Psychological factors after stroke: Are they stable over time?

OBJECTIVE: Psychological factors influence stroke outcomes, such as participation and quality of life. Although important for clinical practice, not much is known about the temporal stability of these factors. This study explored whether psychological factors are stable post-stroke.

METHODS: Prospective longitudinal cohort study. The following psychological factors were assessed using self-report questionnaires at 2 months and at 2 years post-stroke: proactive coping, self-efficacy, extraversion, optimism, passive coping, neuroticism and pessimism. Changes over time, associations and dimensions among psychological factors were considered.

RESULTS: Data for 324 participants were available. Only passive coping scores showed no change between 2 months and 2 years post-stroke. Participants showed less proactive coping, lower self-efficacy, less extraversion, less optimism, more neuroticism and more pessimism over time. All but one inter-correlation of psychological factors, r = [-0.14; 0.71], and all correlations over time, r = [0.42-0.64], were significant. At both time-points, the psychological factors clustered into an "adaptive psychological factor" (proactive coping, self-efficacy, extraversion) and a "maladaptive psychological factor" (passive coping, neuroticism).

CONCLUSION: Across all psychological factors, changes toward less favourable scores were found. Clinicians should pay attention to adaptive and maladaptive psychological factors among stroke patients during long-term care.