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PubMed2000

Nursing stress: the effects of coping strategies and job satisfaction in a sample of Australian nurses.

Nursing stress: the effects of coping strategies and job satisfaction in a sample of Australian nurses The study reported in this paper examined relationships between nursing work-related stressors and coping strategies, and their impact upon nurses' levels of job satisfaction and mood disturbance. It was proposed that higher levels of perceived work stress and use of avoidance coping would increase mood disturbance, while problem-focused coping would be associated with less mood disturbance. The study also aimed to explore the possible 'buffering effects' of using humour in coping with stress, and the effect of job satisfaction on the stress-mood relationship. The sample consisted of 129 qualified Australian nurses who volunteered to complete standardized questionnaires, including the Nursing Stress Scale, Ways of Coping Questionnaire, the Coping Humour Scale, Job Satisfaction Scale of the Nurse Stress Index, and the shortened version of the Profile of Mood States. Results revealed a significant positive relationship between nursing stress and mood disturbance, and a significant negative relationship between nursing stress and job satisfaction. The use of avoidance coping and the perception of work overload were found to be significant predictors of mood disturbance. No evidence was found to indicate that the use of humour had a moderating effect on the stress-mood relationship but there was support for the influence of job satisfaction upon this relationship. These results provided some support for a transactional model of stress since situational factors were found to influence the nurses' coping and perceptions of stress.

Adaptation, Psychological↗

PubMed2004

Coping strategies of people with kidney transplants.

BACKGROUND: There has been little research into coping process following renal transplantation, but it has been shown that health-related stress is not eliminated and that fear of rejection and economic factors are the most stressful issues. Coping strategies used have included prayer, looking at problems objectively, and trying to main control over the situation. AIM: The study was concerned with kidney transplant patients and their efforts to cope with problems posed by the transplantation and treatment. The aim was to describe and compare the use and perceived effectiveness of different coping strategies in people after kidney transplant with an age, gender and civil status-matched sample of the general Swedish population. METHODS: Coping was assessed by the Jalowiec Coping Scale and self-rated efficiency with visual analogue scales. From a total of 73 post-transplant patients, a consecutive series of 30 was compared with an age, gender and civil status-individually matched sample of the general Swedish population (n = 30). Data were collected from 1994 to 1997. RESULTS: The patient sample used significantly more optimistic, self-reliant, supportive and emotive coping than the general population sample. Evasive, emotive, and fatalistic coping were associated with low perceived efficiency in handling various aspects of the condition. STUDY LIMITATIONS: The study design does not permit causal conclusions and the patient sample was relatively small and non-randomly chosen, which could affect its external validity. CONCLUSIONS: The results suggest that assessment of coping strategies should be explored in clinical nursing practice so that nurses can encourage the use of those likely to be more useful, and discourage those with possible negative effects.

Adaptation, Psychological↗

PubMedDate not supplied

Coping styles of pregnant adolescents.

This descriptive study examined the coping styles and specific strategies used by a group of pregnant adolescents attending an adolescent family support service. Seventy-one adolescents, with a mean age of 17 years, and a mean gestation of 25 weeks, completed the Revised Jalowiec Coping Scale (JCS-R). The findings demonstrated that the optimistic coping style (emotion-focused) was the most frequently used and most effective coping style for these young women. A confrontive coping style (problem-focused) was also used and found to be effective. A combination of problem-focused and emotion-focused styles is recommended, with an increased emphasis on problem-focused approaches. The focus by the adolescents on optimistic approaches is suggestive of a lack of understanding of the challenges that motherhood will place upon them, but is consistent with their age and developmental stage. A longitudinal study of coping styles and changes in style throughout pregnancy and early motherhood is recommended. Initial assessment and monitoring of coping styles of pregnant adolescents is proposed. This assessment would be the beginning point for a teaching program that highlights increased use of adaptive coping styles (problem-focused) with decreased use of maladaptive approaches, and includes emotion-focused styles. By expanding the repertoire of coping styles and strategies available to the adolescent, the public health nurse (PHN) prepares these vulnerable mothers for the challenges ahead.

Adaptation, Psychological↗

PubMed2006

Racial differences in coping with the need for kidney transplantation and willingness to ask for live organ donation.

BACKGROUND: Disparities in African-American live donor kidney transplantation continue to grow. How patients cope with the reality of end-stage renal disease and the ensuing need for dialysis or a kidney transplant may directly affect the course of their disease, quality of life, and willingness to ask for live kidney donation. Racial differences in coping may exist and relate to the willingness to ask for live kidney donation. METHODS: The Brief COPE and Living Organ Donor Survey instruments were administered prospectively to potential kidney transplant recipients. The 14 different coping mechanisms were analyzed by race to look for differences. Willingness to ask for live kidney donation was analyzed to look for possible correlations with coping mechanisms and possible predictors analyzed by means of logistic regression. RESULTS: Three hundred thirty-three potential kidney transplant recipients were administered the surveys, with 61% African Americans. Racial differences were seen in the following coping mechanisms: acceptance, humor, religion, denial, and behavioral disengagement. Although racial differences did not exist in overall willingness to ask for donation, positive coping strategies were related to increased willingness to ask for donation. CONCLUSION: African Americans cope with the need for a kidney transplant differently than non-African Americans. Potential African-American kidney recipients are more likely to deny the need for a transplant and are less accepting of their situation. This may affect their perception of the need for transplantation and their persuasiveness in asking for live donations. Transplant programs should ensure that counseling and education programs aim to modify unrealistic expectations and improve recipient coping skills.

Adaptation, Psychological↗

PubMed2000

[Illness-coping in a population-based representative sample. Situational, sociodemographic and social influences].

In spite of the considerable volume of current coping research there is a noticeable lack of studies based on large representative samples. In this study a sample of 2179 subjects of 16 to 96 years of age that was representative of the entire population of Germany, was asked as to how they now cope, how they have coped in the past or how they would cope with: 1. an existing illness, 2. a past illness and 3. an imagined (non-existent) illness. The instrument used was the questionnaire version of the "Berner Bewältigungsformen" (BEFO), a coping questionnaire with 28 systematically derived coping dimensions that are defined independently of the usual empirical-topographical dimensions (behavioural, cognitive and emotional) of the type of illness. The enquiry was concerned with the influence of varying situational (proximity of illness, subjective evaluation of personal health, psychological symptoms), socio-demographic (age, gender) and social (social support) variables on the choice of coping mechanisms. The results showed that each of these factors influences the repertoire of coping mechanisms to varying degrees. This systematic variability in a representative sample should be taken into account in any evaluation of coping with illness in clinical sub-groups.

Adaptation, Psychological↗

PubMed2002

[Coping-activities of stroke patients: intensity and effectiveness].

This study longitudinally examines the intensive and effective ways of coping in a cohort of 63 stroke patients (aged 38 - 85 yrs.). The coping activities of the stroke patients are investigated with the "Freiburg Questionnaire of Coping with Illness (FQCI)". In the acute phase (t1), especially the compliance-focused coping strategies are very often used, whereas the problem-focused, self-constructive strategies leading to a quest for sense are only used quite often. Three months later (t2), compliance- and problem-focused coping strategies are employed with less intensity, the self-constructive ones, however, in a more intensive way. The strategies leading to a quest for sense are hardly employed in an intensive way any longer. A subjective estimation made by the examined stroke patients shows that the most effective coping strategies in the acute phase (t1) are problem- and compliance-focused. Self-constructive coping strategies come second and strategies with regard to a quest for sense only third in view of their effectiveness. Three months later (t2), the effective coping strategies are still problem-focused but only to a very small degree, while the effectiveness of compliance-focused strategies is lost completely. The self-constructive coping behaviour will now become the most effective one, a behaviour which proves to be even more inclined to a quest for sense than in the acute phase.

Adaptation, Psychological↗

PubMed2004

[The influence of stroke laterality on coping with stroke outcome].

Objective of this study was to asses the influence of coping activities on stroke disability- and handicap-outcomes. Of special interest was to investigate if and how the variable "side of lesion" influenced the relationship between coping activities and outcomes. 105 stroke patients (50 women, 55 men, mean age 71.1 years) were investigated. The coping activities of the stroke patients were investigated with the "Freiburg Questionnaire of Coping with Illness" (PQCI). The Disability Outcomes were investigated with the "Depression Status Inventory" (DSI) and the "Self Concept Scale for General Feelings of Self Worth". The Handicap-Outcomes were investigated with the "Perceived Quality of Life Scale" (PQoL) and the "Oxford Handicap Scale" (OHS). Unaffected by the side of lesion, depressive coping showed negative influences on the investigated outcomes. The strategy "trivialization and wishful thinking" intensified significantly the prevailing mood of depression of patients who suffered a right hemisphere stroke. The same negative influence of this strategy was detected on the psycho-social condition of these patients. The influence of the strategies "active and problem-focused coping", "distractive and self-reconstructive coping" and "religious and meaning-searching coping" remained unaffected by the stroke side. These strategies showed no influence on the investigated outcomes. Depressive coping should be avoided.

Adaptation, Psychological↗

PubMed1988

Coping strategies from the perspective of two developmental markers: age and social reasoning.

In this study, we examined coping from a developmental perspective, including its relation to age and social cognitive maturity. The 60 participants, who ranged from adolescents to mature adults, were given Lazarus' Ways of Coping Scale. This consists of both an emotion-focused and problem-focused coping score and two measures of social reasoning performance. Social reasoning was the best predictor of emotion-focused coping, above and beyond years of education and age. None of the developmental variables predicted problem-focused coping. Analyses examining the effect of perceived controllability of the stressful situation on coping demonstrated that it differentially mediated choice of coping strategy across age groups. Whereas older participants endorsed more problem-focused strategies in perceived controllable situations and emotion-focused strategies in perceived uncontrollable situations, adolescents endorsed emotion-focused and defensive coping styles, irrespective of perceived controllability. Implications for the study of development of coping styles in affectively salient contexts is discussed.

Adaptation, Psychological↗

PubMed1999

Coping with failure: relationship with self-concept discrepancy and attributional style.

In the relationship of attributional style and self-concept discrepancy with coping behavior among 10th-grade Hong Kong Chinese students, 3 significant canonical variate pairs were identified. The total criterion redundancy showed that self-concept discrepancy and attributional style predicted about 20% of the variance of coping behavior. The 1st variate pair indicated that students with small self-concept discrepancy and low-depressive attributional style tended to cope with failure by planful problem solving and by positive reappraisal. The 2nd variate pair showed that students, particularly girls, with small self-concept discrepancy in verbal ability and same-sex peer relations tended to cope with failure by seeking social support. The last variate pair showed that students with great self-concept discrepancy in same-sex peer relations and parent relations tended to cope with failure by avoiding or escaping. The 3 canonical variate pairs also suggested a new taxonomy for coping behavior: mobilization of internal coping resources, mobilization of external coping resources, and the inability to mobilize any coping resources.

Adaptation, Psychological↗

PubMedDate not supplied

Contextual analysis of coping: implications for immigrants' mental health care.

Providing high quality and effective health care services that are culturally acceptable and appropriate to clients has become an important issue for many health care providers. This paper explores problems associated with the traditional model that views coping according to hierarchical style and traits. While some scholars who have adopted this theoretical framework have made many contributions to the development of stress and coping theories, limitations are present. Using Vietnamese immigrants' experiences as examples, I argue that coping theories should emphasize the contextual nature of stress and coping, and that coping should be viewed as a dynamic process that varies under different social, cultural, political, economic, and historical conditions. Drawing from the work of others on coping, culture, imperialism, and colonialism, I explore the way that certain cultural conceptualizations determine how individuals cope. An understanding of the contextual nature of coping and of a Vietnamese immigrant's experience of coping with stressors and illness has implications for mental health care practice and research.

Adaptation, Psychological↗

PubMed2002

Predictors of coping strategy selection in paediatric patients.

AIM: To assess the prevalence of specific coping strategies and predictors of coping strategy selection in 179 patients (mean age = 10.2 y). The children were investigated one month after the occurrence of an accident (n = 105), diagnosis of cancer (n = 26) or diagnosis of diabetes mellitus type I (n = 48). RESULTS: Patients used a great variety of coping strategies. The most frequent strategies were cognitive avoidance, positive cognitive restructuring and avoidant actions. The strategies of seeking problem-focused support and emotion-focused support were rarely used. Diagnostic category, length of hospital stay, and gender were not associated with coping strategy use. Age, socioeconomic status and functional status of the patient were found to predict coping strategy selection. Younger children made less use of active coping, distraction and seeking support. Patients of lower socioeconomic status used religious coping strategies significantly more often, whereas patients with lower functional status used avoidance and support-seeking strategies more often. CONCLUSION: In this study it was found that paediatric patients used a wide variety of coping strategies, irrespective of diagnosis and gender. Age of the child and functional status were the most important predictors of coping strategy selection.

Accidents↗

PubMed2003

Investigation of the benefits of HIV/AIDS caregiving and relations among caregiving adjustment, benefit finding, and stress and coping variables.

The present study explored the nature of benefit finding in HIV/AIDS caregiving, and examined relations among caregiver adjustment, benefit finding, and stress and coping variables. A total of 64 HIV/AIDS caregivers and 46 care recipients completed interviews and questionnaires. First, the study aimed to explore the types of benefits associated with HIV/AIDS caregiving. Content analyses of caregiver responses to an interview question inquiring about gains from caregiving revealed eight benefit themes. Second, the study aimed to examine relations between caregiver adjustment and both benefit finding and stress and coping variables. We hypothesized that number of caregiver reported benefits, social support, challenge and control appraisals, and problem focused coping would be inversely related to poorer adjustment, whereas care recipient reported global distress and illness, caregiver threat appraisal and passive-avoidant emotion-focused coping would be positively associated with poorer adjustment. Correlations indicated that poorer adjustment (measured by global distress, depression, caregiving impact, social adjustment and health status) was positively correlated with care-recipient distress, threat appraisals and passive avoidant coping and inversely correlated with social support, and number of reported benefits. Unexpectedly, problem-focused coping, controllability and challenge appraisals, and care recipient illness were unrelated to adjustment. Third, the study aimed to examine relations between benefit finding and stress and coping variables. Correlations indicated that benefit finding was related to social support use, seeking social support coping and problem-solving coping. Findings indicate that the benefit finding and stress/coping frameworks have utility in guiding research into adaptation to HIV/AIDS caregiving. Results also indicate targets for intervention in the provision of services for HIV/AIDS caregivers.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Systems of coping associated with dysphoria, anxiety and depressive illness: a multivariate profile perspective.

As numerous coping strategies to deal with stressors can be used concurrently or sequentially, it may be productive to consider coping from a broad, systemic perspective. Using profile analysis and multivariate techniques, we demonstrated that coping profiles comprising multiple strategies distinguished between various mood states (dysphoria, anxiety, major depression, dysthymia and obsessive-compulsive disorder (OCD)). Generally, affective disturbances were associated with increased levels of rumination, cognitive distraction and emotion-focused coping (emotional expression, other-blame, self-blame, emotional containment and passive resignation) coupled with diminished problem solving and social support seeking. These coping profiles, however, varied as a function of anxiety vs. dysphoria, and severity of dysphoric symptoms, although the profile of dysphoric individuals was similar to that of clinically diagnosed dysthymic and major depressive patients. While coping profiles were generally stable over time (6 months), improvement or deterioration of mood was accompanied by corresponding alterations of coping profiles. Importantly, coping profile was not simply a correlate of dysphoric mood, but was also found to be an antecedent condition that favored the evolution of more severe affective problems. It is suggested that a multidimensional approach may prove useful in understanding coping as a dynamic system, and may have implications for clinical intervention.

Adaptation, Psychological↗

PubMed2006

Coping with unemployment: does educational attainment make any difference?

AIMS: The aim of this study was to examine the cross-sectional association between educational attainment and coping strategies with unemployment in a random sample of 37- to 56-year-old Danish men and women in long-term unemployment. METHODS: Data were based on a survey among 575 men and 1,064 women who had been unemployed at least 70% of the time during a three-year period (October 1996 to October 1999). The outcome measures were two scales for coping with unemployment, one for problem-solving coping, and one for avoidant coping. Educational attainment was measured by years of vocational training. RESULTS: A significant association was found between low educational attainment and low use of problem-solving coping among both men, OR = 1.81 (95% CI 1.19-2.75), and women, OR = 1.57 (1.13-2.18). Adjustment for cohabitation status, self rated health, economic strain, and unemployment status did not change this association substantially. High use of avoidant coping was associated with low educational attainment among men, OR = 1.57 (0.98-2.51). For women, medium educational attainment was significantly associated with low use of avoidant coping, OR = 0.60 (0.42-0.85). This result was not affected by adjustment for the covariates. CONCLUSIONS: Coping strategies are considered a potential modifier of the impact of unemployment on health and well-being. In this study, differences in coping strategies with unemployment were associated with educational attainment.

Adaptation, Psychological↗

PubMed2002

A population-based study of factors associated with combinations of active and passive coping with neck and low back pain.

Pain coping strategies can be active or passive. Previous studies have examined these strategies separately, however individuals use combinations of both types of coping strategies. We examined the associations between sociodemographic, pain and health-related factors and combinations of active and passive strategies in a general population random sample of 1,131 adults. Individuals reporting neck or low back pain during the past 6 months are the subjects of this report (n = 644). Multinomial logistic regression suggests that disabling pain was highly associated with passive coping regardless of active coping. Lower education was associated with the combination of low levels of active and high levels of passive coping. Individuals with better self-reported general health were less likely to use high levels of passive coping regardless of their active coping. We conclude that high levels of passive coping are strongly associated with disabling pain and that there is no evidence of an association between pain severity and active coping.

Adaptation, Psychological↗

PubMed2005

Coping strategy use: does it predict adjustment to chronic back pain after controlling for catastrophic thinking and self-efficacy for pain control?

OBJECTIVE: To explore whether coping strategy use predicted levels of adjustment in chronic low back pain after controlling for the influence of catastrophic thinking and self-efficacy for pain control. METHODS: Eighty-four patients with chronic low back pain completed the Coping Strategies Questionnaire, a pain VAS and the Roland Disability Questionnaire. To derive composite measures of coping, the Coping Strategies Questionnaire subscales, excluding the Catastrophizing subscale and 2 single-item scales, were entered into a principal components analysis. The extent to which scores on the coping measures predicted levels of adjustment after controlling for catastrophic thinking (Catastrophizing subscale) and self-efficacy for pain control (2 single-item scales) was explored using sequential multiple regression analysis. RESULTS: Two coping dimensions emerged from the principal components analysis, which were labelled Distraction and Praying or Hoping, and Denial of Pain and Persistence. Scores obtained on these coping measures explained an additional 5% and 13% of the variance in pain intensity and disability, respectively. Interestingly, however, the scores on the coping measures did not predict pain intensity or disability after controlling for the influence of catastrophic thinking and self-efficacy for pain control. CONCLUSION: Coping strategy use might only be related to levels of adjustment via the effect it has on catastrophic thinking and self-efficacy for pain control.

Adaptation, Psychological↗

PubMed2006

Socioeconomic position and variations in coping strategies in musculoskeletal pain: a cross-sectional study of 1,287 40- and 50-year-old men and women.

OBJECTIVE: To examine the association between socioeconomic position and coping strategies in musculoskeletal pain. DESIGN AND SUBJECTS: Cross-sectional study of a random sample of 40- and 50-year-old Danes, participation rate 69%, n=7,125. The study included 1,287 persons who reported functional limitations due to musculoskeletal pain. METHODS: Data was collected by postal questionnaires and scales were developed on problem-solving coping and avoidant coping, based on a range of preliminary studies. Multivariate logistic regression analyses was used to study the correlation with socioeconomic position, measured by occupational social class. RESULTS: Among women, there was no correlation between social class and avoidant coping, but a significant decrease in the use of problem-solving coping by decreasing social class, adjusted odds ratio (OR) = 2.64 (95% confidence interval (CI) 1.31-5.32) in social class V vs social classes I + II. Among men, there was no correlation between social class and problem-solving coping, but a significant increase in the use of avoidant coping with decreasing social class, adjusted OR = 3.31 (95% CI 1.75-6.25) in V vs I + II. CONCLUSION: It is important for clinicians who advise and support patients in their response to musculoskeletal pain to be aware of socioeconomic differences in coping strategies. Gender differences in the association between socioeconomic factors and coping should be further investigated.

Activities of Daily Living↗

PubMed2004

Survival of persons with Alzheimer's disease: caregiver coping matters.

PURPOSE: Although persons with Alzheimer's disease (AD) require increasingly more assistance with activities of daily living as their disease progresses, the caregiving environment has received little attention as a source of predictors of their survival time. We report here on a study to determine whether variation in survival time of persons with AD can be better explained by including caregiver variables such as coping style and depressive symptoms as predictors. DESIGN AND METHODS: A sample of 193 persons with AD residing in the community and their family caregivers was used to estimate the parameters of a Cox regression model of survival time that included both caregiver characteristics and care-recipient impairments as covariates. RESULTS: Caregiver wishfulness-intrapsychic coping was related to shorter care-recipient survival time, but instrumental and acceptance coping and caregiver depressive symptoms were not associated with survival time. Care-recipient impairments (dependency in activities of daily living, low score on the Mini-Mental State Examination, and problematic behaviors) were associated with shorter survival time. IMPLICATIONS: Because this study is the first to report the link between caregiver coping and care-recipient survival, further study to understand the dynamics is required. We discuss several possible mechanisms, including the possibility that caregivers engaging in wishfulness-intrapsychic coping are less psychologically available to the person with dementia. These caregivers may therefore provide less person-centered care that is responsive to the true capacities of the person with dementia, and thus they may inadvertently contribute to excess disability and consequent accelerated decline. Because wishfulness-intrapsychic coping was uncorrelated with instrumental or acceptance coping, our findings suggest that interventions to enhance coping skills among caregivers, which have focused primarily on increasing problem solving and acceptance coping, also may have to include specific attempts to reduce wishfulness-intrapsychic approaches to benefit not only the caregiver but the care recipient as well.

Activities of Daily Living↗