Hypoxic Brain Injury: Causes, Symptoms, and Recovery by Flint Rehab

 In here they talk about coping, you'll have to scream at your doctor that you want vastly better than that; 100% RECOVERY, NOTHING LESS!

If your doctor incompetently has done nothing since medical school to solve stroke to 100% recovery, find a better doctor!

Hypoxic Brain Injury: Causes, Symptoms, and Recovery

Share your experience of post-stroke fatigue to help others - UK

 Explain to them how useless your doctor is in treating post stroke fatigue, they've known about it for decades, yet have DONE NOTHING! Don't talk about your problems with fatigue, DEMAND TO KNOW WHO IS GOING TO SOLVE IT! NO EXCUSES!

The only way others can be helped by your testimony is if YOU  tell them they need to CURE FATIGUE! No excuses.

Share your experience of post-stroke fatigue to help others

Different Strokes is looking to recruit volunteers for taking part in research in partnership with the Universities of Birmingham and Cambridge.

We are interested in hearing from both stroke survivors and family members/carers of stroke survivors.

This would involve being filmed talking about your experiences of post-stroke fatigue.

COMbAT (COproduction and evaluation of a self-MAnagemenT intervention for post-stroke fatigue) is a self-management programme to help people cope with fatigue following a stroke. (Wrong goal, Survivors don't want to 'cope'! They want recovery. Why aren't you delivering that?)

It is being developed by experts led by the Universities of Birmingham and Cambridge. 

People affected by stroke have told us that hearing other people’s experiences of fatigue is extremely helpful. Therefore, we want to include videos of people telling their fatigue stories in our self-management programme.

We are looking for volunteers to be filmed talking about their experience of post-stroke fatigue, how it affected their life, and tips/ tricks to manage fatigue. The videos or audio clips will be included in the fatigue self-management programme to help others affected by fatigue.

With your help, we want to empower stroke survivors to better manage their fatigue, enabling them to engage in activities that bring joy, value and meaning to their lives.

Who can take part?

• Aged 18 years and over;
• Live in the UK;
• You feel tired all the time or get tired very quickly since your stroke;
• OR you are a family member/ carer of someone who has post-stroke fatigue.

What would taking part involve?

There are different ways to be involved:

• Film yourself on your phone or laptop answering questions;
• The team can film you during an online meeting (such as Zoom);

There will be some opportunities to be filmed in person if you prefer.

You will receive a £25 voucher for your contribution

Next Steps

To express an interest please click on the button below to complete the online form.

Once you submit this you will be contacted directly by a member of the COMbAT Fatigue research team by the end of August 2024. 

The research has been funded by the National Institute for Health and Care Research (NIHR) and Stroke Association (Research ID: SA/NIHR 23\205012).

The Lingering Exhaustion: Understanding Post-Stroke Fatigue

The point is to solve the fatigue problem! HOW EXACTLY ARE YOU GOING TO ACCOMPLISH THAT? 

Survivors don't want to 'cope' They want to have fatigue cured! GET THERE!

Well, post stroke fatigue has been proven for years! Don't you keep up-to-date on research? 

Whomever approved this research needs to be fired! This post stroke fatigue has been known forever. SOLVE THE FUCKING PROBLEM!

At least half of all stroke survivors experience fatigue Known since March 2017

Or is it 70%? Known since March 2015

Or is it 40%? Known since September 2017

I'd have you all fired for incompetence for not solving the problem of fatigue! Telling us it exists does nothing for survivor recovery!

The latest here:

The Lingering Exhaustion: Understanding Post-Stroke Fatigue 

Delving into the cause and impact of post-stroke fatigue.(But not creating a solution! Coping is not a solution, it's a Band-Aid)

Posted November 20, 2023 | Reviewed by Devon Frye

Key points

• Post-stroke fatigue plays a significant role in physical and cognitive rehabilitation outcomes.
• Research indicates that approximately 48 percent of stroke survivors experience symptoms of fatigue.
• Recognising both physical and mental signs of fatigue is essential to finding effective coping strategies.

Post-stroke fatigue (PSF) is a debilitating condition that impacts the well-being and recovery progress of stroke survivors. Studies indicate that approximately 48 percent of stroke survivors experience PSF (1), making it a prevalent and distressing consequence of a stroke.

Prostock-studio/ Shutterstock

What Is Post-Stroke Fatigue?

Post-stroke fatigue is characterised by prolonged tiredness, low energy, and generalised exhaustion. It is essential to recognise the intricate nature of PSF since it differs from typical fatigue and can adversely impact the body, mind, and emotions, and most notably, it is not resolved by rest or sleep.

While physical fatigue may manifest as a sense of bodily weakness, heaviness, or weariness, mental fatigue can lead to difficulties in concentration, cognitive processing, and emotional regulation. This is due to the brain's injury from the stroke, which disrupts the intricate network of neural circuits that are responsible for regulating energy levels and cognitive function, leading to the emergence of chronic fatigue (2).

The combination of physical and mental fatigue can influence a stroke survivor's participation in rehabilitation, social engagements, and personal hobbies. This often leads to frustration and reduced motivation.

How Post-Stroke Fatigue Impacts Recovery

Post-stroke fatigue can delay cognitive, language, and physical recovery during stroke rehabilitation. The persistent exhaustion associated with PSF can compromise primary cognitive domains such as attention, memory, and executive functions, making it challenging to engage in necessary rehabilitation exercises.

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Additionally, PSF can interfere with verbal expression and comprehension, making participation in speech and language therapy a difficult task and slowing down language recovery. Furthermore, reduced energy levels can lead to ineffective physical therapy sessions, delaying improvements in mobility and prolonging the rehabilitation process (3).

During the recovery journey, fatigue can manifest and persist for an extended period, influenced by several factors, such as pre-existing conditions and the location of the stroke lesion. For instance, research has shown that individuals with right thalamic strokes are particularly susceptible to experiencing PSF symptoms in the late stages of recovery (4).

Further studies have also shown that fatigue is connected to other common issues after a stroke, like depression, anxiety, and cognitive function (5). This highlights how these challenges are linked and the importance of understanding all factors that impact the recovery journey.

Strategies to Cope with Post-Stroke Fatigue

When dealing with post-stroke fatigue, it is essential to adopt effective coping strategies that allow individuals to manage their symptoms; these may include, for instance, prioritising and pacing activities, setting achievable goals, and taking regular breaks to conserve energy. It is vital to listen to the body, acknowledge the need for rest, and be open to adjusting daily routines accordingly.

Implementing cognitive strategies is crucial in addressing PSF, especially in relation to memory and concentration difficulties. Utilising aids such as calendars and reminders can be beneficial. Engaging in mentally stimulating activities like puzzles and reading can effectively combat mental fatigue and enhance cognitive well-being.

Engaging in physical activity might appear counterintuitive when dealing with PSF, but it can be a valuable tool for managing symptoms. Gentle activities such as walking, yoga, or swimming can progressively increase physical endurance and counteract the impacts of fatigue (6).

Although post-stroke fatigue may present various physical and mental obstacles, by understanding this condition and developing coping mechanisms, it is possible to ignite a spark of renewed vitality and have a bright future after a stroke.

“I Give It Everything for an Hour Then I Sleep for Four.” The Experience of Post-stroke Fatigue During Outpatient Rehabilitation Including the Perspectives of Carers: A Qualitative Study

Well, duh. Post stroke fatigue has been known for decades. We don't want to cope with it, we want it solved.

“I Give It Everything for an Hour Then I Sleep for Four.” The Experience of Post-stroke Fatigue During Outpatient Rehabilitation Including the Perspectives of Carers: A Qualitative Study

Erin D. Bicknell^1,2*, Catherine M. Said^2,3,4, Kimberley J. Haines² and Suzanne Kuys¹

• ¹School of Allied Health, Australian Catholic University, Brisbane, QLD, Australia
• ²Department of Physiotherapy, Western Health, St Albans, VIC, Australia
• ³Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
• ⁴Australian Institute for Musculoskeletal Science, St Albans, VIC, Australia

Background: Fatigue is a debilitating post-stroke symptom negatively impacting rehabilitation. Lack of acknowledgment from carers can be additionally distressing. The purpose of this study was to describe the experience of post-stroke fatigue during outpatient rehabilitation, including the perspectives of carers.

Methods: This qualitative study was guided by descriptive phenomenology within a constructivist paradigm. Semi-structured interviews were conducted with stroke survivors experiencing fatigue (Fatigue Assessment Scale >23) and attending outpatient rehabilitation. Carers were also interviewed where identified, providing insight into their own and stroke survivor experiences. Data were analyzed according to Colaizzi's analytic method.

Results: Fourteen stroke survivors (50% culturally and linguistically diverse), and nine carers participated. Six themes were identified: 1. The unpredictable and unprepared uncovering of fatigue; 2. Experience and adjustment are personal 3. Being responsible for self-managing fatigue; 4. The complex juggle of outpatient stroke rehabilitation with fatigue; 5. Learning about fatigue is a self-directed problem-solving experience; 6. Family and carers can support or constrain managing fatigue.

Conclusion: Despite engaging in outpatient rehabilitation, stroke survivors largely learnt to manage fatigue independent of healthcare professionals. Carers often facilitated learning, monitoring rehabilitation, daily routines and fatigue exacerbation. Conversely, family could be dismissive of fatigue and possess unrealistic expectations. Post-stroke fatigue must be considered by clinicians when delivering outpatient rehabilitation to stroke survivors. Clinicians should consistently screen for fatigue, provide flexible session scheduling, and educate about individual indicators and strategies for management. Clinicians should also explicitly engage carers who play a critical role in the management of fatigue.

Introduction

Post-stroke fatigue has been described as a feeling of “…tiredness, a lack of energy, or an increased need to rest… (which) has led to difficulty taking part in everyday activities.” (1) (p. 543). Fatigue is associated with dependence in daily activities, poor quality of life (2), reduced physical activity (3), and increased morbidity and mortality (4). Approximately half of all stroke survivors experience fatigue (5), regardless of severity (6). Optimizing motor recovery post-stroke requires high-dose rehabilitation (7, 8). However, stroke survivors report fatigue impacts recovery (9), limiting therapy participation and independent practice (10, 11). Little is known about how people participating in outpatient rehabilitation experience fatigue. This is a challenging time when stroke survivors are adjusting to new disabilities, adapting to life at home while continuing with intensive rehabilitation. Clinicians are not providing sufficient education and support for post-stroke fatigue (12, 13). Understanding how fatigue impacts stroke survivors and their carers while participating in outpatient rehabilitation will assist health professionals to support stroke survivors and equip them and their carers with knowledge and skills to manage.

A systematic review of qualitative studies conceptualized the experience of fatigue in stroke survivors into five core characteristics; lack of energy to perform activities, abnormal need for sleep, becoming easily tired, feeling fatigue is unpredictable, and increased stress sensitivity (12). Interestingly, no themes emerged around fatigue and rehabilitation, as most studies recruited participants in the chronic phase of stroke recovery. One study explored stroke survivor experience of fatigue specifically during inpatient rehabilitation. While factors particular to the hospital environment, such as ward regime and noise were identified as exacerbating fatigue, the relationship between rehabilitation and fatigue was not explored and did not emerge (14). It is possible this experience differs when stroke survivors return to their daily environment whilst also engaging in rehabilitation.

Additionally, stroke survivors appear to cope better if their fatigue is acknowledged and supported and feel increased emotional distress when carers lack appreciation of fatigue (12). Further investigation of carer perspectives is required to understand factors that influence fatigue acknowledgment and carer burden of post-stroke fatigue, with carers identifying this as a research priority (13, 15).

This study aims to describe the experience of post-stroke fatigue during outpatient rehabilitation in a group of stroke survivors and their carers.

More at link.

 

Patients’ experiences of involvement, motivation and coping with physiotherapists during subacute stroke rehabilitation – a qualitative study

 

You're thinking about motivation all wrong.  Provide 100% recovery protocols and even if they require millions of repetitions, survivors will gladly do them because they know the outcome. 

Patients’ experiences of involvement, motivation and coping with physiotherapists during subacute stroke rehabilitation – a qualitative study

Liss Marita Solbakken, Marita Nordhaug & Kristin Halvorsen To cite this article: Liss Marita Solbakken, Marita Nordhaug & Kristin Halvorsen (2022): Patients’ experiences of involvement, motivation and coping with physiotherapists during subacute stroke rehabilitation – a qualitative study, European Journal of Physiotherapy, DOI: 10.1080/21679169.2022.2032825 To link to this article: https://doi.org/10.1080/21679169.2022.2032825 © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Published online: 23 Feb 2022. Submit your article to this journal Article views: 57 View related articles View Crossmark data ORIGINAL ARTICLE Patients’ experiences of involvement, motivation and coping with physiotherapists during subacute stroke rehabilitation – a qualitative study Liss Marita Solbakken , Marita Nordhaug and Kristin Halvorsen Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway 

 

ABSTRACT 

Purpose: 

Physiotherapy is an important, integral part of rehabilitation after stroke. The study aim was to explore and describe patients’ experiences of involvement, motivation, and coping in interaction with physiotherapists during subacute stroke rehabilitation. Methods: The data derive from qualitative semi-structured interviews of six patients following subacute stroke rehabilitation. The interviews were analysed using systematic text condensation. 

 

Results: 

 

Two categories were identified: (1) ‘The physiotherapist’s contribution’, including the themes of motivation through goal attainment, transferring knowledge, and building self-efficacy through a good relationship; (2) ‘The patient’s internal process’, including the themes of attitude and determination, comparison, the importance of feeling well and fending off passivity. 

 

Conclusion: 

This study shows that increased knowledge and a good relationship with the physiotherapist were important for the participants’ involvement, motivation, and coping. Experiencing ownership of the rehabilitation process made the patients accountable, affected their activity level positively, and helped them cope with their challenges.

Training in positivity for stroke? A qualitative study of acceptability of use of positive mental training (PosMT) as a tool to assist stroke survivors with post-stroke psychological problems and in coping with rehabilitation

What a pile of shit. Trying to make you feel better about coping with your disabilities rather than getting you to 100% recovery which will automatically make you feel better about yourself. Solve the correct problem you blithering idiots. 

Training in positivity for stroke? A qualitative study of acceptability of use of positive mental training (PosMT) as a tool to assist stroke survivors with post-stroke psychological problems and in coping with rehabilitation

NeuroRehabilitation , Volume 40(2) , Pgs. 243-249.

NARIC Accession Number: J76242.  What's this?
ISSN: 1053-8135.
Author(s): Mavaddat, Nahal; Ross, Sheila; Dobbin, Alastair; Williams, Kate; Graffy, Jonathan; Mant, Jonathan.
Publication Year: 2017.
Number of Pages: 7.
Abstract: Study assessed acceptability of training in positivity with Positive Mental Training (PosMT), a guided self-help audio, for prevention and management of post-stroke psychological problems and to help with coping with rehabilitation. A modified PosMT tool consisted of 12 audio tracks each lasting 18 minutes, one listened to every day for a week. Ten stroke survivors and 5 caregivers from support groups in the United Kingdom were asked to listen for 4 weeks, but could volunteer to listen for more. Interviews took place about experiences of the tool after 4 and 12 weeks. Three stroke survivors did not engage with the tool. The remainder reported positive physical and psychological benefits including improved relaxation, better sleep and reduced anxiety after four weeks. Survivors who completed the program gained a positive outlook on the future, increased motivation, confidence and ability to cope with rehabilitation. No adverse effects were reported. PosMT shows potential as a tool for coping with rehabilitation and overcoming post-stroke psychological problems including anxiety and depression.
Descriptor Terms: ADJUSTMENT, ANXIETY DISORDERS, DEPRESSION, INTERVENTION, MENTAL HEALTH, REHABILITATION SERVICES, STROKE, TRAINING.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Mavaddat, Nahal, Ross, Sheila, Dobbin, Alastair, Williams, Kate, Graffy, Jonathan, Mant, Jonathan. (2017). Training in positivity for stroke? A qualitative study of acceptability of use of positive mental training (PosMT) as a tool to assist stroke survivors with post-stroke psychological problems and in coping with rehabilitation.  NeuroRehabilitation , 40(2), Pgs. 243-249. Retrieved 7/14/2017, from REHABDATA database.

Mediaplanet and the American Heart Association Partner for Stroke Awareness Campaign

Wow, just wow. Awareness crapola once again, ignoring all the fucking problems in stroke needing to be solved. It is like no one wants to actually help stroke survivors. 

Mediaplanet and the American Heart Association Partner for Stroke Awareness Campaign  

Mediaplanet’s stroke awareness campaign, found within USA TODAY and online, emphasizes stroke prevention techniques and strategies for victims and loved ones to cope in the wake of a stroke. We shouldn't have to cope at all, get us 100% recovered you blithering lazy idiots.

Stroke is the fifth leading cause of death in the United States.

New York, NY (PRWEB) May 31, 2017

Stroke is the fifth leading cause of death in the United States. This statistic is especially troubling, as 80 percent of strokes are preventable. A variety of conditions — from high blood pressure to obesity — can lead to stroke when not managed properly. Even though strokes can often be prevented, when someone does suffer a stroke it can have permanent physical and mental effects. It is critical that stroke survivors know their options for rehabilitation and have the necessary information for adjusting to life after a stroke. This campaign focuses specifically on coping with aphasia, a condition that disrupts written and spoken communication, as about 25 to 40 percent of stroke survivors receive this diagnosis.

The print component of “Stroke Awareness and Prevention” is distributed within today’s edition of USA Today in the New York, Los Angeles, Boston, Chicago, San Francisco and South Florida markets, with a circulation of approximately 250,000 copies and an estimated readership of 750,000. The digital component is distributed nationally, with a robust social media strategy, and across a network of top news sites and partner outlets. To explore the digital version of the campaign, click here.

For this initiative, Mediaplanet has partnered with Baptist Health to educate readers on the importance of fact action in the case of a stroke. Time is key in treating a stroke; For every minute a stroke goes untreated, up to two million brain cells can die. Neurosurgeons Dr. Eric Sauvageau and Dr. Ricardo Hanel share insight into the work that they and other top doctors are doing to minimize the time lost between a person suffering a stroke and receiving proper treatment. “People wait and lose precious time,” says Dr. Sauvageau. “One of the main reasons people don’t get treatment is they show up too late.”

This campaign was made possible with the support of the American Heart Association/American Stroke Association, National Stroke Association, American Speech-Language-Hearing Association, American Association of Neuroscience Nurses, Baptist Health, Gaylord Specialty Healthcare, American Congress for Rehabilitation Medicine, Medtronic, International Alliance for Pediatric Stroke, Paralympian Billy Lister and Congresswoman Joyce Beatty.

About Mediaplanet 
Mediaplanet specializes in the creation of content marketing campaigns covering a variety of industries. We tell meaningful stories that educate our audience and position our clients as solution providers. Our unique ability to pair the right leaders with the right readers, through the right platforms, has made Mediaplanet a global content marketing powerhouse. Our award-winning stories have won the hearts of countless readers while serving as a valuable platform for brands and their missions. Just call us storytellers with a purpose. Please visit http://www.mediaplanet.com for more on who we are and what we do.

Press Contact:
Vanessa Rodriguez
vanessa.rodriguez(at)mediaplanet.com
(646) 979-2833

Training in positivity for stroke? A qualitative study of acceptability of use of Positive Mental Training (PosMT) as a tool to assist stroke survivors with post-stroke psychological problems and in coping with rehabilitation

So rather than finding recovery solutions for survivors we have persons researching coping skills. You wouldn't need so many fucking coping skills if you solved the problems in stroke, like the neuronal cascade of death or how to make neuroplasticity and neurogenesis repeatable processes. Solve the root cause, dead and damaged neurons, not the aftereffects. This is all a stupid result of NO stroke leadership or stroke strategy. People researching this stuff should be laughed out of the profession, survivors don't want coping skills they want recovery you fucking idiots. Use those two neurons in your head.

Training in positivity for stroke? A qualitative study of acceptability of use of Positive Mental Training (PosMT) as a tool to assist stroke survivors with post-stroke psychological problems and in coping with rehabilitation

Citation

Mavaddat, N., Dobbin, A., Ross, S., Williams, K., Graffy, J., & Mant, J. (2016). Training in positivity for stroke? A qualitative study of acceptability of use of Positive Mental Training (PosMT) as a tool to assist stroke survivors with post-stroke psychological problems and in coping with rehabilitation. NeuroRehabilitationhttp://dx.doi.org/10.17863/CAM.1245

Description

This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by IOS Press.

Abstract

BACKGROUND: Post-stroke psychological problems predict poor recovery, while positive affect enables patients to focus on rehabilitation and may improve functional outcomes. Positive Mental Training (PosMT), a guided self-help audio shows promise as a tool in promoting positivity, optimism and resilience. OBJECTIVE: To assess acceptability of training in positivity with PosMT for prevention and management of post-stroke psychological problems and to help with coping with rehabilitation. METHODS: A modified PosMT tool consisted of 12 audio tracks each lasting 18 minutes, one listened to every day for a week. Survivors and carers were asked to listen for 4 weeks, but could volunteer to listen for more. Interviews took place about experiences of the tool after 4 and 12 weeks. Subjects: 10 stroke survivors and 5 carers from Stroke Support Groups in the UK. RESULTS: Three stroke survivors did not engage with the tool. The remainder reported positive physical and psychological benefits including improved relaxation, better sleep and reduced anxiety after four weeks. Survivors who completed the programme gained a positive outlook on the future, increased motivation, confidence and ability to cope with rehabilitation. No adverse effects were reported. CONCLUSIONS:The PosMT shows potential as a tool for coping with rehabilitation and overcoming post-stroke psychological problems including anxiety and depression.

Relationships among religiousness, spirituality, and health for individuals with stroke

But what about this? I don't want to just cope, I want to recover and that requires analytic thinking on your part.

Why Do You Believe in God? Relationships between Religious Belief, Analytic Thinking, Mentalizing and Moral Concern

Analytic thinking is associated with disbelief in God and analytic thinking is required for you to recover from your stroke, since your doctor is basically doing nothing for you. 

Relationships among religiousness, spirituality, and health for individuals with stroke

Johnstone B, et al. J Clin Psychol Med Settings. 2008.

Show full citation

Abstract

The current study evaluated the relationships among spiritual beliefs, religious practices, physical health, and mental health for individuals with stroke. A cross-sectional analysis of 63 individuals evaluated in outpatient settings, including 32 individuals with stroke and 31 healthy controls was conducted through administration of the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) and the Medical Outcomes Scale-Short Form 36 (SF-36). For individuals with stroke, the SF-36 General Mental Health scale was significantly correlated with only the BMMRS Religious and Spiritual Coping scale (r = .43; p < .05). No other BMMRS factors were significantly correlated with SF-36 mental or physical health scales. Non-significant trends indicated spiritual factors were primarily related to mental versus physical health. This study suggests spiritual belief that a higher power will assist in coping with illness/disability is associated with better mental health following stroke, but neither religious nor spiritual factors are associated with physical health outcomes. The results are consistent with research that suggests that spiritual beliefs may protect individuals with stroke from experiencing emotional distress.

PMID

19104988 [PubMed - indexed for MEDLINE]

Full text

Full text at journal site

Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life

So rather than finding recovery solutions for survivors we have persons researching coping skills. You wouldn't need so many fucking coping skills if you solved the problems in stroke, like the neuronal cascade of death or how to make neuroplasticity a repeatable process. Solve the root cause, dead and damaged neurons, not the aftereffects. This is all a stupid result of NO stroke leadership or stroke strategy. 

Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life

1. Marieke M. Visser, MSc;
2. Majanka H. Heijenbrok-Kal, PhD;
3. Adriaan van‘t Spijker, PhD;
4. Engelien Lannoo, PhD;
5. Jan J.V. Busschbach, PhD;
6. Gerard M. Ribbers, MD, PhD

+ Author Affiliations

1. From the Department of Rehabilitation Medicine (M.M.V., M.H.H.-K., G.M.R.) and Department of Psychiatry, Section Medical Psychology and Psychotherapy (A.v.S., J.J.V.B.), Erasmus University Medical Center, Rotterdam, The Netherlands; Rotterdam Neurorehabilitation Research Department (RoNeRes), Rijndam Rehabilitation Center, Rotterdam, The Netherlands (M.M.V., M.H.H.-K., G.M.R.); and Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium (E.L.).

1. Correspondence to Majanka H. Heijenbrok-Kal, PhD, Rotterdam Neurorehabilitation Research (RoNeRes), Rijndam Rehabilitation Center, PO Box 23181, 3001 KD, Rotterdam, The Netherlands. E-mail mheijenbrok@rijndam.nl

Abstract

Background and Purpose—This study investigated whether problem-solving therapy (PST) is an effective group intervention for improving coping strategy and health-related quality of life (HRQoL) in patients with stroke.

Methods—In this multicenter randomized controlled trial, the intervention group received PST as add-on to standard outpatient rehabilitation, the control group received outpatient rehabilitation only. Measurements were performed at baseline, directly after the intervention, and 6 and 12 months later. Data were analyzed using linear-mixed models. Primary outcomes were task-oriented coping as measured by the Coping Inventory for Stressful Situations and psychosocial HRQoL as measured by the Stroke-Specific Quality of Life Scale. Secondary outcomes were the EuroQol EQ-5D-5L utility score, emotion-oriented and avoidant coping as measured by the Coping Inventory for Stressful Situations, problem-solving skills as measured by the Social Problem Solving Inventory-Revised, and depression as measured by the Center for Epidemiological Studies Depression Scale.

Results—Included were 166 patients with stroke, mean age 53.06 years (SD, 10.19), 53% men, median time poststroke 7.29 months (interquartile range, 4.90–10.61 months). Six months post intervention, the PST group showed significant improvement when compared with the control group in task-oriented coping (P=0.008), but not stroke-specific psychosocial HRQoL. Furthermore, avoidant coping (P=0.039) and the utility value for general HRQoL (P=0.034) improved more in the PST group than in the control after 6 months.

Conclusions—PST seems to improve task-oriented coping but not disease-specific psychosocial HRQoL after stroke >6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping.

Clinical Trial Registration—URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2509. Unique identifier: CNTR2509.

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.

Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life

So rather than finding recovery solutions for survivors we have persons researching coping skills. You wouldn't need so many fucking coping skills if you solved the goddamned problems in stroke. God I hate stupid people. 

Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life

Randomized Controlled Trial

1. Marieke M. Visser, MSc,
2. Majanka H. Heijenbrok-Kal, PhD,
3. Adriaan van‘t Spijker, PhD,
4. Engelien Lannoo, PhD,
5. Jan J.V. Busschbach, PhD and
6. Gerard M. Ribbers, MD, PhD

+ Author Affiliations

1. From the Department of Rehabilitation Medicine (M.M.V., M.H.H.-K., G.M.R.) and Department of Psychiatry, Section Medical Psychology and Psychotherapy (A.v.S., J.J.V.B.), Erasmus University Medical Center, Rotterdam, The Netherlands; Rotterdam Neurorehabilitation Research Department (RoNeRes), Rijndam Rehabilitation Center, Rotterdam, The Netherlands (M.M.V., M.H.H.-K., G.M.R.); and Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium (E.L.).

1. Correspondence to Majanka H. Heijenbrok-Kal, PhD, Rotterdam Neurorehabilitation Research (RoNeRes), Rijndam Rehabilitation Center, PO Box 23181, 3001 KD, Rotterdam, The Netherlands. E-mail mheijenbrok@rijndam.nl

Abstract

Background and Purpose—This study investigated whether problem-solving therapy (PST) is an effective group intervention for improving coping strategy and health-related quality of life (HRQoL) in patients with stroke .

Methods—In this multicenter randomized controlled trial, the intervention group received PST as add-on to standard outpatient rehabilitation, the control group received outpatient rehabilitation only. Measurements were performed at baseline, directly after the intervention, and 6 and 12 months later. Data were analyzed using linear-mixed models. Primary outcomes were task-oriented coping as measured by the Coping Inventory for Stressful Situations and psychosocial HRQoL as measured by the Stroke-Specific Quality of Life Scale. Secondary outcomes were the EuroQol EQ-5D-5L utility score, emotion-oriented and avoidant coping as measured by the Coping Inventory for Stressful Situations, problem-solving skills as measured by the Social Problem Solving Inventory-Revised, and depression as measured by the Center for Epidemiological Studies Depression Scale.

Results—Included were 166 patients with stroke, mean age 53.06 years (SD, 10.19), 53% men, median time poststroke 7.29 months (interquartile range, 4.90–10.61 months). Six months post intervention, the PST group showed significant improvement when compared with the control group in task-oriented coping (P=0.008), but not stroke-specific psychosocial HRQoL. Furthermore, avoidant coping (P=0.039) and the utility value for general HRQoL (P=0.034) improved more in the PST group than in the control after 6 months.

Conclusions—PST seems to improve task-oriented coping but not disease-specific psychosocial HRQoL after stroke >6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping.

Clinical Trial Registration—URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2509. Unique identifier: CNTR2509.

“You’re all going to hate the word ‘recovery’”

Does your doctor even have the word recovery in their vocabulary? My definition of it has changed considerably. Now it's doing whatever I want to do, not what I used to do. I will probably never paddle a whitewater canoe safely in class III water ever again. That was a big part of my life and I have trophies to prove it.

“You’re all going to hate the word ‘recovery’”

This line applies to us:
personal journey that is often more about ‘coping’ than ‘cure’.