title: Life satisfaction post stroke: The role of illness cognitions.
abstract: OBJECTIVE
  To describe illness cognitions two months and two years post stroke and to investigate changes in illness cognitions over time. We also examined the associations between illness cognitions and life satisfaction at two months and two years post stroke and investigated if changes in illness cognitions predicted life satisfaction two years post stroke, taking demographic and stroke-related factors and emotional symptoms into account.
  
  
  METHODS
  Prospective cohort study in which 287 patients were assessed at two months and two years post stroke. The illness cognitions helplessness (maladaptive), acceptance (adaptive) and perceiving benefits (adaptive) were measured with the Illness Cognition Questionnaire. Life satisfaction was assessed with two life satisfaction questions. Correlational and regression analyses were performed.
  
  
  RESULTS
  Patients experienced both maladaptive and adaptive illness cognitions two months and two years post stroke. Only acceptance increased significantly from two months to two years post stroke (p≤0.01). Helplessness, acceptance and perceiving benefits were significantly associated with life satisfaction at two months (R2=0.42) and two years (R2=0.57) post stroke. Furthermore, illness cognitions two months post stroke and changes in illness cognitions predicted life satisfaction two years post stroke (R2=0.57).
  
  
  CONCLUSIONS
  Illness cognitions and changes in illness cognitions were independently associated with life satisfaction two years post stroke. It is therefore important during rehabilitation to focus on reducing maladaptive behavior and feelings to promote life satisfaction, and on promoting adaptive illness cognitions.
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: M L
authors.initials: ML
authors.lastname: van Mierlo
authors.affiliation: Maastricht University, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands; Maastricht University, Department of Neuropsychology and Psychopharmacology, Maastricht, The Netherlands.
authors.forename: C M
authors.initials: CM
authors.lastname: van Heugten
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Mwm
authors.initials: M
authors.lastname: Post
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Plm
authors.initials: P
authors.lastname: de Kort
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. Electronic address: j.m.a.visser-meily@umcutrecht.nl.
authors.forename: Jma
authors.initials: J
authors.lastname: Visser-Meily
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003071:Cognition; D015331:Cohort Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011446:Prospective Studies; D012649:Self Concept; D012959:Socioeconomic Factors; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Illness cognitions; Life satisfaction; Rehabilitation; Stroke