Article

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: beta=-.679; P<.001; utility: beta=-.009; P<.001) and stroke-specific HRQOL
(physical HRQOL: beta=-.020; P=.001; psychosocial HRQOL: beta=-.054, P<.001;
total HRQOL: beta=-.037;
P<.001). Positive problem orientation was independently
related to psychosocial HRQOL (beta=.086; P=.018) and total HRQOL (beta=.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.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS