title: Changes in coping strategies, social support, optimism and health-related quality of life following traumatic brain injury: a longitudinal study.
abstract: OBJECTIVE
  To study longitudinal changes in psychological coping strategies, social support, life orientation and health-related quality of life in the late period after traumatic brain injury (TBI).
  
  
  METHODS
  Thirty-one patients with TBI who were first investigated on average 2.3 years after injury and were prospectively followed on average 5.7 years later.
  
  
  METHODS
  Estonian versions of the COPE-D Test, the Brief Social Support Questionnaire, the Life Orientation Test and the RAND-36 questionnaire.
  
  
  RESULTS
  During the late follow-up period health-related quality of life and resuming work did not improve significantly. Persons with TBI reported an increase in seeking social/emotional support (p<0.05), frequent use of avoidance-oriented styles and reduced use of task-oriented styles. This was accompanied by low social support and low satisfaction with support, both of which were associated with health-related quality of life and resuming work after TBI. Although the patients had become more optimistic (p<0.05), this did not correlate with their health status and social well-being.
  
  
  CONCLUSIONS
  This prospective study revealed maladaptive changes in the profile of coping strategies and an increase in optimism. As social support, satisfaction with support and health-related quality of life did not improve, then rehabilitation, social and psychological support are continuously needed.
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Estonia. tiiu.tomberg@kliinikum.ee
authors.forename: T
authors.initials: T
authors.lastname: Tomberg
authors.forename: A
authors.initials: A
authors.lastname: Toomela
authors.forename: M
authors.initials: M
authors.lastname: Ennok
authors.forename: A
authors.initials: A
authors.lastname: Tikk
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life; D012944:Social Support; D013694:Temperament; D013997:Time Factors