Journal of Rehabilitation Medicine 51-1CompleteIssue | Page 27

24 M. L. M. Wijenberg et al. lience were not considered in this study. This limits any conclusion regarding these other psychological factors or the existence of a mediating role, which might be played by a more general negative emotional state (33). Despite these limitations, we found, in a large pro- spective longitudinal multicentre cohort study across 7 different psychological factors in patients with stroke, changes toward less favourable scores, which may be associated with worse outcome, such as participation and quality of life. Clinicians should attend to adaptive psychological factors (e.g. proactive coping, self- efficacy, extraversion) and maladaptive psychological factors (e.g. passive coping and neuroticism) during long-term care. ACKNOWLEDGEMENT The presented study is part of the Restore4Stroke Research Program, which is supported financially by VSBfund (grant no. 89000004) and coordinated by ZonMw (the Dutch Organization for Health Research and Development). 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