Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life: Randomized Controlled Trial
Abstract
BACKGROUND AND PURPOSE: This study investigated whether problem-solving therapy (PST) is an effective group intervention for improving coping strategy and health-related quality of life (HRQoL) in patients with stroke. METHODS: In this multicenter randomized controlled trial, the intervention group received PST as add-on to standard outpatient rehabilitation, the control group received outpatient rehabilitation only. Measurements were performed at baseline, directly after the intervention, and 6 and 12 months later. Data were analyzed using linear-mixed models. Primary outcomes were task-oriented coping as measured by the Coping Inventory for Stressful Situations and psychosocial HRQoL as measured by the Stroke-Specific Quality of Life Scale. Secondary outcomes were the EuroQol EQ-5D-5L utility score, emotion-oriented and avoidant coping as measured by the Coping Inventory for Stressful Situations, problem-solving skills as measured by the Social Problem Solving Inventory-Revised, and depression as measured by the Center for Epidemiological Studies Depression Scale. RESULTS: Included were 166 patients with stroke, mean age 53.06 years (SD, 10.19), 53% men, median time poststroke 7.29 months (interquartile range, 4.90-10.61 months). Six months post intervention, the PST group showed significant improvement when compared with the control group in task-oriented coping (P=0.008), but not stroke-specific psychosocial HRQoL. Furthermore, avoidant coping (P=0.039) and the utility value for general HRQoL (P=0.034) improved more in the PST group than in the control after 6 months. CONCLUSIONS: PST seems to improve task-oriented coping but not disease-specific psychosocial HRQoL after stroke >6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping. CLINICAL TRIAL REGISTRATION: URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2509. Unique identifier: CNTR2509.
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- Authors
- Visser, M. M., Heijenbrok-Kal, M. H., van‘t Spijker, A., Lannoo, E., Busschbach, J. J. V., & Ribbers, G. M.
- Affiliations
- Ghent University Hospital (BE)
- From the Department of Rehabilitation Medicine (M.M.V., M.H.H.-K., G.M.R.) and Department of Psychiatry, Section Medical Psychology and Psychotherapy (A.v.S., J.J.V.B.), Erasmus University Medical Center, Rotterdam, The Netherlands; Rotterdam Neurorehabilitation Research Department (RoNeRes), Rijndam Rehabilitation Center, Rotterdam, The Netherlands (M.M.V., M.H.H.-K., G.M.R.); and Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium (E.L.).
- Venue
- Stroke
- Published
- 2016-01
- Volume
- 47
- Issue
- 1
- Pages
- 135-142
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2180544493
- Cited by
- 60
- References
- 5
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 12 · 2022: 3 · 2021: 2 · 2020: 8 · 2019: 7 · 2018: 4 · 2017: 7 · 2016: 3
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- problem-solving therapy, stroke rehabilitation, coping strategies, health-related quality of life, task-oriented coping, avoidance coping, group intervention, depression, social problem solving, stroke-specific quality of life
- MeSH terms
- Stroke Rehabilitation, Adaptation, Psychological, Adult, Female, Health Status, Humans, Male, Middle Aged, Outpatients, Problem Solving, Quality of Life, Rehabilitation Centers, Stroke
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