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PubMed1995

Evolution of parental stress and coping processes: a framework for critical care practice.

Crisis theory, stress and coping theory, and research on parental stress and coping during pediatric critical care experiences are integrated into a conceptual framework for understanding, assessing, and ultimately intervening to reduce parental stress and bolster coping. Within this framework, cognitive appraisal of stress, coping and person and situation factors are discussed as important determinants of parents' adaptation to this stressful situation. The nurse's ability to respond to the evolving nature of parental stress and coping processes over the course of the experience enhances the use of the framework in designing coping interventions.

Adaptation, Psychological↗

PubMed1995

Perceived stressors and coping strategies of parents who have children with developmental disabilities: a comparison of mothers with fathers.

The purposes of this study were to describe perceived stressors and coping strategies of parents who have children with developmental disabilities and to examine similarities and differences of mothers and fathers in their perceptions of stressors and coping. A sample of 203 parents of children with developmentally disabilities, ages two through five years, participated in the study. Hymovich's Parent Perception Inventory: Concerns (Hymovich, 1988) and the Ways of Coping Questionnaire (Folkmann & Lazarus, 1988) were used for data collection. Stressors and coping strategies were identified. The stressor reported by the largest number of both mothers and fathers was concern about the child's future. There were fewer differences between mothers and fathers in reporting of stressors than in reporting coping strategies. The importance of recognizing parental individuality in family coping is addressed within the context of implications for nursing practice and research.

Adaptation, Psychological↗

PubMedDate not supplied

Maternal expectations and attributions about coping in anxious children.

This study examined maternal expectations and attributions regarding their child's ability to cope with a stressful situation. Children either met DSM III-R criteria for an Anxiety Disorder or were normal. Results indicated that it was not the perception of threat that differentiated the expectations of mothers in both groups, but rather their expectations for coping, both generally and in terms of specific behavior. Mothers of anxiety-disorder (AD) children expected their children to be more upset, less able to make themselves feel comfortable, and were less confident in their children's abilities to perform task related behavior. In general, maternal expectations for coping appear to reflect the actual lower coping ability of anxious children. Concerning attributions, mothers of AD children made fewer causal distinctions between high and low coping than did mothers of normal control (NC) children. Discussion considers how lowered expectations for coping may relate to protective parenting and how such patterns may unwittingly maintain anxious behavior in children.

Adaptation, Psychological↗

PubMed1993

Multiple sclerosis: the relationship among self-esteem, social support, and coping behavior.

This study examines the relationship of self-esteem and social support to problem-focused coping behavior of 101 individuals with multiple sclerosis, a chronic progressive disease. Results included a significant relationship between self-esteem and problem-focused coping; a nonsignificant relationship between social support and problem-focused coping; and that self-esteem and social support taken together did not contribute significantly to problem-focused coping. Although the most frequently used coping strategies employed were problem focused, subjects did use combinations of problem- and emotion-focused strategies to deal with stressful encounters. The findings highlight the importance of assessing self-esteem, social support, and coping behavior of persons afflicted with multiple sclerosis and thus with the ever present potential for physical deterioration.

Activities of Daily Living↗

PubMed2000

Psychological distress among HIV(+) adolescents in the REACH study: effects of life stress, social support, and coping. The Adolescent Medicine HIV/AIDS Research Network.

PURPOSE: To investigate the effects of life events, social support, and coping on anxiety and depression among human immunodeficiency virus (HIV)-infected adolescents. It was hypothesized that higher levels of stressful events would be associated with higher levels of anxiety and depression, but that this association would be moderated by satisfaction with social support and by adaptive coping. METHODS: HIV-infected adolescents from 16 locations in 13 U.S. cities (N = 230, median age 16.09 years, standard deviation 1.2, range 13-19; 77% females) were recruited into the Reaching for Excellence in Adolescent Care and Health (REACH) project. REACH is the first large-scale disease progression study of HIV(+) adolescents infected through sexual behavior or injection drug use. The adolescent assessment was conducted by audio-computer assisted self-interview. Least squares regressions were used to test hypotheses. RESULTS: Life events with high impact were associated with higher levels of depression and anxiety. Frequently reported events included: being prescribed medications (74%), family financial problems (61%), and parental alcohol abuse (20%). Contrary to expectations, the buffering hypotheses of social support and adaptive coping were not supported. Satisfaction with social support and adaptive coping methods were both associated directly with lower levels of depression, but no association was detected between these two measures and anxiety. CONCLUSIONS: Although life event distress was directly associated with psychological distress, neither social support nor adaptive coping seemed to moderate this association. However, both satisfaction with support and adaptive coping were associated directly with depression in HIV-infected adolescents.

Adaptation, Psychological↗

PubMed1997

Spousal coping during the surgical wait.

The purpose of this study was to identify the coping strategies used by a patient's spouse and the perceived effectiveness of these coping strategies while waiting during a loved one's surgery. Forty spouses, male and female (age 25 to 65 years), waiting during a patient's surgery completed a demographic questionnaire and the Jalowiec Coping Scale. Mean scores of the styles and individual strategies were calculated and ranked in descending order. The optimistic coping strategy of "tried to think positively" was used most often by the subjects. The supportant coping strategy of "prayed or put trust in God" was ranked as the most effective strategy. The nurse who instructs the patient regarding their surgery should also prepare the spouse for the surgical wait. Recommending coping strategies to spouses may be a component of stress inoculation.

Adaptation, Psychological↗

PubMed1998

Pain, coping and psychological well-being in late life.

In the present article, the relationships between pain, coping, functional capacity and psychological well-being are examined in a population of older patients (>/=60 years; n=202) treated for a variety of somatic complaints in a university-affiliated hospital. Results indicate that moderate to extreme pain is common in older patients and often occurs in several body regions simultaneously. Extreme pain in one or more body regions is associated with reduced daily functional capacity, lower values for life satisfaction and self-evaluated competence, and more negative attitudes towards the present and future. Results of a hierarchical cluster analysis reveal interindividual differences in coping approaches among older patients suffering from extreme pain; they also emphasize the importance of cognitive strategies and life-review coping. Relevance for clinical practice with older pain patients is discussed.In the present article, the relationships between pain, coping, functional capacity and psychological well-being are examined in a population of older patients (>/=60 years; n=202) treated for a variety of somatic complaints in a university-affiliated hospital. Results indicate that moderate to extreme pain is common in older patients and often occurs in several body regions simultaneously. Extreme pain in one or more body regions is associated with reduced daily functional capacity, lower values for life satisfaction and self-evaluated competence, and more negative attitudes towards the present and future. Results of a hierarchical cluster analysis reveal interindividual differences in coping approaches among older patients suffering from extreme pain; they also emphasize the importance of cognitive strategies and life-review coping. Relevance for clinical practice with older pain patients is discussed. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗

PubMed2004

Religious and nonreligious coping in older adults experiencing chronic pain.

Chronic pain is a significant problem among older adults. Undertreated or poorly managed pain can affect the physical, psychological, social, emotional, and spiritual well-being of older people. Several researchers have found that individuals turn to a wide array of cognitive and behavioral coping strategies when experiencing high levels of chronic pain. In addition, there is a growing body of evidence that supports an association between health outcomes and the use of religious coping to manage pain. Thus, the purpose of this descriptive, cross-sectional study was to explore the use of religious and nonreligious coping in older people who were experiencing chronic pain. Specific aims were to (a) describe the chronic pain experiences of older people; (b) examine the frequency and type of religious and nonreligious coping strategies used by older people to manage chronic pain; and (c) determine if there were differences in the use of religious and nonreligious coping across gender and race. Mean age of this convenience sample of 200 community-dwelling adults was 76.36 years (SD = 6.55). On average, study participants reported that their pain was of moderate intensity. Lower extremities were the most frequently reported painful body locations. Findings from this study support prior research that suggests older people report using a repertoire of pharmacologic and nonpharmacologic strategies to manage chronic pain. Older women and older people of minority racial background reported using religious coping strategies to manage their pain more often than did older Caucasian men. Older women also reported using diversion and exercise significantly more often than did older men.

Adaptation, Psychological↗

PubMed1995

The stability of the Ways of Coping (Revised) Questionnaire over time in parents of children with Down's syndrome: a research note.

The stability of the Ways of Coping (Revised) Questionnaire over time was assessed by comparing the scores of 68 mothers and 53 fathers of school-aged children with Down's syndrome over a 3-year time interval on the five coping strategy subscales described by Knussen et al. (1992). For this analysis, mothers' and fathers' scores were analysed separately. It was shown by t tests that mothers' and fathers' scores on the coping strategy subscales had not significantly changed over the three-year period. Time 1 and Time 2 scores on all of the coping subscales were strongly positively associated, with the exception of fathers' scores on the Stoicism subscale. Test-retest reliability was adequate for all subscales except mothers' scores on the Passive Acceptance subscale and fathers' scores on the Stoicism subscale. These results, by demonstrating the stability of the Ways of Coping (Revised) Questionnaire over a 3-year time period, further illustrate the utility of this instrument for investigating coping with families with special problems.

Adaptation, Psychological↗

PubMed1996

Maladaptive coping and affective disorders among cancer patients.

Coping has attracted much attention in research as a possible mediator of the psychological impact of cancer. Yet, conceptual ambiguity and methodological limitations have resulted in weak and contradictory findings. A major shortcoming has been the use of designs which do not represent adequately the complexity or the diversity of demands which arise from the diagnosis and treatment of cancer. The neglect of appraisal in the assessment of the relationship between coping and mental health is of particular concern, given the role it has been found to play in the onset and maintenance of affective disorders. In a prospective study 673 newly diagnosed cancer patients were interviewed 4 to 8 weeks and 1 year later to assess the effects of their appraisals, coping responses and resolution of any concerns on subsequent mental health. Logistic regression analyses, adjusted for possible confounding variables, were used to investigate the relationships between coping variables and affective disorders. When examined separately the degree of threat appraised, the reporting of a helpless response and perceived success of primary responses in resolving concerns all predicted subsequent effective disorder. However, in a multivariate model only appraisal and success of the response in resolving the concern were significant. No response was found to prevent affective disorders, however certain types of responses were associated with the resolution of specific concerns. The results highlight the importance of assessing the whole coping process and the need to address the complex and multifaceted characteristics of cancer demands. On the basis of our findings we describe a maladaptive cycle of coping, which we believe contributes to the later onset of affective disorders in cancer patients.

Adaptation, Psychological↗

PubMed1992

Coping subtypes for men with coronary heart disease: relationship to well-being, stress and Type-A behaviour.

We used cluster analysis to delineate coping subtypes in a sample of 166 men with coronary heart disease who completed the Antwerp out-patient rehabilitation programme. These subtypes were identified on the basis of three well-defined superordinate traits that were selected from a comprehensive taxonomy: negative affectivity, social inhibition, and self-deception. Using Ward's minimum variance method and the cubic clustering criterion, we identified four coping subtypes; low-negative affectivity (N = 48), high-negative affectivity (N = 30), inhibited (N = 62), and repressive (N = 26) individuals. The accuracy of the resulting classification was demonstrated across parallel data sets and was further validated against external, health-related correlates that were not included in the clustering. The identified coping subtypes were significantly related to self-reports of subjective distress/perceived stress, ratings of Type A behaviour and anger-in, return to work, prevalence of chest-pain complaints, and use of minor tranquillizers and sleeping pills. The major findings of this study suggest that (a) male coronary patients represent a heterogeneous population with distinctly different coping subtypes, and that (b) a relatively small number of homogeneous subtypes can account for a substantial amount of variance in subjective well-being, coronary-prone behaviour, and return to work. These findings indicate that psychosomatic research should focus on how superordinate traits interact within individuals and corroborate the appropriateness of a class model to describe coping styles of male coronary patients. It is argued that discrepant findings across studies of Type-A behaviour and hostility may be related to the coping subtypes of the subject sample. Further attempts to cross-validate this classification scheme and to examine its health-related correlates are needed.

Adaptation, Psychological↗

PubMed1997

Prodromes, coping strategies, insight and social functioning in bipolar affective disorders.

BACKGROUND: Patients suffering from bipolar affective disorders are generally reported to be able to detect prodromes. Insight is also said to be desirable for a good outcome. However, very little is known about the effect of insight and patients' spontaneous strategies for coping with prodromes on their social functioning. METHOD: In a cross-sectional study 40 bipolar patients, who were not in an acute episode, were interviewed about their prodromes of depression and mania, their coping strategies for these prodromes, their levels of insight and their levels of social functioning. RESULTS: A quarter of subjects reported that they could not detect any early warnings of depression compared with only 7.5% of subjects who reported that they could not detect prodromes of mania. Subjects reported both spontaneous cognitive and behavioural strategies for coping with prodromes of depression but only behavioural strategies for prodromes of mania. Subjects' current levels of depression, how they coped with prodromes of mania and their ability to recognize early warnings for depression contributed significantly to their level of social functioning. Insight also had a weaker but significant contribution. CONCLUSION: No causal link was made in this study. However, it did show that patients' level of social functioning was related to their level of insight, and to how well they coped with the prodromes of mania and whether they could detect prodromes of depression. The results suggest that it is worth exploring ways of teaching patients to monitor their moods and to promote insight and good strategies for coping with their prodromes.

Adaptation, Psychological↗

PubMed2002

Does age at the time of elective cardiac surgery or catheter intervention in children influence the longitudinal development of psychological distress and styles of coping of parents?

AIMS: To assess the influence of age at a cardiac procedure of children, who underwent elective cardiac surgery or interventional cardiac catheterisation for treatment of congenital cardiac defects between 3 months and 7 years of age, on the longitudinal development of psychological distress and styles of coping of their parents. METHODS: We used the General Health Questionnaire to measure psychological distress, and the Utrecht Coping List to measure styles of coping. Parents completed questionnaires on average respectively 5 weeks prior to, and 18.7 months after, cardiac surgery or catheter intervention for their child. RESULTS: Apart from one exception, no significant influence was found of the age at which children underwent elective cardiac surgery or catheter intervention on the pre- to postprocedural course of psychological distress and the styles of coping of their parents. Across time, parents of children undergoing surgery reported, on average, significantly higher levels of psychological distress than parents of children who underwent catheter intervention. After the procedure, parents of children who underwent either procedure reported significantly lower levels of psychological distress, and showed a weaker tendency to use several styles of coping, than did their reference groups. CONCLUSION: Age of the children at the time of elective cardiac surgery or catheter intervention did not influence the course of psychological distress of their parents, nor the styles of coping used by the parents. Future research should investigate in what way the age at which these cardiac procedures are performed influences the emotional and cognitive development of the children.

Adaptation, Psychological↗

PubMed2004

Styles of coping and social support in a cohort of adults with congenital heart disease.

OBJECTIVE: To determine styles of coping, that is personal ways of dealing with problems, and social support, or support from the social environment, in a cohort of adults with congenital heart disease. METHODS: We subjected 362 patients with congenital heart disease, aged from 20 to 46 years, belonging to five diagnostic groups, to extensive medical and psychological examination from 20 to 33 years after their first open heart surgical procedure. During psychological examination, 342 patients filled in questionnaires concerning styles of coping, specifically the Utrecht Coping List, and social support, using the Social Support List. RESULTS: Overall, styles of coping in the total sample are comparable to those of peers in the general population, except for lower active problem solving, which can be attributed to female patients. Males with congenital heart disease showed more favourable styles of coping compared to their peers, such as higher seeking of social support, lower passive reaction patterns, and lower expression of negative emotions. Compared to the reference group, the total cohort of patients reported to receive less social support, but also to experience less discrepancies between desired and received social support, indicating feelings of independence in these adults. Females with congenital heart disease were found to seek and receive more social support compared to their male counterparts. CONCLUSION: Overall, few differences in styles of coping were found between the patients and their reference groups. Perceived social support in the sample of patients was favourable.

Adaptation, Psychological↗

PubMed2006

Art therapy improves coping resources: a randomized, controlled study among women with breast cancer.

OBJECTIVE: Women with breast cancer suffer from considerable stress related to the diagnosis, surgery, and medical treatment. It is important to develop strategies to strengthen coping resources among these women. Research in art therapy has shown outcomes such as an increase in self-esteem and cohesion, significant improvement in global health, and a decrease in anxiety and depression. The aim of the present article was to describe the effects of an art therapy intervention program on coping resources in women with primary breast cancer. METHOD: In this article, we report some of the results from a study including 41 women, aged 37-69 years old, with nonmetastatic primary breast cancer, referred to the Department of Oncology at Umeå University Hospital in Sweden for postoperative radiotherapy. The women represented various socioeconomic backgrounds. They were randomized to a study group (n = 20) with individual art therapy for 1 h/week during postoperative radiotherapy or to a control group (n = 21). The article focuses on changes in coping resources, as measured by the Coping Resources Inventory (CRI) before and 2 and 6 months after the start of radiotherapy. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99-386). RESULTS: There was an overall increase in coping resources among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study and control groups in the social domain on the second and third occasions. Significant differences were also observed in the total score on the second occasion. SIGNIFICANCE OF RESULTS: This study shows that individual art therapy provided by a trained art therapist in a clinical setting can give beneficial support to women with primary breast cancer undergoing radiotherapy, as it can improve their coping resources.

Adaptation, Psychological↗

PubMed1999

Adapting the Jalowiec Coping Scale in Norwegian adult psoriasis patients.

The aim of the present study was to adapt the Jalowiec Coping Scale (JCS) to accommodate adult patients with psoriasis. The sample comprised 334 patients who were treated consecutively at three dermatology departments in the eastern Norway. A total number of 273 hospitalised patients (20%) and out-patients (80%) completed the questionnaire, yielding a response rate of 82%. The study assessed the reliability and the face, content and construct validity of the Norwegian version of the JCS. In addition, researchers investigated the most frequently used/effective coping strategies, the relationships between demographic/clinical variables, self-reported physical symptoms and the use of coping strategies. The results (correlational coefficients and interitem alpha s) indicated that there was an overlap in substantive content among the original JCS subscales, due either to measurement error (bias or response style) and/or because the patients in the present study were in a demanding situation in relation to their disease, which may have activated a variety of coping strategies. A factor analysis resulted in a three-factor solution (confrontive problem-solving, normalising/optimistic and combined emotive) with satisfactory internal consistency. This factor solution comprised 31 items with an explained variance of 37% of the total pool of items. The most frequently used and effective coping strategies could be labelled as emotion-focused (optimistic/maintain control). Significant correlations were found between age, hospital setting, self-reported physical symptoms and different coping subscales. However, further studies are needed to assess the validity and reliability of the JCS among different population groups in Norway.

Adaptation, Psychological↗

PubMed2000

Females' coping styles and control over poker machine gambling.

An investigation of the relationship between impaired control over gambling, coping strategies, and demographic variables was conducted by surveying female poker machine players (N = 163) in their gaming venues. Metropolitan (n = 14) and regional (n = 6) gaming venues in Victoria, Australia participated. Control over gambling was measured using the Impaired Control Over Gambling Scale (Baron & Dickerson, 1994). Coping strategies were measured using (Folkman et al., 1986) adaptation of the Revised Ways of Coping Checklist (Vitaliano et al., 1985). MANOVA supported the hypothesis that the lower the control over gambling the greater the reliance on emotion-focused coping (blamed self, wishful thinking, avoidance) with F = 9.92, 13.35, 14.04 respectively, all significant at p <.001. MANOVA failed to supported the hypothesis that problem-focused strategies (problem focus, seek social support) would be significantly related to control over gambling with F =.82 and.21 respectively. Control over gambling was not related to age, employment, relationship status, education, or distress from significant life events, further supporting the relationship between control and coping strategies. Ways in which coping styles might be related to pathological gambling are discussed.

Journal Article↗

PubMed2001

The role of illness, resources, appraisal, and coping strategies in adjustment to HIV/AIDS: the direct and buffering effects.

This study examined the utility of a stress and coping model of adjustment to HIV/AIDS. A total of 114 HIV-infected gay or bisexual men were interviewed and they completed self-administered scales. Predictors included illness variables (disease stage and number of symptoms), coping resources (optimism and social support), appraisal (threat, challenge, and controllability), and coping strategies (problem- and emotion-focused). Adjustment outcomes were depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that better adjustment was related to an asymptomatic illness stage, fewer HIV-related symptoms, greater social support, challenge and controllability appraisals, problem-focused coping, and lower threat appraisals and reliance on emotion-focused coping. There was limited support for the stress-buffering effects of optimism. Findings support the utility of a stress and coping model of adjustment to HIV/AIDS.

Acquired Immunodeficiency Syndrome↗