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Electronic screening and decision support for poststroke depression: an exploration of doctors' and patients'
Jennifer H White1, Sally E Towers, Alyna Turner
1Hunter Stroke Service, Hunter New England Local Health District, Newcastle, NSW, Australia. jennifer.white@hnehealth.nsw.gov.au
Objective:
To explore clinicians' and patients' perceptions of acceptability of an electronic screening and decision support system for poststroke depression.
Design:
A mixed-methods study involved participants from 2 convenience samples.
Setting:
Outpatient stroke and rehabilitation clinics.
Participants:
Stroke patients (n=62) completed surveys. Seven clinicians working at clinics targeted by the depression screening process were interviewed using semi-structured interviews.
Interventions:
Not applicable.
Main Outcome Measures:
Patient data were analyzed from an acceptability survey. Qualitative data analysis involved an inductive thematic approach with constant comparison.
Results:
Most patients found screening easy to complete and understand, important, and a good way of conveying information to the clinician. Most clinicians did not systematically discuss mood disturbances, with attenuating factors and barriers to identification both influencing identification. Variations in the management of mood centered on the use of pharmacotherapy and role overlap with general practitioners. The screening process assisted with identification and saved time during diagnosis and management.
Conclusions:
The positive perceptions of patients and clinicians identified in this study support the concept of routine screening and feedback for poststroke depression. This process has the potential to improve poststroke depression practice to meet national guidelines; however, evaluation of impact on patient outcome is required.
