Changes in coping strategies, social support, optimism and health-related quality of life following traumatic brain injury: a longitudinal study.

PRIMARY 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). SUBJECTS: 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.

Coping strategies, social support, life orientation and health-related quality of life following traumatic brain injury.

OBJECTIVE: To study coping strategies, social support and life orientation in patients following moderate and severe traumatic brain injury (TBI) in relation to health-related quality of life. SUBJECTS: Eighty-five patients with moderate or severe TBI and 68 control persons. METHODS: Estonian versions of the COPE-D test, the Brief Social Support Questionnaire, the Life Orientation Test and the RAND-36 questionnaire. RESULTS: Persons with TBI reported using task-oriented and social/emotional support strategies less often and avoidance-oriented strategies more often than control persons (p < 0.05). The social support network, satisfaction with it and optimism as life orientation were lower in the patient group (p < 0.05). Task-oriented coping styles, satisfaction with social support and optimistic life orientation were associated with the majority of the domains of health-related quality of life and resuming work after TBI. CONCLUSIONS: To achieve effective rehabilitation and to enhance patients' well-being, it is important to improve the quality and amount of social support network, as well as to support patients' adequate coping efforts for promoting an active lifestyle.

Coping strategies in patients following subarachnoid haemorrhage.

OBJECTIVES: To assess psychological coping strategies and their relationship with outcome in patients after primary subarachnoid haemorrhage (SAH). PATIENTS AND METHODS: In 51 unselected patients (24 males, 27 females; mean age 46 years) in an average 15.7+/-12.0 months after SAH usage of coping strategies were assessed by means of Estonian COPE-D test with 15 four-items scales and compared to those obtained from 51 age-, sex- and education-matched healthy persons. The data were analysed according to age, sex and education of the patients, initial severity of disease, localization of aneurysm and outcome characteristics. RESULTS: Patients after SAH reported using social support strategy less than control persons (P<0.05) with a tendency of using acceptance-oriented strategy. Task-oriented coping styles were less used (P<0.05) by patients with severe initial state, who had more marked late disability and dependence in daily living. Healthy women used social support more than men; patients and control persons 50 years or older used task-oriented strategies less than younger persons (P<0.05). CONCLUSION: The structure of coping strategies used by patients after SAH differs compared to healthy persons. The differences in using coping strategies are related to age of the patients, functional state and degree of adaptation after SAH.

Paradoxical facilitation of a free recall of nonwords in persons with traumatic brain injury.

Brain damage is usually associated with behavioral deficits. However, there is an increasing amount of evidence that lesions of some brain regions are associated with improvements instead of impairments of certain behaviors. We report the results of a study of free recall performance in subjects with traumatic brain injury. One-fourth of the subjects displayed above-normal performance in recall of nonwords. No such facilitation was found with nine lists of words.

[Computerized tomographic and clinical examination of children with hemiparesis]. / Komp'iuterno-tomograficheskoe i klinicheskoe obsledovanie detei s gemiparezami.

Clinical examination and computerized tomography of 29 children with hemiparesis of different origin and severity (23 with a hemiparetic form of infantile cerebral paralysis and 6 with acquired hemiparesis) revealed in 69 per cent of the patients pathomorphological changes in the brain whose markedness correlated with the severity of the clinical status. The most frequent finding was dilatation of the ventricular system of the brain which was asymmetrical in most cases. Along with the atrophic process some patients presented focal or diffuse changes in the density of the cerebral matter depending on the nature of the primary damaging factors (zones of decreased density, porencephaly, calcification). Specification by computerized tomography of the structure and size of the pathomorphologic alterations in the brain allows evaluation of the clinical prognosis.