Date of Award
2026-05-31
Degree Name
PhD Nursing
Dissertation Committee
Razel B. Milo, PhD, DNP, MSN, FNP-C, Chairperson Cynthia D. Connelly, PhD, RN, FAAN, Committee Member Sheila Chan, MD, Committee Member
Keywords
Stroke, depression, depression screening, health-related quality of life, acute care
Abstract
Purpose: The purpose of this study is to describe relationships between sociodemographics, clinical characteristics, length of stay, depression screening (Patient Health Questionnaire-2 [PHQ-2] or Patient Health Questionnaire-9 [PHQ-9]) and the likelihood of post-stroke depression diagnosis among inpatient stroke cases in Northern California.
Background: Current depression screening instruments, which were originally designed for the primary care setting, are being used in the acute stroke setting. Post-stroke depression is often underdiagnosed and can lead to poor stroke outcomes. This study looked at the effectiveness of such instruments in detecting post-stroke depression when administered in the inpatient setting during the acute stroke phase while considering sociodemographic and clinical characteristics.
Methods: Using electronic health record case reviews, this retrospective cross-sectional design described the relationships between select patient sociodemographics, clinical characteristics, and use of the PHQ-2 and PHQ-9 instruments in detecting post-stroke depression. Descriptive statistics characterized the sample and tests of association described the relationships between the variables. Binomial logistic regression was done to describe the likelihood of post-stroke depression diagnosis (yes, no) accounted for by select sociodemographics, clinical characteristics, and use of PHQ-2 and PHQ-9 depression screening instruments.
Results: Site of where stroke care was received, history of depression, presence of heart failure, marital status of divorced/separated, as well as the use of PHQ-2 (regardless of score), were associated with the presence of post-stroke depression.
Implications for Research: Future studies need to explore the development of a screening instrument designed specifically for post-stroke depression.
Conclusion: Acute stroke patients with a comorbidity of heart failure, history of depression, are divorced or separated, should be considered as those with a high risk of developing post-stroke depression. Early screening and follow-up must be established to mitigate the risk of underdiagnosing post-stroke depression which can result in sub-optimal or poor stroke care outcomes. In addition, the use of the well-known PHQ-2 and PHQ-9 instruments are not sensitive in detecting post-stroke depression in the acute stroke phase.
Document Type
Dissertation: USD Users Only
Department
Nursing
Digital USD Citation
Shahwan Solorzano, Sheryn, "Post-stroke Depression Among Stroke Survivors in the Acute Stroke Phase" (2026). Dissertations. 1107.
https://digital.sandiego.edu/dissertations/1107
Copyright
Copyright held by the author