Smartphone assessment uncovers real-time relationships between depressed mood and daily functional behaviors after stroke.

Autor:	Bui Q; Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA., Kaufman KJ; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA., Munsell EG; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA.; Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Lenze EJ; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA., Lee JM; Department of Neurology, Washington University School of Medicine, St Louis, MO, USA., Mohr DC; Center for Behavioral Intervention Technologies and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Fong MW; Department of Neurology, Washington University School of Medicine, St Louis, MO, USA.; Psychology and Patient Family Counseling, Shirley Ryan AbilityLab, Chicago, IL, USA.; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Metts CL; Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA., Tomazin SE; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA., Pham V; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA., Wong AW; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA.; Department of Physical Medicine and Rehabilitation and Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	Journal of telemedicine and telecare [J Telemed Telecare] 2024 Jun; Vol. 30 (5), pp. 871-884. Date of Electronic Publication: 2022 May 13.
DOI:	10.1177/1357633X221100061
Abstrakt:	Introduction: The impact of depressed mood in daily life is difficult to investigate using traditional retrospective assessments, given daily or even within-day mood fluctuations in various contexts. This study aimed to use a smartphone-based ambulatory assessment to examine real-time relationships between depressed mood and functional behaviors among individuals with stroke. Methods: A total of 202 participants with mild-to-moderate stroke (90% ischemic, 45% female, 44% Black) completed an ecological momentary assessment five times per day for 2 weeks by reporting their depressed mood and functional behaviors regarding where, with whom, and what activity was spent. Results: Participants spent 28% of their wake-up time participating in passive leisure activities but spent the least time in physical (4%) and vocational (9%) activities. Depressed mood was concurrently lower when participants engaged in social activities (β = -0.023 ± 0.011) and instrumental activities of daily living (β = -0.061 ± 0.013); spent time with family members (β = -0.061 ± 0.014), spouses (β = -0.043, ± 0.016), friends (β = -0.094, ± 0.021), and coworkers (β = -0.050 ± 0.021); and were located in restaurants (β = -0.068 ± 0.029), and homes of family members (β = -0.039 ± 0.020) or friends (β = -0.069 ± 0.031). Greater depressed mood was associated with worse ratings in satisfaction, performance, and engagement of activities in concurrent (βs = -0.036 ± 0.003, -0.053 ± 0.003, -0.044 ± 0.003) and time-lagged models (βs = -0.011 ± 0.004, -0.012 ± 0.004, -0.013 ± 0.004). Discussion: Smartphone-based ambulatory assessment can elucidate functional behaviors and associated mood after stroke. Findings support behavioral activation treatments to schedule social and instrumental activities for stroke survivors to reduce their depressed mood. Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Lenze reported research support from the National Institutes of Health (NIH), Patient-Centered Outcomes Research Institute, and Mercatus Center Emergent Ventures outside the submitted work. He also received grant support (loaned equipment for research) from MagStim. He has served as a consultant for Prodeo, Janssen Pharmaceuticals, and Boehringer Ingelheim. Dr Lee reported research support from the NIH, Barnes-Jewish Foundation, Biogen and consulting fees from Regenera outside the submitted work. Dr Mohr reported research support from the NIH, personal fees from Apple and other support from Actualize Therapy and Otsuka Pharmaceuticals. Dr Mohr has an ownership interest in Adaptive Health and had a patent to US Patent 15/654,245, 2018 pending. Dr Metts has an ownership interest in Infinite Arms. Dr Wong reported research support from the NIH, National Institute on Disability, Independence, and Rehabilitation Research, American Occupational Therapy Foundation, and Craig H. Neilsen Foundation. No other disclosures were reported.
Databáze:	MEDLINE
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