Validation of the distress thermometer among stroke survivors

Abstract

National guidelines for stroke recommend that all patients entering rehabilitation are screened for mood disturbance using a validated measure. The first half of this thesis presents a literature review of 25 self-report screening measures for the detection of post-stroke distress. A total of 26 studies were identified as meeting the search criteria. Fifteen self-report measures met recommended levels of sensitivity (?0.80) and specificity (?0.60) when screening for post-stroke depression. The Hospital Anxiety and Depression Scale (HADS) was the only measure to meet recommended levels of accuracy for post-stroke anxiety. At the commencement of this thesis, the Distress Thermometer (DT) had not been validated among stroke survivors despite being recommended by NICE (2009).

The study presented in the second half of this thesis investigates the diagnostic accuracy and clinical utility of the DT and associated Problem List (PL), the Brief Assessment Schedule Cards (BASDEC), and the Yale. Relative to the HADS, the area under the curve (AUC) for the DT was significantly greater than an AUC of 0.50. Cut-off scores of at least 4 and 5 on the DT met recommended levels of sensitivity and specificity when screening for post-stroke depression and anxiety. The accuracy of the BASDEC and Yale was non-significant. Due to a small sample size, these results should be taken with caution. However, this study provides preliminary evidence to support the use of the DT and PL as a holistic and person-centred screening tool for the prevention and recognition of post-stroke distress.

More information

Identifiers

Catalogue record

Export record