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.

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.