Abstract
New reperfusion therapies have improved the clinical recovery rates of acute ischemic stroke patients (AISP), but it is not known whether other factors, such as the ability to cope, might also have an effect. The aim of this study was to evaluate the effect of endovascular treatment (EVT) on coping strategies, quality of life, and neurological and functional outcomes in AISP at 3 months and 1 year post-stroke. A multicenter, prospective, longitudinal, and comparative study of a sub-study of the participants in the Endovascular Revascularization with Solitaire Device versus Best Medical Therapy in Anterior Circulation Stroke within 8 Hours (REVASCAT) clinical trial was conducted after recruiting from two stroke centers in Catalonia, Spain. The cohort consisted of 82 ischemic stroke patients (n = 42 undergoing EVT and n = 40 undergoing standard best medical treatment (BMT) as a control group), enrolled between 2013–2015. We assessed the coping strategies using the Brief Coping Questionnaire (Brief-COPE-28), the health-related quality of life (HRQoL) with the EQ-5D questionnaire, and the neurological and functional status using the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), and Stroke Impact Scale-16 (SIS-16). Bivariate analyses and multivariate linear regression models were used. EVT patients were the ones that showed better neurological and functional outcomes, and more patients presented reporting no pain/discomfort at 3 months; paradoxically, problem-focused coping strategies were found to be significantly higher in patients treated with BMT at 1 year.
Highlights
The progress of medical treatments and urgent care strategies has evolved in recent decades, which has allowed for the survival rate of stroke patients to improve [1]
We assessed the stroke patients’ coping strategies with the COPE-28 scale after randomization and we found that active coping at 3 months and acceptance and use of emotional support at 3 months and 1 year to be the dimensions with higher scores (Table 2)
The aforementioned studies do not present an accurately selected sample, and they are cross-sectional studies without self-reported questionnaires and with short follow-ups (
Summary
The progress of medical treatments and urgent care strategies has evolved in recent decades, which has allowed for the survival rate of stroke patients to improve [1]. The contributions of health psychology in the field of cardiovascular diseases have gained special importance; these contributions take into account the adaptation of patients to their disease process and neurorehabilitation treatment, the adaptation to new derived lifestyles, and especially the attention to psychological needs generated by the disease status [5]. This research explores the possible relationship between coping styles, understood as the set of efforts that people make to face the problems and difficulties encountered in the environment and the subsequent stress that these situations generate, and the situation of disability that remains in patients who have suffered an acute ischemic stroke and received the most appropriate clinical treatment. The main aim of this research was to study coping strategies, quality of life, and neurological and functional outcomes in a sample of patients at 3 months and 1 year after an ischemic stroke, who had been previously randomized and included in the Endovascular Revascularization with Solitaire Device versus Best Medical Therapy in Anterior Circulation Stroke within 8 Hours (REVASCAT) clinical trial [11] and classified in terms of the treatment received in the acute phase: either endovascular therapy (EVT, thrombectomy alone or with intravenous alteplase) or standard best medical treatment (BMT, intravenous alteplase or Stroke Unit admission)
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