M L van Mierlo1, C M van Heugten2, Mwm Post3, Plm de Kort4, Jma Visser-Meily5. 1. Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. 2. 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. 3. 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. 4. Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands. 5. 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.
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). CONCLUSION: 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.
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). CONCLUSION: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: Chantal F Hillebregt; Eline W M Scholten; Marjolijn Ketelaar; Marcel W M Post; Johanna M A Visser-Meily Journal: BMJ Open Date: 2018-03-08 Impact factor: 2.692