Healthcare professionals' perception of prevalence and assessment of mental ill-health in stroke patients with and without aphasia - a national survey.

Abstract

Mental ill-health is common after stroke. Stroke survivors with aphasia are at higher risk of depression and anxiety, but communication impairment makes identification challenging. This study investigates if, how, and by whom mental health is assessed in Swedish stroke care, and whether resources to assess mental health in stroke patients with aphasia are available. A survey was distributed to healthcare professionals (HCP) in stroke care and rehabilitation across Sweden. 981 complete responses were included. HCP perceive mental ill-health as more common among patients with aphasia than among other stroke patients, but that their mental health is assessed less frequently. Assessment procedures are inconsistent. Physicians, psychologists, and social workers are viewed as responsible, but these professions are lacking in many rehabilitation settings and do not always work with patients with aphasia. HCPs attempt to adapt assessment procedures but report lacking aphasia-friendly material and competence in communication strategies. According to HCP, mental health is not assessed adequately, especially in patients with aphasia. More mental health professionals, greater competence in communication strategies, improved collaboration between professions, and access to aphasia-friendly assessment materials are important to improve mental health care for stroke patients with and without aphasia.