Psychological distress following stroke: a research portfolio
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Introduction: There is a growing literature base focusing on the correlates and predictors of psychological distress following stroke. However, there is still limited understanding regarding the physical, cognitive and psychosocial variables that may increase an individual’s vulnerability to experiencing post stroke psychological distress. This thesis had two aims: 1) to review the evidence relating to functional impairment and depression post stroke, in order to identify any differences in this relationship at different stages of recovery, or over time, and 2) to explore whether perceived social support and perceived control moderate the relationship between cognitive impairment and psychological distress following stroke. Methods: A systematic review of the literature was conducted to investigate any potential differences in the relationship between functional impairment and depression post stroke. Quality criteria were applied to the included studies and the results were discussed in relation to these. A cross-sectional study was conducted to address the second aim of this portfolio. Participants completed three self-report questionnaires and a clinician administered measure. Statistical analysis was utilised to explore the relationships between cognitive impairment, perceived social support, perceived control and psychological distress following stroke. Results: The results of the systematic review were inconclusive. It was not possible to identify any definitive differences in the relationship between functional impairment and depression post stroke, at different time points or with regard to change over time. With regard to the cross-sectional study, none of the independent variables (cognitive impairment, perceived social support and perceived control) were found to be significantly related to psychological distress following stroke. Conclusions: The results of the systematic review highlight the need for methodologically robust, longitudinal studies to investigate differences in the relationship between functional impairment and depression during different stages of recovery and potential change over time in this relationship. Further research into the cognitive and psychosocial correlates and predictors of psychological distress are required in order to identify, and provide timely intervention to, those that are most likely to experience psychological distress following stroke.