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PubMed2001

Anxiety, coping strategies, and coping behaviors in patients undergoing head and neck cancer surgery.

BACKGROUND: Little is reported in the scientific literature about the modulating effect of anxiety on the coping process before and after surgical treatment for head and neck cancer. OBJECTIVES: The major purpose of this article is to describe the relationships among preoperative anxiety and use of coping strategies, and postoperative self-care and resocialization behaviors in patients who sustain facial disfigurement/dysfunction with head and neck cancer surgery. METHODS: Using a prospective descriptive design, 75 (N = 75) adults who were about to sustain facial disfigurement and dysfunction associated with head and neck cancer surgery were entered into the study. The State Trait Anxiety Inventory and the Ways of Coping Questionnaire were administered to the respondents. The Disfigurement/Dysfunction Scale and Coping Behaviors Score values were calculated by the investigator. RESULTS: Self-care and anxiety were significantly correlated on postoperative day 4 (r = 2.30; p < .05) and on postoperative day 5 (r = 2.35; p < .05). For the 3 days under study, the relationship between total self-care and anxiety became stronger on postoperative day 5 (r = 2.39; p < .01), indicating that self-care on postoperative day 4 is related to reduced anxiety on postoperative day 5. In other words, self-care appears to precede reduction in anxiety in this sample. Secondly, there was a negative relationship between self-care and anxiety that increased over the early postoperative period. CONCLUSIONS: This study prospectively documents anxiety in surgical head and neck cancer patients. The findings suggest that at a specific point in time (postoperative day 5), self-care precedes reduction in anxiety, and that this negative relationship increases over time. Additional investigation is now critical in order to describe long-term recovery after surgical treatment for head and neck cancer and to develop appropriate interventions to meet the unique needs of this population.

Adaptation, Psychological↗

PubMed1994

Coping with illness and coping with handicap during the vocational rehabilitation of physically handicapped adolescents and young adults.

Coping with illness and coping with handicap during the vocational rehabilitation of physically handicapped adolescents and young adults are given great consideration in rehabilitation centres. The mutual dependence of defence styles and ways of coping with serious illnesses are demonstrated in case vignettes 1 and 2. Defence processes can block coping with illness. In adolescents who are physically handicapped since birth, other body and self-representations are developed according to the form of handicap. After an accident or illness in later childhood or adolescence, new body and self-representations have to be built up in a way that corresponds to the changed physical circumstances (case vignette 3). This is often a lengthy and painful process of mourning. The extent to which the adolescent patient will be granted independence and autonomy from the family will influence the course of the illness itself. The dangers and prospects of lengthy rehabilitation processes are discussed. The necessary adjustments that physically handicapped adolescents have to make when they are admitted into a residential facility for the physically handicapped are described.

Adaptation, Psychological↗

PubMed2004

Pilot evaluation of the Coping Course: a cognitive-behavioral intervention to enhance coping skills in incarcerated youth.

OBJECTIVE: To describe the development and initial evaluation of the Coping Course, a cognitive-behavioral group intervention designed to enhance general coping and problem-solving skills among incarcerated youth. METHOD: Between 2001 and 2002, 76 male adolescents incarcerated at a youth correctional facility were assessed by questionnaire and randomly assigned to either the Coping Course (n = 46) or usual care (n = 30). Participants repeated the questionnaire after completion of the intervention. A second correctional facility served as an additional source of control group data (n = 62). RESULTS: Significant condition x time effects were present for seven of the examined measures: Youth Self-Report externalizing scores, three measures from the Life Attitudes Scale, self-esteem, one measure of social adjustment, and cognitive-behavioral therapy knowledge. Age and race/ethnicity did not moderate effects. Comparing control group participants with youth at a separate correctional facility who did not receive the Coping Course indicated that change was uniquely associated with participation in the intervention. CONCLUSIONS: Our goal was to take an efficacious adolescent depression group intervention and modify it for use with youth in correctional facilities. Preliminary findings are promising and provide evidence for future research of cognitive-behavioral group treatments with incarcerated youth.

Adaptation, Psychological↗

PubMed1996

A dispositional and situational assessment of children's coping: testing alternative models of coping.

Dispositional and situational measures of children's coping were developed using a theoretically based approach. Two studies (N1 = 217; N2 = 303) assessed the psychometric characteristics of these measures in fourth- through sixth-grade children. Confirmatory factor analyses indicated that a four-factor model of dispositional coping (active, distraction, avoidant, and support seeking) provided a better fit to the data than either the problem- versus emotion-focused (Lazarus & Folkman, 1984) or passive versus active (Billings & Moos, 1981) coping models. The four-factor model was largely invariant with respect to age and gender. Moderate to high correlations were found between the parallel subscales of the dispositional and situational measures of coping. Although the four factor structures of the dispositional and situational measures were generally similar, factor loadings and correlations between dimensions were not equivalent.

Adaptation, Psychological↗

PubMedDate not supplied

Effect of the Teaching Kids to Cope (TKC) program on outcomes of depression and coping among rural adolescents.

PROBLEM: Incidence of depressive symptoms and lack of sufficient adaptive coping skills in adolescents. METHODS: A randomized controlled study to test the effectiveness of a group-administered, cognitive-behavioral interventions method, TKC, on rural adolescents (N = 89). Outcomes were measured by changes in the scores on an Adolescent Depression Scale and the Coping Response Inventory pre/post intervention, at 6 and at 12 months. FINDINGS: Results indicated improvement in depressive symptomatology and certain coping skills. Students in the intervention reported a higher use of cognitive problem-solving coping strategies. CONCLUSIONS: The role of a psychiatric nurse in the school system providing short-term psychoeducation interventions is a practical and effective mental health practice.

Adaptation, Psychological↗

PubMed1992

Stress, coping and coping resources as correlates of adaptation in myocardial infarction patients.

A longitudinal study was conducted to examine the utility of a set of variables derived from the stress and coping literature as correlates of patients' level of psychosocial adaptation to a myocardial infarction. Forty patients participated in the study; data were collected soon after the patients' discharge from hospital and three months after the event. It was proposed that a high level of perceived stress associated with the infarct and the use of emotion-focused coping strategies would be associated with poor adaptation to the event, whereas the use of problem-focused strategies, high levels of self-efficacy and access to the appropriate personal (control beliefs, self-esteem and trait anxiety) and social (marital and family quality) coping resources were variables proposed to facilitate adaptation. There was only weak support for the proposed effects of perceived stress, and no support for the proposal that the use of problem-focused strategies would facilitate the adaptation of infarct patients. In contrast, the data provided some support for the hypothesized effects of self-efficacy and emotion-focused coping. There was also evidence to suggest that adaptation to an infarct was facilitated if subjects had internal control beliefs, high self-esteem, low trait anxiety and high-quality family relations. Contrary to expectations, marital quality was largely unrelated to the measures of adaptation.

Activities of Daily Living↗

PubMed1995

Coping strategies and phobias: the relationship between fears, phobias and methods of coping with stressors.

Two studies are described which assessed the extent to which fears and phobias are associated with particular types of strategies for coping with stress. Study 1 compared scores on the Fear Survey Schedule (FSS) with scores on a modified version of the Health and Daily Living Form and the Miller Behavioural Style Scale (MBSS) in a normal population. A principal component analysis revealed that high scores on the social fears and miscellaneous phobias subscales of the FSS were directly associated with avoidance coping strategies, inversely associated with cognitive reappraisal strategies which devalue or deny the importance of the stressor, but unrelated to any of the measures on the MBSS. Study 2 compared the coping strategies of simple phobics, panic disorder patients and normal controls. Both simple phobics and panic disorder patients differed from normal control subjects by reporting greater use of avoidance coping strategies, and reduced use of cognitive threat devaluation. These findings are consistent with models of anxiety-based disorders which implicate avoidance or escape in the maintenance of such disorders, or which identify the evaluation of the precipitating trauma as important in the acquisition of such disorders.

Adaptation, Psychological↗

PubMed2001

From coping with life to coping with death: problematic integration for the seriously ill elderly.

Decisions made by and for elderly patients nearing death frequently perpetuate unwanted suffering and dependence. This article extends the argument that Babrow's (1992, 1995) problematic integration theory can provide insights into why communication fails to produce desired outcomes for such patients. Open-ended responses obtained in face-to-face interviews with 142 elderly dialysis patients and mailed surveys of 393 dialysis unit nurses were examined to better understand how patients and nurses reconciled incompatible probabilistic and evaluativejudgments. Results indicate that patients seek information that will enable them to cope with debilitating dialysis treatments rather than information nurses believe is necessary for them to make informed choices about whether to undergo such treatments. The tension between the information patients want to successfully cope with life and the information they need to decide intelligently about treatments that forestall death constitutes a key reason why communication about end-of-life issues is frequently flawed. Our analysis of these communication flaws leads to specific recommendations for how this tension can be eased, which in turn may better prepare patients to make the transition from coping with life to coping with death.

Adaptation, Psychological↗

PubMed2002

Coping with the stress of parental depression: parents' reports of children's coping, emotional, and behavioral problems.

Examined children's coping and involuntary responses to the stress of living with a depressed parent in relation to their symptoms of anxiety/depression and aggression. Sixty-six clinically depressed adults rated their children's (ages 7 to 17 years old; N = 101) coping and involuntary responses to parental stressors and anxiety/depressive and aggressive behavior symptoms. Based on parent report, children of depressed parents had high rates of symptoms of anxiety/depression and aggression, were exposed to moderate levels of parental stressors (parental intrusiveness, parental withdrawal), and responded to the stress of living with a depressed parent in ways that were associated with symptoms of psychopathology. Children's use of secondary control coping (e.g., positive thinking, acceptance, distraction) was associated with fewer anxiety/depression and aggression symptoms. In contrast, involuntary engagement responses (e.g., rumination, intrusive thoughts) were associated with more anxiety/depression and aggression symptoms. Path analyses revealed that a model in which secondary control coping and involuntary engagement stress responses mediated the relation between family stressors and child symptoms provided the best fit with the data. Implications of these findings for developing interventions for children to reduce the risk of psychopathology are discussed.

Adaptation, Psychological↗

PubMed1999

[Mental health and stress coping among hospital nurses by stress & stress-coping questionnaire].

This study was aimed to evaluate the relationship between the mental health level and stress coping style in a group of female subjects in a public hospital. A self-administrated questionnaire including questions on nursing work, the General Health Questionnaire (GHQ) as well as the Stress and Stress Coping questionnaire (SSCQ) was used. The subjects of this study were 225 female nurses. The subjects' age and working experience (mean +/- SD) were 34.0 +/- 10.3 and 10.6 +/- 8.3 years, respectively. The results obtained were as follows: 1) Either of the following determinants was related to negative mental health: experience of 1-2 years; working in the operating room or in-patient department. 2) The subjects whose working experience was < 5 years or > or = 10 years had higher scores in the SSCQ. These subjects were among those who did not have higher scores in the GHQ. It was suggested that these subjects need to receive a guidance in stress coping. These findings suggest that because working conditions have a negative influence on mental health, educational system for both inexperienced and experienced nurses is needed to develop an effective stress-coping style in medical institutions.

Adaptation, Psychological↗

PubMed1996

A multidimensional model of the antecedents of stress and coping appraisals: an approach to studying patients' perceptions of post cardiac surgery pain and their coping strategies.

Lazarus' stress and coping theory has been recognized as a valued conceptual framework for nursing scholars who are interested in studying their client's experiences of stress and coping. However, little data provide in-depth critiques in concepts, availability and limitations of employing Lazarus' theory in nursing phenomena in Taiwan, nor did data provide culturally sensitive propositions for Taiwanese nursing scholars to better understand their clients' stress experience such as post cardiac surgery pain. In order to help Taiwanese critical care nurses better understand the process of theoretical development while assessing their clients' perceptions of post cardiac surgery pain, the historical perspective of the concept of stress and the core components of Lazarus' theory are examined. Following is a critical critique of Lazarus' theory as a conceptual framework with which to study how patients perceive post cardiac surgery pain as a stressor. A multidimensional model of the antecedents of stress and coping appraisals for nurses to assess their clients' perceptions of pain and the resulting coping behaviors is further developed based on the aforementioned critiques. Finally, suggestions for testing theoretical propositions related to this phenomenon, as well as implications for nursing practice, research, as theory are delineated and discussed.

Cardiac Surgical Procedures↗

PubMed1996

[References for evaluation scales in quality assurance in rehabilitation--6. Assessment of coping processes with the Freiburg Questionnaire of Illness Coping].

Advantages of coping assessment for the understanding of individual impacts of severe illness are pointed out, the benefit for a better understanding of the rehabilitation process is demonstrated. After the basic positions and preliminary assumptions are described, the guidelines of the development of the inventory are introduced: Assessment of a broad spectrum of coping with chronic diseases with ratings by the patient himself and by others (doctors, relatives), suitability for process measuring, good acceptance, and economical application. Statistical properties of the questionnaires are reported with respect to achieved acceptance, reliability, and validity data. Using selected results as examples, possible applications in psychosomatic research are pointed out for issues such as illness-specific components of coping with chronic diseases, discrepancies between patients' and doctors' views of coping, and adaptational success. Finally, possibilities and limits of the inventory are discussed in terms of research issues and methodology.

Adaptation, Psychological↗

PubMed1992

Coping and the ineffectiveness of coping influence the outcome of in vitro fertilization through stress responses.

The effect of a coping-ineffectiveness of coping construct and of psychoendocrine stress responses upon the outcome of in vitro fertilization treatment was investigated in 40 women. Women with a high Zung depression score, high active coping, high avoidance, and a high expression of emotion have lower pregnancy rates. The mechanisms for this personality effect are not clear, although the desensitization-stimulation process (FSH, E2 concentrations) seems to be involved. The psychoendocrinological responses to the stress of oocyte retrieval and embryo transfer are important: Women with high anticipatory state anxiety levels and high anticipatory cortisol concentrations have lower pregnancy rates. The influence of prolactin stress concentrations is unclear: Women with high prolactin concentrations seem to have more oocytes but lower fertilization rates.

Adaptation, Psychological↗

PubMed1999

Testing a model of family stress and coping based on war and non-war stressors, family resources and coping among Lebanese families.

This study was undertaken to describe the objective stressors, perceived stress, coping, and resources of families living in Beirut during the Lebanese war (1975-1991) and to test a model predicting the relationships of these variables to family adaptation. The sample consisted of 438 families chosen at random. Independent variables included objective stressors and perceived stress. The mediating variables were family resources and coping strategies. The dependent variables were health and interactional indicators of family adaptation: physical and psychological health, depression, and interpersonal and marital relationships. Findings provided support for the theoretical framework. Multiple regression analyses revealed that perceived stress, rather than the objective occurrence of events, predicted family adaptation. Family resources, particularly social support, positively impacted family adaptation and was associated with increased use of cognitive coping. The findings provide a theoretical model which, on further testing, can serve as a basis for practice by health professionals when working with traumatized families.

Adaptation, Psychological↗

PubMed2003

Coping with incest: the relationship between recollections of childhood coping and adult functioning in female survivors of incest.

One hundred and one adult female survivors' recollections of coping with childhood incest, abuse characteristics, and current functioning in adulthood were studied. Analyses controlling for characteristics of the trauma indicated that recollections of using avoidance coping and seeking social support were related to poor adult functioning whereas recollections of using distancing coping were related to better functioning. As a set of variables, abuse characteristics also predicted a significant amount of variance in adult functioning. Implications for future research were discussed.

Adaptation, Psychological↗

PubMed2006

[Coping strategies of children with asthma. Testing the applicability of the German version of the Schoolagers' Coping Strategies Inventory (SCSI)].

Little is known about how children suffering from bronchial asthma assess their own capabilities to cope with the asthmatic symptoms. This descriptive study is designed to record how frequently and effectively children with bronchial asthma (n = 29) make use of coping strategies. An American self-assessment instrument, the Schoolagers' Coping Strategies Inventor, (SCSI), was used in its German translation to test whether or not it is appropriate for use with German children. The German Inventory is appropriate for use (alpha-coeffizient Frequency 0.72, Effectiveness 0.71). There are only two strategies that should be changed in the German translation in order to help German children understand it better: Our study shows that the five strategies "Watch TV or listen to music", "Draw, write or read something", "Do something about it", "Play a game or something" and "Talk to someone" that are used most frequently are also considered to be the most effective ones. In addition, we observed that there are strategies that are rarely used by the children but which are still considered to be effective. A comparison of the studies performed in the USA and in Germany reveals that good strategies to take the minds of both American and German children off things are watching TV and listening to music. Aggressive behaviors do not play any major role.

Adaptation, Psychological↗

PubMed2003

Searching for the structure of coping: a review and critique of category systems for classifying ways of coping.

From analyzing 100 assessments of coping, the authors critiqued strategies and identified best practices for constructing category systems. From current systems, a list of 400 ways of coping was compiled. For constructing lower order categories, the authors concluded that confirmatory factor analysis should replace the 2 most common strategies (exploratory factor analysis and rational sorting). For higher order categories, they recommend that the 3 most common distinctions (problem- vs. emotion-focused, approach vs. avoidance, and cognitive vs. behavioral) no longer be used. Instead, the authors recommend hierarchical systems of action types (e.g., proximity seeking, accommodation). From analysis of 6 such systems, 13 potential core families of coping were identified. Future steps involve deciding how to organize these families, using their functional homogeneity and distinctiveness, and especially their links to adaptive processes.

Adaptation, Psychological↗

PubMedDate not supplied

Influence of ethnicity and gender on cardiovascular responses to active coping and inhibitory-passive coping challenges.

OBJECTIVE: The goal of this study was to evaluate how black and white men and women responded physiologically to specific laboratory challenges. METHODS: Hemodynamic responses to an active coping (evaluated speaking) and two inhibitory-passive coping (mirror tracing, cold pressor) tasks were examined in 138 black and white men and women. RESULTS: Significant ethnicity by gender interactions occurred for the evaluated speaking task. Black men responded with lower blood pressure, cardiac output or heart rate, or both, than black women, white men, and white women, who did not differ from each other. Black men, relative to the other subgroups, also reported more inhibitory-passive coping, hostility, and pessimism, and less social support. Whites also responded with greater increases in systolic blood pressure during mirror tracing than blacks. CONCLUSIONS: These findings indicate that black-white differences in physiological responsivity obtained for men may have limited generalizability for women. The results also suggest that environmental and social factors rather than genetic or constitutional factors may play a role in black-white reactivity differences.

Adaptation, Psychological↗