How flexible is coping after acquired brain injury? A 1-year prospective study investigating
coping patterns and influence of self-efficacy, executive functioning and self-awareness
Sammanfattning
OBJECTIVES: To investigate coping flexibility in patients with newly acquired brain injury and to
investigate the influence of problem type, self-efficacy, self-awareness and self-reported executive
functions on coping flexibility.
METHODS: Data were collected from a prospective clinical cohort study of 136 patients assessed
after discharge home (mean time since injury = 15 weeks) and 1 year later. Situation-specific coping
was measured by asking patients to complete the Coping Inventory for Stressful Situations (CISS) for
3 acquired brain injury (ABI)-related situations, which were then categorized into problem types
(physical, cognitive, emotional, behavioural, communication, other). Coping consistency (number of
strategies used throughout every situation) and variability (range in frequency of use of strategies
over situations) were measured. Random effects regression analyses were used.
RESULTS: Patients used more task-oriented coping for cognitive compared with physical problems.
Coping variability was limited. Reliance on emotion-oriented coping decreased over time. Higher
self-efficacy correlated with increased task-oriented and avoidance coping and decreased emotion-
oriented coping. Greater self-reported problems in executive function correlated with greater
consistency in task-oriented and emotion-oriented strategies.
CONCLUSION: Patients with acquired brain injury rely on a defined set of coping options across
situations and time. High self-efficacy increases active coping. Subjective executive dysfunction
might hamper effective strategy selection.