Coping, Problem Solving, Depression, and Health-Related Quality of Life in Patients Receiving Outpatient Stroke Rehabilitation

This has been researched many times before and we still don't seem to have a protocol for this. Just like we have NO protocols for anything to do with stroke. So rather than actually  coming up with solutions to deficits from stroke we are told how to cope with them better. What a fucking waste of time.

Supporting Family Caregivers in Stroke Care - A Review of the Evidence for Problem Solving  2005

Telephone Intervention With Family Caregivers of Stroke Survivors After Rehabilitation 2002

Escitalopram and Problem-Solving Therapy for Prevention of Poststroke Depression  2008

 The latest here:

Coping, Problem Solving, Depression, and Health-Related Quality of Life in Patients Receiving Outpatient Stroke Rehabilitation

Presented as an oral presentation to Neuropsychological Rehabilitation Special Interest Group of the World Federation for NeuroRehabilitation, July 14–15, 2014, Limassol, Cyprus.

Marieke M. Visser, MSc

,

Majanka H. Heijenbrok-Kal, PhD

,

Adriaan van't Spijker, PhD

,

Kristine M. Oostra, MD

,

Jan J. Busschbach, PhD

,

Gerard M. Ribbers, MD, PhD

DOI: http://dx.doi.org/10.1016/j.apmr.2015.04.007

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Published Online: April 25, 2015

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• Abstract
• Full Text
• References

Abstract

Objectives

To investigate whether patients with high and low depression scores after stroke use different coping strategies and problem-solving skills and whether these variables are related to psychosocial health-related quality of life (HRQOL) independent of depression.

Design

Cross-sectional study.

Setting

Two rehabilitation centers.

Participants

Patients participating in outpatient stroke rehabilitation (N=166; mean age, 53.06±10.19y; 53% men; median time poststroke, 7.29mo).

Interventions

Not applicable.

Main Outcome Measures

Coping strategy was measured using the Coping Inventory for Stressful Situations; problem-solving skills were measured using the Social Problem Solving Inventory–Revised: Short Form; depression was assessed using the Center for Epidemiologic Studies Depression Scale; and HRQOL was measured using the five-level EuroQol five-dimensional questionnaire and the Stroke-Specific Quality of Life Scale. Independent samples t tests and multivariable regression analyses, adjusted for patient characteristics, were performed.

Results

Compared with patients with low depression scores, patients with high depression scores used less positive problem orientation (P=.002) and emotion-oriented coping (P<.001) and more negative problem orientation (P<.001) and avoidance style (P<.001). Depression score was related to all domains of both general HRQOL (visual analog scale: β=−.679; P<.001; utility: β=−.009; P<.001) and stroke-specific HRQOL (physical HRQOL: β=−.020; P=.001; psychosocial HRQOL: β=−.054, P<.001; total HRQOL: β=−.037; P<.001). Positive problem orientation was independently related to psychosocial HRQOL (β=.086; P=.018) and total HRQOL (β=.058; P=.031).

Conclusions

Patients with high depression scores use different coping strategies and problem-solving skills than do patients with low depression scores. Independent of depression, positive problem-solving skills appear to be most significantly related to better HRQOL.