Life after stroke: your coping style counts!

Life after suffering from stroke is hard enough physically. However, certain psychological and social factors seem to make life even harder. This is especially true in patients who survived a so-called subarachnoid hemorrhage (SAH) stroke, according to a Dutch study. SAH “occurs when a blood vessel on the brain’s surface ruptures and bleeds into the space between the skull and brain, but not into the brain.”

The study followed up 141 SAH stroke survivors with an average age of 51 years and monitored health-related quality of life (QOL) for two to four years. The study showed that QOL was adversely influenced by psychological symptoms such as mood disorders, fatigue, cognitive complaints. In addition, a link to personality characteristics was also observed.

The following findings were reported:

• 32% of the survivors reported anxiety;
• 23% reported depression; and
• 67% reported fatigue

These psychological symptoms were significant associated to decreased QOL of the patients.

Low QOL was also associated with certain personality types, especially those who are neurotic and with passive coping style.

According the lead author Anne Visser-Meily

“When you analyze depression, anxiety and fatigue, you find there is a strong correlation with a passive coping style and neuroticism. Those with a passive coping style need psychological support to encourage them to be more independent.” In addition, these personality types also tended to suffer from cognitive dysfunction.

The psychosocial problems and decreased quality of life are not only restricted to teh patients. Another Dutch study looked at the well-being of spouses and partners of stroke survivors. The researchers followed up 211 stroke survivors and their spouse up to three years after the stroke. The findings showed that the psychosocial well-being of the spouses too, was dependent on their coping style. Spouses who practiced active coping strategies have less stress than those who practiced passive coping strategies.

• Those who had passive coping styles tended to exhibit depressive symptoms at the start of the rehabilitation period. A slight improvement was noticeable two months later due to a decrease in caregiver burden but no improvement was observed after that.
• These psychosocial problems of spouses can have significant and adverse effects on the marital relationship or partnership as well as other social relationships.
• The caregiver burden after 3 years was still high among those with passive coping styles – 43% more than the active copers.

The findings of the two studies highlight the need for “psychosocial interventions by physicians caring for stroke patients long-term teaching spouses how to actively cope with the consequences of stroke and how to decrease the negative consequences for family functioning and harmony in the relationship.”

Passive coping is characterized by denial, withdrawal and wishful thinking. Active coping involves a direct and rational approach in dealing with a problem.

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