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PubMed2002

Coping and health service utilisation in a UK study of paediatric sickle cell pain.

AIMS: To assess sickle cell pain and coping in children and to examine the relation between these factors and the utilisation of health services. METHODS: Cross sectional study involving 67 children with sickle cell disease attending three London hospitals. Interviews and questionnaires involved measures of pain, health service utilisation, and coping responses (measured with the Coping Strategies Questionnaire (CSQ), revised for children with sickle cell disease). Medical data on complications, haemoglobin (Hb) levels, and foetal haemoglobin (HbF) percentage were also collected. RESULTS: Pain accounted for about 24% of hospital service use, independent of age, sex, number of with sickle cell disease complications, and Hb levels. However, 42% of patients had not utilised hospital services in the past 12 months. Three higher order factors emerged from analysis of the CSQ (active coping, affective coping, passive adherence coping). Pain severity was predicted by passive adherence coping, while utilisation of hospital services was predicted by active coping. CONCLUSIONS: Sickle cell disease in children involves severe recurrent pain leading to hospitalisation in some cases. Psychological coping patterns are relevant to both pain experience, and the use of acute hospital services. It is likely that children would benefit from community based interventions that incorporate both medical and psychological assessments.

Adaptation, Psychological↗

PubMed2000

Stress vulnerability and climacteric symptoms: life events, coping behavior, and severity of symptoms.

To explore a possible association between climacteric symptoms and ways of coping with stress, a comparative study was conducted among 19 menopausal women who sought treatment for climacteric symptoms (the study group) and 44 healthy menopausal women (the control group). Life stress was assessed using a life event method in which factor analysis extracted four ways that women cope with stress: avoidance-oriented coping, consultation-oriented coping, aggression-expression coping, and problem-solving coping. The study group had a higher symptom score and was more prone to avoidance-oriented coping than the control group despite experiencing the same number of undesirable life events. The severity of climacteric symptoms correlated positively with the number of undesirable life events and the degree of avoidance-oriented coping and correlated negatively with the degree of aggression- expression coping for the study group. These results suggest that vulnerability to stress contributes to worsening climacteric symptoms caused by stress.

Adaptation, Psychological↗

PubMedDate not supplied

Coping strategies used in residential hospice settings: findings from a national study.

The purpose of this study was to explore professional caregivers' coping strategies for dealing with the deaths of patients in residential hospices in the United States. Using the Guide to the Nation's Hospices, 1996-97, purely residential hospices were identified and invited to participate in the study. Employees at each residential hospice were asked to complete the Ways of Coping Questionnaire. Results indicated that positive reappraisal coping was the most frequently used coping strategy. Employees dissatisfied with the coping experience reported greater use of confrontive coping, escape-avoidance coping, and accepting responsibility strategies. The findings suggest that in-service training related to coping strategies and environmental interventions may help in strengthening the coping responses of residential hospice staff.

Adaptation, Psychological↗

PubMed2003

Avoidant coping with health problems is related to poorer quality of life among lung transplant candidates.

CONTEXT: Lung transplant candidates face numerous health-related stressors. Although previous work has described the range of coping strategies candidates may use, whether those strategies are related to quality of life in physical functioning, emotional, and social domains has rarely been examined. METHODS: Adult lung transplant candidates (N = 128) participated in semistructured interviews that included questions regarding global and domain-specific quality of life and a multidimensional assessment of coping with health-related problems. Demographic characteristics, health status, and other psychosocial variables were also assessed, and their effects were examined and controlled in multivariate analyses of the coping-quality-of-life relationship. RESULTS: Respondents were most likely to use active, acceptance, and support-seeking strategies to cope with health problems. Self-blame or avoidance were rarely used. Although used least often, avoidant coping was the most strongly and consistently related to quality of life. With demographic and psychosocial variables controlled, higher avoidant coping remained associated with significantly poorer global quality of life, bodily pain, difficulty with daily work or activities as a function of emotional problems, and depressive symptomatology. Avoidant coping accentuated the association of poor health status and lower quality of life. Among respondents with lower health status, using more avoidant coping was associated with greater difficulty functioning in daily activities as a result of emotional problems. Those with higher health status had less difficulty functioning in daily activities as a result of emotional problems. CONCLUSIONS: Transplant team members are encouraged to be aware of and help patients refrain from using avoidant coping strategies.

Activities of Daily Living↗

PubMed2001

Appraised control, coping, and stress in a community sample: a test of the goodness-of-fit hypothesis.

Lazarus and Folkman proposed one of the most comprehensive theories of stress and coping in the psychology literature, but many of their postulates have received little empirical attention, and some of the existing research hasyielded contradictory findings. This longitudinal study sought to clarify the associations among control appraisal, coping, and stress within this theoreticalframework. The theory postulates that coping strategies used tend to match the level of appraised controllability of the stressor (matching hypothesis). It further states that the effects of problem-focused versus emotion-focused coping are moderated by the appraised controllability of the stressor (goodness-of-fit hypothesis). An alternative to the latter is the main-effects hypothesis, which states that problem-focused coping is generally more effective in reducing distress regardless of appraisal. These hypotheses were tested on 72 adults who completed questionnaires on coping and control appraisal. Stress was assessed using self-report (Symptom Checklist-90-Revised) and a behavioral measure (proofreading task) at two times approximately 2 months apart. Appraised control significantly predicted type of coping such that greater control was associated with more problem-focused and less emotion-focused coping. Although the main-effects hypothesis was not supported, the goodness-of-fit hypothesis was partly confirmed by a significant control by emotion-focused coping interaction predicting both self-report and behavioral measures of stress.

Adaptation, Psychological↗

PubMed2006

Reductions in depressed mood and denial coping during cognitive behavioral stress management with HIV-Positive gay men treated with HAART.

BACKGROUND: Stress management interventions for HIV-positive persons have been designed to enhance coping skills and encourage health-promoting behaviors with the hope of decreasing distress and slowing disease progression. PURPOSE: We examined the efficacy of a cognitive behavioral stress management (CBSM) intervention in combination with medication adherence training (MAT) in 130 gay and bisexual men living with HIV infection. METHODS: Participants were randomized to either a 10-week CBSM+MAT intervention (n = 76) or a MAT-only condition (n = 54). Measures of self-reported adherence, active cognitive coping (i.e., acceptance and positive reinterpretation), avoidant coping (i.e., denial and behavioral disengagement), and depressed mood were examined over the 10-week intervention period. RESULTS: Men in CBSM+MAT reported reductions in depressed mood and denial coping during the 10-week intervention period, but no changes in active cognitive coping or self-reported adherence were observed. Using path analysis, greater reliance on denial coping at baseline was associated with decreased depressed mood at 10 weeks. We also determined that CBSM+MAT may decrease depressed mood by reducing reliance on denial coping over the 10-week intervention period. CONCLUSIONS: Although denial may be an effective means of distress reduction in the short term, reliance on this coping strategy may result in a decreased capacity to effectively manage a variety of disease-related stressors in the long term. CBSM+MAT addresses this potentially detrimental pattern by teaching stress reduction skills that may decrease depressed mood via reduced reliance on denial coping.

Adaptation, Physiological↗

PubMed2005

Perceptions of psychosis, coping, appraisals, and psychological distress in the relatives of patients with schizophrenia: an exploration using self-regulation theory.

OBJECTIVE: Following Leventhal's self-regulation model, the purpose of the present study was to provide an examination of the relationship between psychosis perceptions, coping strategies, appraisals, and distress in the relatives of patients with schizophrenia. DESIGN: Cross-sectional study. METHOD: Participants were 42 relatives of patients with schizophrenia who completed the Hospital Anxiety and Depression Scale (HADS), a brief coping strategies measure (COPE), the Revised Illness Perception Questionnaire (IPQR), and a measure of primary and secondary appraisals (Family Questionnaire). RESULTS: In general, carers who viewed their relative's psychosis as chronic, who had a stronger illness identity (experience of symptoms), who held a stronger belief in the severity of its consequences, and who reported weaker beliefs in treatment control but stronger beliefs that their relative could exert control over their condition had higher distress scores. Coping through seeking emotional support, the use of religion/spirituality, active coping, acceptance, and positive reframing were associated with less distress, while coping through self-blame was associated with higher distress scores. Hierarchical regression demonstrated that illness perceptions and coping (acceptance, positive reframing, and self-blame), respectively, made significant additional contributions to the variance in distress when entered after demographics, and primary and secondary appraisals. Furthermore, a mediational analysis suggested that coping strategies characterized by greater positive reframing, less self-blame, and greater acceptance mediated the relationship between distress, and both illness identity and carer's beliefs about how much personal control the patient could exercise over their condition. There was no mediational effect of coping on the relationship between distress and carers' perceptions about symptom control through medical treatment. CONCLUSION: Results provide partial but not unequivocal support for the self-regulation model in the current sample. Findings may invite us to consider the further use of the self-regulation/common sense model as a framework for understanding distress in the carers of people with a diagnosis of schizophrenia.

Adaptation, Psychological↗

PubMed2006

A validity and reliability study of the coping self-efficacy scale.

OBJECTIVES: Investigate the psychometric characteristics of the coping self-efficacy (CSE) scale, a 26-item measure of one's confidence in performing coping behaviors when faced with life challenges. DESIGN: Data came from two randomized clinical trials (N1=149, N2=199) evaluating a theory-based Coping Effectiveness Training (CET) intervention in reducing psychological distress and increasing positive mood in persons coping with chronic illness. METHODS: The 348 participants were HIV-seropositive men with depressed mood who have sex with men. Participants were randomly assigned to intervention and comparison conditions and assessed pre- and post-intervention. Outcome variables included the CSE scale, ways of coping, and measures of social support and psychological distress and well-being. RESULTS: Exploratory (EFA) and confirmatory factor analyses (CFA) revealed a 13-item reduced form of the CSE scale with three factors: Use problem-focused coping (6 items, alpha=.91), stop unpleasant emotions and thoughts (4 items, alpha=.91), and get support from friends and family (3 items, alpha=.80). Internal consistency and test-retest reliability are strong for all three factors. Concurrent validity analyses showed these factors assess self-efficacy for different types of coping. Predictive validity analyses showed that residualized change scores in using problem- and emotion-focused coping skills were predictive of reduced psychological distress and increased psychological well-being over time. CONCLUSIONS: The CSE scale provides a measure of a person's perceived ability to cope effectively with life challenges, as well as a way to assess changes in CSE over time in intervention research.

Adaptation, Psychological↗

PubMed2006

Suicidal and deliberate self-harm ideation among patients with physical illness: the role of coping styles.

The relationship between coping styles and suicidal ideation (SI) or deliberate self-harm (DSH) ideation among patients with physical illness was examined. Four hundred fifteen adult male medical inpatients completed the Coping Styles Questionnaire. Patients with and without SI, and with and without DSH, were compared on coping styles. Sixteen percent of patients (n = 67) had SI and 18.3% (n = 76) had DSH. SI was associated with higher scores on emotional coping and lower scores on rational and detachment coping styles, compared with those without SI. DSH, compared with those without DSH, was associated with significantly higher scores on avoidance coping strategies. These data suggest coping styles among medical patients with and without SI or DSH may differ. The mechanism of this link is not entirely clear, but it may be that coping styles reflect one possible pathway of the association between poor physical health and SI and DSH. Replication of these results in a longitudinal study is needed. If replicated, incorporation of these data into the development of intervention strategies focused on improving coping strategies may be worthwhile.

Adaptation, Psychological↗

PubMed2002

Religious/spiritual coping in childhood cystic fibrosis: a qualitative study.

OBJECTIVE: To understand the role of religiousness/spirituality in coping in children with cystic fibrosis (CF). METHODS: Participants were a convenience sample of 23 patients with CF, ages 5 to 12 years, and their parent(s) in an ambulatory CF clinic. The design was a focused ethnography including in-depth interviews with children and parent(s), children's drawings, and self-administered written parental questionnaires. Analysis used grounded theory. RESULTS: Main outcome measures were participants' views on religion/spirituality in coping with illness. Data included 632 quotes organized into 257 codes categorized into 11 themes. One overarching domain emerged from analysis of the 11 themes: Religious/Spiritual Coping, composed of 11 religious/spiritual coping strategies. CONCLUSIONS: Children with CF reported a variety of religious/spiritual coping strategies they nearly always associated with adaptive health outcomes. A preliminary conceptual framework for religious/spiritual coping in children with CF is presented. More study is needed to assess how variability in age, disease type, disease severity, religious/spiritual preference, and religious/spiritual intensity affect religious/spiritual coping in children with chronic illness. Future studies should also investigate whether physician attention to religious/spiritual coping could assist patients in coping with CF and strengthen the doctor-patient relationship.

Adaptation, Psychological↗

PubMed1992

Stress buffering and glycemic control. The role of coping styles.

OBJECTIVE: To test the hypotheses that chronic psychosocial stress is associated with worse glycemic control and that coping moderates (buffers) this effect. RESEARCH DESIGN AND METHODS: Subjects consisted of 105 insulin-treated adults from the Diabetes Division of Henry Ford Hospital who filled out questionnaires on stress and coping and received an HbA1 test at a clinic appointment. Six coping styles were examined, including both emotion- and problem-focused styles. Two standardized stress inventories were administered. Ineffective coping was defined as scoring below the median for stress-dampening coping styles and above the median for stress-exacerbating styles. RESULTS: Stress was significantly (P less than 0.05) correlated with higher HbA1 in all but one ineffective coping subgroup. Conversely, none of 12 correlations between stress and glycemic control was significant in the effective coping subgroups. CONCLUSIONS: Chronic psychosocial stress is associated with worse glycemic control among those who do not cope effectively with stress. Effective coping can protect individuals from the deleterious effects of stress.

Adaptation, Psychological↗

PubMed1995

Coping style and preterm labor.

Psychometric tests (State-Trait Anxiety Index and Utrechtse Coping Lijst) were administered to 23 primigravidae hospitalized for preterm labor and to 22 controls in order to investigate whether women with and without preterm labor present a different coping style or (in) effectiveness of this coping and whether the coping style predicts duration of hospitalization and gestational age at delivery. No significant differences in trait anxiety nor in coping style were found between women with and women without preterm labor. However, within the group of women with preterm labor, coping mechanisms are important predictors of course and outcome of the preterm contractions. Palliative coping and social support seeking are protective mechanisms while active coping has an adverse effect upon outcome: an older gestational age at the moment of delivery is for 44% predicted by a higher social support seeking and a lower active coping.

Adaptation, Psychological↗

PubMed2003

What is coping? A critical review of the construct and its application in audiology.

The term 'coping' is increasingly used in audiology, in particular by researchers and clinicians interested in the psychosocial aspects of hearing disorders. Coping has been defined as the process of managing demands (external or internal) that are appraised as taxing or exceeding the resources of the person. It is seen as a process involving at least two stages: primary appraisal (is this something to bother about?), and secondary appraisal (what can I do about it?). It is proposed to serve two distinct purposes: to do away with the problem (i.e. problem-focused coping), and to regulate emotional reactions (emotion-focused coping). The following observations are made: (1) there is a lack of correspondence between what people in general mean by coping and how the concept is used in research; (2) coping is most often measured by checklists with questionable validity; (3) the outcome of using different coping strategies is largely unexplored; and (4) what is regarded as coping in some circumstances (e.g. telling about your hearing impairment) can become a problem in another situation, or even the same situation (e.g. stigma). Finally, some recommendations regarding the future use of the coping construct in audiology are made.

Adaptation, Psychological↗

PubMedDate not supplied

Coping during inpatient stroke rehabilitation: an exploratory study.

The emotional impact of surviving a stroke has not received the same attention as physical aspects. This is particularly true regarding how stroke survivors cope during inpatient rehabilitation. This study examined the coping strategies used by stroke survivors undergoing inpatient rehabilitation and the relationships between demographic or clinical variables and coping behaviors. This case series examined 16 acute stroke survivors via standardized assessments and a medical records review completed during the first week of inpatient rehabilitation. Stroke survivors used combinations of multiple coping strategies. All stroke survivors used a higher number and frequency of adaptive rather than maladaptive strategies. Women used a higher number of adaptive strategies. Stroke survivors with depression used maladaptive coping strategies more frequently, whereas those presenting with a greater number and severity of comorbidities used adaptive coping strategies more frequently. Stroke survivors with higher levels of coping self-efficacy used the strategies of active coping and positive reframing more frequently. Based on these results, it is recommended direct-care providers place greater emphasis on objectifying the emotional consequences of stroke. Further research is recommended regarding understanding the relationship between coping and outcomes.

Adaptation, Psychological↗

PubMedDate not supplied

Stress, job satisfaction, coping, and psychological distress among emergency medical technicians.

INTRODUCTION: Although several studies link job-related stressors with adverse reactions among emergency medical technicians (EMTs), more standardized research is needed, since much remains unknown about stress responses, coping styles and their consequences for EMTs. This paper presents the results of two studies. Study I investigated the relation between job-related stressors, job satisfaction, and psychological distress, while Study II investigated how coping is related to occupational burnout, job-related stress, and physiological arousal. HYPOTHESIS: Study I: Those EMTs experiencing greater job-related stressors are less satisfied with their jobs and more psychologically distressed. OBJECTIVE, STUDY II: To obtain preliminary information about which coping strategies are associated with greater feelings of stress and burnout and more intense autonomic nervous system reactivity. METHODS: For both studies, EMTs from a large, urban, public EMS organization in the southern United States were asked to participate. Study I: Subjects completed an informed consent document, a demographics questionnaire, a measure of job stress (the Stress Diagnosis Inventory), a measure of job satisfaction (Job-in-General), and a measure of psychological symptomatology (Symptom Checklist-90, Revised). Pearson product-moment correlations were computed between the measures. Study II: Subjects completed an informed consent document, a demographics/information sheet, the Maslach Burnout Inventory (MBI), and the Ways of Coping Scale (WOCS). They then completed 30 days of monitoring using the Daily Stress Inventory (DSI) and the Daily Autonomic Nervous System Response Inventory (DANSRI). Pearson product-moment correlations were computed between the measures. RESULTS: Study I: Those EMTs who experienced greater job-related stress also were significantly more dissatisfied with their jobs, more depressed, anxious, hostile, and endorsed greater global psychological distress. Study II: The Depersonalization subscale on the MBI correlated significantly with the following WOCS subscales: Accepting Responsibility, Confrontive Coping, Distancing, and Escape/Avoidance. Emotional Exhaustion on the MBI correlated significantly with Confrontive Coping, Escape/Avoidance, and Social Support, while data obtained on the 40 subjects who completed the daily monitoring revealed that DSI-Impact, DANSRI-Number, and DANSRI-Impact scores each correlated significantly with Accepting Responsibility, Confrontive Coping, and Escape/Avoidance. CONCLUSION: A significant portion of an EMT's job satisfaction and psychological well-being is associated with the degree to which they are experiencing job-related stress, and, furthermore, this distress level appears to be clinically elevated. This implies that in-service programs and psychological support services designed to help EMTs manage their job-related stress may improve job satisfaction and decrease psychological distress. The coping styles most consistently associated with maladaptive outcomes were: Accepting Responsibility, Confrontive Coping, and Escape/Avoidance. Thus, subjects who were more likely to handle stress with self-blame, aggression, hostility, and risk taking or with wishful thinking, escape tendencies, and avoidance were more likely to endorse more negative outcomes.

Adaptation, Psychological↗

PubMed1999

Quality of life in patients with human immunodeficiency virus infection: impact of social support, coping style and hopelessness.

We aimed to determine whether the quality of life (QOL) in the patients infected with human immunodeficiency virus (HIV) infection was influenced by satisfaction with social support, coping style and hopelessness. One hundred and thirty-eight HIV-infected patients were prospectively studied in this multicentre, longitudinal study. The QOL was assessed by Medical Outcome Study Health Survey SF-36, social support by Sarason Social Support Questionnaire, hopelessness by Beck Hopelessness Scale, and coping by Billing and Moos Inventory of coping with illness. The QOL did not correlate with age, sex, race, HIV risk factor, education or marital status. Employment (P = 0.0001), higher income (P = 0.03), satisfaction with social support (P = 0.04), regardless of the source of that support, and problem-focused coping (P = 0.03) were associated with a significantly better QOL, while, emotion-focused coping (r = -0.19, P = 0.04), avoidant coping (r = 0.40, P = 0.0001), hopelessness (r = -0.64, P = 0.0001) and AIDS (P = 0.09) were predictors of poorer QOL. Physical functioning correlated positively with employment (P = 0.0001), and inversely with AIDS (P = 0.0002), hopelessness (P = 0.03), avoidant coping (P = 0.03), and age (P = 0.10). At 6 months follow up, QOL score had changed in 20% of the patients; older age (P = 0.01), and lesser satisfaction with social support (P = 0.15) were associated with a decline in QOL, while adherence with antiretroviral therapy (P = 0.006) was associated with an increase in QOL score. Seven of 138 patients died during follow up; these patients had significantly lower QOL at baseline than all other patients (P = 0.003). Interventions to alleviate hopelessness, maladaptive coping, and enhancement of satisfaction with social support may improve overall QOL in HIV-infected patients. Older patients with HIV were less satisfied with their social support, were more likely to utilize unhealthy coping styles, and experienced a greater decline in QOL over time.

Adult↗

PubMed1999

Culture, coping, and context: primary and secondary control among Thai and American youth.

Do cultural values and traditions influence the development of coping styles ? To address this question, we compared self-reports of coping by 6-14-year-olds in Thailand and the U.S. One hundred and forty-one children were interviewed about six common stressors: separation from a friend, injection in a doctor's office, adult anger, peer animosity, school failure, and physical injury. Children's self-reported coping methods were coded as overt or covert. Coping goals were coded as reflecting primary control (attempts to influence objective conditions), secondary control (attempts to adjust oneself to objective conditions), or relinquished control. Although findings revealed numerous cross-national similarities, there were also multiple main and interaction effects involving culture, suggesting that sociocultural context may be critical to our understanding of child coping. Consistent with literature on Thai culture, Thai children reported more than twice as much covert coping as American children for stressors involving adult authority figures (i.e. adult anger, injection in doctor's office). Thai children also reported more secondary control goals than Americans when coping with separation, but American children were five times as likely as Thais to adopt secondary control goals for coping with injury. The findings support a model of coping development in which culture and stressor characteristics interact, with societal differences most likely to be found in situations where culture-specific norms become salient.

Adaptation, Psychological↗

PubMed1996

Monitoring anxiety levels and coping skills among military recruits.

Military training is a very stressful life event for many recruits. It is purposefully made so in order to prepare military personnel for the long, stress-filled hours of combat. It is a time when recruits are molded into stronger, more disciplined individuals. This study investigated the stress levels and coping skills of recruits during boot camp. The Undergraduate Stress Questionnaire, State-Trait Anxiety Inventory, and the Ways of Coping Questionnaire were distributed to 48 recruits during weeks 1, 5, and 8 of training. Results of the Undergraduate Stress Questionnaire indicated that the most stressful period was week 5. This was statistically significant (p < 0.001) compared to weeks 1 and 8. Results of the State-Trait Anxiety Inventory indicated that state anxiety was highest during week 1, and was statistically significantly higher (p < 0.05) compared to weeks 5 and 8. The Ways of Coping Questionnaire indicated that problem solving was the most frequently used coping skill, followed by self control and accepting responsibility. The least used coping skill was escape/avoidance. Conclusions to be drawn from this study suggest that weeks 1 and 5 are very stressful for the recruits; however, a majority of them coped adequately with the stress by employing effective coping mechanisms. Implications include enhancing effective coping mechanisms already in place. Recruits with ineffective coping skills require anticipatory guidance and close surveillance, with possible psychiatric intervention. Replication of this study with a greater number of subjects and female recruits is indicated, as are studies that correlate physical symptoms with stress levels.

Adaptation, Psychological↗