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Use of alcohol to cope with tension, and its relation to gender, years in medical school and hazardous drinking: a study of two nation-wide Norwegian samples of medical students.

AIMS: To study the association between the use of alcohol to cope with tension and hazardous drinking, and the prevalence and the predictors of such drinking behaviours. DESIGN: Cross-sectional surveys of two nation-wide samples of medical students, one at the beginning and one at the end of medical training. PARTICIPANTS: Medical students entering Norwegian medical schools in 1993 (N = 379) or graduating in 1993 and 1994 (N = 522); 55.6% of the total sample were women. MEASUREMENTS: Postal questionnaires including SCL-5, Perceived Medical School Stress. FINDINGS: Use of alcohol to cope was reported by 10.5% of the students with no significant gender difference. Hazardous drinking ('binge drinking' at least 2-3 times per month) was reported by 14% of all the students, 24% among the men and 6% among the women. There was a strong association between use of alcohol to cope with tension and hazardous drinking, OR = 5.11, 95% CI (2.88-9.07) when controlling for other possible predictors. Use of alcohol to cope was also associated with increasing age, mental distress and lack of religious activity. The senior students used alcohol as a way of coping less often, but not hazardous drinking. Male gender, religious inactivity, high self-esteem and having no children were predictors of hazardous drinking. CONCLUSION: This study suggests that the use of alcohol to cope with tension is an independent risk factor connected with hazardous drinking among medical students, with no difference in prevalence between the genders.

Adaptation, Psychological↗

Coping strategies, illness perception, anxiety and depression of patients with idiopathic constipation: a population-based study.

BACKGROUND: Functional constipation has important psychological elements. AIM: To investigate the prevalence of functional constipation in an Asian population, and the interplay among functional constipation, anxiety/depression, perception and coping strategies. METHODS: An interview of 3282 patients was made by telephone survey. Constipation was diagnosed by Rome II criteria. Coping ability and anxiety/depression were assessed by validated questionnaires. RESULTS: Fourteen percent of the interviewees had constipation. Anxiety and depression scores were higher in constipated than in healthy subjects (P < 0.0001 and < 0.0001), and in female than male patients (P = 0.02 and < 0.0001). Patients who were aware of their symptoms perceived greater impact on their lives (P < 0.001). Frequent use of coping strategies associated with lower anxiety scores (P < 0.0001). Female were more frequently aware of the symptoms (P = 0.004), less frequently used coping strategies (P = 0.008). Regression analysis showed that female and high anxiety level were the independent factors for predicting the perception of constipation, whereas anxiety was the only independent factor for predicting the use of coping strategies. CONCLUSION: Constipation associated with anxiety and depression is prevalent in the general Asian population. Female sex and anxiety are important aetiological factors in constipation, affecting perception and the use of coping strategies.

Adaptation, Psychological↗

Family care-giving and chronic illness: how parents cope with a child with a sickle cell disorder or thalassaemia.

There has been increasing interest in the way parents cope with childhood chronic illness and a shift away from merely describing the 'burdens' of care. An emphasis on coping by introducing ideas such as co-ordinated, accessible and appropriate service delivery as well as empowerment raises important policy and practice issues for public health. This paper, by drawing on qualitative material from a project evaluating service support to families caring for a child with a haemoglobinopathy, examines how parents cope with their caring responsibilities. First, it discusses the general literature on how carers respond to their role, before examining the specific literature dealing with the response of parents who look after a child with a haemoglobinopathy. Second, it presents the empirical accounts of parents who care for a child with a sickle cell disorder (SCD) or thalassaemia within the context of this broader literature. The paper concludes that all parents found caring stressful and demanding, but accept that they have to cope with the situation for the sake of the child. Parents' contact with services is an especially important contributory factor to their ability to cope and parents described how services can both hinder and support their caring role. Appropriate professional support can help reduce stress and facilitate coping by offering information, financial help and emotional support. Unsympathetic responses from professionals, or their incompetence, however, meant that many parents identified service provision as part of the problem, potentially undermining their ability to come to terms with the condition.

Journal Article↗

Coping strategies and quality of life among patients on continuous ambulatory peritoneal dialysis (CAPD).

The present study describes CAPD patients' coping strategies and quality of life. A descriptive-comparative design was chosen and a consecutive series of patients (n = 26) was included. Data collection was performed through questionnaire and interview. Coping was measured by the Jalowiec Coping Scale and quality of life by the Swedish Health-Related Quality of Life Survey (SWED-QUAL). The main results show that an optimistic coping style was the most widely used by both men and women and this style was also considered to be the most effective in terms of dealing with stressful treatment aspects. Significantly more men than women found emotive coping to be less effective. Compared to a sample from the general population, CAPD patients had lower values on all SWED-QUAL sub-scales except those that tapped family functioning and emotional health. In general, women evidenced a more negative perception of their health than did men. With respect to emotional well-being/negative aspect, the CAPD patients achieved higher scores than the general population. The findings suggest targets for nurse practitioners' provision of support and information and in assisting patients to better utilize adequate coping methods to enhance their quality of life.

Adaptation, Psychological↗

Strategies used by burns nurses to cope with the infliction of pain on patients.

The infliction of pain on patients is part of the daily routine for many nurses, particularly those who work in burns units, but there has been little help available for nurses to develop useful ways of coping with such circumstances. Few researchers have considered how the ways that nurses manage their feelings about pain may provide insights into the reasons why available pain control methods have not been fully practiced. The aim of this study was to identify the range of coping strategies used by nurses when conducting painful procedures. Nurses working in five burns units were interviewed about their feelings when it was necessary for them to inflict pain on patients in the course of giving patient care. Content analysis was used to identify the kinds of coping strategies used by nurses to manage their feelings about such situations. Fourteen kinds of strategy were identified and were then grouped into four categories: (i) distancing oneself from the patient's pain; (ii) engaging with the patient's pain; (iii) seeking social support and (iv) reconstructing the nurse's core role. The use of each of these categories of coping have implications for both the management of patient's pain and the nurse's emotional well-being. While distancing oneself from the patient's pain was the most prevalent way for nurses to cope with their feelings about causing pain to patients, all types of coping strategies had their advantages. It is possible that combinations of various strategies may be the most effective way for nurses to deal with their patients' pain.

Adaptation, Psychological↗

Eating as both coping and stressor in overweight control.

AIM: The aim of this study was to test a conceptual model proposing that stress evokes eating as coping, that eating then becomes a stressor in itself, and that a coping repertoire specific for overeating is required to moderate its yield of negative mood states. BACKGROUND: It is known that stressors may evoke eating as a coping response, and that some persons respond to lapses in their dietary regimen with depression and self-criticism. These two findings are linked within the context of a stress and coping paradigm that has in the past been applied to the study of substance abuse. METHOD: A survey of 79 women who reported overeating was implemented, including the administration of five instruments and a telephone interview. FINDINGS: Over 43% of the variance in the dependent variable, negative mood states, was explained by hierarchical regression of the independent variables, entered sequentially as exemplars of: social stressors, coping, degree of required calorie consumption, use of overweight control strategies and the interaction between the degree of required weekly calorie consumption and use of overweight control strategies. Significant contributions were made by variables denoting stressors, coping, and the interaction between degree of required calorie consumption and use of overweight control strategies. Of particular interest was the suggestion that for individuals who frequently use strategies to control overeating and overweight, eating may produce negative mood states. Individuals intensively involved in efforts to control their weight may be vulnerable for dysphoria, may require unique nursing interventions, and thus deserve continued study in this context.

Adaptation, Psychological↗

Selected coping strategies in labor: an investigation of women's experiences.

BACKGROUND: Antenatal education classes offer women information about labor and birth and ways of coping with pain and emotional distress. The purpose of this paper was to describe women's experiences of using, starting, and discontinuing three coping strategies in labor that were taught in antenatal education classes. METHODS: An exploratory research design was used in which 121 women were interviewed within 72 hours of the birth of their first child. Information was obtained on why women initiated and discontinued their use of three coping strategies (breathing technique, postural changes, relaxation technique) and the reported effects of use. RESULTS: The effects of the coping strategies investigated varied widely among participants. Common aspects of care, changes of environment, and use of pharmacological pain relief affected women's discontinuation of coping strategies. CONCLUSIONS: The implications of study findings for clinical practice include the need for caregivers to provide women with accurate information about the effects of coping strategies and to be alert to aspects of care that may disrupt women's use of strategies.

Adaptation, Psychological↗

Quality of life, coping strategies, and family routines in children with headache.

OBJECTIVE: To identify the relationship between headache severity, child coping, and quality of life (QoL) in the context of everyday family life. BACKGROUND: In the pediatric headache research only 3 studies have examined children's coping strategies and only 4 studies considered QoL. METHODS: A sample of 48 Italian families with children seeking treatment for primary headaches was interviewed using an adaptation of the Ecocultural Family Interview (EFI). The EFI is a parent interview that explores the daily routines of family life in which the child and parent participate and the main concerns regarding how that routine is organized. RESULTS: As expected the Lisrel analyses consistently showed that QoL is affected by a child's coping abilities in a causal direction. Headache frequency and duration have a significant impact on a child's QoL. The family daily routine influences significantly both the child's coping ability and QoL. Surprisingly enough, children's coping strategies are not related to headache severity. CONCLUSIONS: More research is needed on the causal factors influencing child's ability to cope with pain, and in particular more attention should be devoted to the contextual and family factors related to pediatric headache.

Activities of Daily Living↗

Adjustment and coping in epilepsy.

Our study investigated interrelationships between problems in psychosocial adjustment, coping and epilepsy variables. Establishing the cross-cultural applicability of the Washington Psychosocial Seizure Inventory (WPSI) was an additional objective. The WPSI, Ways of Coping Scale, Modified Version, as well as scales measuring depression and anxiety were administered to 310 outpatients with epilepsy. When the scores of patients with high Lie scores were eliminated, the WPSI profiles were found to be similar to former studies, with some score elevations in emotional adjustment and interpersonal adjustment. When relationships between adjustment variables and coping were modelled, coping was found to be a mediator between the effects of interpersonal and emotional adjustment and integration to the broader social context (vocational adjustment). Family background was found to be a significant predictor of the emotional well-being and interpersonal adjustment scores of the patients. Results support the central role of coping and emotional well-being and emphasize the importance of family factors in adjustment to epilepsy. Psychotherapy and psychological interventions could support coping with illness, primarily through elimination of negative family and social effects and treatment of emotional problems.

Adaptation, Psychological↗

Coping with the challenge of transition in older adolescents with epilepsy.

Chronic illnesses, such as epilepsy, have been shown to have detrimental effects on both psychological adjustment and coping behaviour. Using the process model of coping, these effects were investigated in a patient group of 36, 16-21 year olds with epilepsy and a control group of 31 of their peers. Participants completed a postal questionnaire containing measures of psychological adjustment (self-esteem, affect, self-efficacy) and an adolescent coping questionnaire. Comparison of the two groups showed that the patient group exhibited significantly more non-productive coping than the control group. The control group exhibited significantly more problem solving coping and displayed significantly more problem solving bias than the patient group. No significant differences were found between the patient and control group on measures of psychological adjustment. However, psychological adjustment was found to be associated with coping response in the patient but not the control group.

Adaptation, Psychological↗

[Coping in patients after liver transplantation with regard to their membership in a self-group].

BACKGROUND: Within the past 15 years, liver transplantation has proven itself to be the treatment of choice among patients with terminal liver disease. The one-year survival rate is about 80 %; after 8 years 61 % of the patients are still alive. The present study investigates the influence of active or depressive coping on the physical and mental quality of life in two different groups of patients after liver transplantation. METHODS: Members (n = 65) and non-members (n = 20) of a German self-help group were asked to fill out a postal survey. Patients were included if their liver transplantation was conducted 6 to 36 months ago. The health-related quality of life was surveyed using the SF-36 and coping strategies were investigated with the Freiburg questionnaire on coping with illness. RESULTS: All patients had a good physical and mental quality of life compared with a German normative sample. Members of the self-help group showed substantially higher active coping with illness (p < 0.0001), but only depressive coping correlates (negatively) with physical as well as with mental health-related quality of life (r between -0.24 and -0.68). This was true for both groups investigated. CONCLUSION: Based on an overall good health-related quality of life, depressive coping as well as aspects of the social environment contribute considerably in determining the well-being and quality of life in patients after liver transplantation.

Adaptation, Psychological↗

[Pain management and coping behaviour in premature babies (< 1500 g) at corrected age of 36 months influence of neonatal experience and maternal anxiety].

INTRODUCTION: Neonatal experience of pain and distress can lead to developmental problems, which can be associated with long-term emotional and behavioural disorders. The aim of the study was to analyse the effects of early experiences of pain and maternal reactions on the pain and coping behaviour of preterm infants. METHODS: In a prospective longitudinal study of 69 very low birth weight (VLBW) preterm infants, neonatal data regarding painful manipulations, analgesics and sedatives, and general medical condition (Nursery Neurobiological Risk Score; NBRS) were assessed. At the (corrected) age of 36 months, 53 preterm infants and a control group of 23 full-term infants were re-examined. Pain and coping behaviour were estimated by a questionnaire. Maternal anxiety was assessed in semi-structured interviews at the age of 3, 12 and 36 months in the preterm group. RESULTS: The mean gestational age was 29 + 0 weeks (23 + 3 to 34 + 1), the mean birth weight 1058 g (380 to 1480 g) in preterms and 39 + 3 weeks (37 + 0 to 42 + 0) and 3379 g (2400 to 4130 g), respectively, for the full-terms. The sex ratio was equal, 45.3 % of the preterms were multiples (controls 34.8 %). Preterms had higher descriptive scores for all types of pain situations. After controlling for other associated factors, a negative correlation between birth weight and later pain behaviour in medical situations remained. Preterms had a more negative coping behaviour during every day injuries. In terms of coping behaviour, only a shorter inpatient treatment in the neonatal period was associated with social withdrawal after controlling for other associated factors. Maternal anxiety at the age of 12 and 36 months was associated with negative coping behaviour following simple injuries. CONCLUSIONS: While preterms do not have a higher pain threshold in general, a subgroup does have a higher risk for later sensation to pain. Preterms use more unfavourable coping strategies in simple injuries which, in turn, seem to be decisively mediated by maternal anxiety. Future research should focus on psycho-social factors involved in the development of pain reactions, as these can predispose towards behavioural disorders.

Adaptation, Psychological↗

[Autoprotective mechanisms in patients with schizophrenic psychoses--compensation and coping].

For a long time, the coping and compensatory mechanisms of patients with schizophrenic psychoses have mostly been neglected by the psychiatric research. We extended the six categories of coping mechanisms described in the Bonn Scale for the Assessment of Basic Symptoms (BSABS) by three further categories. With fifty schizophrenic patients in different stages of their disease semistructured interviews concerning these categories were done. The main sociodemographic and historical parameters were registered as well. Then the protocols of the interviews were analyzed, the coping strategies were quantified, and it was tried to disclose relations between the disease progress and sociodemographic parameters. Patients used to a certain degree of autonomy e. g. unmarried patients had--compared to less independent patients--stronger coping strategies. Patients with a strong interest for their disease and a positive opinion about neuroleptic therapy had--compared to patients without interest for their disease and/or negative opinion about neuroleptic therapy--stronger coping and compensatory psychisms. It is concluded that the coping strategies might be reinforced by influencing these parameters.

Adaptation, Psychological↗

Stress and coping of Canadian rural nurses caring for trauma patients who are transferred out.

INTRODUCTION: The present study investigated acute stress and coping among rural nurses who work with transfer trauma patients. METHODS: Nineteen rural nurses ages 34 to 53 years participated in 4 focus groups. Each group was asked to identify a specific stressful situation involving transfer of trauma/accident patients and to share their experience of the situation. RESULTS: Stressful situations encountered included system problems (EG, lack of resources; time pressures), lack of communication, visual impact, and professional discord. Coping responses included efforts to alter the problem (problem-focused coping) and efforts to control emotions (emotion-focused coping). Social support coping was identified as the most helpful way of coping with trauma. DISCUSSION: Overall the findings suggest that rural nurses face unique stressors not identified in the nursing literature, which most often reflects urban settings.

Adaptation, Psychological↗

Coping in adolescent children of HIV-positive and HIV-negative substance-abusing fathers.

The authors examined coping in the adolescent children of drug-abusing fathers who have, or are at risk for contracting, human immunodeficiency virus (HIV). The ability to cope is an important factor in the adolescent's own risk behaviors, including drug use and associated problems. Each father and his adolescent child were separately administered a structured interview regarding personality, drug use, relationships, coping, and other behaviors. Adolescent adaptive coping was found to be related to greater conventionality, less marijuana use, fewer intra- and interpersonal problems, paternal adaptive coping, and a close father-child bond. Moreover, analysis using a risk factor index indicated an exponential increase in adolescent maladaptive coping with each additional psychosocial risk. Implications for policy and intervention are also discussed.

Adaptation, Psychological↗

Age differences in coping resources and satisfaction with life among middle-aged, young-old, and oldest-old adults.

The authors examined age differences in perceived coping resources and satisfaction with life across 3 older-adult age groups (45-64, 65-74, and 75 years and older). The 98 participants represented healthy, socially active, community-residing adults. Group comparisons were made on 12 individual coping scales, and an overall coping resource effectiveness score was computed. No significant differences were found for 11 of the coping resources or for overall coping resource effectiveness. Similar consistencies in life satisfaction were found across the 3 age groups. The findings indicate that (a) for healthy adults, the oldest old cope at least as effectively as their younger counterparts, despite their likelihood of encountering increased levels of stress; and (b) psychologically, old age may be viewed as a time of resilience and fortitude.

Adaptation, Psychological↗

The relationship between coping style and loneliness in adolescents: can "sad passivity" be adaptive?

The authors' purpose in this paper was to examine how the use of the "sad passive" coping style may be related to adolescent self-reported loneliness. Subjects were asked to complete the revised UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1980) to determine self-reported loneliness and the Coping with Loneliness Questionnaire (CLQ; Rubenstein & Shaver, 1980) in order to examine coping styles. We hypothesized that those adolescents whose coping strategies fell into the category of sad passivity described by Rubenstein and Shaver would indicate greater loneliness than those adolescents whose coping strategies fell into other categories. Results indicated that sad passivity was used by both lonely and nonlonely adolescents, but that nonlonely youngsters resorted to this method only temporarily and in preparation for a more active coping style. Lonely teens, on the other hand, appeared to remain in the sad-passive mode to a maladaptive degree. These results were discussed in terms of their importance for theories of adolescent loneliness and for possible intervention strategies.

Adaptation, Psychological↗

The relation of coping, appraisal, and burnout in mental health workers.

This study was undertaken as an attempt to determine the relationship between individual coping (in response to stressful work events) and concomitant symptoms of burnout and the relationship between coping and burnout as moderated by secondary cognitive appraisal. Professional mental health workers (N = 234) employed by a state psychiatric facility completed the Ways of Coping Checklist (revised) (Lazarus & Folkman, 1984) and a measure of secondary appraisal, after reporting a typical stressful work event. They also completed the Maslach Burnout Inventory (Maslach & Jackson, 1986) and a demographic questionnaire. Results suggested that individual coping was related to burnout. Escape-avoidance was the primary coping strategy related to all three symptoms of burnout: emotional exhaustion, depersonalization, and lack of personal accomplishment. Secondary appraisal did not moderate the relation of coping and burnout.

Adaptation, Psychological↗