TY - JOUR
T1 - Smartphone assessment uncovers real-time relationships between depressed mood and daily functional behaviors after stroke
AU - Bui, Quoc
AU - Kaufman, Katherine J.
AU - Munsell, Elizabeth G.S.
AU - Lenze, Eric J.
AU - Lee, Jin-Moo
AU - Mohr, David C.
AU - Fong, Mandy W.M.
AU - Metts, Christopher L.
AU - Tomazin, Stephanie E.
AU - Pham, Vy
AU - Wong, Alex
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2024/6
Y1 - 2024/6
N2 - 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.
AB - 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.
KW - Telemedicine
KW - ambulatory assessment
KW - daily functional behaviors
KW - depression
KW - ecological momentary assessment
KW - mobile health
KW - smartphone
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85130514475&partnerID=8YFLogxK
U2 - 10.1177/1357633X221100061
DO - 10.1177/1357633X221100061
M3 - Article
C2 - 35549589
AN - SCOPUS:85130514475
SN - 1357-633X
VL - 30
SP - 871
EP - 884
JO - Journal of Telemedicine and Telecare
JF - Journal of Telemedicine and Telecare
IS - 5
ER -