Assessing acute psychological distress in the immediate aftermath of stroke.
Vanessa Juth, Michelle K Chan, Steven C Cramer and 1 others
PMID 28699766WHAT IT FOUND
Assessing acute psychological distress is feasible during early stroke hospitalization.
Patients tolerated interviews averaging 21 minutes. The shorter Acute Stress Disorder Scale had higher completion rates than the longer checklist, with all 10 patients answering all items.
Key findings
01All 10 patients who received the Acute Stress Disorder Scale completed the interview with no missing data, whereas 2 of 10 patients receiving the PCL-5 had missing items.
02Interviews took an average of 21 minutes, with the longest lasting 90 minutes, and were generally conducted between 2 and 4 days post-stroke.
03Patients often required questions to be repeated or simplified due to fatigue, inattention, or difficulty concentrating, but still provided meaningful responses.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Very small sample size (20 patients) limits generalizability. Eligibility criteria excluded patients with significant pre-stroke disability or cognitive impairment, so findings apply only to those with milder strokes and better prognosis. Completion rates differed by race, suggesting potential cultural or demographic factors not fully explored. Focus group participants were interviewed months after their stroke (median 31.5 months), so their retrospective feedback may not accurately reflect acute hospital experiences.
Declared interests
The authors declared no conflicts of interest. The study was supported by NIH funding.
The easy way to misread this
Do not interpret the average scores (25.3 for ASDS, 30.2 for PCL-5) as evidence of clinical severity or prevalence of acute stress disorder. This was a feasibility study of 20 patients with mild strokes, not a diagnostic validation or prevalence study. The scores simply indicate that patients could answer the questions, not that these scores represent typical or pathological levels in the broader stroke population.