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PubMed2005

Communication and coping as predictors of fertility problem stress: cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment.

BACKGROUND: We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment. METHODS: We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up. Data were based on self-administered questionnaires measuring communication with partner and with other people, coping strategies: active-avoidance coping, active-confronting coping, passive-avoidance coping, meaning-based coping, and fertility problem stress. The study population included those participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up. RESULTS: Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09-5.76; odds ratio for men, 3.69, 95% confidence interval 2.09-6.43). Active-avoidance coping (e.g. avoiding being with pregnant women or children, turning to work to take their mind off things) was a significant predictor of high fertility problem stress. Among men, high use of active-confronting coping (e.g. letting feelings out, asking other people for advice, seeking social support) predicted low fertility problem stress in the marital domain (odds ratio 0.53, 95% confidence interval 0.28-1.00). Among women, medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain. CONCLUSION: The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment.

Adaptation, Psychological↗

PubMed2005

Attributions and coping in children's pain experiences.

OBJECTIVE: To examine how children's injury attributions and coping strategies relate to procedure-related distress during unplanned medical procedures (laceration repair). METHODS: Children (N = 50) with minor lacerations were assessed from emergency department admittance until discharge. Children's attributions of causes regarding their injury were assessed, and the Procedural Behavior Checklist was administered to each child (to assess coping strategies and procedure-related distress). RESULTS: Internally focused attributions of blame correlated with higher distress. Overall, children who reported primary-control coping, as opposed to secondary-control coping and relinquished-control coping, exhibited more pain during the procedure. Children who reported secondary-control coping, as opposed to relinquished-control coping, reported less pain after the procedure. CONCLUSIONS: Injury attributions and coping style are significant factors in children's pain experiences. These results suggest that self-blame may heighten subsequent pain experiences. In addition, similar coping strategies appear to be adaptive for unplanned medical procedures as have been found for planned medical procedures.

Adaptation, Psychological↗

PubMed2006

Appraisal and coping with daily stressors by pediatric patients with chronic abdominal pain.

OBJECTIVE: To test the hypothesis that pain patients differ from well children in their appraisal and coping with daily stressors and to test a model of the relation of stress appraisal and coping to symptoms and disability. METHODS: Pediatric patients with chronic abdominal pain (n = 143) and well children (n = 104) completed a 5-day diary study regarding their appraisal and coping with daily stressors. Somatic symptoms, depressive symptoms, and functional disability were assessed 2 months later. RESULTS: Compared to well children, pain patients were less confident of their ability either to change or to adapt to stress and were less likely to use accommodative coping strategies. Different patterns of stress appraisal were associated with active, passive, and accommodative coping. Both appraisals and coping were significantly related to symptoms and disability. CONCLUSIONS: The relation between stress and symptoms in pediatric pain patients may be explained in part by their appraisal and coping with stressors. The relation between appraisal and coping was consistent with Lazarus, R. S., & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.

Abdominal Pain↗

PubMedDate not supplied

Coping and emotional adjustment following traumatic brain injury.

OBJECTIVES: To examine the association between coping style and emotional adjustment following traumatic brain injury. PARTICIPANTS: Thirty three individuals who had sustained a traumatic brain injury (mean duration of posttraumatic amnesia = 32 days) between 1(1/2) months and almost 7 years previously. MEASURES: Coping Scale for Adults, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, State-Trait Anger Expression Inventory, and the Sickness Impact Profile. RESULTS: Approximately 50% of the sample reported clinically significant levels of anxiety and depression. Coping characterized by avoidance, worry, wishful thinking, self-blame, and using drugs and alcohol was associated with higher levels of anxiety, depression, and psychosocial dysfunction and lower levels of self-esteem. Coping characterized by actively working on the problem and using humor and enjoyable activities to manage stress was associated with higher self-esteem. Lower premorbid intelligence (measured via the National Adult Reading Test) and greater self-awareness (measured via the Self-Awareness of Deficits Interview) were associated with an increased rate of maladaptive coping. CONCLUSIONS: The strong association between the style of coping used to manage stress and emotional adjustment suggests the possibility that emotional adjustment might be improved by the facilitation of more adaptive coping styles. It is also possible that improving emotional adjustment may increase adaptive coping. The development and evaluation of interventions aimed at facilitating adaptive coping and decreasing emotional distress represent important and potentially fruitful contributions to enhancing long-term outcome following brain injury.

Adaptation, Psychological↗

PubMed1999

A multidimensional longitudinal analysis of family coping with brain injury.

Longitudinal research is needed to advance knowledge and practice in the area of family coping with brain injury. The purpose of this investigation was to examine the dimensions that underlie family coping with brain injury across a 2-year time period (1995 to 1997). Two-dimensional configurations of 30 family coping behaviours indicated a like family coping pattern of cognitive versus behavioural coping (Dimension 1) in both 1995 and 1997. The data also showed that families had a differing, or changed, family coping pattern along Dimension 2 from brain injury-focused coping versus family-to-community fit in 1995 to seeking professional help versus intra-family coping in 1997. Results thus indicated both changes and consistent coping patterns within the same group of families across time. Such information can be used to guide clinical family intervention, the development of long-term family support services, and future brain injury family research.

Adaptation, Psychological↗

PubMed1994

Ways of coping in women with eating disorders.

The aim of this study was to investigate the strategies used for coping with stress in eating disorder patients. Twenty-four anorexia nervosa (AN) patients, 66 bulimia nervosa (BN) patients, and 30 female control subjects completed a revised Ways of Coping Checklist, indicating how they dealt with a self-nominated stressor. The AN and BN patients used proportionately more avoidance than control subjects. The BN patients used proportionately more wishful thinking and sought less social support than control subjects but patients with AN did not differ significantly from either BN or control groups. Patient groups did not differ significantly from control subjects on their use of problem-focused coping or self-blame, although the use of problem-focused coping was significantly lower, and self-blame significantly higher, with psychological problems than with relationship and general problems in all groups. Coping failed to predict severity of eating pathology but, in the patient groups, Beck Depression scores were related positively to avoidant coping (avoidance in BN patients and wishful thinking in AN patients) and inversely to problem-focused coping and seeking social support (although the latter just failed to reach significance in the AN group). It is concluded that a treatment approach that teaches coping strategies, as well as removing the obstacles (cognitive, emotional, or practical) that preclude the use of more effective coping, may be a useful component of treatment.

Adaptation, Psychological↗

PubMed1999

Examining an affect regulation model of substance abuse in schizophrenia. The role of traits and coping.

Comorbid substance use disorders occur frequently in schizophrenia with significant detrimental effects to clinical outcome. Unfortunately, attempts to identify factors associated with comorbid substance use disorders (beyond demographic characteristics such as gender) have not been successful. This study examined an affect regulation model of comorbid substance use in schizophrenia with a focus on personality traits and coping. It was hypothesized that maladaptive coping and the traits of negative affect (NA) and disinhibition (DIS), but not trait positive affect (PA), would be associated with greater substance use problems. Thirty-nine patients with schizophrenia or schizoaffective disorder completed measures of personality traits, coping, and negative consequences associated with substance use. Traits were differentially associated with coping in that NA and DIS, but not PA, were associated with maladaptive coping including the use of drugs and alcohol to cope with stress. Alternatively, PA, but not DIS or NA, was related to adaptive coping strategies. Individuals high in NA and endorsing the use of drugs and alcohol to cope reported the greatest number of negative consequences from substance use. This finding held after controlling for gender. These results are consistent with an affect regulation model of substance use and suggest the advantage of examining the role of affect, traits, and coping in understanding comorbid substance use in schizophrenia.

Adaptation, Psychological↗

PubMedDate not supplied

Coping strategies and associated features of medically ill patients.

This study examined the psychological and behavioral correlates of three major coping strategies used by medically ill patients in dealing with their illness; namely, confrontation, avoidance, and acceptance-resignation. The subjects consisted of 223 male medical patients with a variety of life-threatening and chronic illnesses. Coping responses were measured by the Medical Coping Modes Questionnaire, while other variables were tapped by a variety of self-report and test measures, as well as by interview data. Significant correlates were found for each of the coping strategies accounting for 10 to 53% of the variance. These included demographic, illness, and psychological variables. Employment of acceptance-resignation as a coping strategy was particularly evident in patients with little expectation of recovery and a lack of hope. Effectiveness of coping appeared to be negatively linked to frequent use of avoidance and acceptance-resignation in life-threatened patients. Overall, it seems that a variety of variables across several domains accompany the use of a particular coping strategy; that choice of a specific strategy is most likely multidetermined; and that the configuration of variables associated with a particular strategy is likely to be different for each coping strategy. Coping behavior is a subtle, multifashioned expression the complete grasp of which demands an integrative approach.

Adaptation, Psychological↗

PubMedDate not supplied

Coping with breast cancer: patient, spouse, and dyad models.

OBJECTIVE: The objectives of this study were 1) to assess similarities and differences between patients with breast cancer and their spouses in terms of coping strategies and adjustment (psychosocial and psychological) to cancer and 2) to investigate the pattern of relationships between the patients' and spouses' coping strategies and between each of these strategies and the patient's adjustment to the illness using three types of models: patient, spousal, and dyadic coping. METHODS: Seventy-three patients with breast cancer and their spouses completed questionnaires that measured distress (Brief Symptom Inventory), psychosocial adjustment, and coping strategies. RESULTS: The patients' distress was greater than their spouses', but a similar level of psychosocial adjustment was reported. The patients used more strategies involving problem-focused coping than their spouses. The use of emotion-focused coping, which included ventilation and avoidance strategies, was highly related to distress and poor adjustment on the part of the patient. The spouses' emotion-focused coping and distress were related to that of the patients. Dyad emotion-focused coping measures were highly associated with the patients' distress and adjustment. CONCLUSIONS: Spousal and dyad coping are important factors in a patient's adjustment to breast cancer.

Adaptation, Psychological↗

PubMed2006

Avoidant coping partially mediates the relationship between patient problem behaviors and depressive symptoms in spousal Alzheimer caregivers.

OBJECTIVE: Caring for a loved one with Alzheimer disease is a highly stressful experience that is associated with significant depressive symptoms. Previous studies indicate a positive association between problem behaviors in patients with Alzheimer disease (e.g., repeating questions, restlessness, and agitation) and depressive symptoms in their caregivers. Moreover, the extant literature indicates a robust negative relationship between escape-avoidance coping (i.e., avoiding people, wishing the situation would go away) and psychiatric well-being. The purpose of this study was to test a mediational model of the associations between patient problem behaviors, escape-avoidance coping, and depressive symptoms in Alzheimer caregivers. METHODS: Ninety-five spousal caregivers (mean age: 72 years) completed measures assessing their loved ones' frequency of problem behaviors, escape-avoidance coping, and depressive symptoms. A mediational model was tested to determine if escape-avoidant coping partially mediated the relationship between patient problem behaviors and caregiver depressive symptoms. RESULTS: Patient problem behaviors were positively associated with escape-avoidance coping (beta = 0.38, p < 0.01) and depressive symptoms (beta = 0.26, p < 0.05). Escape-avoidance coping was positively associated with depressive symptoms (beta = 0.33, p < 0.01). In a final regression analysis, the impact of problem behaviors on depressive symptoms was less after controlling for escape-avoidance coping. Sobel's test confirmed that escape-avoidance coping significantly mediated the relationship between problem behaviors and depressive symptoms (z = 2.07, p < 0.05). CONCLUSION: Escape-avoidance coping partially mediates the association between patient problem behaviors and depressive symptoms among elderly caregivers of spouses with dementia. This finding provides a specific target for psychosocial interventions for caregivers.

Adaptation, Psychological↗

PubMedDate not supplied

Parental history of hypertension and coping responses predict blood pressure changes in black college volunteers undergoing a speaking task about perceptions of racism.

OBJECTIVE: This investigation explored the relationship of coping responses and parental history of hypertension to task-induced blood pressure changes. MATERIALS AND METHODS: The sample consisted of 215 black college student volunteers (median age = 25.95 y). During the speaking task, participants responded to standardized questions about perceptions of intra-ethnic and inter-ethnic group racism. Systolic blood pressure and diastolic blood pressure were measured via an automated blood pressure monitor. Usual ways of coping with intra-ethnic group racism were assessed with the COPE Scale, and parental history of hypertension (PHH) was self-reported by participants. RESULTS: Findings from the final step of hierarchical general linear models indicated that the main effect of emotion-focused coping was negatively associated with diastolic blood pressure (p = 0.02) and systolic blood pressure (p = 0.002) changes. Further, these analyses revealed that PHH interacted: (1) with the coping responses of planning (p = 0.007) and denial (p = 0.002) to predict changes in systolic blood pressure and (2) with the planning coping response to predict diastolic blood pressure changes (p = 0.02). The direction of these effects indicated that among participants who were high in these coping responses, participants who also had a positive PHH had larger blood pressure changes. Regression analyses also revealed that PHH interacted with the cognitive coping response (p = 0.01) to predict changes in systolic blood pressure. The direction of this effect indicated that among participants who were low in this coping response, participants who also had a positive PHH had larger systolic blood pressure changes. CONCLUSION: This study highlights the importance of examining the joint contribution of biological and psychosocial parameters to blood pressure reactivity in blacks.

Adaptation, Psychological↗

PubMed2003

Coping and optimism in relation to dental health behaviour--a study among Finnish young adults.

Our aim in this paper was to investigate active coping in relation to optimism, dental health behavior and self-reported dental health among 31-yr-old men and women born in Northern Finland in 1966. Connecting coping strategies and optimism with health behavior is an unexplored approach in dentistry, even though both coping strategies and optimism are known to be associated with many health outcomes. The data were based on a postal questionnaire, which was sent to the Northern Finland 1966 Birth Cohort at age 31 yr (n = 11 541). The number of replies was 8690, with a 75.3% response rate. Active coping was measured using the Ways of Coping Checklist and optimism using a revised Life Orientation Test. Prevalence proportion ratios were estimated by applying a log-binomial regression models. The results showed a correlation between active coping and optimism. Both active coping and optimism were related to different dental health behaviors. The effect of active coping on dental health behavior disappeared by adjusting for optimism, education and gender. The results support the previous findings that active coping acts as a mediator between optimism and health. Optimism was also related to self-reported dental health, which supports the comprehensiveness of optimism as a determinant for health.

Adaptation, Psychological↗

PubMed1989

Burnout and coping strategies among hospital staff nurses.

This study examined the relationship between use of coping strategies and burnout among 150 randomly selected staff nurses from four hospitals. The instruments used were the frequency dimension of the Maslach Burnout Inventory (Maslach & Jackson 1981) and the Ways of Coping (Revised) (Folkman & Lazarus 1985). In the canonical correlation analysis, two significant canonical variate sets differentiated nurses on the dimension of burnout. Nurses who experienced increased levels of burnout used the coping strategies of escape/avoidance, self-controlling and confronting (P less than 0.001). Nurses who experience decreased levels of burnout used the coping strategies of planful problem solving, positive reappraisal, seeking social support, and self-controlling (P less than 0.003). Self-controlling coping, although present in both variate sets, was used to a lesser extent by nurses with decreased burnout levels. The positive relationship between planful problem solving and reduced burnout levels supports the theoretical framework of Lazarus. This framework asserts that during the appraisal process, persons evaluate the harmfulness of an event and their own coping resources. Persons with lower levels of burnout may perceive the event as amenable to change or they may perceive their coping resources as adequate. Either perception may promote the view that the situation is amenable to problem solving. Another rationale for the effectiveness of particular coping strategies may lie in the reactions that these strategies engender in others. The use of planful problem solving, seeking social support and positive reappraisal has been reported to result in the offering of greater social support than when confronting and self-controlling coping were used.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗

PubMed2004

Coping strategies of family carers for older relatives in Finland.

BACKGROUND: As the population continues to age, it is important that older people and their family carers get all the help and support they need with coping. This requires knowledge and understanding of the factors that foster and promote coping strategies, and on the other hand that complicate coping. AIMS AND OBJECTIVES: Conducted as part of a major international research project on carers' work and coping in four countries, the purpose of this study was to explore the coping strategies of family carers looking after older relatives in their own home and to identify related factors. DESIGN: A survey involving 290 family carers from three towns in Finland. METHODS: The data were collected with a questionnaire including the Carers' Assessment of Managing Index developed by Nolan et al. (1995). RESULTS: The most helpful coping strategy was to establish one's priorities and concentrate on them. Other strategies that over 80% of the respondents regarded as helpful were believing in oneself and one's ability to handle the situation, taking life 1 day at a time, looking for positive things in each situation and relying on one's own expertise and experience. The 10 most helpful coping methods included five problem-solving strategies, four emotional-cognitive strategies and one managing stress strategy. The age and gender of the family carers were found to correlate with the results. CONCLUSIONS: Our findings lend further support to earlier results according to which there are both similarities and differences in the coping strategies of family carers in different countries. RELEVANCE TO CLINICAL PRACTICE: Nurses who meet family carers of ageing individuals in their work will be able to use these results in assessing how these carers are coping and whether they need support, as well as in developing services for family carers.

Adaptation, Psychological↗

PubMed2006

Coping over time: the parents of children with autism.

BACKGROUND: Although coping with autism has been examined in a number of papers, virtually no research exists on how families cope over time. This paper reports the results of a longitudinal study of parents coping with autism over a period of approximately a decade. METHODS: The research method for the study was based on ethnographic methods that emphasized in-depth interviews and participant observation. The sample for this study consisted of 28 parents (19 mothers and nine fathers) of children with autism. The instrument for the interviews consisted of questions concerning: the child's medical history and referral experience, the child's present symptomatology, the effects of the child's problems on the parent's well-being, the effects of autism on the family's social life, parental coping strategies, illness conceptualization and the parents' expectations for the future. RESULTS AND CONCLUSIONS: Coping strategies changed from the time of the initial study, as fewer parents coped through reliance on service providers, family support, social withdrawal and individualism and relatively more parents coped through their religious faith and other emotion-focused strategies. The results tentatively support previous research on coping that indicates that aging is linked to the use of more emotion-focused coping strategies.

Adaptation, Psychological↗

PubMed2005

Planning helps, behavioral disengagement does not: coping and depression in the spouses of heart transplant candidates.

OBJECTIVE: To describe the coping strategies used by the spouses of cardiac patients who are pursuing heart transplant and to determine whether coping strategies predict depression in these spouses. METHOD: This is a cross-sectional design with 28 spouses (86% female) of cardiac patients who were being evaluated for heart transplant at a large medical center. Coping styles were measured using the COPE Inventory (Carver CS, Scheier MF, Weintraub JK, J Pers Soc Psychol 1989: 56: 267). Depression was assessed with the Center for Epidemiological Studies Depression Scale (Radloff LS, Appl Psychol Meas 1977: 1: 385). RESULTS: Spouses reported using adaptive coping strategies more than the less adaptive strategies. Increased levels of depression were positively correlated with 'behavioral disengagement' and negatively correlated with 'planning' coping strategies. CONCLUSIONS: Most studies find that maladaptive coping styles are associated with psychological distress. Consistent with these findings, we found that behavioral disengagement was associated with increased levels of depression. However, in the present study the more adaptive coping strategy of planning was associated with lower levels of psychological distress. These findings suggest that in the spouses of heart transplant candidates, both maladaptive and adaptive coping strategies may serve as markers of the presence or absence of emotional distress and thus may help in identifying spouses who may benefit from psychological, social work, or nursing interventions.

Adaptation, Psychological↗

PubMed2005

Cultural variations in children's coping behaviour, TV viewing time, and family functioning.

AIM: To examine children's coping behaviour, TV viewing hours and family functioning in four ethnic groups and factors related to children's coping behaviour. METHODS: This study was part of two larger research projects investigating children's health behaviours in the United States and Taiwan. Fifty-six White American children of European ancestry, 66 Mexican American children, 68 Chinese American children and 95 native Taiwanese children were included in the analysis. Standardized instruments were used to measure coping strategies, children's TV viewing hours and family functioning. RESULTS: There were significant differences in the types of stressor that children of different ethnicity reported. Similarities and differences were found in the four ethnic groups regarding the top five most frequently used and most effective coping strategies. Multiple regressions identified two variables that contributed significantly to the variance in the frequency of children's coping strategies--ethnicity and poorer behaviour control in the family. Ethnicity was the only variable found to contribute to the variance in coping effectiveness. Significant differences were found in the number of hours children spent watching TV. CONCLUSIONS: Findings suggest that children of different ethnicity utilized different types of coping strategies and ethnicity is one of the important factors related to children's coping behaviour. These findings provide evidence for nurses to assess children's coping behaviour and TV viewing and provide children with healthier alternatives.

Adaptation, Psychological↗

PubMed2004

Complete dentures and oral health-related quality of life -- do coping styles matter?

UNLABELLED: Oral health-related quality of life (OHRQOL) in edentulous patients with complete dentures is often impaired. This paper investigates the effect of different coping styles on OHRQOL. PURPOSE: (a) To assess OHRQOL of edentulous patients with conventional complete dentures, and (b) to investigate if individual differences in these patients' styles of coping with stress affect their OHRQOL. MATERIALS AND METHODS: Data were collected from 249 fully edentulous patients with complete dentures (mean age: 66.0 years) who responded to a mailed survey (adjusted response rate: 48.8%). OHRQOL was measured with the 14-item short form of the oral health impact profile (OHIP). Ratings of coping strategies were obtained using the 28-item Brief COPE, an instrument measuring various styles of coping with stress. Linear regression analyses were used to explore the relationships between coping styles, background variables such as age, gender, income, and age of prosthesis, and the patients' OHRQOL. RESULTS: About 35% of the respondents reported impacts from their oral conditions on their overall OHRQOL (OHIP-14 total score) occasionally, fairly often, or often. Physical pain was even more prevalent, with 53.3% of the respondents reporting pain impacts. The linear regression model (P < 0.0001) explained 31.1% of the variation in the OHIP-14 total score. The coping variables instrumental support, behavioral disengagement, substance abuse, denial, and religion were significant negative predictors of OHRQOL. Only emotional support was a significant positive predictor of OHRQOL. CONCLUSION: Wearing conventional complete dentures has a significant impact on OHRQOL. This impact is moderated by the styles a patient uses to cope with stress. Using emotional support has a positive effect on OHRQOL, while other coping styles, namely instrumental support, behavioral disengagement, substance abuse, denial, and religion are significant negative predictors of OHRQOL.

Adaptation, Psychological↗