Integrating mental and physical health assessment in a neuro-otology clinic: feasibility, acceptability, associations and prevalence of common mental health disorders.

People with persistent physical symptoms are at risk of psychological symptoms, although recognition in medical settings is low. This is a retrospective observational study of 954 patients in a hospital outpatient neuro-otology clinic in order to assess the feasibility and acceptability of an electronic informatics system for collection of patient-reported outcomes, with real-time feedback to guide clinical care and describe the prevalence of anxiety and depressive symptoms.The proportion of patients successfully completing the screen was high (70%). The decline rate was low (5%). The most common reason to decline was lack of confidence with technology. The prevalence of probable depression was 21% and for probable anxiety was 29%. Suicidal ideation was present in 5%. Anxiety and depression were highly correlated to dizziness specific outcome measures (p<0.01).Electronic screening is feasible and acceptable to patients and staff in this setting, helping to identify service needs, inform care and monitor outcomes.

Experiences of an exercise referral scheme from the perspective of people with chronic stroke: a qualitative study.

OBJECTIVE: To explore stroke survivors' experiences of undertaking exercise in the context of an exercise referral scheme for people with chronic stroke. DESIGN: A qualitative design, using semi-structured interviews within a constructivist framework to explore the experiences of individual participants. Verbatim transcripts were thematically analysed. Rigour mechanisms included respondent validation, peer checking, and reflexivity. SETTING: An exercise referral scheme, based at a leisure centre in South London. PARTICIPANTS: Nine community-dwelling stroke survivors took part; 5 male and 4 female, mean age 51 years (range 37-61 years); time post stroke 1-4 years, with mixed ethnic backgrounds. FINDINGS: Participants described greater physical and psychological well-being following participation in the exercise referral scheme. Categories that emerged were: improved exercise engagement and confidence, more internalised perceptions of control and enhanced lifestyle, work and social roles. Categories linked to form a master theme, labelled: 'Exercise Referral Scheme as a catalyst for regaining independence.' CONCLUSIONS: This study supports the value of exercise referral schemes in enabling people with stroke to engage in exercise. For participants in this study, the scheme seemed influential in the process of regaining independence.