DOI
https://doi.org/10.25772/M4YM-ZB76
Author ORCID Identifier
https://orcid.org/0000-0001-8636-9180
Defense Date
2019
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Nursing
First Advisor
Victoria Menzies PhD, APRN, FAAN
Abstract
Traumatic Brain Injury (TBI) affects approximately 1.7 million persons in the United States annually, 75% are categorized as mild (mTBI). Most persons who experience mTBI will recover, however an estimated 10% will develop Postconcussion Syndrome (PCS). Evidence supports a relationship between perceived stress, salivary cortisol, and depressive symptoms in persons after TBI; however, there are no known studies exploring these relationships in the PCS patient population. A sample of 17 men and women diagnosed with PCS were recruited from Southwest and Central Virginia. Data collection included the Rivermead Postconcussion Questionnaire, Perceived Stress Scale-10, Center for Epidemiological Studies-Depression Scale and the PROMIS Emotional Distress (ED)- Depression Short form (SF). Salivary cortisol was collected with a SalivaBio Oral Swab Collection System. Data were analyzed with Wilcoxon Rank-Sum and Pearson’s Chi Square. Spearman’s Rank Order Correlation Coefficients were used to compare variables for correlation. We found a statistically significant relationship between stress and depression (Spearman rho=0.87; p <0.0001); however, we did not find a statistically significant relationship between stress and cortisol (Spearman rho=-0.11; p =0.6887) or depression and cortisol as measured by the CES-D (Spearman rho=-0.10; p=0.6989) and the PROMIS ED-Depression SF (Spearman rho= -0.40; p=0.1327). While perceived stress may impact report of depressive symptoms in persons diagnosed with PCS, much is unknown about the influence of other factors in the development of this syndrome. More research is needed to identify mechanisms behind the presence of PCS to further inform our understanding of this condition, and to apprise the development of nursing interventions.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
3-28-2019