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The concept of coping is firmly embedded in warlike connotations. This article explores three settings for coping behavior that illustrate long-term consequences of coping: the coping of survivors of Nazi concentration camps, the coping of an ancient city, and the coping shown by a modern nation state at war. Coping may have effects which are beneficial in the short run but ominous in the long run.
OBJECTIVE: This study evaluated the strategies used by employment specialists to help clients in supported employment programs manage cognitive impairments that interfered with obtaining and keeping jobs. METHODS: Twenty-five supported employment specialists were surveyed to identify strategies they used to help their clients cope with cognitive problems in the domains of attention, psychomotor speed, memory, and problem solving. Then, 50 employment specialists were surveyed to determine whether they used each of the different coping strategies generated in the first part of the study. For each strategy used, they rated how effective it was. RESULTS: Employment specialists reported using a total of 76 different strategies for helping their clients cope with cognitive difficulties. The specialists reported using an average of 48 different coping strategies, which they rated on average as just below effective. Strategies for dealing with attention problems were rated as more effective than strategies used in the other three domains. The number of coping strategies that they reported using was significantly correlated with the perceived effectiveness of the strategies and the proportion of clients in their caseload who were working. CONCLUSIONS: Supported employment specialists were actively involved in helping clients cope with their cognitive impairments. Use of more strategies was correlated with specialists' greater perceived effectiveness of the strategies and with higher rates of working clients on their caseloads, although the reasons for these associations are unclear. Further research is needed to evaluate whether employment specialists' use of more strategies to help clients cope with cognitive problems contributes to better work outcomes.
School-age children (N = 43) with insulin-dependent diabetes mellitus were studied to determine if the coping strategies they used were associated with their self-care management and/or with their metabolic control. Instruments used included the Schoolagers Coping Strategy Inventory and the Self-care Questionnaire. Results indicated that the choice of coping strategies did not differ by demographic characteristics, and level of self-care was not associated with metabolic control. Participants used cognitive coping strategies most often; higher frequencies tended to be associated with higher levels of self-care and metabolic control. Those who utilized distracting strategies also tended to have higher levels of self-care. Emotional coping strategies tended to be related to poorer metabolic control. The use of coping strategies explained approximately 18% of the variance in metabolic control. These data suggest that healthcare providers should assess what coping strategies are employed by school-age children with diabetes because the choice of strategies may have a significant impact on their metabolic control. The use of strategies related to poorer metabolic control (eg, emotional strategies) should be discouraged, and the use of more effective strategies related to higher levels of self-care and metabolic control (eg, cognitive strategies) should be modeled and encouraged.
The purpose of this descriptive, correlational study was to examine coping and emotion in patients prior to and after cardiac surgery. The revised Ways of Coping Checklist (WCCL) and the Profile of Mood States (POMS) were completed by 120 patients before surgery and on the fifth postoperative day. Participants had significant (p < .01) differences in coping prior to and following surgery. There were significant (p < .05) postoperative decreases in the use of several coping strategies (seeking social support, blaming oneself, and wishful thinking); however, the use of other coping strategies (problem-focused coping and avoidance) remained unchanged. Emotion did not change. There were positive, significant (p < .05) relationships between several of the coping strategies and perioperative emotion. Preoperative emotion was found to be the best independent predictor of the postoperative emotion.
Social support, depressive symptoms, and three methods of coping were assessed in 45 patients with Parkinson's disease (PD) and 24 comparably disabled controls. The PD subjects employed significantly fewer cognitive and behavioral coping strategies compared with the controls. Fewer depressive symptoms were related to increased cognitive coping in PD subjects. Behavioral coping strategies were associated with lesser depression among controls. Avoidance coping methods showed a marginally significant positive association with depressive symptoms in PD subjects. Social support was related to the significant coping predictors in each group, but was not related to depressive symptoms. Although correlational, these results might suggest that active (cognitive and behavioral) coping strategies are superior to avoidance strategies in attenuating the affective distress expected from chronic deteriorative illnesses.
The purpose of this study is to explore labor pain coping methods among Jordanian parturients. Descriptive statistics and content analysis were used to analyze data on demographics and coping methods from 100 low-risk parturients who were recruited from the postpartum unit in a major hospital in Jordan: Four labor pain-coping methods that included physiological, psychological, spiritual, and cognitive coping were reported. This study confirms previous findings regarding coping methods and adds new knowledge on coping with labor pain among Jordanian parturients: The significance of childbirth education as a means to inform Jordanian women about coping with labor pain is emphasized. This study also highlighted the important roles that nurses and midwives can play as educators and supporters during pregnancy and labor.
In this article, the authors report on an interview study in which parents described the coping strategies they used to deal with the demands of having a daughter diagnosed with anorexia nervosa. They compare parents' accounts with commonly used categorizations in quantitative studies of parental coping and adjustment. The study indicates that parents attribute multiple, complex, and unique motives to their actions that problematize quantitative constructions of types of coping. Parents often defined their actions differently and reported using coping strategies that were not considered or measured by the most widely used quantitative coping instruments. The analysis indicates that when the focus is on understanding and assisting parental coping in particular circumstances, situated, context-specific analyses are necessary to design measures that accurately reflect parents' coping efforts.
To examine certain correlates of patterns of coping with stress, 43 patients with multiple sclerosis (MS) read a vignette describing a stressful social situation and completed the Ways of Coping Checklist, describing how they would cope with the stressful situation. Performance on a test of solving problems in everyday living was positively correlated with the total number of coping responses and with the number of problem-focused strategies, but neither vocabulary nor verbal abstract reasoning were related to coping patterns. In agreement with earlier work, increases in psychological distress were positively correlated with endorsement of emotion-focused coping strategies but unrelated to the use of other coping responses.
In the current study the relations between coping and psychological/physical health in a sample of minority adolescents was investigated. Participants (n = 182) were all low-income, first-generation college-bound students from historically underrepresented groups. For Mexican-Americans, positive reinterpretation, focusing and venting emotions, instrumental social support, active coping, religious, restraint, emotional support, acceptance and planning forms of coping were all associated with positive psychological and physical health; for African-Americans, coping methods were not significantly associated with psychological or physical health; for Asian-Americans, positive reinterpretation, active coping, religious coping, restraint, acceptance and planning forms of coping were associated with only psychological health. Cultural-specific (rather than gender-specific) socialization is identified as a potential explanation of these results.
Using a daily process methodology, the current study examined the role of social support in coping and pain severity among patients with rheumatoid arthritis (RA). Seventy-three adults with RA completed a structured record twice daily for one week on pain severity, pain coping, satisfaction with support and disappointment in support. Findings suggested that support influenced pain indirectly, by encouraging the use of specific coping strategies, as well as impacting coping effectiveness. Satisfaction with support was associated with adaptive and maladaptive coping, while disappointment was associated with maladaptive coping. Findings highlight the importance of close others in promoting adaptive coping strategies.
CONTEXT: Certain appraisals and coping strategies have been associated with increased levels of psychological distress and disability in other medical populations, but no study has examined this relationship with patients who are awaiting lung transplantation. OBJECTIVE: To describe the cognitive appraisal and coping strategies used by patients who are pursuing lung transplantation and to evaluate the extent to which these processes are associated with depression, anxiety, and disability. METHODS: This is a cross-sectional design with 160 participants (42.5% men) who have end-stage lung disease and were evaluated for lung transplantation at a large medical center. MEASURES: The outcome variables of depression, anxiety, and physical disability were assessed using the Beck Depression Inventory, Spielberger Trait Anxiety Inventory, and the Sickness Impact Profile, respectively. The predictor variables, coping and appraisal styles, were measured using the COPE and the Stress Threat Questionnaire, respectively. Demographic variables were also assessed. RESULTS: Patients used a variety of adaptive problem- and emotion-focused coping strategies. Hierarchical multiple regressions demonstrated that harm appraisals and the use of particular types of coping styles; namely, disengagement, avoidance, ruminating and venting emotions, low solicitation of emotional support, and suppressing other activities are maladaptive and were uniquely related to psychological distress and disability. CONCLUSIONS: Maladaptive appraisal and coping styles can serve as markers of emotional distress and disability that may help the transplant team identify patients who may benefit from counseling and psychological interventions.
PURPOSE/OBJECTIVES: To explore the process of coping with breast cancer among African American women and their spouses. DESIGN: Exploratory, qualitative study using grounded theory methods. SETTING: Large metropolitan area in the mid-Atlantic United States. SAMPLE: 12 African American couples (N = 24). METHODS: African American women and their spouses were asked to complete a background data sheet and participate in a face-to-face semistructured interview. Qualitative data were audiotaped and transcribed verbatim. Themes were identified using the constant comparative method. Quantitative data were analyzed with descriptive statistics. MAIN RESEARCH VARIABLES: The process of coping with breast cancer among African American couples. FINDINGS: The basic social concern was living through and beyond a breast cancer diagnosis. The core variable was merging strengths to cope with and survive a breast cancer diagnosis. Six main categories emerged to describe how African American couples actively worked together to cope with a breast cancer diagnosis: walking together, praying together, seeking together, trusting together, adjusting together, and being together. CONCLUSIONS: African American couples described the importance of combining their strengths and working together as a couple to cope with a breast cancer diagnosis. IMPLICATIONS FOR NURSING: Nurses must understand the importance of developing culturally sensitive and culturally relevant interventions to assist African American couples with effectively coping with a breast cancer diagnosis. When providing care to African American couples, nurses should incorporate the six categories of walking, praying, seeking, trusting, adjusting, and being together to help couples cope with the various phases of the breast cancer experience.
BACKGROUND: A multi-dimensional approach was used to examine coping in chronic pain. The following hypotheses were tested: (a) patients who cope maladaptively also cope generally in a similar way; (b) patients' maladaptive coping is associated with childhood adversity. METHOD: Cross-sectional and retrospective data were collected from 68 consecutive patients (aged 18-70) at a pain clinic where their disease was non-systemic and the pain had lasted for at least three months. Sixty-one patients were interviewed using the Structured Clinical Interview for DSM-III-R, and the Measure of Parental Care in Childhood. All patients completed questionnaires on their pain and personality. RESULTS: Two coping styles emerged from factor analysis. One was associated with chronicity, psychiatric morbidity, harm avoidance, immature defence style and reporting parental indifference. CONCLUSION: Patients may be predisposed to cope maladaptively after the experience of parental indifference in early life. Such coping is likely to reflect more general patterns.
In this study, we examined the effects of coping information and self-affirmation on an individual's response to threatening health information. A total of 202 women college students read an essay containing threatening information about breast cancer. The essay described their population as being at risk for breast cancer and included both pictures of cancerous breasts and vivid descriptions of chemotherapy treatments. Participants were randomized into either the low-affirmation condition or the high-affirmation condition when they first arrived. In addition, half of the participants were randomly assigned to receive coping information that described breast self-examinations as an effective method of detecting breast cancer and focused on the importance of early detection. Participants who received coping information scored lower on maladaptive behaviors (avoidance, hopelessness, religiosity), suggesting that coping information plays a role in decreasing maladaptive behaviors. No significant differences were found between the low-affirmation and high-affirmation conditions. Supplemental analyses indicated that vicarious exposure to breast cancer (having a friend, relative, or mother diagnosed with breast cancer) affected how individuals interpret threatening health information. Participants with previous exposure scored higher on the adaptive coping modes (behavioral intentions, rational problem solving) and 1 maladaptive coping mode (religiosity) when compared to individuals without previous exposure. In addition, participants in the high-affirmation condition with previous exposure scored higher on avoidance and hopelessness than those without previous exposure. The results suggest that coping information and previous exposure are factors that need to be considered when presenting threatening health information.
We examined whether habitual defense and coping affect the response of hormones (ACTH. cortisol, prolactin. endorphins, and noradrenaline) and immune parameters (numbers of T cells. B cells. natural killer [NK] cells, and proliferative responses to mitogens or antigens) to an acute laboratory stressor (i.e., solving a 3-dimensional puzzle and explaining it to a confederate) in 86 male high school teachers. Defense and coping were assessed by Kragh's tachistoscopic Defense Mechanism Test (a measure of perceptual defense) and by 4 questionnaire-based coping styles assessing instrumental mastery-oriented coping, emotion-focused coping, cognitive defense, and defensive hostility. The laboratory stressor per se caused a relative increase in immunological (in particular NK cells) and endocrine (cortisol, prolactin) parameters. Defense and coping, however, significantly codetermined the response to the stressor. In particular, instrumental mastery-oriented coping and perceptual defense were related to stress-induced changes in numbers of B cells and in the pituitary-adrenal hormones. The results indicate that the impact of a mild psychological stressor on the immune and endocrine system depends to a considerable extent on the specific ways people deal with stressors.
Heart transplantation confronts the patient with major physical, psychological and social demands. Psychological adjustment to these stressors requires effective coping abilities. The purpose of this study was to investigate the coping mechanisms used by heart transplant recipients. A group of 42 heart transplant recipients completed the questionnaire. The instrument, F-COPES (Family Crisis Oriented Personal Evaluation Scales), was used to measure coping behaviours, thereby producing scores on five coping subscales: Acquiring social support; Reframing; Seeking spiritual support; Mobilizing family to accept help; and Passive appraisal. The results indicated that subjects in the present study (Scottish patients) scored slightly higher than normative subjects (American patients) on the Reframing subscale, slightly lower on the two subscales Acquiring social support and Mobilizing family to accept help, and much lower on Spiritual support. These results also indicated that the coping strategies used by this sample appeared to be largely independent of the time elapsed since transplantation, and the age of the subject. The major finding was that subjects scored much higher on the Passive appraisal coping subscale (almost double the score of the normative subjects).
Although psychosocial coping techniques and supportive care services have been shown to improve cancer patients' quality of life, there is evidence that many of these strategies have not been widely integrated into the routine care of cancer patients. This study examined: (1) the extent to which cancer patients use certain coping strategies; (2) reasons for non-use; (3) perceived effectiveness of the coping strategies; (4) participants' interest in trying the strategies; and (5) if the strategies were recommended to participants. At the Northwestern Ontario Regional Cancer Centre in Thunder Bay, Ontario, Canada, 292 outpatients (98% response rate) completed an in-person interview with a research assistant concerning seven individual coping strategies (music, breathing exercises, meditation, prayer, muscle relaxation, visualization/imagery, hypnosis/self-hypnosis) and four coping strategies offered through supportive care services (individual counselling, family counselling, support groups, religious support). Of all the coping strategies presented, prayer was used by the highest number (n = 186) of participants (64%). Music was the next most commonly used strategy, used by 43% (n = 124) of participants, and all other strategies were used by less than 30%of participants. The individualized approaches that are used for disseminating disease and treatment information to cancer patients should also be used to provide them with information on effective coping strategies.
BACKGROUND: Stress and social support influence adolescents' coping strategies. Adolescents need to acquire a large repertoire of coping strategies in light of a rapidly changing socio-economic and political situation. AIM: This study reports on the coping strategies of Zimbabwean adolescents and highlights some major stressors they face. The interplay among stress, social support and the coping strategies of Zimbabwean adolescents are also reported. SAMPLE: A sample of 101 Zimbabwean students (ages 17-19) participated in this study. METHOD: Participants completed three instruments: the Perceived Stress Scale, the Social Provision Scale and the Ways of Coping Scale. RESULTS: Zimbabwean adolescents experienced slight stress as measured by the Perceived Stress Scale. Major stressors included schoolwork, relationships, social life and financial hardship. Females reported a higher level of perceived stress than males. Zimbabwean adolescents reported having fewer social provisions than the norm group. Results from the Ways of Coping Scale indicated that Zimbabwean adolescents use emotion-focused strategies more frequently than problem-solving strategies. CONCLUSION: The implications of the study are that Zimbabwean adolescents may need to acquire a larger repertoire of coping skills adding to what they may already have. Problem-solving skills need to be employed in face of today's challenging situations.