ABSTRACT
OBJECTIVE: The Fist-Edge-Palm task is a motor sequencing task believed to be sensitive to frontal lobe impairment. The present study aimed to investigate the inhibitory processes underlying successful execution of this task. METHOD: Seventy-two healthy participants were asked to perform the Fist-Edge-Palm task paced at 120 bpms, 60 bpms and self-paced. They also completed assessments sensitive to recently dissociated forms of inhibition (the Hayling Sentence Completion Test and the Stroop Color-Word Test) that have recently been shown to be differentially lateralized (the right and left Prefrontal Cortex, respectively), and Cattell's Culture Fair Intelligence test. RESULTS: Analysis revealed that performance on the Hayling Sentence Completion Test predicted the amount of crude errors and the overall score on the Fist-Edge-Palm task, and that pacing condition had no effect on this outcome. Neither the Stroop Color-Word Test nor Cattell's Culture Fair Intelligence Test predicted performance on the Fist-Edge-Palm task. CONCLUSIONS: Consistent with some previous neuroimaging findings, the present findings suggest that Fist-Edge-Palm task performance relies on right lateralized inhibitory processes.
Subject(s)
Inhibition, Psychological , Neuropsychological Tests/standards , Prefrontal Cortex/physiology , Psychomotor Performance/physiology , Adult , Female , Hand/physiology , Humans , Male , Young AdultABSTRACT
PURPOSE: Psychological problems are common complications following stroke and have an impact on all aspects of recovery. This article investigates levels of psychological distress in patients during hospital admission and after discharge into the community. Early detection and review of poststroke psychological problems may optimize recovery from stroke as recommended in the national stroke guideline. Currently, there are very few follow-up investigations on poststroke mood disorders available that could inform clinical practice. METHOD: Psychological symptoms were defined as poststroke anxiety and depression and were measured using the Hospital Anxiety and Depression Scale (HADS). Revised cutoff scores for this clinical group were applied. Seventy-seven stroke patients were assessed in the hospital. Forty-two patients from this sample were reassessed after their discharge into the community. RESULTS: Patients in the hospital sample presented with mean anxiety and depression scores above the recommended cutoff for stroke. Far more than 50% of male and female patients presented with heightened psychological distress. Psychological symptoms were slightly less intense and less frequent in the follow-up after discharge sample. The differences between the HADS outcomes of hospitalized and community patients were nonsignificant but remained beyond cutoff for more than 50% of follow-up patients. CONCLUSION: The study highlights the importance of mood assessments for all stroke patients. The percentage of patients with residual psychological problems was lower than that reported in the literature. However, it is highly recommended for those patients with chronic poststroke psychological distress to have access to specialist psychological interventions.
Subject(s)
Anxiety/etiology , Depression/etiology , Stroke/complications , Stroke/psychology , Adult , Aged , Aged, 80 and over , Anxiety/diagnosis , Depression/diagnosis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Statistics, Nonparametric , Surveys and QuestionnairesABSTRACT
Psychological problems, and post-stroke depression in particular, are common following stroke. This article describes the development and evaluation of a mood screening pathway on a hospital-based stroke unit. The pathway is evaluated against the criteria of the national stroke guidelines, particularly the National Stroke Sentinel Audit (Royal College of Physicians, 2008a). The outcome reveals that the Stroke Mood Screening pathway meets the target of assessing every patient in 88.9% of cases. This places the performance of this procedure within the top quarter of stroke units in the UK. The Stroke Mood Screening pathway enabled the rehabilitation team to identify mood disturbances very early following patients' admission to the unit. Good communication pathways between rehabilitation staff and easy referral routes to neuropsychology made rapid and efficient responses to emerging mood problems possible. The outcomes of this evaluation also give useful guidance for service improvements and consequently, could optimize the provision of psychological support for the patients on the unit.
Subject(s)
Hospital Units , Inpatients , Mood Disorders/diagnosis , Stroke/psychology , Humans , Mood Disorders/etiology , Practice Guidelines as Topic , Risk Factors , Stroke/complications , United KingdomABSTRACT
This article describes the general principles of a psychological care model and the outcomes of a questionnaire survey with members of a multidisciplinary stroke rehabilitation team. Twenty-eight staff members' responses concerning their understanding and attitudes about the presented model were analysed. The responses revealed that rehabilitation staff had good knowledge about possible psychological reactions of patients following a stroke. They were supportive of the idea that it is important to understand and address patients' psychological needs to improve recovery. The survey revealed differing opinions regarding the way such a service could be implemented. Furthermore, the outcomes described personal requirements of rehabilitation staff in addressing the psychological care needs of patients. The results of the survey will have implications for staff training programmes and service developments.
