A Meta-analysis of the Variables related to Depression in Korean Patients with a Stroke

Park, Eun-Young; Shin, In-Soo; Kim, Jung-Hee

doi:10.4040/jkan.2012.42.4.537

J Korean Acad Nurs. 2012 Aug;42(4):537-548. Korean.
Published online Aug 31, 2012.
https://doi.org/10.4040/jkan.2012.42.4.537

Original Article

A Meta-analysis of the Variables related to Depression in Korean Patients with a Stroke

Eun-Young Park,¹ In-Soo Shin,² and Jung-Hee Kim³

Author information

Author notes

Copyright and License

- ¹Department of Secondary Special Education, College of Education, Jeonju University, Jeonju, Korea.
- ²Department of Education, College of Education, Jeonju University, Jeonju, Korea.
- ³Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea.
Address reprint requests to: Kim, Jung-Hee. Department of Nursing, College of Medicine, Dankook University, San 29 Anseo-dong, Cheonan 330-714, Korea. Tel: +82-41-550-3877, Fax: +82-41-550-7902, Email: jhee90@dankook.ac.kr

Received November 01, 2011; Accepted July 23, 2012.

Abstract

Purpose

The purpose of this study was to use meta-analysis to evaluate the variables related to depression in patients who have had a stroke.

Methods

The materials of this study were based on 16 variables obtained from 26 recent studies over a span of 10 years which were selected from doctoral dissertations, master's thesis and published articles.

Results

Related variables were categorized into sixteen variables and six variable groups which included general characteristics of the patients, disease characteristics, psychological state, physical function, basic needs, and social variables. Also, the classification of six defensive and three risk variables group was based on the negative or positive effect of depression. The quality of life (ES=-.79) and acceptance of disability (ES=-.64) were highly correlated with depression in terms of defensive variables. For risk variables, anxiety (ES=.66), stress (ES=.53) showed high correlation effect size among the risk variables.

Conclusion

These findings showed that defensive and risk variables were related to depression among stroke patients. Psychological interventions and improvement in physical functions should be effective in decreasing depression among stroke patients.

Keywords

Stroke; Depression; Meta-analysis

Figures

Figure 1
Literature searches and results.

KISS=Korean studies information service system.

Click for larger image

Tables

Table 1
Summary of Characteristics of Studies Included Meta-analysis

Click for larger image

Table 2
Effect Size of Defensive Sub-variables related to Depression

Click for larger image

Table 3
Effect Size of Defensive and Risk Variables according to Categories

Click for larger image

Table 4
Effect Size of Risk Sub-variables related to Depression

Click for larger image

Notes

The present research was supported by the research fund of Dankook University in 2011.

Appendix

Review Paper List

Bang, Y. S., Kim, H. Y., & Heo, M. (2009). A study of the relationship between post-stroke depression, acceptance of disability, and social support. Journal of Korean Society of Occupational Therapy, 17(2), 29-40.

Chu, E. J. (2008). A study on the cognitive function, depression and relationship of the elderly suffering from stroke. Unpublished master's thesis, Deagu University, Daegu.

Han, Y. A. (2004). Analysis of in daily activities, family support and depression in hemiparesis patients due to stroke. Unpublished master's thesis, Yonsei University, Seoul.

Jang, M, Y., & Hwang, R. H. (2008). The relationship between dysphasia and depression among stroke patients. Journal of Kwangju Women's University, 11, 23-40.

Kim, E. Y. (2006). The effect of post stroke depression and cognitive function status on ADL and IADL of stroke patients. Unpublished master's thesis, Seoul National University, Seoul.

Kim, H. J., & Park, Y. S. (2003). A study on life style, functional condition, depression and perceived health status of stroke patient at home. Journal of Korean Public Health Association, 29, 127-139.

Kim, H. M. (2005). A study on the effects of stroke patients' activities of daily living, depression and social support for them on their life quality. Unpublished master's thesis, Hanyang University, Seoul.

Kim, J. H. (2008). Relationship among sexual knowledge, frequency, satisfaction, marital intimacy and levels of depression in stroke survivors and their spouses. Journal of Korean Academy of Nursing, 38, 483-491. http://dx.doi.org/10.4040/jkan.2008.38.3.483

Kim, I. J., Suh, M. J., Kim, K. S., Cho, N. O., & Choi, H. J. (2000). Predicting factors of post-stroke depression. Journal of Korean Academy of Adult Nursing, 12, 147-162.

Kim, K. S., Chun, S. I., Oh, H. C., & Shin, J. B. (1995). A study of stress and depression in stroke patients: Relationship to ADL. Journal of Korean Society of Occupation, 3, 3-20

Kim, M. H. (2006). Factors influencing depression of the elderly with post stroke hemiplegia. Journal of the Korean Gerontological Society, 26, 911-927.

Kim, W. O., Kang, H. S., Wang, M. J., Kim, J. H., & Choi, J. Y. (2007). Relationship among activity of daily living, depression, and quality of life (QQL) in patients with stroke. Journal of East-West Nursing Research, 13, 138-146.

Koo, J. H., Lee, J. W., Kim, S. Y., Yeo, J. Y., Yoo, S. D., & Chun, M. H. (2004). The relationship between post stroke depression and functional recovery of rehabilitation inpatients. Journal of the Korean Geriatrics Society, 8, 14-19.

Lee, D. J., & Ko, T. S. (2010). Relationship between symptoms of depression and cognitive function, physical function, and activities of daily living in stroke patients. Journal of Special Education & Rehabilitation Science, 49, 159-178.

Moon, H. H. (2010). Relationship among depression, family support, and rehabilitation motive in patient with acute or subacute hemorrhagic stroke. Unpublished master's thesis, Yonsei University, Seoul.

Oh, E. M. (2010). The relationship of perceived health status daily living activities, depression and quality of life among elderly suffering from stroke. Unpublished master's thesis, Hanyang University, Seoul.

Park, D. H., Yeon, B. K., & Suk, J. H. (1995). The differences of severity of depression and dexamethasone suppression according to lesional location in post-stroke depression. Journal of Korean Neuropsychiatry Association, 34, 139-147.

Park, K. H. (2007). Association for daily activities with depression and anxiety in stroke patients. Unpublished master's thesis, Ajou University, Suwon.

Park, S. W., Jang, K. E., Lee, H. S., & Park, D. S. (1999). The relationship between activities of daily living and cognitive function anxiety, stress, depression in stroke patients. Journal of Korean Academy of Rehabilitation Medicine, 23, 1-8.

Park, W. K. (1988). Perceived stress and depression in hemiplegic patients using neuman's stressors concepts factors. Unpublished master's thesis, Ewha Womans University, Seoul.

Shin, J. W. (2011). Depression after acute mild stroke and care burden of care giver. Unpublished master's thesis, Chungnam National University, Daejeon.

Suh, M., & Choi-Kwon, S. (2010). Structural equation modeling on quality of life in stroke survivors. Journal of Korean Academy of Nursing, 40, 533-541. http://dx.doi.org/10.4040/jkan.2010.40.4.533

Wi, S. H. (2009). The relationship between depression and sleep in stroke patients. Unpublished master's thesis, Ewha Womans University, Seoul.

Yang, J. B. (2010). A study on the major factors affecting health-related quality of life of elderly stroke survivors. Journal of the Korean Gerontological Society, 30, 1239-1261.

Yoon, H. S., Nam, H. J., Park, S. Y., Han, J. H., & Jang, S. J. (2008). Post traumatic Stress symptoms, anxiety, and depression after stroke. Journal of Korean Academy of Social Home Care Nursing, 15(1), 5-13.

Yoo, S. D., Chun, M. H., & Pyun, S. B. (2009). Relationship between the severity of post stroke depression (PSD) and cognitive function in the patients with stroke. Journal of Korean Academy of Rehabilitation Medicine, 33, 527-532.

References

1. Angelelli P, Paolucci S, Bivona U, Piccardi L, Ciurli P, Cantagallo A, et al. Development of neuropsychiatric symptoms in poststroke patients: A cross-sectional study. Acta Psychiatrica Scandinavica 2004;110:55–63.
  http://dx.doi.org/10.1111/j.1600-0447.2004.00297.x.
1. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. In: Introduction to meta-anaylsis. West Sussex, UK: Wiley; 2009.
1. Bruggimann L, Annoni JM, Staub F, von Steinbuchel N, Van der Linden M, Bogousslavsky J. Chronic posttraumatic stress symptoms after nonsevere stroke. Neurology 2006;66:513–516.
  http://dx.doi.org/10.1212/01.wnl.0000194210.98757.49.
1. Carson KP, Schriesheim CA, Kinicki AJ. The usefulness of the "fail-safe" statistic (N) in meta-analysis. Educational and Psychological Measurement 1990;50:233–243.
1. Carter AC. Post stroke depression. Journal of Psychosomatic Research 2004;56:634.
1. Chau JP, Thompson DR, Twinn S, Chang AM, Woo J. Determinants of participation restriction among community dwelling stroke survivors: A path analysis. BMC Neurology 2009;9(49):1–7.
  http://dx.doi.org/10.1186/1471-2377-9-49.
1. Cohen J. In: Statistical power analysis for the behavioral sciences. New York, NY: Academic Press; 1977.
1. Dafer RM, Rao M, Shareef A, Sharma A. Poststroke depression. Topics in Stroke Rehabilitation 2008;15:13–21.
  http://dx.doi.org/10.1310/tsr1501-13.
1. Hackett ML, Anderson CS. Predictors of depression afterstroke: Systemic review of observational studies. Stroke 2005;36:2296–2301.
  http://dx.doi.org/10.1161/01.STR.0000183622.75135.a4.
  PubMed
  
  CrossRef
1. Huffcutt AI, Arthur W Jr. Development of a new outlier statisticfor meta-analytic data. Journal of Applied Psychology 1995;80:327–334.
1. Jorge RE, Robinson RG, Arndt S, Starkstein S. Mortality and poststroke depression: A placebo-controlled trial of antidepressants. American Journal of Psychiatry 2003;160:1823–1829.
1. Kim JH. Relationship among sexual knowledge, frequency, satisfaction, marital intimacy and levels of depression in stroke survivorsand their spouses. Journal of Korean Academy of Nursing 2008;38:483–491.
  http://dx.doi.org/10.4040/jkan.2008.38.3.483.
1. Kim JH, Kim O. Influence of mastery and sexual frequency on depression in Korean men after a stroke. Journal of Psychosomatic Research 2008;65:565–569.
  http://dx.doi.org/10.1016/j.jpsychores.2008.06.005.
1. Kimura M, Robinson RG, Kosier JT. Treatment of cognitive impairment after poststroke depression: A double-blind treatment trial. Stroke 2000;31:1482–1486.
  http://dx.doi.org/10.1161/01.STR.31.7.1482.
1. Kwon SM. In: Depression. 4th ed. Seoul: Hakjisa; 2004.
1. Law M, Stewart D, Pollock N, Letts L, Bosch J, Westmoreland M. Critical review form-Quantitative studies. 1998 [Retrieved September 13, 2011].
  from http://www.srs-mcmaster.ca/Portals/20/pdf/ebp/quanreview_form1.doc.
1. Lee DJ, Ko TS. Relationships between symptoms of depression and cognitive function, physical functions, and activities of daily living in stroke patients. Journal of Special Education & Rehabilitation Science 2010;49(4):159–178.
1. Lee WJ. In: Adjustment of middle-aged people with hemiplegia after stroke. Seoul: Seoul National University; 2004.
  Unpublished doctoral dissertation.
1. Nys GM, Van Zandvoort MJ, De Kort PL, Jansen BP, Van der Worp HB, Kappelle LJ, et al. Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases. Journal of the International Neuropsychological Society 2005;11:795–806.
  http://dx.doi.org/10.1017/S1355617705050952.
1. Orwin RG. A fail-safe N for effect size in meta-analysis. Journal of Educational Statistics 1983;8:157–159.
1. Park EY, Shin IS. The effects of transitional education programs on adaptive behavior in students with developmental disabilities: A meta analysis. Disability & Employment 2011;21:59–78.
1. Rosenthal R. The file drawer problem and tolerance for null results. Psychological Bulletin 1979;86:638–641.
1. Salter K, Bhogal SK, Foley N, Jutai J, Teasell R. The assessment of poststroke depression. Topics in Stroke Rehabilitation 2007;14(3):1–24.
  http://dx.doi.org/10.1310/tsr1403-1.
1. Singh A, Black SE, Herrmann N, Leibovitch FS, Ebert PL, Lawrence J, et al. Functional and neuroanatomic correlations in poststroke depression: The sunnybrook stroke study. Stroke 2000;31:637–644.
  http://dx.doi.org/10.1161/01.STR.31.3.637.
1. Sterr A, Herron K, Dijk DJ, Ellis J. Time to wake-up: Sleep problems and daytime sleepiness in long-term stroke survivors. Brain Injury 2008;22:575–579.
  http://dx.doi.org/10.1080/02699050802189727.
1. Sung TJ. In: Education research methodology. Seoul: Hakjisa; 2005.
1. Teoh V, Sims J, Milgrom J. Psychosocial predictors of quality of life in a sample of community-dwelling stroke survivors: A longitudinal study. Topics in Stroke Rehabilitation 2009;16(2):157–166.
  http://dx.doi.org/10.1310/tsr1602-157.
1. Verdelho A, Henon H, Lebert F, Pasquier F, Leys D. Depressive symptoms after stroke and relationship with dementia: A three-year follow-up study. Neurology 2004;62:905–911.
  http://dx.doi.org/10.1212/01.WNL.0000115107.66957.8C.
  PubMed
  
  CrossRef
1. Warlow J, van Gijn M, Dennis J, Wardlaw J, Bamford G, Hankey P, et al. In: Stroke practical management. Malden, MA: Blackwell publishing;
1. Whyte EM, Mulsant BH. Post stroke depression: Epidemiology, pathophysiology, and biological treatment. Biological Psychiatry 2002;52(3):253–264.
  http://dx.doi.org/10.1016/S0006-3223(02)01424-5.