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Stability and change in patterns of coping with Parkinson's disease.

This study examined how Parkinson's disease patients cope with disease-related stressors over time. Of interest was whether patterns of coping would support a dispositional model of coping (i.e., stability) or a contextual model of coping (i.e., change). The influence of stability and change in coping on mental and physical health outcomes was also examined. As expected, results showed that as the disease progressed, severity and distress increased and quality of life decreased. There was no change overall in the symptoms perceived as most stressful or the coping strategies employed to manage them. However, stability within individuals was associated with poorer mental and physical outcomes, whereas change in coping strategies was associated with more optimal outcomes. Evidence supporting both models of coping was found, and the potential applications of these findings for psychosocial intervention are discussed.

Activities of Daily Living↗

Religious coping, health, and health service use among bereaved adults.

OBJECTIVE: This report examined associations between religious coping, health, and health service use among a sample of 265 recently bereaved adults. METHOD: Participants were interviewed an average of 6.3 (SD = 7.4) months after their loss and again 4 months later. Multivariate regression models and repeated measures ANOVA analyses estimated the influence of religious coping on health and health service use at baseline and follow-up, controlling for significant confounding influences, such as health promoting behaviors. RESULTS: At baseline, those high on religious coping had significantly more functional disabilities than did those low on religious coping. Controlling for health status, participants with higher religious coping scores were significantly less likely to visit their doctor during the 60 days prior to the baseline interview. Despite worse health and less health service use at baseline, those high on religious coping had equivalent health status to those low on religious coping at follow-up. CONCLUSIONS: Greater use of religious coping is associated with more functional disabilities and fewer outpatient physical health care visits at baseline, but a lack of decline in health at 4-month follow-up among the bereaved, a sub-group at risk for numerous health impairments. Possible reasons for this association and its implications are discussed.

Adaptation, Psychological↗

The coping styles of adolescents with type 1 diabetes are associated with degree of metabolic control.

OBJECTIVE: To systematically study the various coping styles in a population-based sample of adolescents with type 1 diabetes, exploring the association of different coping styles with metabolic control and adolescent self-reported diabetes-related quality of life. RESEARCH DESIGN AND METHODS: Of a total population of 116 adolescents with type 1 diabetes (age 13-18 years), 103 (89%) participated in the study, completing a questionnaire to obtain information on coping styles and perception of diabetes-specific quality of life. The mean age (+/-SD) was 14.9 +/- 1.6 years, diabetes duration 7.1 +/- 3.8 years, HbA(1c) 9.4 +/- 1.6%, and male-to-female ratio 52:51. RESULTS: There was a significant correlation between higher HbA(1c) values and higher degree of mental (r = 0.25, P < 0.05) and behavioral (r = 0.33, P < 0.01) disengagement and aggressive coping (r = 0.33, P < 0.01). Stepwise multiple regression analyses indicated that greater use of aggressive coping (P < 0.05) and behavioral disengagement (P < 0.05) were significantly related to increase in HbA(1c). Greater use of active coping (P < 0.05) was significantly related to a decrease in HbA(1c). Partial correlation analysis showed that lower scores on diabetes-specific quality of life were significantly related to greater use of emotion-focused coping (r = -0.22 to -0.49). Stepwise multiple regression analyses showed that greater use of mental disengagement was significantly related to lower degree of perceived diabetes-related impact. CONCLUSIONS: Poor metabolic control and lower degree of diabetes-related quality of life are associated with greater use of emotion-focused coping in adolescents with type 1 diabetes.

Adaptation, Psychological↗

Psychological and physical variables as predictors of coping strategies.

26 women and 17 men between the ages of 26 and 62 yr. of age and diagnosed as having chronic illnesses were administered four questionnaires to assess physical and psychological variables and coping strategies: the Sickness Impact Profile, the Time Reference Inventory, and the Multidimensional Health Locus of Control. The Jaloweic Coping Scale assessed coping strategies. Canonical correlation indicated a single-factor link (Wilks' lambda) between scores on the first 3 tests, and the subscales of the coping scale. A significant but small correlation of .31 between the Multidimensional Health Locus of Control subscale, Powerful Others, and the coping subscale of Emotion-focused strategies was observed, that with the subscale Chance and the coping subscale confrontive strategies was negative. A second canonical correlation deleting the Time Reference Inventory score of age extension and including the three Sickness Impact Profile subscales was significant and positive for the Composite score and the subscale Palliative of the Jaloweic Coping Scale. Such data suggest that individuals who have a locus of control orientation of Powerful Others respond to chronic illness with emotionally based behaviors. In addition, chronically ill individuals who are physically dysfunctional tend to respond with palliative coping strategies.

Activities of Daily Living↗

Coping and culture: a research note on Diaz-Guerrero's theory.

Diaz-Guerrero hypothesized in 1967 that Anglo-Americans differed from Mexicans along a dimension of active versus passive coping styles. Specifically, he thought Anglo-Americans preferred to engage in other-modifications (active coping) whereas Mexicans preferred to engage in self-modifications (passive coping) in response to stressful events. In a test of Diaz-Guerrero's proposal the Coping Orientations to Problems Experienced was given to 108 Anglo- and Hispanic-American female inmates; no differences between the groups were found on measures of active and passive coping. The Hispanic group did not differ on active or passive coping as a function of measured acculturation; however, for both groups, education and active coping mildly correlated, suggesting that socioeconomic status may be more related to active coping than culture.

Acculturation↗

Review of adolescent coping research: representation of key demographic variables and methodological approaches to assessment.

Stressful experiences can be traced to surrounding social structures, the most encompassing of which include gender, socioeconomic status (SES), and race. An integrative review of adolescent coping research was conducted to examine the inclusion of key demographic variables and methodological approaches to the assessment of coping. Results indicated that the majority of studies investigated coping among both gender groups. However, only 46.7% reported information on SES. Coping among adolescents of lower SES and the inner city was not adequately examined. Similarly, only 53% of the studies reported information on racial composition. African-American and other minority adolescents were underrepresented in the research. To assess coping, 73.3% of the studies utilized the questionnaire format. However, instruments were not used in a consistent manner with regard to the period of time from which to recall a stressor and the context from which the stressor was selected. For those using the open-ended format for assessment, data were analyzed exclusively via the deductive approach. Our findings suggest that future research should (a) investigate coping among youth from diverse SES and racial groups, (b) examine coping over a full range of stressors, (c) utilize daily reports, and (d) assess coping by applying qualitative methods.

Adaptation, Psychological↗

[The cause-effect relationship between coping and psychological/physical symptoms].

This research was conducted to explore the cause-effect relationship between coping and adaptational outcomes. Cognitive behavior therapy was employed to change coping styles. During a 4-week period, 10 subjects were treated with methods of relaxation as an active-coping skill (RCT) and problem-solving training (PST), while 10 subjects served as a waiting list control. Coping scale scores measured by the revised Ways of Coping Checklist and psychological/physical symptom levels were obtained before and after the treatments, and also after a follow-up period of 14 months. The subjects treated with RCT and PST showed significant reductions in symptoms as well as significant increases in problem-focused coping both after the treatment and at the follow-up measurement. The control group did not show any significant change in symptoms and coping. The results indicate that RCT and PST are effective in changing tangible coping styles and, therefore, in reducing psychological/physical symptoms.

Adaptation, Psychological↗

Behavioral coping and physical functioning: the effect of adjusting the level of activity on observed dexterity.

OBJECTIVE: To assess the relationship between behavioral coping and dexterity in rheumatoid arthritis (RA) after controlling for disease activity, impairment of the hands, and pain. METHODS: A random sample of 109 patients with RA was assessed twice within one year. Dexterity, disease activity, and impairment of the hands were measured using observational methods. Pain and coping with RA were assessed using self-report instruments. RESULTS: Correlational findings showed that "decreasing activity" to cope with pain was negatively related to dexterity. "Pacing" as a way of coping with limitations was positively related to dexterity. Both relations were significant after controlling for duration of disease, impairment of hands, disease activity, and pain. "Decreasing activity" as a way of coping with pain was related to a decrease in dexterity in the subsequent year, after controlling for baseline measurements of dexterity, impairment, and disease activity as well as measurements of current disease activity and pain. "Pacing" as a way of coping with limitations was unrelated to subsequent changes in dexterity, after controlling for the above mentioned variables. CONCLUSION: Behaviorial coping is related to current and subsequent levels of dexterity. Therefore, it is concluded that more attention should be given to behaviorial coping in both research and clinical practice.

Adaptation, Psychological↗

Will I make it through this choppy water? A psychological characteristic as a predeterminant factor to coping with multiple sclerosis.

The ability to cope with major stressors and adversity in our lives is as individual as the human experience. An unpredictable disease such as Multiple Sclerosis (MS) can demand major adjustments to one's lifestyle, employment, and personal relationships. Why is it that some sail smoothly through major upheaval in all of these realms despite the acquisition of significant physical disability while others are immobilized by seemingly trivial disruptions in their routine. How can we, as health professionals, assist those who are coping in a non-adaptive manner, to identify and implement more effective strategies. Does focused counseling early in the disease promote effective coping? Existing literature reviews coping with chronic illness, detailing the tools and strategies which individuals may use to manage stressors. This paper will build on this foundation of knowledge. How well you are determines how well you cope. The emphasis will be on "premorbid" personality traits which may be critical to coping. The author will critically examine the practicality of utilizing existing assessment tools for those at differing stages of MS and offer assessment guidelines for nurses working both with newly diagnosed and well-established disease. Suggestions for counseling techniques which may promote effective coping behaviors will be offered. How an individual copes with a chronic illness such as MS has implications for that person's family, social network and society at large. Those who become overwhelmed by a disease such as MS will stop working earlier, utilize more healthcare resources, and rate themselves as having poor quality of life. Nurses and other health professionals who have regular contact with those with MS may be able to influence this scenario.

Adaptation, Psychological↗

Coping strategies of HIV-positive and HIV-negative female injection drug users: a longitudinal study.

This study longitudinally examined the psychosocial correlates of coping strategies among 165 HIV positive and 179 HIV negative female injection drug users (IDUs). Participants were interviewed twice using a structured questionnaire, with a 6-month interval between interviews. The questionnaire included psychosocial measures as well as measures of general coping and specific HIV-related coping. Data were analyzed using logistic regression analyses. The findings indicated that favorable factors in the psychosocial domains at Time 1 were significantly associated with an increased likelihood at Time 2 of the use of general coping and specific adaptive coping strategies, such as problem solving and seeking social support, and with a decreased likelihood at Time 2 of the use of maladaptive coping strategies, such as aggression and the use of illicit drugs. These findings highlight particular areas of psychosocial functioning that can be targeted by intervention programs to promote adaptive coping and minimize maladaptive coping among HIV positive and HIV negative female IDUs.

Adaptation, Psychological↗

[Snacking behavior among elementary and junior high school students and its relationship to stress-coping].

The aim of the present study was to investigate current problems of snacking behavior and their relationship to stress coping among 1,486 fourth through ninth grade students from 10 elementary schools and six junior high schools. An anonymous self-completed questionnaire was utilized which included items about 1) selection of snack foods, which were classified into healthy, popular, complementary and western-style snacks, 2) problems of snacking behavior, which included external and emotional eating scores, and 3) stress coping scale. The stress coping scale contained two sub-scales; problem-focused and emotion-focused coping. The results were as follows: 1) Students who frequently went without breakfast did not select healthy foods, i.e., fruits and dairy products, but popular snacks, i.e., potato chips, pop corn and sweet beverage. 2) Both external and emotional eating scores increased by age in girls but was not apparent in boys. 3) Students who preferred either western-style or popular snacks showed higher score of external and emotional eating. 4) The score of problem-focused coping was positively correlated with preference for health snacks, but emotion-focused coping was positively correlated with external and emotional eating scores. The close relationship between snack food selection and problematic aspects of eating behavior suggests that modification of eating behavior is necessary to develop healthy snack habits in early adolescents. Also, it is interesting that snacking behavior is closely related to stress coping, which suggested the behavioral intervention for healthy eating habit should be included in development of stress-coping skills against various kinds of demands in life.

Adaptation, Psychological↗

Coping strategies of female adolescents with HIV/AIDS.

This descriptive study was designed to assess coping strategies of female adolescents infected with Human Immunodeficiency Virus (HIV) or the Acquired Immunodeficiency Syndrome (AIDS) (N = 30). Results from the Adolescent Coping Orientation for Problem Experiences Questionnaire (ACOPES) revealed that the most often utilized coping strategies identified by the adolescents were: listening to music, thinking about good things, making your own decisions, being close to someone you care about, sleeping, trying on your own to deal with problems, eating, watching television, daydreaming and praying. The adolescents also reported low utilization of certain maladaptive coping strategies such as alcohol and illicit drug usage. Chronic illnesses such as HIV, cancer and diabetes are difficult for adolescents because of the unique developmental tasks needed to understand the psychological and social impact caused by chronic illnesses. The research presented illustrates the complexities of stress and the effects of coping on psychological well-being, health behavior, and health. This research explores specific coping strategies used by HIV-infected adolescents. Findings provided baseline data of the various coping strategies of female adolescents infected with HIV in an outpatient setting. These findings may serve as a foundation for future studies on coping strategies among females infected with HIV. Furthermore, the findings may also be useful in developing an outpatient behavior-modification/coping effectiveness training program that is both gender-specific and culturally appropriate.

Adaptation, Psychological↗

Parental coping and activities during pediatric critical care.

OBJECTIVE: To investigate the relationship of locus of control, parental age, and state anxiety to parental coping and activities performed during hospitalization of a child in a pediatric critical care center. DESIGN: Cross-sectional. SETTING: Pediatric critical care center at a university medical center. PARTICIPANTS: A convenience sample of 47 parents of 47 children hospitalized in a critical care center. MAIN OUTCOME MEASURES: Parental coping strategies and activities performed during hospitalization in a critical care center. RESULTS: Older, more self-directed and less anxious parents were found to use coping strategies focusing on problem solving rather than on their emotional response to a child's hospitalization. Further, those who used the problem-focused coping modes were more likely to be involved in caring for the child, while parents who used emotion-focused coping modes participated less in care activities. CONCLUSIONS: Appropriate strategies to bolster coping and reduce stress of parents need to be constantly reassessed because coping mechanisms vary according to parental age, locus of control, anxiety level, and parental involvement in child-care activities. More research is needed in the changes of parental coping mechanisms with time and child-care activity, to assess the benefits of interventions planned to encourage a problem-focused approach.

Adaptation, Psychological↗

Perceived stress and coping strategies among families of cardiac transplant candidates during the organ waiting period.

OBJECTIVE: To explore and describe perceived stress and coping strategies among families of candidates for cardiac transplant during the organ waiting period. DESIGN: This descriptive, multiinstitutional study was guided by the T-Double ABCX Model of Family Adjustment and Adaptation (McCubbin & Thompson, 1987). SETTING: Five tertiary care centers with transplant programs in three Southeastern cities. SUBJECTS: Thirty-eight family members of patients on the active list for cardiac transplantation, including 35 women and three men with a mean age of 44 years (SD = 13.17). Subjects had a family member on the waiting list for a mean of 6.5 months. INSTRUMENTS: Family members completed the following three instruments: (1) Family Inventory of Life Events and Changes (FILE), (2) Family Crisis Oriented Personal Scale (FCOPES), and (3) Family Perception of the Transplant Experience Scale (FPTES). RESULTS: Stress: 53% and 47% of respondents indicated that they were experiencing moderate and low degrees of stress, respectively. Coping: Family members used more coping mechanisms than normative subjects in the literature. Coping strategies used in order of decreasing frequency: (1) knowing our family has the strength to solve our problems, (2) facing problems head-on, and (3) seeking support from friends. Appraisal: Mean score of 32.13 reflects subjects' positive perception of the pretransplant experience. The three statements with which the subjects most strongly agreed: (1) heart illness has changed roles of family members, (2) family member will survive the transplant operation; and (3) this is an experience that could bring out the family's strengths. CONCLUSIONS: An increase in the number of coping strategies used with low to moderate stress levels suggests the effectiveness of coping strategies in mediating stress. The preference for active rather than passive coping strategies may be reflective of the selection criteria for transplant candidates or nursing interventions during this period to minimize stress and promote family coping.

Adaptation, Psychological↗

[The relationship between hardiness, coping strategies and burnout in psychiatric nurses].

Hardiness is a personality trait in which the ability to buffer the health related effects of stress is inherent. It has been frequently and enthusiastically investigated in connection with human health. In order to understand hardiness in psychiatric nurses, to prevent burnout, and to enhance the quality of nursing care, this study sought to investigate the relationships between hardiness, burnout and quality of nursing care. One hundred and forty-seven psychiatric nurses were selected in a stratified random sample from the psychiatric units of district hospitals in Taipei City. Data were collected through structured questionnaires and concerned: (1) demographic variables, (2) the Health Related Hardiness Scale, (3) the Jalowiec Coping Scale, and (4) the Maslach Burnout Inventory. The main results indicated that: (1) Most respondents enjoyed high levels of hardiness (M = 157.84, SD = 18.42); (2) Respondents' levels of hardiness were positively correlated to the use of confrontational coping styles, optimistic coping styles, supportive coping styles and self-reliant coping styles; (3) Levels of hardiness were negatively correlated to emotional exhaustion but positively correlated to personal accomplishment; (4) There was a significantly positive correlation between the evasive coping style and emotional exhaustion; (5) The confrontational, optimistic and self-reliant coping styles were positively correlated to personal accomplishment. The findings of this study should contribute to our understanding of the relationship between hardiness, coping strategies and burnout in psychiatric nurses.

Adaptation, Psychological↗

Development and psychometric testing of the coping with breast cancer threat instrument.

Women with a positive family history of breast cancer have a higher relative breast cancer risk. Research pertinent to this "at-risk" population has focused primarily on the early detection measures of breast self-exam, clinical breast exam, and mammography. Other specific primary prevention coping behaviors have received little research attention and, while there are instruments that measure general coping behaviors in the face of illness threat, there are no known instruments that measure coping behaviors specific to dealing with breast cancer threat. This study tested the psychometric properties of the Coping with Breast Cancer Threat instrument (CBCT). The CBCT was designed to measure primary prevention and early detection coping strategies used by women with family histories of breast cancer in response to their appraised breast cancer threat. The tool's format was modeled after the Jalowiec Coping Scale (JCS) and included use and effectiveness scales. Internal consistency reliabilities and content and construct validity of the CBCT were assessed in a sample of 209 women with a family history of breast cancer. Alpha coefficients for the CBCT's total use and effectiveness scales were .70 and .76, respectively. Principal components factor analysis with a varimax rotation revealed three conceptually relevant subcales that accounted for 52% of the variance in breast cancer threat coping behaviors. The CBCT was shown to be a reliable and valid measure of coping with breast cancer threat in a well-educated, European Amercian sample of middle-aged women.

Adaptation, Psychological↗

[Mental health status and coping strategies of dementia patients' caregivers of diverse ethnicities: a cross-cultural study].

OBJECTIVE: To explore the relationship between the mental health status and coping strategies among the dementia patients' caregivers of diverse ethnicities. METHODS: A survey of questionnaire, including sub-questionnaires related to the perceived living ability and cognitive damage, activities of daily living, instrumental activities of daily living, of the patients, and the mental health, coping strategies, and depression status of the CGs, was conducted among 121 caregivers (CGs) of dementia patients in the US, including 4 ethnicities: Chinese-Americans (CN, n = 29), African-Americans (BK, n = 29), Caucasians (WT, n = 32), and Latinos (LT, n = 31). RESULTS: The primary CGs were daughters in the BK, WT, and LT groups, while the spouses, sons, and daughters shared the caregiving role in the CN group. No significant difference in depression status and health status and physical and mental health were detected among the 4 groups (all P < 0.05). The CGs of different ethnicities origins presented different coping strategies. The subtotal scores of accepting the current situation and seeking for positive profiles were significantly different among the 4 ethnic groups with BK > WT > LT > CN (all P < 0.05). Regression analysis suggested that the CGs' depression status was associated with the background characteristics of the CGs and the care receivers and the coping strategies of the CGs were cross-ethnic differences of coping patterns relevant to the CGs' depressive experiences. CONCLUSION: Mental health status is associated with the coping strategies among the dementia patients' CGs, and there is cross-ethnic difference of coping strategies relevant to the CGs' depressive experience. Culturally appropriate training on coping strategies and care service is needed to improve the quality of care and quality of life for the dementia patients and their caregivers.

Activities of Daily Living↗

Changes in coping style following traumatic brain injury and their relationship to productivity status.

The use of maladaptive coping strategies following traumatic brain injury (TBI) is known to be associated with increased depression and a lower productivity status. What is not known is whether coping behaviours change following TBI and if they do change whether these changes account for significant variance in outcome. Seventy-three significant others of TBI survivors were recruited at the time their friend/family member was injured and followed prospectively. They reported on their friend/family member's pre-injury and 6-month coping behaviours using the Coping with Health Injuries and Problems Scale. The use of emotional pre-occupation coping (p = .02) increased significantly and approached significance for distraction coping(p = .08). These changes in coping also accounted for significant variance (22%, p = .02) in productivity status over and above that accounted for by demographics and injury severity. Whether maladaptive coping changes can be prevented with a view to improving outcomes is a question that now needs to be explored.

Adaptation, Psychological↗