Coping, problem solving, depression, and health-related quality of life in patients receiving outpatient stroke rehabilitation

Marieke M Visser; Majanka H Heijenbrok-Kal; Adriaan Van't Spijker; Kristine M Oostra; Jan J Busschbach; Gerard M Ribbers

doi:10.1016/j.apmr.2015.04.007

Coping, problem solving, depression, and health-related quality of life in patients receiving outpatient stroke rehabilitation

Arch Phys Med Rehabil. 2015 Aug;96(8):1492-8. doi: 10.1016/j.apmr.2015.04.007. Epub 2015 Apr 25.

Authors

Marieke M Visser¹, Majanka H Heijenbrok-Kal², Adriaan Van't Spijker³, Kristine M Oostra⁴, Jan J Busschbach³, Gerard M Ribbers²

Affiliations

¹ Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Rotterdam Neurorehabilitation Research (RoNeRes), Rijndam Rehabilitation Center, Rotterdam, The Netherlands. Electronic address: mvisser@rijndam.nl.
² Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Rotterdam Neurorehabilitation Research (RoNeRes), Rijndam Rehabilitation Center, Rotterdam, The Netherlands.
³ Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, The Netherlands.
⁴ Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium.

PMID: 25921980
DOI: 10.1016/j.apmr.2015.04.007

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.

Keywords: Coping skills; Depression; Quality of life; Rehabilitation; Stroke.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adaptation, Psychological*
Adult
Cross-Sectional Studies
Depression / psychology*
Emotions
Female
Humans
Male
Middle Aged
Outpatients
Problem Solving*
Quality of Life / psychology*
Rehabilitation Centers
Stroke Rehabilitation*