Combining Standard Conventional Measures and Ecological Momentary Assessment of Depression, Anxiety and Coping Using Smartphone Application in Minor Stroke Population: A Longitudinal Study Protocol.

Camille Vansimaeys,Claire Join-Lambert,Wassim Farhat,Benjamin Pitrat,Catherine Bungener,Mathieu Zuber,Ruben Tamazyan

doi:10.3389/fpsyg.2017.01172

Abstract

Context: Stroke has several consequences on survivors’ daily life even for those who experience short-lasting neurological symptoms with no functional disability. Depression and anxiety are common psychological disorders occurring after a stroke. They affect long-term outcomes and quality of life but they are difficult to diagnose because of the neurobiological consequences of brain lesions. Current research priority is given to the improvement of the detection and prevention of those post-stroke psychological disorders. Although previous studies have brought promising perspectives, their designs based on retrospective tools involve some limits regarding their ecological validity. Ecological Momentary Assessment (EMA) is an alternative to conventional instruments that could be a key in research for understanding processes that underlined post-stroke depression and anxiety onset. We aim to evaluate the feasibility and validity of anxiety, depression and coping EMA for minor stroke patients.Methods: Patients hospitalized in an Intensive Neuro-vascular Care Unit between April 2016 and January 2017 for a minor stroke is involved in a study based on an EMA methodology. We use a smartphone application in order to assess anxiety and depression symptoms and coping strategies four times a day during 1 week at three different times after stroke (hospital discharge, 2 and 4 months). Participants’ self-reports and clinician-rates of anxiety, depression and coping are collected simultaneously using conventional and standard instruments. Feasibility of the EMA method will be assessed considering the participation and compliance rate. Validity will be the assessed by comparing EMA and conventional self-report and clinician-rated measures.Discussion: We expect this study to contribute to the development of EMA using smartphone in minor stroke population. EMA method offers promising research perspective in the assessment and understanding of post-stroke psychological disorders. The development of EMA in stroke population could lead to clinical implications such as remotely psychological follow-ups during early supported discharge.Trial registration: European Clinical Trials Database Number 2014-A01937-40

Highlights

BackgroundRecent estimations (Murray et al, 2012; Lozano et al, 2013; Feigin et al, 2015) ranked stroke as the second cause of death and the third health-problem leading to disability and loss of life years worldwide and is considered as a major health priority in contemporary world
Stroke is an acute unforeseen medical condition caused by an interruption of the blood supply to the brain which causes damages to the tissue. Those damages are frequently related to neurological, motor and cognitive symptoms which can variate in the severity and disablement
We aim to evaluate feasibility, acceptability, quality and reliability of data collected by Ecological Momentary Assessment (EMA) in minor stroke patients at different times and in different contexts during the first 4 months following a stroke

Summary

Introduction

BackgroundRecent estimations (Murray et al, 2012; Lozano et al, 2013; Feigin et al, 2015) ranked stroke as the second cause of death and the third health-problem leading to disability and loss of life years worldwide and is considered as a major health priority in contemporary world. Stroke is an acute unforeseen medical condition caused by an interruption of the blood supply to the brain (ischemia or hemorrhage) which causes damages to the tissue. Those damages are frequently related to neurological, motor and cognitive symptoms which can variate in the severity and disablement. Minor Stroke is defined as an actual cerebrovascular accident with mild and short-lasting neurological symptoms causing no functional disability (Fischer et al, 2010; Green and King, 2010). Prevalence of minor strokes has been estimated to 60% of overall strokes (Rothwell et al, 2004; Green and King, 2010)

Objectives

Methods

Findings

Conclusion