Nursing Assessment of Depression in Stroke Survivors

Stroke is a leading cause of death and disability worldwide.1,2 Because depression is the second leading cause of disability in the world,3 stroke complicated by depression is doubly disabling. Thirty-one percent of stroke survivors are estimated to be clinically depressed (95% confidence interval 28%–35%).4 Thus, at any given time, between 28% and 35% of stroke survivors are likely to be living with depression. With an annual incidence of 795 000 new or recurrent strokes in the United States,1 we might expect 246 000 will be depressed.Poststroke depression is associated with poorer recovery, reduced health-related quality of life,5 and a higher risk of subsequent stroke and mortality.6,7 We also know that many people hospitalized with stroke have not had their mood assessed by discharge.8 Because depression in chronic illness, including stroke, can be successfully treated, it becomes imperative that we assess for depression for all stroke survivors in our health systems. Indeed, this has become a standard for credentialing stroke care in Australia, the United Kingdom, and the United States.8–12 Nurses are the health professionals most in contact with stroke survivors and their families during an acute episode and are therefore key to assessing the presence of clinical depression.The purpose of this article is to review the screening and diagnostic assessment tools available to health professionals, with emphasis on clinically feasible instruments that can be used by staff nurses.A literature search was conducted in MEDLINE with a secondary search in PsycINFO and CINAHL to ascertain any papers relevant to nursing missed by the MEDLINE search. The search terms included stroke and depression, poststroke depression, assessment, measurement, diagnosis. Sub-collections of systematic reviews, diagnosis, and nursing journals were followed until there were …