I. Scope and role.
(a) Screening for post-stroke neuropsychological disorders He Yan, Department of Neurology, Shandong Qianfo Mountain Hospital
(B) Assessment of post-stroke cognitive function
(C) Consultation of post-stroke psychosomatic disorders
(D) Psychological treatment and intervention of post-stroke psychosomatic disorders
(E) Psychological assessment is the preliminary work of psychological rehabilitation program
(6) Psychological assessment is an objective indicator to evaluate the effect of psychological rehabilitation.
(7) Psychological rehabilitation depends on psychological assessment, and at the same time is a test of psychological assessment.
(H) Psychological rehabilitation can draw on some technical skills of psychological assessment.
B. Common clinical methods for psychological assessment of stroke unit: interview, observation and psychometric methods
(a) Interview method
1.Concept: To examine the psychological condition of the patient through conversation. Interview questions involve: neuropsychological function, emotion and mood, and the patient’s general mental status. Structured interview: a guided, formal, pre-interview formulated question items and reflective possibilities interview format.
2. Approach: Unstructured interview: Non-guided, informal, free question and answer interview. Semi-structured interviews: 1) free to answer predetermined interview content. 2) structured way to answer unstructured questions.
3. Advantages and disadvantages
Advantages: high efficiency; wide range of people; fully reflects humanistic care, etc.
Disadvantages: high demands on the interviewer; complex analysis of interview results.
(II) Observation method
1.Concept
The naturalistic observation method is mostly used to observe the behavioral performance of stroke patients and to determine the behavioral unit.
Pay attention to the objectivity of the observation and reduce the halo effect, leniency effect, convergence effect, etc. in the observation.
2.Advantages and disadvantages
Advantages: comprehensive, accurate and objective.
Disadvantages: high requirements for the assessor; susceptible to the influence of the observation environment; time-consuming; high cost.
(iii) Psychometric methods
Selection of clinical psychological measures: According to the specific clinical performance of the patient, select the corresponding psychological scale with good reliability and validity.
1. Method: Teaser measurement. Preparation of both sides of the measure. Preparation of measurement materials. Preparation of the measurement environment.
2. Precautions: The measurement room environment should be quiet, comfortable, ventilated, with appropriate temperature and good light. Standardization: Guidance language, measurement presentation time, sequence, can prompt, etc. need to be standardized. Reduce the influence of irrelevant factors. Accurate scoring.
3.Psychometric tools commonly used in stroke units
(1) Neuropsychological package: Holstead-Reitan Neuropsychological Package (HRB), Luria-Nebraska Neuropsychological Package (LNNB), LOTCA Neuropsychological Package
(2) Psychometric instruments for cognitive impairment: Goldstein-Scherrer Abstract and Concrete Thinking Test, Symbolic-Numeric Test, Visual Completion Test, Brief Mental Status Examination (MMSE), Memory Scale: WMS, Clinical Memory Scale, Benton Visual Retention Test (BVRT) Visual Tracking and Discrimination Test, Number and Word Discrimination Test, Intelligence Power Test. (3) Post-stroke Emotional State Examination, Memory Scale: WMS, Clinical Memory Scale, Benton Visual Retention Test (BVRT) Number and Word Recognition Test, Intelligence Scale: Raven’s Test, Wechsler Intelligence
(3) Post-stroke affective scales: BACK Depression, Anxiety, SDS, SAD, DSI, HAMA, HRSD, NDI (Newcastle Depression Diagnostic Inventory), HAD (Hospital Anxiety and Depression Scale), Geriatric Depression Inventory