Development, Implementation, and Outcomes of Post-stroke Mood Assessment Pathways: Implications for Social Workers

Abstract

Depression and anxiety are prevalent in the stroke population and can have a significant impact on the patient and their family's long-term outcomes, however the screening for these conditions does not meet best practice recommendations. To address this deficit, this study developed "Post-Stroke Mood Assessment Pathways" and embedded them into practice by utilising the PARiHS framework (for the implementation of evidence-based practice), in conjunction with staff training. The study examined the rates of mood screening, clinical interviews, and completion of interventions for stroke patients through a retrospective chart audit (n = 213) one year prior to, and one year post-implementation (n = 238) of the pathways. The data show statistically significant increased documentation around mood screening and clinical interview 95% CI [4.86, 19.88]

The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

“…Of the articles reporting type of setting where the implementation project/research took place, a majority were undertaken in hospitals ( n = 126) [ 26 , 27 , 30 , 38 , 39 , 41 , 42 , 45 , 49 , 51 – 55 , 60 , 62 – 64 , 67 , 70 – 72 , 77 , 84 , 85 , 88 , 89 , 95 – 98 , 103 , 106 , 107 , 111 , 115 – 118 , 120 – 122 , 128 , 131 , 132 , 136 , 137 , 139 , 143 , 146 , 149 , 151 , 153 – 155 , 157 , 161 , 165 , 167 – 169 , 172 , 173 , 175 , 180 – 182 , 184 , 186 , 190 – 193 , 205 , 207 , 212 , 215 , 221 , 223 , 227 , 230 , 231 ,…”

“…A total of 102 (28%) articles described testing or validating PARIHS, or provided comments on the validity of the framework [ 3 , 13 , 23 , 24 , 35 , 44 , 46 , 58 , 60 , 62 , 64 , 67 , 71 , 74 , 76 , 78 – 81 , 84 , 85 , 89 , 98 , 105 , 107 , 110 , 113 , 115 , 120 , 121 , 143 , 149 , 150 , 153 , 155 , 157 – 159 , 166 , 168 , 170 , 172 , 180 – 182 , 187 , 188 , 190 , 191 , 195 , 198 , 201 , 203 , 204 , 206 – 209 , 211 , 212 , 214 , 229 , 246 , 249 , 250 , 252 , 253 , 255 , 264 , 267 , 268 , 277 , 278 ...…”

Voicing the perspectives of stroke survivors with aphasia: A rapid evidence review of post‐stroke mental health, screening practices and lived experiences

“…Anxiety is the second-most likely mental health condition poststroke and is an independent contributor to emotional distress (McLean et al, 2019). Carota et al (2002) review paper explored how a person's stroke affected their mood and functioning.…”

“…Hart and Morris's (2008) mixed-method survey of 75 staff across 16 stroke units in the UK noted that staff positively perceived mood screening; however, compliance levels were low (Hart & Morris, 2008). McLean et al (2019) noted that low mood screening rates did not meet best practice and were attributed to reduced knowledge and skills. Stroke health professionals described the need for specialist training to understand aphasia and the concomitant communication difficulties and mental health outcomes, as well as to conduct aphasia-specific mood screening (Baker et al, 2021).…”

“…Excluding the aphasic post-stroke population from research could be due to (a) the societal belief that disabilities reduce mental capacity, (b) a lack of knowledge from researchers regarding how to communicate with this cohort effectively and (c) the effects of unaddressed mental health outcomes (Carota et al, 2016;McLean et al, 2019;Ryan et al, 2019). Furthermore, excluding this population could also be attributed to medical models that commonly dominate mental health intervention (Morley & Stenhouse, 2020;Tew, 2013).…”