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Problem-solving therapy during outpatient stroke rehabilitation improves coping and health-related quality of life

(2015) STROKE. 47(1). p.135-142
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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.
Keywords
adaptation, psychological, problem solving, quality of life, randomized controlled trial, stroke, EAST MELBOURNE STROKE, BRAIN-INJURY, PSYCHOMETRIC PROPERTIES, BEHAVIORAL ACTIVATION, POSTSTROKE DEPRESSION, INVENTORY, VERSION, SCALE, INTERVENTION, CAREGIVERS

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Chicago
Visser, Marieke M, Majanka H Heijenbrok-Kal, Adriaan van‘t Spijker, Engelien Lannoo, Jan JV Busschbach, and Gerard M Ribbers. 2015. “Problem-solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-related Quality of Life.” Stroke 47 (1): 135–142.
APA
Visser, M. M., Heijenbrok-Kal, M. H., van‘t Spijker, A., Lannoo, E., Busschbach, J. J., & Ribbers, G. M. (2015). Problem-solving therapy during outpatient stroke rehabilitation improves coping and health-related quality of life. STROKE, 47(1), 135–142.
Vancouver
1.
Visser MM, Heijenbrok-Kal MH, van‘t Spijker A, Lannoo E, Busschbach JJ, Ribbers GM. Problem-solving therapy during outpatient stroke rehabilitation improves coping and health-related quality of life. STROKE. 2015;47(1):135–42.
MLA
Visser, Marieke M, Majanka H Heijenbrok-Kal, Adriaan van‘t Spijker, et al. “Problem-solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-related Quality of Life.” STROKE 47.1 (2015): 135–142. Print.
@article{8509791,
  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 {\textrangle}6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping.},
  author       = {Visser, Marieke M and Heijenbrok-Kal, Majanka H and van{\textquoteleft}t Spijker, Adriaan and Lannoo, Engelien and Busschbach, Jan JV and Ribbers, Gerard M},
  issn         = {0039-2499},
  journal      = {STROKE},
  keyword      = {adaptation,psychological,problem solving,quality of life,randomized controlled trial,stroke,EAST MELBOURNE STROKE,BRAIN-INJURY,PSYCHOMETRIC PROPERTIES,BEHAVIORAL ACTIVATION,POSTSTROKE DEPRESSION,INVENTORY,VERSION,SCALE,INTERVENTION,CAREGIVERS},
  language     = {eng},
  number       = {1},
  pages        = {135--142},
  title        = {Problem-solving therapy during outpatient stroke rehabilitation improves coping and health-related quality of life},
  url          = {http://dx.doi.org/10.1161/strokeaha.115.010961},
  volume       = {47},
  year         = {2015},
}

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