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Full-ceramic CAD/CIM anterior crowns and copings.

The purpose of the investigation was to examine the marginal and internal fit of Cerec anterior crowns and crown copings. The marginal and internal fit of Cerec anterior crowns (n = 18) and copings was examined on each of six anterior model tooth preparations, with different types of butt-margin crown preparation design on different teeth: 1.) straight flat (tooth 22), 2.) following the CEJ with mid-approximally steep curvature angles of 90 degrees mesial and 40 degrees distal (tooth 21) and 3.) same as 2, but with obtuse angles of 130 degrees and 150 degrees (tooth 41). The anterior crowns were machined on Cerec 2 units using Mark II ceramic (Vita), and the Cerec copings using In-Ceram Spinell (Vita). Laboratory slip-cast In-Ceram spinell anterior crown copings served as controls (n = 18). All reconstructions were seated (with adhesive) on the preparations, and the width of the marginal interface was measured circumferentially using SEM at 150x magnification. After cross-sectioning all samples in the bucco-oral direction, the internal fit was measured using this same technique. The marginal width of computer machined Cerec CAD/CIM anterior crowns (59.9 +/- 5.6 microns) was significantly (p < 0.01) lower than that of machined (73.4 +/- 12 microns) and slip-cast In-Ceram spinell copings (75.5 +/- 17 microns). The internal fit values of the slip-cast copings (94.1 +/- 20 microns) were significantly (p < 0.001) lower than those of the Cerec Mark II anterior crowns (141.3 +/- 21 microns) and copings (146.8 +/- 17 microns). Cerec CAD/CIM machined anterior full-ceramic crowns and copings showed excellent fit in comparison with slip-cast In-Ceram spinell copings. In terms of the marginal and internal fit, there were no significant differences (p > 0.05) between the different butt-margin preparation designs. Selected clinical cases demonstrate the high esthetics of anterior Cerec crowns.

Acrylates↗

[Uncertainty and anxiety in patients with initial attack of myocardial infarction: the effect of coping methods].

Myocardial infarction is a life threatening disease. Patients, especially those with a first time attack, experience a great deal of uncertainty and emotional disturbance which depend on the effectiveness of coping methods. Four questions were addressed in this study: (1) the degree and sources of uncertainty, (2) the coping methods used, (3) the degree of anxiety, (4) the relationship among uncertainty, coping methods and anxiety, and (5) the effect of coping methods on the relationship between uncertainty and coping methods. Fifty patients with first time attack in a teaching hospital participated this study. The instruments were Chinese versions of Mishel's Uncertainty in Illness Scale, the Revised Ways of Coping Check List and Spielberger's State Anxiety Inventory. The results showed that only 2% of patients experienced high uncertainty and 10% experienced anxiety; the average of uncertainty and anxiety were between sometimes and fairly often. "It is not clear what is going to happen to me" was the first source of uncertainty. The most often used coping method for these patients was seeking social support. Finally, the results showed that emotion-oriented coping had both positive main effect and mediating effect on the relationship between uncertainty of complexity and anxiety. The findings of this study suggest nurses should help patients utilize different coping methods, according to individual difference, in order to achieve optimal emotional state.

Adaptation, Psychological↗

[A study on the resources coping with occupational stress in teachers].

OBJECTIVE: To explore the status of the resources coping with occupational stress in teachers. METHODS: Occupational stress inventory revised edition (OSI-R) was used to measure their occupational stress, strain and psychological coping resources for 1,460 teachers in primary and secondary schools and 319 non-teacher intellectuals. Analyses were focused on coping resources of teachers. RESULTS: The higher the level of coping resource of teachers, the lower the personal strain in them, with an inverse correlationship. Coping resource in the teacher group was significantly higher than that in the non-teacher group, with scores of (130.4 +/- 18.2) and (126.9 +/- 19.1), respectively. Coping resource in teachers decreased with the increase of age, with the scores from (134.1 +/- 18.1) in the group aged less than 30 to (128.5 +/- 17.5) in the group aged 50. Coping resource in the female teachers was significantly higher than that in the male teachers, with scores of (131.4 +/- 18.3) and (129.4 +/- 18.1), respectively. Coping resource in the primary school teachers was significantly higher than that in the secondary school teachers, with scores of (132.7 +/- 18.1) and (128.5 +/- 18.1), respectively. CONCLUSION: It is important to enhance teacher's coping resource, especially for the male teachers in the secondary schools, for improving their teaching efficiency.

Adaptation, Psychological↗

The relationship between spontaneous coping strategies and perceived anxiety of patients undergoing cardiac catheterization.

Little is known about how patients spontaneously cope with the inherent stressors of the cardiac catheterization procedure. In this study, spontaneous coping strategies were identified and the relationship between coping strategies and anxiety throughout the procedure was examined. Data consisted of 62 patients' subjective ratings of anxiety, reported at 6 points during the procedure, and the coping strategies which were used at those times. The Coping with Invasive Medical Procedures (CIMP) Scoring System was developed and utilized to examine the relationships between coping and anxiety. At various points throughout the procedure, "control" and "hoping" were associated with high anxiety, while "passive coping" and "positive reframing" were associated with low anxiety. Patients who repeatedly changed coping strategies during the procedure experienced slightly less anxiety than those using a more consistent coping approach. The results are discussed with an emphasis on patient teaching.

Adaptation, Psychological↗

Titanium dental copings prepared by a powder metallurgy method: a preliminary report.

PURPOSE: The purpose of this study was to determine if the Procera pressed-powder method can be used to fabricate titanium copings. MATERIALS AND METHODS: Commercially pure titanium powder was used to prepare the copings. The powder was pressed onto an enlarged tooth preparation die of aluminum using cold isostatic pressing. The outer shape of the coping was formed using a Procera milling machine, and the copings were vacuum sintered. RESULTS: Titanium copings could be prepared using this method. The density of the sintered copings reached 97% to 99%+ of theoretic density, and the copings showed ductile behavior after sintering. Enlarging the tooth preparation die to compensate for the sintering shrinkage could optimize the final size of the copings. CONCLUSION: Ductile and dense titanium dental copings can be produced with powder-metal processing using cold isostatic pressing, followed by milling and sintering to final shape. The forming technique has, if properly optimized, a potential of becoming a more cost-efficient production method than spark erosion.

Cold Temperature↗

[The role of mother-child relationship in development of self-image, dysfunctional attitudes and coping strategies].

INTRODUCTION: Our study consisted of two interrelated work stages. In stage one, we set the goal to investigate coping styles and dysfunctional attitudes in patients with eating disorders. In stage two we studied the relationship between coping styles of the patients and mother-child interactional patterns, considering the role of communication in development of stress handling and problem management. PURPOSES: 1. Revealing characteristic coping patterns of the patients, comparing the coping styles to conrtrol subjects; 2. identifying dysfunctional attitudes in patients' thinking; 3. testing the hypothesis about existence of relationship between dysfunctional attitudes and coping; 4. finding out whether any dysfunctional attitudes or coping styles can be related to processes in mother-child communication. SUBJECTS: There were 28 participants in the first stage (9 subjects with anorexia nervosa, 10 subjects with bulimia nervosa and 9 control subjects). In stage two, 20 subjects (5 patients with anorexia, 5 with bulimia together with their mothers) were studied. METHODS: We used two questionnaires: Anxiety Handling Questionnaire and the Beck-Weissman Dysfunctional Attitudes Scale (DAS), shortened version. The Consensus Rorschach was administered in order to reveal interactional dynamics. In summary, 1769 code units were analyzed. RESULTS: Our subjects, primarily subjects with bulimia nervosa, used more self-punishing coping compared to control subjects. Dysfunctional attitudes were found to have an effect on coping style. The present results indicate some possibilities for explanation hov fragile self-image, dysfunctional attitudes and self-punishing coping patterns may develop in the patients as a possible effect of mother-child interaction dynamics.

Adaptation, Psychological↗

[Correlation between psychopathological symptoms, coping style in adolescent and childhood repeated physical, emotional maltreatment].

OBJECTIVE: To study possible relationship between psychopathological symptoms, positive and negative coping styles in adolescents who experienced repeated serious childhood physical abuse (CPA), moderate CPA, and childhood emotional abuse (CEA). METHODS: A total of 5453 students were recruited as subjects from 9 middle schools at grades 7, 8, 10, and 11. They provided informed consent and participated in the self-administered anonymous survey on their frequencies of serious or moderate physical abuse and emotional abuse by his/her parents or other caregivers about average times of experiencing maltreatment every year during primary school. The Symptoms Checklist 90 (SCL-90) was used to rate general mental problem and 9 special psychopathological symptoms. The trait positive and negative coping styles were assessed with the Trait Coping Style Questionnaire (TCSQ). Totally 5141 respondents substantially completed surveys. It was defined as repeating childhood maltreatment that the adolescent reported he/she had suffered 3 or more episodes of one or more forms of serious CPA, moderate CPA, and CEA. Multinomial logistic regression model was used to analyze the effect of the types and quantities of repeating childhood experiences on mental health when the positive, negative coping styles, and both of them entered the statistics model, taking the demographic variables as covariates. RESULTS: Of respondents, 9.1 percent were rated as having general mental health problem. The rates of somatization, obsession, interpersonal susceptivity, depression, anxiety, phobia, paranoia, and psychotic symptoms were 1.3%, 3.6%, 3.6%, 2.8%, 2.2%, 4.0%, 2.1%, 2.8% and 1.6%, respectively. Dose-response trend existed between the number of items of repeating serious CPA, moderate CPA, CEA, and rates of general mental problems, 9 kinds of psychopathological symptoms, number of positive items of psychopathological symptoms. Compared with the respondents without serious CPA, moderate CPA or CEA, those with repeating childhood maltreatment had higher scores of negative coping styles. In the respondents with repeating childhood maltreatments, the prevalence of general mental problems and number of positive psychopathological symptoms increased with the rising of scores of negative coping styles. The results from multinomial logistic regression analysis showed that negative coping style decreased the odds ratio (OR) of repeating serious CPA, moderate CPA, and CEA with general mental health problems, but positive coping style did not. CONCLUSIONS: The experiences of repeating childhood physical or emotional maltreatment are associated with a wide variety of psychopathological symptoms and general mental health problems. Negative coping strategies may moderate the links of childhood abusive experiences and mental problems.

Adaptation, Psychological↗

Loneliness and coping among tertiary-level adult cancer patients in the home.

This exploratory study measured the degree of loneliness experienced by adult cancer patients. All were in the initial phases of the illness, that is, currently receiving treatment consisting of either chemotherapy or radiation therapy on an outpatient basis and/or recuperating from surgery in the home setting. All were within 100 days of initial diagnosis of cancer. The UCLA Loneliness Scale by Peplau was used in measuring loneliness. In addition, the coping methods of this same group of patients were examined using the Jalowiec Coping Scale to determine predominant methods of coping with the situational crisis imposed by cancer diagnosis and treatment. The instruments were administered in the home or in an outpatient setting and patients were accessed through cancer treatment centers and from oncologists in the southern Illinois area. The study was conducted to determine the prevalence of loneliness, to identify predominant coping methods, and to discern the relationship, if any, between coping methods employed and the degree of loneliness reported by the adult cancer patients. The conceptual framework chosen for the study was taken from the work of Lazarus and Jalowiec with regard to coping; the work of Peplau, Russell, and Cutrone on loneliness formed the conceptual basis for the portion of the study regarding that dimension. A total of 41 cancer patients were surveyed--21 were male and 20 were female. The median age was 60 years, and the mean educational level was 10.5 years. There were significant differences found between loneliness scores by age categories and by marital status, as well as a relationship between membership in organizations and loneliness scores. There were significant relationships found between coping methods (confrontive, emotive, palliative) employed and the degree of loneliness experienced by these cancer patients. Coping methods were also ranked by frequency of use, and interesting patterns emerged--especially noteworthy were group findings regarding most- versus least-preferred methods. Based on the sample results of this small study, a profile of vulnerability emerges for the adult cancer patient within 100 days of diagnosis. Nursing interventions aimed at alleviating loneliness and facilitating positive coping are indicated, as well as the need for continued study with an expanded population.

Adaptation, Psychological↗

Nurses' perceptions of coping behaviors in hospitalized preschool children.

This study examined nurses' perceptions of coping in hospitalized preschool children. Thirty nurses were interviewed using a structured questionnaire and open-ended questions. Analysis included content analysis of the nurses' definitions of coping, strategies used to help children during stressful procedures, and classification of nurses' emotional responses to specific coping behaviors. The majority of nurses defined coping as an outcome, fewer than one third as a process, and none as a trait. Over 80% saw 21 of 40 coping behaviors as coping. Most of these included information-seeking, direct action, seeking help, and movement toward growth or independence. Behaviors that 80% or more of the nurses saw as coping elicited pleasant emotional responses; those that fewer than 50% saw as coping elicited unpleasant responses. Overall, the nurses described 10 types of strategies to help children cope. Only six nurses described more than five types. The clinical implications of these findings are discussed.

Adaptation, Psychological↗

Life stress and clinically elevated MMPI scales: gender differences in the moderating influence of coping.

Coping styles were evaluated as moderators of life stress-psychopathology relationships. Five hundred twenty-one undergraduates (271 females and 250 males) completed the Life Experiences Survey, the Coping Strategies Inventory, and the MMPI. To assess maladaptive coping styles, groups were constructed for each of 8 clinical scales (Hs, D, Hy, Pd, Pa, Pt, Sc, and Ma) composed of all subjects with a clinically significant elevation on that scale. The coping styles of these "clinical" groups were compared to the coping styles of "normal" groups, made up of subjects whose life stress scores were approximately the same but whose corresponding MMPI scale scores were within normal limits. To assess adaptive coping styles, a group of effective copers (with high life stress but normal MMPI profiles) was compared to a group of less effective copers (with high life stress but with at least one scale outside of normal limits). All groups were constructed separately for gender. The predicted gender differences and specific coping style-psychopathology relationships were, by and large, found. Coping style differences between the effective and less effective copers were also found. These findings suggest that several coping styles are important moderators of life event stress-psychopathology relationships.

Adaptation, Psychological↗

Self-efficacy, coping, and well-being among nursing students sexually abused in childhood.

Preparing nursing students to work with sexually abused children has received little attention by pediatric nurse educators. These students often are themselves survivors of such abuse. The population of undergraduate nursing students attending a major university was invited to participate in a mailed survey to test hypotheses concerning differences in self-efficacy, coping, and well-being between subjects who were sexually abused in childhood and those who were not. A total of 87 students (79 women and 8 men) responded by returning the completed survey. Forty-seven percent of the women (n = 37) and 38% of the men (n = 3) in the sample reported having had one or more unwanted sexual experiences in childhood. Significant correlations were found between self-efficacy and confrontive coping (r = .58), emotive coping (r = .49), and palliative coping (r = -.46); between well-being and emotive coping (r = -.24); and between well-being and palliative coping (r = -.25). One-way analysis of variance (ANOVA) techniques were used to analyze differences in self-efficacy, coping (confrontive, emotive, and palliative), and well-being between the two groups (abused = 40 and not abused = 47). A significant difference in emotive coping was found. These findings suggest that nurse educators and administrators need to be sensitive to pediatric nurses' childhood sexual experiences. Such nurses must be knowledgeable and emotionally equipped to support the child and family through the process of recovery. It is important for them to be aware of how their own coping strategies and well-being affect the care they provide vulnerable children.

Adaptation, Psychological↗

[Coping with occupational stresses in health professions].

A model of coping with job stressors is presented, whereby the mediating effect of coping always is goal directed. There exists a variety of stressors in health professions which call for flexible adaptation. Results of studies by this author on coping with job stressors in nursing and dentists are presented. Coping strategies of nurses are not always optimal: in factor analysis coping by will and problem solving was followed by social support; less favourable is diversion and compensation by consumption, fatalistic-depressed withdrawal or aggressive acting out. Religions support seems to be especially helpful in a subgroup. Job satisfaction remains high (80% satisfied), with progressive satisfaction going with little stress values, but poor satisfaction with high stress. In the coping process of doctors and dentists there is a better correspondence between stressors and coping strategies. Quite in contrast to the rich literature on stressors there are few studies on coping of healthcare professionals, so that it is difficult to derive general conclusions. Nevertheless, based on qualitative analysis (repertory grid by Kelly) certain typical patterns were elaborated like "manager; denier; pleaser; problem seeker". Finally intervention strategies to improve coping of health professionals are reviewed.

Adaptation, Psychological↗

Coping strategies and styles of hemodialysis patients by gender.

OBJECTIVE: The purpose of this study was to examine the relationship of gender to coping strategies of patients on hemodialysis. DESIGN: Nonexperimental, retrospective. SAMPLE/SETTING: A stratified random sample of 15 male and 15 female hemodialysis subjects was obtained from two privately owned outpatient hemodialysis centers in North Carolina. METHOD: All subjects completed a demographic data form and the Jalowiec Coping Scle. A t-test was performed on the overall mean scores for the total coping scale. RESULTS: There was not a statistically significant difference between gender and coping strategies of patients on hemodialysis. However, the data suggest that male and female hemodialysis patients predominately used emotion-focused coping strategies. Patients on hemodialysis less than 8 years, between the ages of 50 and 60, and who had an educational level less than twelfth grade, used more emotion-focused coping strategies. CONCLUSIONS: No significant difference was noted between the overall coping scores for men and women. The variables of length of time on hemodialysis, age, and education could have an education on the choice of coping strategies and coping scores for men and women.

Adaptation, Psychological↗

Nurse-led attribution remodeling training based on the Neuman systems model to enhance resilience, adaptive coping, and attributional style in women newly diagnosed with breast cancer: A randomized controlled trial.

BACKGROUND: Psychological interventions for patients with breast cancer often overlook the critical role of maladaptive attributional style in shaping their adjustment. Therefore, the need for theory-driven, scalable interventions that target cognitive restructuring, particularly during the vulnerable post-diagnosis period, is clear. OBJECTIVE: To evaluate the effectiveness of a nurse-led attribution remodeling training intervention grounded in the Neuman systems model for improving resilience, adaptive coping, and attributional style among women newly diagnosed with breast cancer. DESIGN: A randomized controlled trial. SETTING: A tertiary general hospital. PARTICIPANTS: A total of 130 eligible women newly diagnosed with breast cancer were recruited between March and November 2024. METHODS: A two-arm parallel-group randomized controlled trial was conducted. Participants were randomly assigned to receive either attribution remodeling training plus routine nursing (n&#xa0;=&#xa0;65) or routine nursing only (n&#xa0;=&#xa0;65). The nurse-led attribution remodeling training intervention, delivered via a blended model of in-person sessions and continued support through the WeChat mobile platform, was designed to systematically reshape maladaptive attributions into more adaptive ones. Resilience (primary indicator), coping strategy (i.e., confrontation, avoidance, resignation), and attributional style (secondary indicators) were assessed at baseline and at 1, 3, and 6&#xa0;months post-baseline. A linear mixed model was used to analyze the effects of group, time, and group-by-time interactions. Effect sizes (Cohen's D) were calculated based on the means and standard deviations. RESULTS: At the 6-month follow-up, the intervention group had better outcomes than the control group in terms of resilience (mean difference: 1.49, 95% confidence interval: 0.37, 2.61), confrontation coping (3.35 [2.33, 4.37]), and adaptive attributional style (4.16 [3.87, 4.45]). Avoidance coping showed a small increase (0.82 [0.22, 1.42]), whereas resignation coping decreased (-1.66 [-2.49, -0.83]). Group effects and group-by-time interactions were statistically significant for all outcomes. Effect sizes at 6&#xa0;months ranged from small for resilience (D&#xa0;=&#xa0;0.28) and avoidance coping (D&#xa0;=&#xa0;0.26) to moderate for confrontation coping (D&#xa0;=&#xa0;0.60) and resignation coping reduction (D&#xa0;=&#xa0;-0.51), and large for attributional style (D&#xa0;=&#xa0;0.94). CONCLUSIONS: Attribution remodeling training is a promising and effective theory-based intervention that can enhance psychological adaptation in women newly diagnosed with breast cancer. By strengthening key defense mechanisms, as conceptualized by the Neuman systems model, the program is effective, scalable, and nurse-deliverable for psycho-oncology care, bridging a critical gap in supportive cancer care and empowering nurses as primary psychological support providers. REGISTRATION: ChiCTR2000031827, registered prospectively on April 11, 2020, www.Chictr.or.cn.

Humans↗

Perceived self-efficacy and outcome expectancies in coping with chronic low back pain.

The purposes of this study were to explore the coping strategies used by patients with chronic low back pain, to test hypothesized mediators of the relationship between self-efficacy and pain outcomes, and to determine the roles of self-efficacy and outcome expectancies in coping with pain in patients (N = 85) with chronic low back pain. The most common coping behaviors were reporting pain, using pain medications, and coping self-statements. Patients' self-efficacy to cope with pain was inversely correlated with pain intensity. Self-efficacy was positively correlated with perseverance of coping effort. Perseverance of coping effort was found to mediate the effects of self-efficacy on pain outcomes; however, level of distress was not found to be a mediator. Outcome expectancies were positively correlated with perseverance of coping effort. These findings are discussed in terms of implications for practice and directions for future research.

Adaptation, Psychological↗

Dimensions of coping that contribute to psychopathology.

In an attempt to clarify the components of coping that relate to psychopathology, this study evaluated the simultaneous contribution of coping ability and coping actually executed, as well as the independent contribution of each, to psychopathology. Ninety female college students served as the primary sample, while an additional sample of 90 female college students served as the cross-validation sample. Each subject completed the MMPI and two versions of the Ways of Coping Checklist. Findings suggest that, while coping actually executed and coping ability show substantial overlap, both components of coping independently contribute unique variance to psychopathology. Implications for coping research and theory are discussed.

Adaptation, Psychological↗

Spouse-assisted coping skills training in the management of knee pain in osteoarthritis: long-term followup results.

OBJECTIVE: To evaluate the long-term effects of a spouse-assisted coping skills intervention in patients with osteoarthritis (OA) of the knees, and to evaluate how pre- to posttreatment changes in marital adjustment and self-efficacy relate to long-term improvements in pain, psychological disability, physical disability, pain coping, and pain behavior. METHODS: A followup study was conducted with 88 OA patients who had been randomly assigned to 1 of 3 treatment conditions: 1) spouse-assisted coping skills training (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement, and 3) an arthritis education-spousal support (AE-SS) control condition. To evaluate long-term outcome, comprehensive measures of self-efficacy, marital adjustment, pain, psychological disability, physical disability, pain coping, and pain behavior were collected from these individuals at 6 and 12 months posttreatment. RESULTS: Data analysis revealed that, at 6-month followup, patients in the spouse-assisted CST condition scored higher on measures of coping and self-efficacy than those in the AE-SS control group. At 6-month followup, patients who received CST without spouse involvement showed a significantly higher frequency of coping attempts and reported higher levels of marital adjustment than those in the AE-SS control group. At 12-month followup, patients in the spouse-assisted CST condition had significantly higher overall self-efficacy than those in the AE-SS control condition. In addition, patients in both the spouse-assisted CST and CST only conditions tended to show improvements in physical disability at the 12-month followup. Individual differences in outcome were noted at the 12-month followup. Patients in the spouse-assisted CST condition who reported initial (pre- to posttreatment) increases in marital adjustment had lower levels of psychological disability, physical disability, and pain behavior at 12-month followup. However, for patients in the conventional CST and AE-SS control conditions, increases in marital adjustment occurring over the initial phase of treatment were related to increases in pain and decreases in scores on the Pain Control in Rational Thinking factor of the Coping Strategies Questionnaire. Finally, patients in the spouse-assisted CST condition who showed pre- to posttreatment increases in self-efficacy were more likely to show decreases in pain, psychological disability, and physical disability at 12-month followup. CONCLUSIONS: These findings suggest that spouse-assisted CST can enhance self-efficacy and improve the coping abilities of OA patients in the long term. Individual differences in the long-term outcome of spouse-assisted CST were noted, with some patients (those showing increases in marital satisfaction and self-efficacy) showing much better outcomes than others.

Activities of Daily Living↗

Effects of a coping intervention on patients with rheumatic diseases: results of a randomized controlled trial.

OBJECTIVE: To test the effects (on coping, social interactions, loneliness, functional health status, and life satisfaction) of an intervention aimed at teaching people with rheumatic diseases to cope actively with their problems. METHODS: A total of 168 patients with chronic rheumatic disorders affecting the joints were randomly assigned to a coping intervention group, a mutual support control group, or a waiting list control group. Measurements were by self-report questionnaires. RESULTS: Post-intervention measurements showed that the coping intervention increased action-directed coping and functional health status, but these effects did not persist up to 6-months followup. In patients who attended at least half of the 10 sessions, the coping intervention contributed to decreased loneliness at post-intervention and to improvements in social interactions and life satisfaction at 6-months followup. CONCLUSION: Teaching patients with rheumatic diseases to cope actively with their problems had positive impacts. Consequently it is recommended that the coping intervention be incorporated into regular care. Maintenance sessions are advisable.

Adaptation, Psychological↗