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The relationship between function, quality of life and coping in patients with low-grade gliomas.

OBJECTIVES: The principal aim of the study was to describe function, quality of life and coping with illness-related problems in patients with low-grade gliomas (LGG), to evaluate the need of support. A second aim was to investigate how function, quality of life and coping were related. MATERIALS AND METHODS: Thirty-nine patients with a diagnosis of LGG answered the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30) and the Ways of Coping Questionnaire (WCQ). The patients' level of function was assessed in accordance with the WHO performance status scale. RESULTS AND DISCUSSION: Nearly all patients were capable of self-care, but less than half were able to carry out normal activities without restriction. Problems with fatigue, sleep disturbances and pain were most frequent. Most difficulties were reported in the domains, Role, Cognitive and Emotional functioning. Seventeen patients (45%) had scores indicating low overall quality of life. Ratings of overall quality of life and fatigue had the strongest relationship. The trend in the results suggested that mental problems have a stronger impact on quality of life than physical ones. Emotion-focused coping dominated. There was a significant relationship between coping by escape-avoidance and lower level of emotional functioning. CONCLUSIONS: The results of this study indicate that a multidisciplinary team is needed for assessment and treatment of the different problems in patients with LGG. Furthermore, special attention should be paid to patients who use coping by escape-avoidance, as this is associated with emotional distress.

Activities of Daily Living↗

Individual differences in reactivity to and coping with the stress of lecturing.

The aim of this study was to evaluate the moderating effect of several psychologically and biologically defined characteristics for both psychological and physiological indices of reactivity to and coping with lecturing stress. Student teachers were measured in two standardized lecturing situations: once at the start of a three-month practice period and once at the end of this period. Reactivity was operationalized as an increase in heart rate, cortisol excretion and subjective anxiety responses in anticipation of and at the start of the lecture. Coping was operationalized as the attunement of these responses during, or recovery after lecturing (short term coping), and as the adaptation of these responses across the three-month practice period (long term coping). It was found that reactivity to and (particularly long term) coping with the lecturing stressor could well be predicted by moderators such as physical fitness, extraversion, neuroticism, social anxiety and several coping styles. Specificity of predictor sets for sex and response parameters is discussed.

Adaptation, Psychological↗

Measuring coping in breast cancer.

The emotional distress associated with breast cancer varies between individual women. These variations may be accounted for by differences in cognitive and behavioural coping responses to diagnosis. This study has attempted to develop a reliable, situation-specific approach to the measurement of coping responses in women with breast cancer. It has adapted a general coping questionnaire and modified an interview-based schedule for coping with cancer. The strengths and weaknesses of the interview and self-report methods of assessment are highlighted. Consistent results from these complementary approaches have been obtained. Both indicate the extensive use of cognitive avoidance and positive reappraisal. It has been shown that the majority of patients use a wide repertoire of coping responses which challenges the notion of mutually exclusive coping styles. These measures may be employed to examine the relationship between women's thoughts and behaviours in response to the diagnosis and treatment of breast cancer and subsequent psychological outcome.

Adaptation, Psychological↗

A multifactorial study of test anxiety and coping responses during a challenge examination.

Challenge examinations offer registered nurse students enrolled in our baccalaureate nursing programme the opportunity to demonstrate mastery of course content through a testing process. Successful students receive credit for the course while those who are unsuccessful must take the course to proceed in the programme. Faculty observations of registered nurse students during the challenge process suggested this testing was stressful. Therefore, a study was conducted to determine anxiety levels and coping strategies of on-campus and distance education registered nurse students at three different times during the challenge examination process. Differences between the two groups of nursing students on selected demographic variables, past academic performance, anxiety levels and coping strategies were assessed from the perspective of Folkman & Lazarus's (1984) theory of stress and coping. Significant differences were found in anxiety levels, coping strategies and past academic performance by age, marital status, employment and work setting. Several different coping strategies were used. However, problem solving was used extensively by both groups while social support was used more by the on-campus students. The results are discussed in terms of Folkman & Lazarus's theory of stress and coping, and implications for nurse educators are presented.

Adaptation, Psychological↗

Ways of coping with chronic fatigue syndrome: development of an illness management questionnaire.

Chronic fatigue syndrome (CFS) is a disorder of uncertain aetiology, and there is uncertainty also about the appropriate way in which patients should manage the illness. An illness management questionnaire (IMQ) was designed to assess coping in CFS. This was completed by 207 patients, in parallel with the COPE scales (a general measure of coping that can be applied situationally), and measures of functional impairment, anxiety and depression. The IMQ yielded four factors: maintaining activity, accommodating to the illness, focusing on symptoms and information-seeking. Scales based upon these factors together predicted 26, 27 and 22% of the variance in functional impairment, anxiety and depression, respectively, and each scale had significant relationships with relevant scales of the COPE, supporting the interpretation of the factors. It is suggested that the IMQ may be employed to relate ways of coping to outcomes in CFS, and to assess coping as a mediator of change in cognitive-behavioural interventions.

Adaptation, Psychological↗

Coping with persistent pain: a comparison of persistent pain sufferers in a specialty pain clinic and in a family practice clinic.

Coping has been defined as an effort to manage external and internal demands and conflicts that tax or exceed a person's resources. This paper examines the types of coping strategies used by two groups of persistent pain sufferers: one from a family practice clinic and the other from a specialty pain clinic. The relationship between the use of different types of coping strategies and adjustment was determined. The two study groups of persistent pain sufferers differed significantly from each other on many of the indices developed to tap adjustment but did not differ on any of the Billings and Moos original categories of coping strategies. When a factor analysis of coping items was performed, 5 valid clusters relevant to the chronic pain patient samples were determined. The factor the authors entitled 'adversarialness' with the qualities of dysphoric withdrawal, avoidant behavior and catastrophizing was found to explain adjustment defined by several indices. The authors conclude that it may be important to help persistent pain sufferers to alter their attitudes and behavior that tend toward catastrophizing, avoidance and withdrawal, rather than simply concentrate on trying to teach them techniques for 'coping with stress.'

Adaptation, Psychological↗

The relationship of locus of control to pain coping strategies and psychological distress in chronic pain patients.

Although behavioral scientists have long been interested in how an individual's locus of control relates to coping and adjustment, basic information remains to be gathered on the relevance of locus of control to adaptation to persistent pain. This study examined the relationship of locus of control orientation to pain coping strategies and psychological distress in chronic pain patients. Subjects were 62 chronic pain patients. All patients were administered: (1) the Multidimensional Health Locus of Control Scales to assess locus of control, (2) the Coping Strategies Questionnaire to evaluate pain coping strategies, and (3) the Symptom Checklist-90 Revised to assess psychological distress. Correlational analyses revealed that patients who viewed outcomes as controlled by chance factors such as fate or luck tended to rely on maladaptive pain coping strategies and rated their abilities to control and decrease pain as poor. They also exhibited greater psychological distress. Regression analyses indicated that patients having a chance orientation toward locus of control were more likely to report depression, anxiety, and obsessive-compulsive symptoms and to have higher overall levels of psychological distress. Chance locus of control also predicted greater reliance on diverting attention and praying/hoping in dealing with their pain. In addition, patients high on chance locus of control reported feeling helpless to deal effectively with their pain problem. Clinicians evaluating chronic pain patients need to be aware that patients who view outcomes as controlled by external factors such as chance may have deficits in pain coping strategies and may report greater psychological distress than patients who do not have this locus of control orientation.

Adaptation, Psychological↗

Analyzing pain in rheumatoid arthritis patients. Pain coping strategies in patients who have had knee replacement surgery.

This study used the Coping Strategies Questionnaire (CSQ) to investigate pain coping strategies in 52 rheumatoid arthritis patients who reported having knee pain 1 year or more following knee replacement surgery. Data analysis revealed that, as a group, these patients were active copers in that they reported frequent use of a variety of pain coping strategies. Pain coping strategies were found to be related to measures of pain and adjustment. Patients who rated their ability to control and decrease pain high and who rarely engaged in catastrophizing (i.e., who scored high on the Pain Control and Rational Thinking factor of the CSQ) had much lower levels of pain and psychological disability than patients who did not. Coping strategies were not found to relate to age, gender, obesity status or disability/compensation status. Taken together, these results suggest that an analysis of pain coping strategies may be helpful in understanding pain in arthritis patients who have pain following joint replacement surgery.

Adaptation, Psychological↗

Pain beliefs and the use of cognitive-behavioral coping strategies.

Patients' beliefs about chronic pain, such as how long it will last and whether it is a mysterious experience, have been shown to be related to compliance with treatment programs. The present study examined whether these pain beliefs related to a specific component of pain management, namely the frequency of use and the perceived effectiveness of cognitive and behavioral coping strategies. One hundred twenty chronic pain patients were administered the Pain Beliefs and Perceptions inventory (PBAPI) and the Coping Strategies questionnaire (CSQ). A cluster analysis of 2 pain beliefs (that pain is enduring and that pain is mysterious) was conducted revealing 3 distinct subgroups of patients based upon these 2 beliefs. Multivariate analysis of variance was used to detect whether the use of cognitive-behavioral pain coping strategies differed in patients in the 3 pain beliefs subgroups. The results indicated that patients belonging to the group characterized by the belief that pain was enduring and mysterious were less likely to use cognitive coping strategies (e.g., reinterpretation of pain sensation), more likely to catastrophize, and less likely to rate their coping strategies as effective in controlling and decreasing pain than patients believing their pain to be understandable and of short duration. The implications of these results for understanding the patient's choice of and compliance with treatment and coping efforts is discussed.

Adaptation, Psychological↗

Daily coping with pain from rheumatoid arthritis: patterns and correlates.

Seventy-five individuals with rheumatoid arthritis reported their pain coping, mood, and joint pain for 75 consecutive days. Pain coping strategies used most often were taking direct action to reduce the pain and using relaxation strategies; those used least often were expressing emotions about the pain and redefining the pain to make it more bearable. Several background characteristics, including gender, disability, neuroticism, and pain control perceptions predicted use of various coping strategies. Controlling for these characteristics, individuals who used relaxation more frequently as part of their daily coping repertoire had less daily pain during the course of the study, and those who reported more overall coping efforts were more likely to display declining levels of daily pain across time. Pain severity moderated the relations of seeking emotional support and use of distraction with daily mood. At low levels of pain, greater use of these strategies related to more positive mood but, at high levels of pain, related to less positive mood. Finally, individuals who reported a greater number of distinct forms of coping were more apt to enjoy improving daily mood over the course of the study. Findings are discussed in terms of the advantages of prospective daily research designs.

Adaptation, Psychological↗

Cognitive coping and appraisal processes in the treatment of chronic headaches.

The purpose of the present study was to investigate the active cognitive ingredients of change in psychological treatments for long-term chronic headache complaints. The primary questions this study addressed were: (1) Is a cognitive self-hypnosis training which explicitly attempts to change appraisal and cognitive coping processes more effective in producing these changes than a relaxation procedure, and (2) are changes in pain appraisal and cognitive coping related to changes in pain and adjustment in the short and long term? A total of 144 patients were assigned at random to a cognitive self-hypnosis (CSH) treatment or autogenic training (AT) with a duration of 7 weeks. Measures used were: Headache Index (HI), Symptom Checklist-90 (SCL-90), Coping Strategy Questionnaire (CSQ), Multidimensional Locus of Pain Control Questionnaire (MLPC) and treatment expectations. The results indicated that patients successfully changed their use of coping strategies and pain appraisals. Cognitive therapy was more effective than relaxation training in changing the use of cognitive coping strategies which were the direct targets of treatment. However, treatment effects were only related with changes in the use of coping strategies and appraisal processes to a limited extent and the mediational role of cognitive processes in pain reduction and better adjustment was inconclusive.

Adaptation, Psychological↗

Coping with the temptation to drink.

Part one of this study examined the efficacy of coping responses among college students (N = 137) attempting to control their temptation to drink. Using the taxonomy delineated by Shiffman ("Coping with the Temptation to Smoke, Journal of Consulting and Clinical Psychology, vol. 50, pp. 261-267, 1984), results indicated that both cognitive and behavioral coping were effective in resisting the temptation to drink. When specific coping responses were compared, 3 of 10 behavioral responses and 3 of 13 cognitive responses showed a significant relationship with outcome. These responses were differentially effective in resisting the temptation to drink. A comparison was made to Shiffman's (1984) previous work and the conceptual and methodological problems which may account for the divergent results are discussed. Part Two of this study examined the relationship between the coping responses people use in attempting self-control and those used in dealing with daily stressors. Results suggest that coping is a highly situationally specific response which shows little consistency across these two contexts. Conceptual and methodological difficulties which qualify the obtained results are discussed.

Adaptation, Psychological↗

Chemotherapy-induced nausea and emesis in pediatric cancer patients: an analysis of coping strategies.

We investigated the preference and perceived efficacy of coping strategies used to manage chemotherapy-induced nausea and emesis in 57 pediatric oncology patients. Over 85% of children preferred "Wishful Thinking," "Emotional Regulation," and "Distraction" to cope with nausea, and "Emotional Regulation" to manage emesis. Stepwise logistic regression analyses revealed that the coping strategy used and its perceived efficacy depended upon patient age and gender, severity of symptom distress, time elapsed from last chemotherapy, experience, and whether nausea or emesis was the identified problem. Successful copers, defined as those reporting high coping efficacy and minimal distress, composed only 25% of the sample. These children most often used "Problem Solving" combined with "Social Support" for symptom management. Successful coping was also associated with lower emetogenic potential of chemotherapy. The significance of these results is discussed for identifying high-risk children who may benefit from coping interventions.

Adaptation, Psychological↗

Situational analysis of coping in substance-abusing patients.

A recently revised version of the Situational Competency Test (SCTDR), a tape-recorded role-play assessment procedure, was used to evaluate situational specificity of coping in hospitalized substance-abusing patients (N = 24). Responses to six types of high-risk situations were scored according to coping method used (active cognitive, active behavioral, avoidance, help-seeking) and objective response parameters (latency, duration, specification, compliance). Additionally, patterns of past drug use and self-efficacy were evaluated for situational variability and association with coping response measures. Findings revealed that the situational profiles for each of the four coping methods were distinct, and that each coping method was used differentially across high-risk situations. Objective scoring dimensions demonstrated patterns of situational specificity, for example, subjects' responses in situations involving unpleasant emotions were more delayed, shorter, and less specific than in other types of high-risk situations. Heavy past drug use and low self-efficacy were significantly related to latency in responding. These findings are consistent with previous studies in which substance abusers' coping was shown to be at least partially dependent on situational parameters.

Adaptation, Psychological↗

Individual differences in adolescent health symptoms: the effects of gender and coping.

Previous studies have suggested that adult men and women experience different types and severities of physical and psychological health symptoms. This study examined whether in the case of adolescents these reported gender differences in physical and psychological health symptoms could actually be the result of differences in coping styles. Five hundred and forty-six adolescents were questioned on their coping styles and symptoms. We found gender differences in physical and psychological health symptoms (e.g. anger, depression, tension, negative moods), as well as in coping styles. We also found that the relation between health symptoms and coping varied significantly by gender. The results of this study suggest that doctors, school counselors and family therapists may want to take gender differences in coping styles into account when seeing adolescent patients for physical or psychological health symptoms, and find ways to help the adolescents cope more effectively with their stressors.

Adaptation, Psychological↗

Relations between negative affect, coping, and emotional eating.

The study was designed to examine the relations between negative affect, coping, and emotional eating. It was tested whether emotion-oriented coping and avoidance distraction, alone or in interaction with negative affect, were related to increased levels of emotional eating. Participants were 125 eating-disordered women and 132 women representing a community population. Measures included the Positive and Negative Affectivity Schedule (PANAS), the Coping Inventory for Stressful Situations (CISS), and the Dutch Eating Behavior Questionnaire (DEBQ). Both emotion-oriented coping and avoidance distraction were related to emotional eating, while controlling for levels of negative affect. Negative affect did not have a unique contribution to emotional eating over and above emotion-oriented coping or avoidance distraction. The findings suggest that emotional eating is related to reliance on emotion-oriented coping and avoidance distraction in eating-disordered women as well as in relatively healthy women.

Adaptation, Psychological↗

Relationship of resilience to personality, coping, and psychiatric symptoms in young adults.

Developing a comprehensive understanding of resilience across the lifespan is potentially important for mental health promotion, yet resilience has been vastly understudied compared to disease and vulnerability. The present study investigated the relationship of resilience to personality traits, coping styles, and psychiatric symptoms in a sample of college students. Measures included the Connor-Davidson Resilience Scale, NEO Five Factor Inventory, Coping Inventory for Stressful Situations, and Brief Symptom Inventory. Results supported hypotheses regarding the relationship of resilience to personality dimensions and coping styles. Resilience was negatively associated with neuroticism, and positively related to extraversion and conscientiousness. Coping styles also predicted variance in resilience above and beyond the contributions of these personality traits. Task-oriented coping was positively related to resilience, and mediated the relationship between conscientiousness and resilience. Emotion-oriented coping was associated with low resilience. Finally, resilience was shown to moderate the relationship between a form of childhood maltreatment (emotional neglect) and current psychiatric symptoms. These results augment the literature that seeks to better define resilience and provide evidence for the construct validity of the Connor-Davidson Resilience Scale.

Adaptation, Psychological↗

Coping strategies and interpersonal support in patients with irritable bowel syndrome and inflammatory bowel disease.

BACKGROUND & AIMS: Coping strategies are used to manage conflict and illness and can have adaptive or maladaptive effects on health status. Perceived availability and quality of social support also influences health status. Coping strategies and social support have not been well studied in irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). To understand their role better, coping strategies, social support, and psychiatric distress were assessed in patients with IBS and IBD and in controls. METHODS: Participants completed the Ways of Coping Questionnaire, the Interpersonal Support Evaluation, Symptom Checklist-90-revised, IBS-Quality of Life (QOL), and IBD-QOL. Participants also completed the Toronto Alexithymia Scale and Somatosensory Amplification Scale. RESULTS: The study population included 55 controls, 74 IBS patients, and 48 IBD patients. The IBS and IBD patients had higher scores on measures of psychiatric distress, alexithymia, and somatosensory amplification than controls, but did not differ from one another. QOL scores did not differ between patients with IBS and IBD. Patients with IBS and IBD reported significantly less interpersonal support than controls. Controls identified planful problem solving as the dominant coping strategy whereas patients with IBS and IBD relied significantly less on planful problem solving and positive reappraisal and more on escape-avoidance strategies. CONCLUSIONS: Compared with controls, IBS and IBD patients had increased levels of psychiatric distress, a poorer QOL, less interpersonal support, and greater reliance on passive coping strategies. These data suggest that psychosocial disturbances are common in IBD and IBS and suggest that the observed differences reflect illness behavior rather than a disorder-specific process.

Adaptation, Psychological↗