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PubMedDate not supplied

Moderating effects of coping on the relationship between stress and the development of new brain lesions in multiple sclerosis.

OBJECTIVE: Many patients with multiple sclerosis (MS) report that stress can trigger disease exacerbations. Considerable research has supported a relationship between stress and both clinical exacerbation and the development of new brain lesions. However, these relationships are not always consistent either within patients or across patients, suggesting the presence of moderators. This study examined the hypothesis that coping moderates the subsequent relationship between stress and the development of new brain lesions in MS. METHODS: Thirty-six patients (mean age = 44.4; 22 women, 14 men) with relapsing forms of MS were assessed once every 4 weeks for 28-100 weeks. New brain lesions were identified using monthly Gd+ MRI. Stress was measured within 24 hours before MRI using a modified version of the Social Readjustment Rating Scale that assessed Conflict and Disruption in Routine. Coping was measured at baseline using the Coping with Health Injuries and Problems questionnaire, which produces four scales: distraction, instrumental, palliative, and emotional preoccupation. Data were analyzed using mixed effects logistic regression to account for within-subject correlations. Analyses were lagged such that stress assessments predicted new Gd+ MRI brain lesions 8 weeks later. RESULTS: As reported previously, stress was significantly related to the development of new Gd+ brain lesions 8 weeks later (OR = 1.62, p =.009). Greater use of distraction was found to be a significant moderator of the relationship between stress and new Gd+ lesions (OR = 0.69, p =.037) such that greater use of distraction was associated with a decreased relationship between stress and new Gd+ lesions. Increased instrumental coping was marginally associated with a decreased relationship between stress and new Gd+ lesions (OR = 0.77, p =.081), while increased emotional preoccupation was marginally associated with an increased relationship between stress and new Gd+ lesions (OR = 1.46, p =.088). There was no significant moderating effect for palliative coping (p =.27) and no significant main effects for any coping variables and the subsequent development of new Gd+ brain lesions (p values >.21). CONCLUSIONS: These findings provide modest support for the hypothesis that coping can moderate the relationship between stress and the MS disease activity. Several limitations in this study are discussed. While these findings suggest areas of potentially fruitful research, readers are cautioned that these are preliminary results; inferences regarding the clinical importance of these findings are premature.

Adaptation, Psychological↗

PubMedDate not supplied

Coping and burden among informal HIV caregivers.

OBJECTIVE: The aim of this study was to examine the role of coping on caregiver burden among a heterogeneous group of caregivers of persons living with HIV during the era of highly active antiretroviral therapy. METHODS: Burden and coping were examined among 176 caregivers of persons living with HIV. Three styles of coping were examined using a 7-item scale: active-approach (task), blame-withdrawal (emotion), and distancing (avoidance). RESULTS: A total of 58.8% of the caregivers were women. They had a mean age of 42 years; 61.9% cohabited with the persons living with HIV who had a mean CD4 count of 401. All three styles of coping were significantly positively correlated with caregiver burden. After controlling for demographic variables and caregiver depression, active-approach coping and distancing coping independently moderated the relationship between perceived severity of HIV-related symptoms (stress) and caregiver burden; however, some caregivers experienced burden even at low levels of stress. CONCLUSIONS: These results indicate that in the era of highly active antiretroviral therapy, coping mitigates the effect of stress on burden.

Adaptation, Psychological↗

PubMed1999

Coping with bereavement in relation to different feminine gender roles.

The effect of gender role on coping with conjugal bereavement was studied in 44 Norwegian widows. A "traditional" and a "modern" feminine gender role were juxtaposed. Information was collected by two semi-structured interviews concerning coping with bereavement, and by a health inventory (UHI). The information was analysed qualitatively in relation to central elements in the coping process (appraisals, problems, coping strategies, self-evaluations of coping, future expectancies of coping, and relevance of external resources). The findings revealed considerable differences in coping between the two gender roles, favouring the modern feminine gender role.

Adaptation, Psychological↗

PubMed2002

Coping with birthparent loss in adopted children.

BACKGROUND: Relationships among adopted children's appraisals of birthparent loss, their coping strategies for managing such loss, and child and parent reports of child adjustment were investigated within the context of a stress and coping model of adoption adjustment. METHODS: Eighty-two 8-12-year-old adopted children and one of their parents participated. Children completed questionnaires assessing their negative affect about birthparent loss, their curiosity about birthparents, their use of coping strategies to manage birthparent-related distress, and their levels of depression, anxiety, and global self-worth. Parents reported on children's externalizing and internalizing behavior problems and social competence. RESULTS: Children who reported higher levels of negative affect about birthparent loss also reported higher levels of depression and lower self-worth. Curiosity about birthparents predicted parent-rated externalizing behavior. Behavioral avoidant coping was associated with greater self-reported anxiety and parent-rated externalizing behavior, whereas problem solving coping was associated with increased parent-rated social competence. CONCLUSIONS: The findings, though limited by issues of measurement and sampling, add to the knowledge base regarding adopted children's appraisal and coping behaviors, and provide partial support for a stress and coping model of adopted children's adjustment.

Adaptation, Psychological↗

PubMed2005

Differences in coping style and locus of control between older and younger patients with head and neck cancer.

OBJECTIVES: This prospective study analyses whether older and younger patients with cancer of the head and neck make use of different coping styles and locus of control mechanisms, and how these mechanisms are related to quality of life (QOL) and depressive symptoms. DESIGN: Before treatment, 78 older (>or=70 years) and 105 younger patients (45-60 years) with carcinoma of the oral cavity, pharynx (stage II-IV), or larynx (stage III-IV) completed questionnaires on QOL (EORTC-QLQ-C30), depression (CES-D), coping (Utrecht Coping List), and locus of control (Cancer Locus of Control Scale). Fifty-one older and 70 younger patients completed the follow-up questionnaires at 6 and 12 months. RESULTS: Before treatment and at 12 months, the number of depressive symptoms and QOL scores, apart from physical functioning, did not differ between the two groups. Before treatment and at 6 months, younger patients used active coping strategies significantly more often and they perceived more internal control over the cause of their disease. Older patients used religious coping and religious control more frequently at all assessments. In both groups, avoidance coping was associated with more depressive symptoms and a worse QOL. CONCLUSIONS: Although older and younger patients use different coping and locus of control strategies, this does not give rise to differences in QOL and depressive symptoms after treatment.

Adaptation, Psychological↗

PubMed2006

Religious coping and problem-solving by couples faced with prostate cancer.

Religion can be an important resource for people struggling with chronic illness. Problem-solving skills have also been shown to be helpful. This study examined whether turning to religion as a coping resource would be associated with better problem-solving in couples trying to manage challenges associated with prostate cancer. The sample was 101 patients with prostate cancer and their wives. Wives completed the Social Problem-Solving Inventory--Revised at baseline (T1) and 10 weeks later (T2). Patients and their wives also completed a measure that included items on religious coping. These items were used to classify couples into four groups based on whether one or both members engaged in religious coping: (1) husband only, (2) wife only, (3) both husband and wife, and (4) neither husband nor wife. From T1 to T2, wives who used religious coping along with their husbands (group 3) showed a significantly greater reduction in dysfunctional problem-solving (specifically, on impulsive/careless problem-solving) in comparison with wives who used religious coping while their husbands did not (group 2). Findings suggest that when couples share in turning to religion as a source of coping, this may be associated with improved problem-solving, but sole engagement in religious coping by wives may be associated with worse problem-solving.

Adaptation, Psychological↗

PubMed1996

Assessment of pain coping styles: development of an inventory.

The Pain Coping Style Inventory (PCSI) is an instrument designed to measure the pain coping style of individuals. It is based on the pain coping model and typology described by Copp. A study with a convenience sample of 145 university graduates, undergraduates, and faculty revealed a Cronbach's alpha reliability coefficient of 0.90, adequate stability, and a nine factor analysis solution representing 57% of the variance. Four of Copp's five coping styles are clearly defined by the factor analysis: interactive, reactive, combatant, and victim. Five more coping styles are named: contractor, distractor, spiritual coping, substance users, and mind over matter. The development and piloting of the PCSI is a step towards empowering the nurse with the ability to provide patients with individualized pain coping strategies.

Adaptation, Psychological↗

PubMed2005

Paternal reactions to a child with epilepsy: uncertainty, coping strategies, and depression.

AIM: This paper reports a study examining the stress that fathers experience when caring for a child with epilepsy. BACKGROUND: A seizure, which is frightening and potentially damaging, creates uncertainty about its possible effects and threatens the integrity of family systems. In the Chinese social context, epilepsy is stereotyped 'sudden craziness' of people and affected family feel shamed by the diagnosis. When a child has epilepsy, the stereotype of epilepsy affects the family experience in terms of stress and their coping process. Few studies have focused on how a father with an ill child adapts to family stress. METHODS: This study was based on the resiliency model of family stress, adjustment, and adaptation, and was designed to examine the relationships among fathers' uncertainty, coping strategies, and depression. From three teaching hospitals in Taiwan, 210 fathers were recruited. A pilot study was conducted to establish the reliability and face validity of the Chinese language version of the Coping Health Inventory for Parents. FINDINGS: Results showed that paternal uncertainty was negatively associated with the total Coping Health Inventory for Parents score for family coping patterns for factors I, II, and III. Uncertainty and coping strategies for factors II and III were indicators of paternal depression and accounted for 10.3% of the total variance. CONCLUSIONS: The results give insight into the unique family stress that fathers experience as a result of the interaction between the social context of a child with epilepsy and the family's coping patterns. They also suggest ways to improve family-centred nursing interventions to help parents establish effective caring patterns to manage the family stress.

Adaptation, Psychological↗

PubMed2006

Coping with breast cancer in newly diagnosed Iranian women.

AIM: This paper reports a study exploring how Iranian women coped with newly diagnosed breast cancer and provides a foundation for cultural-based care. BACKGROUND: Although research has indicated that coping strategies are associated with adaptation to breast cancer, and despite the number of women with newly diagnosed breast cancer increasing each year, there is no information on how Iranian women cope with breast cancer when compared with women of other cultures. METHOD: In this qualitative study, 19 women with newly diagnosed breast cancer were interviewed during the period May-September 2004 about coping with their disease. Interviews were analysed using a content analysis method. FINDINGS: The main themes emerging from this qualitative study included coping using a religious approach (acceptance of disease as God's will; spiritual fighting), thinking about the disease (positive thinking: positive suggestion, hope, intentional forgetfulness; negative thinking: hopelessness, fear, impaired body image), accepting the fact of the disease (active acceptance; passive acceptance), social and cultural factors and finally finding support from significant others. CONCLUSION: Understanding how Iranian women cope with diagnosis of breast cancer is important to nurses involved in the process of healing. The majority of strategies used by Iranian women were positive, and religious faith played a major role in this. The findings of the study can be used to design a nursing approach to improve successful coping in Iranian women suffering from breast cancer, and can provide nurses and other healthcare professionals with deeper understanding of these women as they face this diagnosis.

Adaptation, Psychological↗

PubMed2006

Thin-wall ceramic CAD/CAM crown copings: strength and fracture pattern.

The strength and fracture pattern of posterior CAD/CAM-generated crown copings with 0.4 mm wall thickness were evaluated in vitro hypothesizing that fracture resistance of YTZP-zirconia copings might be independent of mode of cementation whether resin-bonded or cemented because of the high strength of YTZP-zirconia. Two sets of copings (n = 15) each were fabricated using CEREC inLab CAD/CAM from (i) lithiumdisilicate glass-ceramic, (ii) infiltration ceramic as controls and (iii) YTZP-zirconia. Copings (n = 15) of ceramics (i), (ii) and (iii) each were (a) zinc-phosphate cemented, (b) adhesively seated on resin-based composite dies and loaded until fracture. Load (N) data was analysed using anova and Scheffé tests. Crack pattern was evaluated on additional three sample cross-sections for each group at fracture-start. Radial cracks originated early at the cementation interfaces and cone cracks were observed finally at the loading sites. Mean load (N) values (+/-s.d.) of A-copings at fracture-start/-end (i) 804 +/- 195/862 +/- 162, (ii) 923 +/- 180/975 +/- 147, (iii) 697 +/- 110/1607 +/- 145, were all significantly (P < 0.01) lower when compared with their B-crown coping analogs (i) 1183 +/- 318/1919 +/- 326, (ii) 1621 +/- 165/1820 +/- 211, (iii) 731 +/- 115/1973 +/- 287 except for A3 and B3 at fracture-start. This confirmed our hypothesis at fracture-start (P > 0.05) but rejected it at fracture-end (P < 0.01). The A3 fracture-end data, even if significantly (P < 0.01) lower, came close to the B3 values by 18%. A3 was significantly (P < 0.001) stronger by 86/74% than A1/A2 at fracture-end. The data indicates that YTZP-zirconia copings have the potential to provide support for all-ceramic core crowns, which may be adequate for non-adhesive cementation.

Cementation↗

PubMed2005

Personality, coping and sperm count.

Previous research has suggested an association between personality traits and coping, as well as between coping and sperm concentration. In the present study, both domains of research were combined, leading to the formulation of specific hypotheses. A total of 54 healthy volunteers were given questionnaires twice to assess personality traits and coping behaviour. Participants also produced up to three semen specimens. As hypothesized, active coping was correlated negatively with neuroticism (r = -0.59) and positively with conscientiousness (r = 0.56), whereas sperm concentration was correlated negatively with both active coping (r = -0.28) and conscientiousness (r = -0.37). The relationship between conscientiousness and sperm concentration did not appear to be mediated by active coping. Although the correlations were small, evidence is mounting that psychological aspects and male sperm parameters are not independent. The present findings, however, should not lead to the conclusion that conscientiousness and active forms of coping are characteristics of infertile patients.

Adaptation, Psychological↗

PubMed1996

Psychosocial problems of children and adolescents with a chronic disease: coping strategies.

The purpose of this pilot study was to identify the coping strategies used by children, adolescents and youths with insulin dependent diabetes mellitus (IDDM) attending a camp for IDDM patients near Ryosen town, Fukushima Prefecture, Japan. Forty-three IDDM patients (24 females and 19 males) were studied, divided into two age groups. The first group included children (seven males and 10 females). The second group included adolescents and youths (12 males and 14 females). For the child group a projective drawing method was used for study and for the older group, an open questionnaire was used. Ryan-Wenger's taxonomy of children's coping strategies and Band's coding systems and classification were used for the content analysis. 'Instrumental action', 'Emotional expression' and 'Catastrophizing thinking' were the coping strategies, represented in the child group. Gender differences in coping strategies were found in the group of adolescents and youths. The most often represented and most important coping category for the male subgroup was 'Behavioral avoidance'. Next in frequency of representation for the male subgroup were 'Cognitive distraction' and 'Behavioral distraction'. The coping categories 'Seeking social support' and 'Behavioral distraction' were represented with equal frequency in the female subgroup and the next was 'Aggressive activities'. The most important coping strategy for the female group was 'Talking to peers' from the seeking social support category. The study also helped to identify several children and adolescents who might need special psychological support.

Adaptation, Psychological↗

PubMed2006

Concept analysis of coping with arthritic pain by South Korean older adults: development of a hybrid model.

This study was conducted to clarify and conceptualize the phenomenon of coping with arthritic pain by older adults. The Hybrid Model of concept development was applied to develop a conceptual structure of coping with arthritic pain by older adults. A refined definition of coping with arthritic pain by older adults emerged that identified the attributes and structure of the concept. This study reveals the characteristics of the ways that older adults cope with arthritic pain, such as how they experience themselves, how pain affects their daily life, and how they perceive the meaning of coping with arthritic pain. These characteristics indicate the complexity of the concept regarding the coping of older adults with arthritic pain. This area needs to be clarified when nursing staff assess coping with pain and plan pain management for older adults.

Activities of Daily Living↗

PubMed1996

The mismeasure of coping by checklist.

Hundreds of studies have now used standardized checklists to assess respondents' self-reports of coping with naturally occurring stress. This article presents a critical review of the conceptual and methodological issues involved in the use of these checklists. As they are currently employed, conventional checklists render an incomplete and distorted portrait of coping. Specifically, these checklists are grounded in too narrow a conception of coping; the application and interpretation of checklists in the typical study are not faithful to a transactional model of stress and coping; statistical controls cannot eliminate the effects of key person and situation variables on coping; and no consistent interpretation can be assigned to coping scale scores. Researchers are encouraged to consider a broader range of methods for assessing coping, including semistructured interviews, customized checklists tailored to their specific hypotheses and objectives, daily diaries, and traditional trait measures.

Adaptation, Psychological↗

PubMed2005

Coping with interpersonal stress: role of big five traits.

Seventy-one couples living in a stepfamily context reported interpersonal family stressors and related coping strategies daily for 1 week in a daily process study. The role of personality and of the stressful context in each of the spouse's coping was examined. Personality was assessed via the Five-Factor Model (Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness). Two types of stressors emerged as primary dimensions of stepfamily stress: marital conflict and child misbehavior. These were treated as contextual factors in multilevel modeling analyses examining the independent and interactive effects of personality and situation on coping. Nine subscales of coping were examined based on three main functions of coping: problem-, emotion- and relationship-focused. Both the situational context and the five dimensions of personality examined were significantly and independently related to coping-strategy use. Moreover, there were significant personality-by-context interactions. The present study highlights the importance of considering personality in context when examining coping behaviors.

Adaptation, Psychological↗

PubMed1994

Coping, stress, and the psychological symptoms of children of divorce: a cross-sectional and longitudinal study.

The authors conducted a cross-sectional and prospective longitudinal study of stress, coping, and psychological symptoms in children of divorce. The sample consisted of 258 children (mean age = 10.1; SD = 1.2), of whom 196 were successfully followed 5.5 months later. A 4-dimensional model of coping was found using confirmatory factor analysis, with the factors being active coping, avoidance, distraction, and support. In the cross-sectional model avoidance coping partially mediated the relations between negative events and symptoms while active coping moderated the relations between negative events and conduct problems. In the longitudinal model significant negative paths were found from active coping and distraction Time 1 to internalizing symptoms Time 2, while Time 1 support coping had a positive path coefficient to Time 2 depression. Positive paths were found between negative events at Time 1 and anxiety at Time 2, and between all symptoms at Time 1 and negative events at Time 2.

Adaptation, Psychological↗

PubMedDate not supplied

Socialization of coping with community violence: influences of caregiver coaching, modeling, and family context.

A socialization model of coping with community violence was tested in 101 African American adolescents (55% male, ages 9-13) and their maternal caregivers living in high-violence areas of a mid-sized, southeastern city. Participants completed interviews assessing caregiver coping, family context, and child adjustment. Caregiver-child dyads also discussed a film clip depicting community violence. Parental coaching (caregivers' strategies suggesting how to cope) and child-reported coping were coded from the discussion. Coaching, modeling (caregivers' own coping), and family context each contributed to children's coping with violence. Children's problem-focused coping in response to violence had the strongest associations with changes in their adjustment 6 months later. Implications for interventions with youth and families are discussed.

Adaptation, Psychological↗

PubMed2004

Impairment and coping in children and adolescents with chronic fatigue syndrome: a comparative study with other paediatric disorders.

BACKGROUND: Functional impairment is a key feature of chronic fatigue syndrome (CFS) of childhood. AIM: To compare impairment, illness attitudes and coping mechanisms in childhood CFS and in other paediatric disorders. METHOD: Participants were 28 children and adolescents with CFS, 30 with juvenile idiopathic arthritis (JIA) and 27 with emotional disorders (ED). The measures used were interviews with children and parents, with detailed enquiry on impairment, including the Functional Disability Inventory (FDI), Illness Attitudes Scales (IAS), and Kidcope to measure coping styles in relation to common problems, illness and disability. RESULTS: Children with CFS reported significantly more illness impairment, especially in school attendance, than those with JIA and ED. They had higher 'worry about illness' scores on the IAS. On the Kidcope they named school issues (work, expectations, attendance) as illness- or disability-related problems more than the other two groups. Fewer CFS participants reported using problem solving as a strategy to cope with illness and disability than with other problems in their lives. More in the CFS than in the JIA group used emotional regulation to cope with illness and disability. Fewer in the CFS than in the ED groups used social withdrawal to cope with illness and self-criticism for disability, but more used resignation to cope with disability. CONCLUSION: Severe illness-related impairment, particularly through school non-attendance, and high levels of illness-related school concerns appear specific to CFS. CFS may also have characteristically high levels of generalised illness worry and particular styles of coping with illness and disability.

Adaptation, Psychological↗