Resilience among stroke survivors: A cohort study of the first 6months.

Abstract

To explore (a) resilience among patients over the first 6months following a first ischaemic stroke; (b) factors associated with resilience at hospitalization, 1, 3, and 6months postdischarge; (c) baseline predictors of resilience at 6months postdischarge. a cohort study. From February 2017-January 2018, 217 patients presenting at two hospitals with a first ischaemic stroke were recruited. Their resilience, medical coping styles, general self-efficacy, functional independency, socio-demographic, and clinical data were assessed while they were still in hospital (baseline) and at 1, 3, and 6months after discharge. Resilience among stroke patients decreased significantly 1month after hospital discharge and remained stable. Predictors of resilience were as follows: self-efficacy and resignation at baseline; number of children, functional independency, general self-efficacy, and resignation at 1month; and religion, resignation, self-efficacy, confrontation at 3months and 6months. The baseline factors that predicted resilience at 6months were income level, religion, stroke severity at discharge, self-efficacy, and resignation. Stroke survivors experienced a significant decrease in resilience from hospitalization until 1-month postdischarge. Factors contributing to resilience after a stroke varied across time. Self-efficacy and coping styles were particularly important and contributed to long-term resilience. Understanding resilience among stroke survivors is needed to inform the development of interventions to enhance the psychological recovery of survivors. The levels of resilience among stroke survivors were low compared with those in the normal older population. Nurses should provide greater psychological support during hospitalization to stroke survivors and especially to those with lower income, higher stroke severity at discharge, no religion, lower self-efficacy, or who use resignation as a coping strategy as those survivors may have lower resilience 6months later. Future studies are needed to test interventions designed to change or modify stroke survivors' coping styles and promote self-efficacy, thereby enhancing higher resilience.