Assessment of Coping With Invasive Procedures in Children With Cancer: State-Trait and Approach-Avoidant Dimensions

Abstract

We examined the relation between children's trait-dependent coping styles and situation-specific coping behaviors during invasive medical procedures. Children with cancer (N = 66) completed the Children's Behavioral Style Scale (CBSS), a measure of approach-avoidant coping styles, and the Procedural Coping Questionnaire (PCQ), an analogous measure of coping behaviors specific to invasive procedures developed for this study. Parents also completed a parent-report version of the PCQ, and both parents and children rated the severity of the child's distress before, during, and after the procedure. Factor analysis of thePCQ produced 3 distinct factors with adequate internal reliability (attention to sensory stimuli, cognitive strategies, preference for sedation), none of which were directly interpretable within the CBSS approach-avoidant framework. CBSS scores did not significantly predict procedural distress, although the higher total coping behavior scores on the PCQ were associated with greater distress, suggesting that higher levels of distress lead to an increase in all categories of coping behaviors. Pending further validation with behavioral observation methods, the PCQ may provide a useful measure of child coping behaviors related to medical procedures.