title: The relative effect of coping strategy and depression on health-related quality of life in patients in the chronic phase after stroke.
abstract: OBJECTIVE
  To investigate the relative associations of coping strategy and depression on health-related quality of life in patients in the chronic phase after stroke.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A total of 213 patients after stroke (> 18 months post-onset), mean age 59 years (standard deviation (SD) 9.86 years), 56% men, mean time post-stroke 53 months (SD 37.8 months).
  
  
  METHODS
  Coping strategy was measured using the assimilative-accommodative coping scale, depression using the Center for Epidemiologic Studies Depression Scale, and quality of life using the World Health Organization Quality of Life-BREF. Multivariable regression analyses were performed, adjusted for patient characteristics.
  
  
  RESULTS
  Depression score was independently related to all domains of quality of life (Psychological Health (B = -0.924; p = 0.000), Physical Health (B = -0.832; p = 0.000), Social Relationships (B = -0.917; p = 0.000), Environment (B = -0.662, p = 0.000)). Accommodative coping (B = 0.305; p = 0.024) and assimilative coping (B = 0.235; p = 0.070) were independently related to the domain Psychological Health, adjusted for depression and education level.
  
  
  CONCLUSIONS
  Coping strategies and depression score were independently associated with Psychological Health in patients in the chronic phase after stroke. Patients who prefer an accommodative coping strategy may show less symptoms of depression. Preferable coping strategies may be trained in order to improve both depression score and health-related quality of life in future research.
authors.affiliation: , Rehabilitation Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands. mvisser@rijndam.nl.
authors.forename: Marieke M
authors.initials: MM
authors.lastname: Visser
authors.forename: Laurien
authors.initials: L
authors.lastname: Aben
authors.forename: Majanka H
authors.initials: MH
authors.lastname: Heijenbrok-Kal
authors.forename: Jan J V
authors.initials: JJ
authors.lastname: Busschbach
authors.forename: Gerard M
authors.initials: GM
authors.lastname: Ribbers
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation