Evidence map›Paper›PMID 38165320›Full record

ArticleNeurology2024

Long-Term Psychological Distress Among Surrogate Decision Makers for Mexican American and Non-Hispanic White Patients With Severe Stroke.

Lewis B Morgenstern, Christopher J Becker, Rebecca Lank, Carmen Ortiz, Guanghao Zhang, Kevin He, Erin Case, Darin B Zahuranec

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PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Lewis B MorgensternFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0000-0002-5787-592X
Christopher J BeckerFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0000-0003-3414-9826
Rebecca LankFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0009-0009-8996-1900
Carmen OrtizFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0009-0004-0191-0177
Guanghao ZhangFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0000-0002-7615-4415
Kevin HeFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0000-0002-8354-426X
Erin CaseFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0000-0002-4198-454X
Darin B ZahuranecFrom the Department of Neurology (L.B.M., C.J.B., C.O., D.B.Z.), Michigan Medicine; Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor; University of Iowa (R.L.), Iowa City; and Departments of Biostatistics (G.Z., K.H.), and Epidemiology (E.C.), University of Michigan School of Public Health, Ann Arbor.ORCID 0000-0002-9772-2469
University of Michigan · US

Funding

STROKE SURVEILLANCE IN A BIETHNIC COMMUNITYR01NS038916 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI LISABETH, LYNDA D, MORGENSTERN, LEWIS B · 1999 to 2023
$20.9M
Outcomes Among Surrogate decision makers In Stroke (OASIS)R01NS091112 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MORGENSTERN, LEWIS B, ZAHURANEC, DARIN B · 2015 to 2019
$2.6M
NINDS NIH HHS R01 NS038916NINDS NIH HHS R01 NS091112
6 · The paper itself

Abstract

BACKGROUND AND

objectivesDuring acute hospitalizations, physicians often focus on the stroke patient and not family who may be traumatized by this sudden change to their loved one. We investigated long-term psychological distress among family surrogate decision makers for Mexican American (MA) and non-Hispanic White (NHW) severe stroke patients. Previous work in other diseases suggested worse psychological outcomes in MA than NHW caregivers.

methodsThis was a population-based, prospective cohort study in Nueces County, TX. Stroke patient participants and their surrogate decision makers were enrolled soon after any stroke between April, 2016, and October, 2020, if surrogates had made decisions about life-sustaining treatments. Surrogates completed validated measures of posttraumatic stress, National Stressful Events Survey for Posttraumatic Stress Disorder Short Scale; anxiety, Generalized Anxiety Disorder-7; and depression, Patient Health Questionnaire-8 at discharge, 3, 6, and 12 months. Ethnic differences were assessed with multilevel linear mixed models, sequentially adjusted for prespecified patient and surrogate demographic, socioeconomic, and clinical covariates.

resultsThere were 301 family surrogates for 241 severe stroke patients. The mean follow-up was 315 days. High scores on measures of psychological distress ranged between 17% and 28% of surrogates. One or more high levels of the psychological outcomes were found in 17%-43% of surrogates; 2 or more were found in 12%-27%; and all 3 were found in 5%-16% of surrogates. All psychological outcomes were worse among MAs on unadjusted analyses. In fully adjusted models, posttraumatic stress remained worse among MAs (0.36, 95% CI 0.17-0.56); ethnic differences were attenuated and no longer significant in the final model for anxiety (0.59, 95% CI -0.55 to 1.74) and depression (0.97, 95% CI -0.25 to 2.19). The trajectory for depression did differ by ethnicity (interaction DISCUSSION: Psychological distress is common among family surrogate decision makers in the year after stroke and may be worse among MAs. Efforts are needed to support family members of all ethnic groups after severe stroke.

Indexed as

CaregiversPsychological DistressStrokeDecision MakingEthnicityHumansMexican AmericansProspective StudiesWhite

Identifiers

PMID38165320
PMCPMC10870740
OpenAlexW4390038505

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.