Screening Depression and Suicidality in Post Stroke Aphasia: A Theory of Planned Behaviour Study

BackgroundClinical guidelines recommend screening for post-stroke depression, which is particularly important for people with post-stroke aphasia, due to increased risk of depression and suicidality. The Theory of Planned Behaviour (TPB) suggests that behavioural intentions are influenced by three factors: attitudes, normative beliefs, and perceived behavioural control. It has been used to investigate staff intentions to perform post-stroke screening, but little is known about staff intentions to screen people with aphasia for depression or suicidality.AimsWe examined how UK stroke professionals describe screening for depression and suicidality with people with aphasia and whether the TPB predicts intent to screen depression with this population.Methods & ProceduresWe conducted a cross-sectional online survey and used multiple regression to test whether attitudes, normative beliefs, and perceived behavioural control predicted intent to screen people with aphasia for depression and suicidality. To assess response stability over time we asked respondents to repeat the survey over a fortnight later.ResultsOne hundred and eighteen UK stroke professionals completed the survey between May and September 2020. Intent to screen people with aphasia for depression was high (M = 71.6%, SD = 34.7) but much lower for suicidality (M = 42.4%, SD = 39). Approximately half the variance in intent to screen for depression was predicted by the TPB, R-2 = .48, F (3,101) = 30.60, p < .001, with normative beliefs identified as a significant predictor, beta = .62, p < .001. Responses were stable over time for those who repeated the survey (N = 13).ConclusionsMore support is needed to help stroke professionals screen for depression and suicidality in people with post-stroke aphasia. Screening rates may be improved by communicating clear expectations that staff should screen all stroke survivors for depression and suicidality, developing aphasia-accessible screening tools and providing training to all stroke professionals.