title: Coping strategies as determinants of quality of life in stroke patients: a longitudinal study.
abstract: BACKGROUND
  Quality of life (QoL) is reduced for stroke patients and coping strategies have been suggested as determinants of QoL. Thus far the relationship between coping and QoL has only been examined in small-scale cross-sectional designs. Therefore, the current study set out to examine this relationship in a longitudinal setting.
  
  
  METHODS
  Stroke patients who were discharged home were interviewed at 4 different time points; just before discharge (T1), and 2 months (T2), 5 months (T3) and 9-12 months after discharge (T4). QoL was measured by the EQ-5D index score and the SF-36 utility score and coping expressed in terms of tenacious goal pursuit and flexible goal adjustment. Modified Rankin scale was assessed as a measure of general functioning.
  
  
  RESULTS
  Eighty stroke patients were included. Coping was not predictive of QoL at T1 and T2 but rather at T3 and T4. At T4 both coping strategies determined the levels of QoL as measured with the EQ-5D index score; higher levels of tenacious goal pursuit as well as flexible goal adjustment were associated with higher levels of QoL. This regression model explained 44% of the variance.
  
  
  CONCLUSIONS
  Coping is a powerful determinant of QoL, but only more than 5 months after discharge; before this time QoL is mainly determined by general functioning. Both coping strategies were important determinants of QoL.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Rotterdam, The Netherlands. a.darlington@erasmusmc.nl
authors.forename: Anne-Sophie E
authors.initials: AS
authors.lastname: Darlington
authors.forename: Diederik W J
authors.initials: DW
authors.lastname: Dippel
authors.forename: Gerard M
authors.initials: GM
authors.lastname: Ribbers
authors.forename: Romke
authors.initials: R
authors.lastname: van Balen
authors.forename: Jan
authors.initials: J
authors.lastname: Passchier
authors.forename: Jan J V
authors.initials: JJ
authors.lastname: Busschbach
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000523:psychology; D011788:Quality of Life; D020127:Recovery of Function; D012044:Regression Analysis; D020521:Stroke / Q000503:physiopathology / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors