Department of Nursing, Rovira Virgili University, Campus Terres de l'Ebre, 43500 Tortosa, Spain.
Hospital de Tortosa Verge de la Cinta, Pere Virgili Institut, 43500 Tortosa, Spain.
Int J Environ Res Public Health. 2020 Aug 19;17(17):6014. doi: 10.3390/ijerph17176014.
New reperfusion therapies have improved the clinical recovery rates of acute ischemic stroke patients (AISP), but it is not known whether other factors, such as the ability to cope, might also have an effect. The aim of this study was to evaluate the effect of endovascular treatment (EVT) on coping strategies, quality of life, and neurological and functional outcomes in AISP at 3 months and 1 year post-stroke. A multicenter, prospective, longitudinal, and comparative study of a sub-study of the participants in the Endovascular Revascularization with Solitaire Device versus Best Medical Therapy in Anterior Circulation Stroke within 8 Hours (REVASCAT) clinical trial was conducted after recruiting from two stroke centers in Catalonia, Spain. The cohort consisted of 82 ischemic stroke patients ( = 42 undergoing EVT and = 40 undergoing standard best medical treatment (BMT) as a control group), enrolled between 2013-2015. We assessed the coping strategies using the Brief Coping Questionnaire (Brief-COPE-28), the health-related quality of life (HRQoL) with the EQ-5D questionnaire, and the neurological and functional status using the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), and Stroke Impact Scale-16 (SIS-16). Bivariate analyses and multivariate linear regression models were used. EVT patients were the ones that showed better neurological and functional outcomes, and more patients presented reporting no pain/discomfort at 3 months; paradoxically, problem-focused coping strategies were found to be significantly higher in patients treated with BMT at 1 year.
新的再灌注治疗方法提高了急性缺血性脑卒中患者（AISP）的临床康复率，但尚不清楚其他因素（如应对能力）是否也有影响。本研究旨在评估血管内治疗（EVT）对 AISP 患者在卒中后 3 个月和 1 年时的应对策略、生活质量以及神经和功能结局的影响。这是一项多中心、前瞻性、纵向、比较研究，对西班牙加泰罗尼亚的两个卒中中心招募的血管内再通装置与最佳药物治疗在前循环卒中 8 小时内（REVASCAT）临床试验的参与者进行了亚组研究。该队列包括 82 例缺血性卒中患者（EVT 组 42 例，标准最佳药物治疗（BMT）组 40 例作为对照组），招募时间为 2013 年至 2015 年。我们使用Brief Coping Questionnaire（Brief-COPE-28）评估应对策略，使用 EQ-5D 问卷评估健康相关生活质量（HRQoL），使用 National Institute of Health Stroke Scale（NIHSS）、Barthel Index（BI）、modified Rankin Scale（mRS）和 Stroke Impact Scale-16（SIS-16）评估神经和功能状态。我们使用了双变量分析和多变量线性回归模型。EVT 患者的神经和功能结局更好，3 个月时更多患者报告无疼痛/不适；但矛盾的是，在接受 BMT 治疗的患者中，1 年后发现问题导向的应对策略显著更高。
