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Post-Stroke Hopelessness Can Raise Mortality Risk
Stroke
07/06/2001
By Anne MacLennan
Patients attitude appears to affect their outcomes after stroke. Those who feel there is nothing they can do to help themselves six months post-stroke have a shorter survival.
These findings need to be confirmed and any causal link between attitude and survival further explored with a view to 'improving' the attitudes of stroke patients, these authors urge.
Although patients are known to respond differently to serious illness, the researchers sought to determine whether attitudes are linked with stroke survival.
Participants in this study by researchers from the Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, Scotland were 372 stroke patients identified and medically assessed as part of a randomized trial to evaluate a stroke family care worker. All of the patients had survived six months from randomization.
A research psychologist visited each patient and administered the Mental Adjustment to Stroke Scale (a self-rated attitude scale based on the Mental Adjustment to Cancer Scale).
Disability and dependence (Barthel Index, modified Rankin Scale) and mood (Hospital Anxiety and Depression Scale, General Health Questionnaire 30) were also assessed.
Patients were then followed up three to five years after the initial stroke to establish their survival. Of the total number of patients, 82 (22 percent) died within three years.
Once researchers took into account other significant factors, fatalism and helplessness/hopelessness were both linked with decreased survival. However, fighting spirit, anxious preoccupation and denial/avoidance were not.
Mood was found not to be linked with survival.
Stroke. 2001;32:1640.
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