Research Reports - Coping strategies in individuals after traumatic brain injury

Disabil Rehabil. 2014 Mar 3

Sasse N(1), Gibbons H, Wilson L, Martinez R, Sehmisch S, von Wild K, von Steinbüchel N.

Abstract Purpose: This study investigates coping strategies after traumatic brain
injury (TBI) and their associations with health-related quality of life (HRQoL).
Methods: Participants were 141 adults followed up 3 months to 15 years after TBI
of all severity degrees. Coping was assessed by the Freiburg Questionnaire of
Coping with Illness (FQCI) and HRQoL by the Quality of Life after Brain Injury
(QOLIBRI) scale and the Short Form-36 Health Survey (SF-36). Coping dimensions
were extracted by principal component analysis. Multiple linear regression
analysis was used to identify predictors of coping strategies. Results: Two
factors for coping after TBI were extracted: Action/Distraction and
Trivialisation/Resignation. The Trivialisation/Resignation strategy was
negatively correlated with all aspects of HRQoL, while relationships with the
Action/Distraction strategy were positive and significant for two domains. These
two factors also showed significant associations with anxiety, depression,
recovery, cognitive status, mood states and trauma severity. Multiple regression
analysis identified recovery status as a predictor for the maladaptive
Trivialisation/Resignation strategy. Conclusion: Two coping factors were
identified, which were differentially associated with HRQoL. Maladaptive coping
strategies play a particularly important role, and less reliance on such
strategies is associated with better HRQoL; use of adaptive strategies should
correspondingly be fostered. Implications for Rehabilitation This study
highlights the relationship of coping strategies and HRQoL after TBI. For the
assessment of HRQoL a novel disease-specific instrument was applied, that
provides in detail TBI-relevant aspects of well-being and HRQoL. Individuals
after TBI use two main sets of coping strategies that are differentially
associated with HRQoL (and clinical variables). One is adaptive and the other
maladaptive for HRQoL after TBI. Maladaptive and adaptive coping strategies used
by the individual should be identified and considered in rehabilitation efforts
to improve HRQoL after TBI.

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