jones5, Angelle M Sander3,6,7, Susan C Weller2,8,9, Timothy A Reistetter1,2,4. 1. a Division of Rehabilitation Sciences, School of Health Professions , University of Texas Medical Branch at Galveston (UTMB) , Galveston , TX , USA. 2. b Sealy Center on Aging, UTMB , Galveston , TX , USA. 3. c Brain Injury Research Center , TIRR Memorial Hermann , Houston , TX , USA. 4. d Department of Occupational Therapy , School of Health Professions, UTMB , Galveston , TX , USA. 5. e Division of Clinical Neuropsychology and Psychology , University of Gdansk , Gdansk , Poland. 6. f Departments of Physical Medicine and Rehabilitation & Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry , Baylor College of Medicine , Houston , TX , USA. 7. g Center for Neurotrauma Rehabilitation , Department of Physical Medicine & Rehabilitation, Harris Health System , Houston , TX , USA. 8. h Department of Preventive Medicine and Community Health , UTMB , Galveston , TX , USA. 9. i Department of Family Medicine , UTMB , TX , USA.
Abstract
Objectives: Few studies have explored the lived experiences of chronic cognitive and mood symptoms following stroke using a racially/ethnically diverse sample. Therefore, we aimed to explore the perceptions of chronic post-stroke cognition and mood symptoms and goals among a racially/ethnically diverse sample of community-dwelling adults aging with stroke. Method: This qualitative study using mixed-methods analysis included semi-structured interviews regarding perceived post-stroke cognitive and mood symptoms among community-dwelling stroke survivors at least one-year post stroke. Transcripts were subjected to thematic content analysis, and differences in theme usage patterns by age, gender, race/ethnicity, and post-acute rehabilitation setting were assessed using an inferential clustering technique. Results: The majority of participants (93%) reported cognition-related themes, including language and communication, memory, thinking abilities, comprehension, visual-spatial processing, and cognitive assessments and training. Nearly half of participants mentioned mood-related themes, including depression, aggression and anger, mood fluctuations, anxiety, and psychological services and medication. Nearly half reported an unmet need for cognition or mood-related treatment. Inferential clustering analysis revealed that older participants reported a different pattern of cognitive and mood symptoms than those aged younger than 65 (p = 0.02). Older adults were more likely to describe post-stroke language/communication changes, while younger adults described post-stroke mood changes. Conclusion: Stroke survivors experienced cognitive and mood-related symptoms beyond one-year post stroke, which has implications for long-term assessment and management. Incorporation of continued symptom monitoring into existing community-based services is needed to address chronic cognitive and mood symptoms affecting the quality of life of persons with stroke.
Objectives: Few studies have explored the lived experiences of chronic cognitive and mood symptoms following stroke using a racially/ethnically diverse sample. Therefore, we aimed to explore the perceptions of chronic post-stroke cognition and mood symptoms and goals among a racially/ethnically diverse sample of community-dwelling adults aging with stroke. Method: This qualitative study using mixed-methods analysis included semi-structured interviews regarding perceived post-stroke cognitive and mood symptoms among community-dwelling stroke survivors at least one-year post stroke. Transcripts were subjected to thematic content analysis, and differences in theme usage patterns by age, gender, race/ethnicity, and post-acute rehabilitation setting were assessed using an inferential clustering technique. Results: The majority of participants (93%) reported cognition-related themes, including language and communication, memory, thinking abilities, comprehension, visual-spatial processing, and cognitive assessments and training. Nearly half of participants mentioned mood-related themes, including depression, aggression and anger, mood fluctuations, anxiety, and psychological services and medication. Nearly half reported an unmet need for cognition or mood-related treatment. Inferential clustering analysis revealed that older participants reported a different pattern of cognitive and mood symptoms than those aged younger than 65 (p = 0.02). Older adults were more likely to describe post-stroke language/communication changes, while younger adults described post-stroke mood changes. Conclusion:Stroke survivors experienced cognitive and mood-related symptoms beyond one-year post stroke, which has implications for long-term assessment and management. Incorporation of continued symptom monitoring into existing community-based services is needed to address chronic cognitive and mood symptoms affecting the quality of life of persons with stroke.
Entities:
Keywords:
Cognition; psychological and behavioral symptoms; qualitative methods; quality of life/wellbeing; stroke
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