The emotional state and quality of life in patients after a stroke and the focus of a psychological assistance program

Abstract

Along with motor and cognitive impairments, the clinical picture of stroke in 40–60% of patients includes emotional disorders (Bogolepova 2019; Kadykov et al. 2021), which may depend on lesion localization or be psychogenic in nature. Emotional disorders after a stroke can reduce treatment adherence and complicate the rehabilitation process (Kovalchuk et al. 2022; Tanashyan et al. 2023), highlighting the importance of studying the emotional state of patients experiencing post-stroke consequences. This study aimed to identify the clinical and psychological characteristics of emotional state and coping strategies in patients with different lesion localizations and to develop a psychological assistance program. The study involved 75 patients in the early recovery period after a stroke, observed in hospitals in Saint Petersburg and Pskov. Patients were divided into three groups depending on lesion localization: left hemisphere, right hemisphere, and vertebrobasilar basin (VBB). The study employed the clinical and psychological interview method and the following questionnaires: the EQ-5D questionnaire to assess quality of life, the Hospital Anxiety and Depression Scale (HADS), the Well-Being, Activity and Mood Scale (WAM), the Barthel Index to assess activities of daily living, the Mini-Mental State Examination (MMSE), and the Ways of Coping Questionnaire (R. Lazarus). Patients with severe motor or cognitive impairments were not included. Patients with right-hemisphere lesions exhibited significantly more difficulties in self-care compared to the VBB group, which may be associated with damage to their visuospatial functions. They were also significantly more likely to use self-control as a coping strategy compared to patients with left-hemisphere lesions. No differences were found among the groups regarding depression and anxiety, although anxiety was elevated in all three groups. A psychological assistance program was developed, aimed at teaching techniques for emotional stabilization, enhancing stress-coping skills, and increasing treatment adherence.