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The mediating effect of anxiety on the association between residual neurological impairment and post-stroke participation among persons with and without post-stroke depression.

Authors
  • Randolph, Samantha1
  • Lee, Yejin1
  • Nicholas, Marjorie L2
  • Connor, Lisa Tabor3
  • 1 Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
  • 2 Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, USA.
  • 3 Program in Occupational Therapy and Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
Type
Published Article
Journal
Neuropsychological Rehabilitation
Publisher
Informa UK (Taylor & Francis)
Publication Date
Mar 01, 2024
Volume
34
Issue
2
Pages
181–195
Identifiers
DOI: 10.1080/09602011.2023.2165115
PMID: 36630107
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Previous research has reported that residual neurological impairment and emotional factors play a role in regaining successful participation post-stroke. The objective of this study was to investigate the mediating impact of anxiety on the association between residual neurological impairment and participation in survivors with and without post-stroke depressive symptoms. Participants (N = 79) were classified into 2 categories, those with post-stroke depressive symptoms (N = 40) and those without post-stroke depressive symptoms (N = 39). Variables measured in this study: residual neurological impairment (NIH Stroke Scale Score), participation (Reintegration to Normal Living Index), depressive symptoms (Patient Health Questionnaire-9), and trait anxiety (State-Trait Anxiety Inventory). A regression-based mediation analysis was conducted for each group of participants. The majority of participants had some level of anxiety. Residual neurological impairment predicted participation in stroke survivors both with (β = -.45, p = .003) and without (β = -.45, p = .004) post-stroke depressive symptoms. Anxiety mediated this relationship in participants with depressive symptoms (β = -.19, 95% CI = -.361 ∼ -.049), but not in participants without depressive symptoms (β = -.18, 95% CI = -.014 ∼ .378). Depressive and anxious symptoms should both be addressed to best facilitate participation by stroke survivors.

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