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Cancer patients' coping styles and doctor-patient communication.

Monitoring and blunting styles have become relevant concepts regarding their potential impact on patients' and doctors' behaviors. The present study aimed at investigating the relation between cancer patients' coping styles and doctor-patient communication and global affect. Coping styles were assessed by means of the Threatening Medical Situations Inventory (TMSI). Since a shortened version of the TMSI was used, the validity of this instrument was also evaluated. First, it was examined whether the two factor structure of the original TMSI could be confirmed in our version. Then, the relation between coping style and patients' preferences for information and participation in decision-making was evaluated. Second, the relation between monitoring and blunting and patients' age, sex, education, quality of life and prognosis was investigated. Finally, the relation between patients' coping styles and communicative behaviors and global affect of both patients and physicians during the initial oncological consultation was examined. Patients (N = 123) visited their gynaecologist or medical oncologist for an initial discussion of possible treatment. Patients' coping styles, socio-demographics, preference for information and participation in decision-making, quality of life and prognosis were assessed by postal questionnaire prior to the visit to the outpatient clinic. The consultation was audiotaped and analysed according to Roter's Interaction Analysis System, to identify instrumental and affective communicative behaviors of both patients and physicians. The two factor structure of the TMSI could be confirmed. A monitoring style was related to a preference for detailed information (r = 0.23) and participation in medical decision-making (r = 0.23). A monitoring style was also related to patient question-asking (r = 0.25) and patient dominance (r = 0.23). To conclude, the validity of the shortened TMSI is satisfactory. Also, cancer patients' coping styles are not related to other personal and disease characteristics. Further, a monitoring style seems to have an impact on patients' question-asking and dominance during the oncological consultation.

Adaptation, Psychological↗

Coping with head and neck cancer during different phases of treatment.

BACKGROUND: Little is known about how patients cope with head and neck cancer despite its devastating impact on basic functioning. This study examined coping patterns among patients at different phases of illness. METHODS: Participants were 120 patients with advanced disease, who were grouped according to the following phases of illness: (1) pretreatment, (2) on treatment, (3) <6 months after treatment, and (4) >6 months after treatment. Coping was assessed with the COPE questionnaire, and outcome measures assessed general distress (Profile of Mood States) and illness-specific distress (Impact of Events Scale). RESULTS: Use of specific coping responses differed among the groups. Denial (p <.05), behavioral disengagement (ie, giving up or withdrawing, p <.05), suppression of competing activities (ie, focusing exclusively on the illness, p <.01), and emotional ventilation (p <.10) were most characteristic of patients who were receiving or had recently completed treatment. There were no differences in flexibility of coping or overall effort expended, but patients who were on treatment or who had recently completed treatment used the greatest number of strategies. Generally, denial, behavioral disengagement, and emotional ventilation were associated with greater distress. CONCLUSIONS: Results suggest that phase of illness may be important in shaping patients' responses to life-threatening illness.

Adaptation, Physiological↗

Coping and attributional styles as predictors of depression.

This study examined how coping styles relate to attributional styles and how the two interact in relation to depression. One hundred seventy-six subjects completed the Ways of Coping Checklist, the Attributional Style Questionnaire, and the Beck Depression Inventory. Problem-focused coping correlated with stable and global attributions for positive events for men. Emotion-focused coping correlated with internal, stable, and global attributions for negative events for women and internal and global attributions for men. Correlations between depression and attributions as predicted by the reformulated model of helplessness were significant only for women. These results indicate that research on attributional styles should analyze all data separately by gender. While the results show that both coping and attributions accounted for some of the variance in depression for females, coping contributed considerably more unique variance than attributions.

Adaptation, Psychological↗

Coping and academic problem-solving ability in test anxiety.

The present study examined coping tendencies and perceptions of problem-solving ability in test anxiety. A sample of 125 students completed the revised Ways of Coping Questionnaire, the Academic Problem-Solving Inventory, and measures of state and trait test anxiety. Correlational analyses confirmed that emotion-focused coping (i.e., avoidant and confrontive coping) was associated positively with test anxiety. Also, test-anxious individuals reported poorer ability to solve academic problems. Finally, regression analyses revealed that coping tendencies and perceived problem-solving ability predicted unique variance in test-anxiety scores. The results are discussed in terms of the need for a multidimensional model of test anxiety that includes coping processes and self-evaluations of problem-solving ability.

Achievement↗

A factor analytic study of coping styles and the MMPI-2 content scales.

The relationships among coping styles and psychopathology were examined with the MMPI-2 content scales and a reliable and valid coping measure--the Coping Inventory For Stressful Situations (CISS). Subjects were 167 higher-functioning normal adult males. The results are consistent with previous research that employed the CISS; a strong positive association was found between emotion-oriented coping strategies and various measures of psychopathology. Task-oriented coping strategies were found to be unrelated to these measures. Results are discussed in the context of a potential model for understanding the various relationships among coping styles and psychopathology.

Adaptation, Psychological↗

Coping and catastrophizing in chronic pain: a psychometric analysis and comparison of two measures.

We analyzed and compared the psychometric properties of two measures of strategiesfor coping with pain:The Coping Strategies Questionnaire (CSQ) and the Cognitive Coping Strategies Inventory (CCSI). The CSQ and CCSI were repeatedly administered to 30 chronic pain patients. Several subscales of both measures showed inadequate internal consistency, and test-retest (one week interval) reliability lower than 0.7. For each inventory, moderate to strong intercorrelations between several subscales were observed. The Catastrophizing subscale was the only subscale for which there was clear evidence of construct validity. Results indicated that both measures showed similar psychometric difficulties, and question the construct validity of subscales other than Catastrophizing. Catastrophizing, however, more closely reflects appraisal processes than a coping strategy per se. We suggest that measures that use more parsimonious and empirically derived coping strategy subscales and that also assess appraisal factors would assist in advancing our understanding of coping with chronic pain.

Adaptation, Psychological↗

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: correlation with pain, physical function, and psychological distress.

OBJECTIVES: The purpose of this study was twofold: 1) to describe the coping strategies used by children with juvenile primary fibromyalgia syndrome (JPFS), and 2) to examine how pain coping relates to measures of pain, disability/function, psychological distress, and pain behavior. METHODS: Sixteen children with JPFS completed the Child Version of the Coping Strategies Questionnaire (CSQ-C), the visual analog scale for pain, the McGill Pain Questionnaire, the Fibromyalgia Impact Questionnaire modified for children, the Arthritis Impact Measurement Scales 2, and the Symptom Checklist-90-Revised. Subjects also also underwent pain behavior observation. Pearson's product moment correlations were conducted to examine the relationship of coping to measures of pain and disability. RESULTS: The Pain Control and Rational Thinking composite factor score on the CSQ-C correlated with measures of pain severity, functional disability, and psychological distress. Results supported the internal reliability of the CSQ-C in assessing pain coping. CONCLUSIONS: These results suggest that the CSQ-C may provide a reliable measure for assessing variations in pain coping in JPFS patients. Behavioral interventions aimed at increasing the perception of pain control may be beneficial in treating JPFS.

Activities of Daily Living↗

Spouse-assisted coping skills training in the management of osteoarthritic knee pain.

OBJECTIVE: To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain, psychological disability, physical disability, pain-coping, and pain behavior in patients with osteoarthritis (OA) of the knees. METHODS: Eighty-eight OA patients with persistent knee pain were randomly assigned to 1 of 3 conditions: 1) spouse-assisted pain-coping skills training, (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement (CST), or 3) an arthritis education-spousal support (AE-SS) control condition. All treatment was carried out in 10 weekly, 2-hour group sessions. RESULTS: Data analysis revealed that at the completion of treatment, patients in the spouse-assisted CST condition had significantly lower levels of pain, psychological disability, and pain behavior, and higher scores on measures of coping attempts, marital adjustment, and self-efficacy than patients in the AE-SS control condition. Compared to patients in the AE-SS control condition, patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies. CONCLUSION: These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients.

Adaptation, Psychological↗

Coping strategies, pain, and disability in patients with hemophilia and related disorders.

OBJECTIVE: To analyze the use of various coping strategies in homogeneous groups of patients with hemophilia and von Willebrand's disease and to investigate the relationship between the state of the disease, the use of coping strategies, and management of the disease. METHODS: The coping strategies measured by the Coping Strategies Questionnaire were analyzed in 3 homogeneous groups of 224 patients. Psychosocial well-being (PWB) measured by the Rand 36-item Health Survey 1.0 was used as an indicator of management of the disease. The pain factor consisted of the following variables: pain intensity, use of analgesics, Functional Disability Index, and physical activity level. RESULTS: The groups of patients differed significantly only in the use of the catastrophizing strategy (CAT). In all pain groups, distraction was the most commonly used coping strategy. A significant interaction effect of pain factor and age on PWB (P = 0.04) was found. The mediating function of the CAT strategy was confirmed by the series of regression analyses. CONCLUSION: The coping strategy profile in hemophilia was found to be similar to those in other chronic pain states. The use of the strategies does not depend on the severity of the disease. We confirmed the role of age and the use of the CAT strategy as, respectively, moderator and mediator in the pattern of relationships between the clinical state of the disease and psychosocial well-being.

Adaptation, Psychological↗

Coping strategies and affect in rheumatoid and psoriatic arthritis. Relationship to pain and disability.

Affective state and utilization of coping strategies are factors that may be related to pain and disability in chronic disease, but may also be interrelated. The relationship of coping strategies and affect to both concurrent and 18-month follow-up pain and disability was studied in 60 women with rheumatoid or psoriatic arthritis of < 8 years' duration. The type of coping strategy used was not associated with concurrent mood level. After accounting for physical variables, mood and strategy use were significantly, and largely independently, related to concurrent pain and disability measures. Future disability was not predicted by either mood or coping strategy use. These results show that mood and use of coping strategies are significantly related to concurrent function but, perhaps due to the variable nature of the disease process, are not predictive of future function. The clinical implications of this study are that interventions to promote better adjustment for people with rheumatoid or psoriatic arthritis should target both mood and coping strategies, as both may contribute independently to adjustment.

Adaptation, Psychological↗

Coping with pain in the hip or knee in relation to physical disability in community-living elderly people.

OBJECTIVE: To investigate the use of pain coping strategies by community-living older people with pain in the hip or knee and the mediating role of coping with pain in the relationship between the chronicity of pain and physical disability. METHODS: A group of 157 people with pain "in the last month" was identified. Coping with pain was assessed with the Pain Coping Inventory, physical disability with the Sickness Impact Profile, and household and sport activities with a validated structured interview method. RESULTS: People with chronic pain used relatively more "resting," and "reducing demands" as pain coping strategies. Pain chronicity made a significant contribution to physical disability; however, when corrected for other variables in a regression model, no significant partial correlation was found. CONCLUSION: We conclude that pain coping has a mediating role in the relationship between pain chronicity and physical disability. Less use of "resting" and a physically active lifestyle are independently associated with less physical disability.

Adaptation, Psychological↗

Relationship of pain-coping strategies and pain-specific beliefs to pain experience in children with juvenile idiopathic arthritis.

OBJECTIVE: To examine whether pain-specific beliefs and coping strategies of patients with juvenile idiopathic arthritis (JIA) independently predict their reported pain, while controlling for relevant demographic variables, disease activity, and parent-rated disability. To compare use of pain-coping strategies and pain-related beliefs of a selected subgroup of patients with high pain and low disease activity (high pain group) with the remaining patients. METHODS: Children with JIA (n = 56) completed the Pain Coping Questionnaire, a revised version of the Survey of Pain Attitudes, and a 3-week pain diary. The parents completed the Childhood Health Assessment Questionnaire (CHAQ). Second order principal component analyses were conducted in order to reduce the number of independent variables. Regression analyses of the dependent measure were performed. The use of coping strategies and health beliefs were compared using t-tests for independent samples. Pearson's correlation coefficients were calculated to examine the direct associations between each individual coping and belief scale, and the pain measure. RESULTS: Only the CHAQ and the cognitive belief composite factor score made statistically significant contribution to the prediction of pain after controlling for other variables. Significant differences were found between the scores of high pain patients and the rest of the group for the health belief subscale of disability (mean +/- SD 2.0 +/- 0.6 and 1.2 +/- 0.7, respectively), and for the health belief subscale of harm (mean +/- SD 2.7 +/- 0.6 and 1.8 +/- 0.7, respectively). Significant correlations were obtained between the pain measure and the pain-coping subscale of catastrophizing, the pain belief subscales of disability, harm, solicitude (inverse), control, and medical cure. CONCLUSION: These results support a model of pain experience in patients with JIA where psychological factors are strongly influential. It may be efficient to focus behavioral interventions on a subgroup of children where the pain experience seems to be in discordance with the disease activity.

Adaptation, Psychological↗

Daily stress, coping, and dietary restraint in binge eating.

OBJECTIVE: The current study evaluated whether psychological stress, use of specific coping strategies, and trait dietary restraint would prospectively predict binge eating episodes. METHOD: After completing a baseline measure of restraint, 46 binge eating college women kept daily diaries assessing depressed affect, stress, coping, and binge eating for 30 days. RESULTS: Regardless of level of depressed mood, higher stress was associated with increased risk of same-day binge eating; distraction coping was associated with increased risk of future binge eating; social support was associated with decreased risk of same-day binge eating; and women with high versus low dietary restraint showed different patterns of relationship for stress, coping, and binge eating. DISCUSSION: Vulnerability to binge eating in women who differ in terms of dietary restraint level may vary as a function of their coping responses to stress. Results highlight the complexities of stress and coping in binge eating.

Adaptation, Psychological↗

Can a pulmonary health teaching program alter patients' ability to cope with COPD?

Many clinical nurse specialists (CNSs) are involved in providing group teaching programs for individuals with chronic obstructive pulmonary disease (COPD). Although knowledge levels often are enhanced by these programs, what is less well known is whether such programs also can affect the coping methods used by those with this disease. The exploratory study described here was part of a larger research project aimed at determining patients' knowledge, specific psychological parameters (anxiety, hostility, depression), and coping strategies. Thirty people agreed to participate in the study. The Jalowiec Coping Scale (JCS) (Jalowiec & Powers, 1981) was used so that participants could rate each coping method according to the degree of use and to determine whether the methods employed were affective or problem-solving approaches. There was very little change in the pre- and posttest scores on the JCS, indicating that there was little change in coping strategies used. There also were no significant correlations between the JCS scores and the demographic characteristics of age, educational level, and the length of time since diagnosis of COPD. The results of this study seem to indicate that pulmonary rehabilitation programs should place more emphasis on appropriate coping strategies that the COPD patient can incorporate into his or her lifestyle.

Adaptation, Psychological↗

Coping patterns and related characteristics in patients with IBD.

This article describes a study designed to examine the coping behaviors, personality, and mood characteristics of 150 nonhospitalized adults with inflammatory bowel disease (IBD). Self-report questionnaires and interviews were used to collect the data. Coping responses were measured with the Jalowiec Coping Scale. The Eysenck Personality Questionnaire (EPQ) and Beck Depression Inventory (BDI) were used to ascertain other characteristics. Data were analyzed using analysis of variance (ANOVA), Pearson's correlation coefficient (r), and descriptive statistics. IBD patients scored significantly higher on using problem-oriented coping patterns than on using affective-oriented methods. The results suggest that coping patterns in IBD patients are remarkably effective in contributing to lifestyle satisfaction. It can be inferred that adaptive efforts of IBD patients can be enhanced if health professionals consider coping patterns in the assessment process and if they actively support a sense of control in these patients.

Activities of Daily Living↗

Use of the Coping Inventory for Stressful Situations in a clinically depressed sample: factor structure, personality correlates, and prediction of distress.

The Coping Inventory for Stressful Situations (CISS; Endler & Parker, 1990) is a self-report measure of Emotion-, Task-, and Avoidance-oriented coping. The psychometric properties of the CISS were evaluated in a large sample of outpatients with major depressive disorder (N = 298). The CISS scales demonstrated good reliability and support for their factorial validity was obtained. Relationships between the CISS scales and the broad personality domains from the five-factor model of personality, as well as two measures of emotional distress, were examined. Less-adaptive coping strategies (i.e., Emotion-oriented coping) were associated with less-adaptive personality traits (i.e., Neuroticism) and with psychological distress (i.e., Depression), whereas the reverse was found regarding adaptive coping strategies (i.e., Task-orientated coping). The incremental validity of the CISS was demonstrated by multiple-regression analyses that found two CISS scales accounted for significant variance in psychological distress beyond that contributed by the demographic and personality variables.

Adaptation, Psychological↗

Coping, meaning in life, and suicidal manifestations: examining gender differences.

Life meaning and coping strategies were investigated as statistical predictors of suicidal manifestations in a sample of 298 university undergraduates. Participants completed measures of hopelessness, sense of coherence, purpose in life, coping for stressful situations, suicide ideation, prior suicide attempts, and self-reported likelihood of future suicidal behavior. Moderated multiple regression techniques examined the incremental validity of life meaning by coping interactions for predicting each suicide variable separately by gender. The interaction of sense of coherence and emotion-oriented coping made a unique, significant contribution to the statistical prediction of all suicide variables for women. For men, the interaction between sense of coherence and emotion-oriented coping contributed significantly to the statistical prediction of suicide ideation. All interactions remained significant when hopelessness was statistically controlled. The hypothesis that life meaning acts as a buffer between coping style and suicidal manifestations was partially supported. Implications for suicide prevention and intervention are discussed.

Adaptation, Psychological↗

Posttraumatic stress symptoms, coping, and physical health status among university students seeking health care.

This study examined posttraumatic stress disorder (PTSD) symptoms, coping, and physical health status in students reporting a trauma history (N = 138) using structural equation modeling. Participants completed questionnaires assessing PTSD symptoms, coping specific to health-related and trauma-related stressors and physical health. After accounting for coping with health-specific problems, trauma-specific avoidance coping was uniquely associated with poorer health status. Posttraumatic stress disorder symptoms were associated with poorer physical health status, controlling for age, health behaviors, and other psychopathology. In addition, the effect of PTSD symptoms on poorer health status was mediated by health- and trauma-specific avoidance coping. Results suggest that university health centers should screen for PTSD and consider psychoeducational programs and coping skills interventions for survivors of trauma.

Adaptation, Psychological↗