[Stages in coping after stroke].

Abstract

People who suffer a stroke most often experience a major crisis in their lives. This leads to psychological problems which are likely to influence the patient's life satisfaction, long-term rehabilitation outcome, and quality of life as much as the physical consequences caused by the stroke, The patient's ability to accept the new reality created by a disability as a part of their future life is therefore essential. This necessitates an individual coping strategy in the center of which is a mourning process, which unfolds in the same way as other experiences of vital threat, e.g. confrontation with one's own dying. Different stages of mourning that can also be found in stroke patients are nonacceptance of the facts, erupting emotions, parting with the former and finding of a new self as well as new perspectives for one's future. Whether a coping process is successful does not depend on the type of the defense mechanisms or stages, but essentially on their persistence. It is the task of the therapeutical team to support this process by applying a basic therapeutic behavior, stage-consistent interventions and a positive feedback. A failed process of coping may be one of the causes of the high prevalence of psychological disorders like depression and anxiety disorders in patients having suffered a stroke.