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Nadina B Lincoln

Publications and source records attributed to Nadina B Lincoln.

11 recordsLinked to original sources
PubMed2006

The assessment of fitness to drive in people with dementia.

OBJECTIVE: To determine whether cognitive tests predict fitness to drive in patients with dementia. DESIGN: Two group comparison of patients with dementia and healthy elderly volunteers, and comparison of patients with dementia who were found safe to drive and those found unsafe, followed by a validation study. PARTICIPANTS: Forty-two people with dementia and 33 healthy elderly volunteers with no known memory problems who were driving. Of the 42 people with dementia 37 were assessed on the road. A second sample of 17 people with dementia was also assessed on the road. MAIN MEASURES: Stroke Drivers Screening Assessment, Mini Mental State Examination, Salford Objective Recognition Test, Stroop Test, Test of Everyday Attention, Visual Object and Space Perception Battery, Behavioural Assessment of the Dysexecutive Syndrome, Adult Memory and Information Processing Battery. RESULTS: All healthy elderly volunteers were safe to drive but 10 of the 27 patients with dementia were unsafe. Discriminant function analysis identified a combination of tests, which correctly classified 92% of drivers with dementia as safe or unsafe. Validation of this prediction on an independent sample had 59% accuracy using a cut-off of 0 but 88% accuracy using a cut-off of 5. CONCLUSIONS: Safety to drive in people with dementia could be predicted from a combination of six cognitive tests. These correctly identified 67% of safe drivers in a validation sample. This assessment could be used to identify those who need evaluation of their safety on the road.

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PubMed2006

Factors relating to depression after stroke.

OBJECTIVES: Depression is common after stroke and can impede rehabilitation. The aim of this study was to determine which factors predicted the severity of depression at the time of recruitment to a treatment study and depression 6 months later. DESIGN: A questionnaire-based longitudinal study. METHODS: A total of 123 depressed stroke patients who were between 1 and 6 months post-stroke and had mild to moderate disabilities were recruited to a randomized controlled trial of cognitive behavioural psychotherapy (CBT) to treat depression (Lincoln & Flannaghan, 2003). At recruitment and at 6 months follow-up, patients (N=112) were assessed on the Beck Depression Inventory (BDI), General Health Questionnaire-28 (GHQ-28), Wakefield Depression Inventory (WDI), Barthel index, Extended activities of daily living scale (EADL), Sheffield Screening Test for Acquired Language Disorders (SST) and Recovery locus of control scale (RLOC). RESULTS: Logistic regression showed that greater communication impairment on the SST at recruitment was predictive of severe depression on the BDI at recruitment (OR=0.72, p=.01). Patients with greater communication impairment (OR=0.69, p<.05) and a more external locus of control (OR=0.89, p<.05) at recruitment were more likely to remain depressed at follow-up. Patients who remained depressed at follow-up were more severely depressed at recruitment (p=.001). CONCLUSIONS: Locus of control and communication impairment were related to depression. Communication impairment was the strongest predictor of depression severity and prognosis. Mild depression was more likely to resolve. The regression models only accounted for a small proportion of the variance in depression scores. Therefore, further studies of psychosocial factors in a more representative sample are required.

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PubMed2004

Concurrent validity of the stroke drivers screening assessment.

OBJECTIVE: To determine the concurrent validity of the Stroke Drivers Screening Assessment (SDSA). DESIGN: Comparison of the SDSA with criterion standards. SETTING: Subjects' homes in the community in the United Kingdom. PARTICIPANTS: Ninety-three stroke patients (age range, 22-83y) who were referred for assessment of fitness to drive or who had been driving before their stroke. Participants were assessed a median of 5 months post stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patients were assessed on the SDSA and tests of visuospatial ability (Visual Object and Space Perception [VOSP] Battery), executive abilities (Stroop Neuropsychological Screening Test, Trail-Making Test [TMT], Cognitive Estimates Test [CET]), and visual memory (Recognition Memory Tests [RMT], Verbal Descriptions of Road Signs [VDRS]). RESULTS: The SDSA subtests all correlated significantly with the Stroop test (P<.001) and TMT (P<.001), which suggests that they measure executive abilities and attention. The SDSA Dot Cancellation (DC) also correlated significantly with the VDRS (P<.01). The SDSA Square Matrices (SM) test correlated significantly with the VOSP cube analysis (P< or =.01) and the RMT faces subtest (P<.001), which suggests that the SM test also measures visuospatial abilities and visual memory. The SDSA Road Sign Recognition (RSR) test also correlated significantly with the VOSP cube analysis (P<.05), which suggests that the RSR test also measures visuospatial abilities. Factor analysis produced a 2-factor solution with DC time, SM compass, and RSR all loading on factor 1, together with the Stroop and TMT. This factor was interpreted as "executive abilities and attention." The RMT faces subtest and CET loaded onto a second factor. CONCLUSIONS: The SDSA seems to measure predominantly attention and executive abilities, which have previously been shown to be important determinants of safety to drive. This may account for the high predictive validity of the SDSA.

Adult↗
PubMed2003

Evaluation of a stroke family support organiser: a randomized controlled trial.

BACKGROUND AND PURPOSE: There is inconclusive evidence of the effectiveness of the Stroke Family Support Organiser (FSO) service. We report the results from a randomized controlled trial of the service. METHODS: Stroke patients admitted to hospital and their informal caregivers were randomly allocated to receive the FSO service (n=126) or standard care (n=124). Outcome assessments were undertaken 4 and 9 months after recruitment with the General Health Questionnaire 12, Carer Strain Index, Barthel Index, Extended Activities of Daily Living scale, and a specially designed questionnaire to determine knowledge of stroke and satisfaction with services. RESULTS: There were no significant differences between groups in patients' mood and independence in personal or instrumental activities of daily living or caregivers' mood, strain, or independence. Patients in the intervention group were significantly more knowledgeable about whom to contact for stroke information, reducing the risk of stroke, practical help, community services, and emotional support. Patients in the intervention group were also significantly more satisfied with the stroke information received. Caregivers in the intervention group were significantly more knowledgeable about whom to contact for information on stroke, reducing the risk of stroke, community services, and emotional support. Caregivers in the intervention group were also significantly more satisfied with stroke information. CONCLUSIONS: The FSO service had no significant effect on mood, independence in activities of daily living, or reduction in caregiver strain, but it did increase knowledge of stroke and satisfaction with that knowledge. The results may not be representative of all FSO services, and the sample was small relative to the heterogeneity of the participants. However, results suggest that the policies and training procedures of FSOs need to be evaluated to ensure that a cost-effective service is being provided to stroke patients and their caregivers.

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PubMed2003

Caregiver strain in spouses of stroke patients.

OBJECTIVE: To test the ability of a previously generated logistic regression model to predict caregiver strain from carer mood, negative affectivity and perceived patient functional ability. DESIGN: Postal prospective survey. SETTING: Spouses of community-residing patients identified from hospital stroke registers. METHOD: Spouses were assessed at three and six months after stroke. A previously derived equation was used to make predictions at three months of their level of strain at six months, which were compared with observed outcomes. MEASURES: Spouses were asked to complete the Caregiver Strain Index (CSI), the General Health Questionnaire (GHQ-12), the Positive and Negative Affectivity Schedule (PANAS) and to assess patients' independence in activities of daily living on the Extended Activities of Daily Living Scale (EADL). RESULTS: Of 409 stroke patients, 276 had an identifiable co-resident spouse and 116 (42%) completed the measures. At three months after stroke, 39 carers (34%) were under significant strain with 40 (35%) under strain at six months. The predictive model using the GHQ-12, PANAS and EADL at three months was 78% accurate in predicting levels of caregiver strain at six months. CONCLUSION: Carers at risk of later strain could be identified for further follow-up. Services to provide emotional support to carers might be effective in the reduction of carer strain.

Activities of Daily Living↗
PubMed2003

A qualitative study of stroke patients' and carers' perceptions of the stroke family support organizer service.

OBJECTIVE: To investigate stroke patients' and carers' perceptions of the family support organizer (FSO) service in order to highlight its value for potential purchasers and to help shed light on findings from randomized controlled trials. DESIGN AND SUBJECTS: Twenty semi-structured interviews were undertaken with a subsample of stroke patients and their primary informal carers after completion of nine-month outcome assessments as part of a randomized controlled trial. SETTING: Community stroke services in North Nottinghamshire, UK. RESULTS: Interviewees who received the service reported that the presence of an FSO was valuable in many respects, including helping to claim benefits, as a source of information on stroke, and providing continuity between stroke services. Emotional support was only described by a few. Interviewees who did not receive the service described feelings of isolation and being let down by other stroke services after discharge. They also reported problems accessing information. Help needed to address the practical problems after stroke was commonly reported. For those who did not receive the FSO service, access to support appeared to be found through other channels. CONCLUSION: The FSO service appeared to be an information service. In order to evaluate community stroke services, a mixture of qualitative and quantitative outcome measures are necessary.

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PubMed2003

Assessing mood in patients with multiple sclerosis.

OBJECTIVE: To assess the validity and reliability of mood measures for use with people with multiple sclerosis (MS). DESIGN: Four mood measures designed for use with people with communication and cognitive problems were completed; two were completed with the patient at interview and two by hospital staff or carers of the patients. This procedure was repeated two weeks later to assess test-retest reliability. SUBJECTS: People with MS at a rehabilitation unit (n = 22) and living in the community (n = 27). MAIN OUTCOME MEASURES: The Stroke Aphasic Depression Questionnaire (SADQ) and Signs of Depression Scale (SODS) were completed by rehabilitation unit staff or by carers of the patients. An assistant psychologist completed the Visual Analogue Self-Esteem Scale (VASES) and the Visual Analogue Mood Scales (VAMS) with each patient. The Guy's Neurological Disability Scale (GNDS) was administered to assess physical disability. Nonprofessional carers were asked to complete the General Health Questionnaire 12 (GHQ-12) about themselves. RESULTS: In both samples there were significant correlations between scores on the two self-report measures (VASES and VAMS) (r(s) = 0.51-0.79) and between scores on the two observational measures (SADQ and SODS) (r(s) = 0.62-0.81) but not between the observational and self-report measures. There was a significant correlation between the SODS and the carer GHQ (r(s) = 0.68, p < 0.01), indicating that carer mood influenced reporting of patients' mood. There was no significant influence of profession on the observational measures, indicating good inter-rater reliability. Test-retest reliability was high for patients in the community but not for patients in hospital. CONCLUSIONS: In both the inpatient and community samples, the self-report and observational mood measures appeared to be measuring different aspects of patients' mood. Further investigation is needed to determine which of these is providing the most accurate information.

Affect↗
PubMed2002

An evaluation of screening measures for cognitive impairment after stroke.

OBJECTIVES: To assess the sensitivity and specificity of a screening battery for detecting cognitive impairment after stroke. DESIGN: A randomized controlled trial. METHODS: Stroke patients were recruited from hospitals in three centres. Patients were screened for cognitive impairment on the Mini-Mental State Examination, the Sheffield Screening Test for Acquired Language Disorders and Raven's Coloured Progressive Matrices and received a further battery of assessments of cognitive function. Sensitivity and specificity values were calculated for the three screening measures for overall conclusions regarding cognitive impairment reached from a comprehensive assessment. Receiver Operating Characteristic Curves were plotted. CONCLUSION: The Mini-Mental State Examination was not a useful screen for memory problems or overall cognitive impairment after stroke. The Sheffield Screening Test for Acquired Language Disorders was an appropriate screen for language problems. The Raven's Coloured Progressive Matrices was appropriate as a screen for perceptual problems and visual inattention but not for executive deficits.

Adult↗
PubMed2002

Cognitions and post-stroke depression.

OBJECTIVES: Studies investigating the efficacy of cognitive-behavioural treatment for post-stroke depression have produced contradictory results (Flannaghan, 2000; Lincoln, Flannaghan, Sutcliffe, & Rother, 1997). This study aimed to assess whether depressed stroke patients experienced more negative and less positive cognitions than non-depressed stroke patients in order to ascertain whether post-stroke depression is suitable for cognitive-behavioural therapy. DESIGN: A questionnaire-based study compared stroke patients who were assessed as depressed or not depressed. METHODS: A Cognitions scale was developed from transcripts of cognitive-behavioural therapy sessions with depressed stroke patients. A total of 50 stroke patients, the majority of whom were still in hospital, were assessed on the Beck and Wakefield Depression Inventories and the Cognitions scale. RESULTS: The prevalence rate for depression was similar to that found in previous studies. The internal reliability and construct validity of the scale were found to be acceptable. Significantly more negative cognitions and less positive cognitions were found in stroke patients who were depressed as compared with stroke patients who were not depressed. CONCLUSIONS: The study suggests that post-stroke depression does not differ qualitatively from general depression and that general theories and thus treatments for depression may be valid within this population.

Adult↗