Depression literacy among Chinese stroke survivors.

OBJECTIVES: Mental health literacy is fundamental to the pursuit of health. Little is known about patients' literacy levels regarding depression even though it is common among elderly stroke survivors. This paper will report the level of mental health literacy and thematic constructs of depression interpreted by a group of stroke survivors. METHOD: Qualitative data on patients' understanding of 'depression' in Chinese were translated and analyzed by an academic and a researcher separately to identify emerging constructs using a thematic approach. Out of 214 ischemic stroke older adults, aged 50+, 85 were able to explain the term in their own words after their first stroke attack. RESULTS: The majority of stroke patients (60%, 129 out of 214) had never heard of depression and only four referred to it as a medical disease. Only a third would like to learn more about depression. Older Chinese adults depicted depression mainly by using words in the cognitive and affective domains, but the descriptors used were mostly non-specific and might not match the diagnostic criteria for depression or the commonly used screening tools. CONCLUSION: Low mental health literacy among older patients indicated that much more work needs to be done in health promotion and education on depression literacy.

The smiley as a simple screening tool for depression after stroke: a preliminary study.

UNLABELLED: In Hong Kong, there is a paucity of evidence to support which tool is superior in measuring depression after stroke (DAS). A simple, non-language-based, culturally neutral, non-verbal and easy to apply tool that is not highly dependent on training will be desirable. OBJECTIVES: The present study aimed to examine the clinical utility of three smiley pictures in detecting DAS for older Chinese patients at 1 month after first-ever ischemic stroke. METHODS: This was a cross-sectional study. A total of 253 stroke patients were interviewed by a research nurse at 1-month follow-up. RESULTS: Taking Diagnostic and Statistic Manual (DSM IV) as the gold standard, the measurement properties of emoticon (sad) in terms of sensitivity, specificity, positive and negative predictive values, as well as Kappa's value were found comparable to Geriatric Depression Scale (GDS). The emoticon (happy) demonstrated a highly significant inverse relationship with all depression assessment tools (p<0.001). It was also found that the emoticon (flat) could capture 98% of all depressed subjects identified by DSM IV, although its predictive values were less satisfactory. CONCLUSIONS: The smiley pictures seemed to fulfil the requirements for early and prompt screening among older patients. Cultural implication regarding emotions dissipation among Chinese patients should be further studied.