Coping strategies and well-being among young Polish adults: the mediating role of inner dialogues

413 Background: Latina breast cancer survivors (BCS) report increased symptom burden and worse health-related quality of life (HRQoL) compared to non-Latina BCS. However, the association between symptom burden and HRQoL in this population and how specific coping strategies influence HRQoL remains understudied. This study aims to assess the impact of symptom burden on HRQoL and identify adaptive versus maladaptive coping strategies among Latina BCS. Methods: Forty-eight Latina stage I-III BCS at Memorial Sloan Kettering Cancer Center completed surveys assessing HRQoL (Functional Assessment of Cancer Therapy-General), symptom severity and interference (MD Anderson Symptom Inventory), and coping (Brief COPE). Pearson correlation test, age-adjusted regression models, and mediation analyses were used to examine the associations between coping, symptom burden, and HRQoL (p < 0.05). Results: Of 48 Latina BCS (mean age 58.7 ± 9.2), most were in active treatment (54%). Fatigue (89.6%), problems with memory (87.5%), and disturbed sleep (83.3%) were the most reported symptoms, while nausea (33.3%) and vomiting (14.6%) were the least common. Greater symptom severity (p = 0.001) and interference (p < 0.001) were both associated with lower HRQoL. Latina BCS commonly coped through acceptance, planning, and self-distraction (100%), emotional support and active coping (97.9%), positive reframing (93.8%), denial (83.3%), venting (64.6%), and humor (50%). Behavioral disengagement (20.8%) and substance use (4.2%) were less used coping strategies. Emotional support (β, 8.78; SE, 2.58; p = 0.001), active coping (β, 7.23; SE, 2.28; p = 0.003), self-distraction (β, 7.93; SE, 2.56; p = 0.003), and planning (β, 9.11; SE, 2.83; p = 0.002) were associated with higher HRQoL. Conversely, behavioral disengagement (β, -9.91; SE, 3.85; p = 0.014), venting (β, -5.48; SE, 2.41; p = 0.028), and substance use (β, -11.8; SE, 5.48; p = 0.037) were associated with worse HRQoL. Mediation analyses showed that greater substance use and venting predicted increased symptom interference (p = 0.009, p = 0.023, respectively), which led to lower HRQoL (p = 0.009, p = 0.016, respectively). Conclusions: Latina BCS experiencing lower symptom burden reported significantly better HRQoL. Adaptive coping strategies (emotional support, active coping, self-distraction, and planning) correlated with higher HRQoL, whereas maladaptive strategies (behavioral disengagement, venting, and substance use) were linked to lower HRQoL. While adaptive coping strategies were frequently used by Latina BCS, maladaptive approaches, like venting, were also common. Future interventions should focus on promoting adaptive coping while simultaneously discouraging maladaptive coping in Latina BCS to improve their HRQoL.

BACKGROUND AND AIMSPatient activation refers to the knowledge, skills and confidence needed to manage one's health [1]. Higher patient activation is associated with better health outcomes in long-term conditions [2] such as kidney disease (KD). The COVID-19 pandemic has presented a myriad of additional challenges for people living with KD. Individuals may display different coping strategies in response to stressful and difficult circumstances such as health management during the pandemic [3]. Our group conducted a multicentre survey to evaluate the impact of the pandemic on kidney patient experiences, lifestyle and health care. As part of this larger study, we hypothesized that higher patient activation may be associated with more effective coping strategies. The purpose of this analysis was to explore coping styles utilised during the pandemic across different levels of patient activation in people with nondialysis CKD (ND-CKD) and kidney transplant recipients (KTR).METHOD214 ND-CKD and KTR participants [50.9% male, mean age 60.71 (SD 14.15) years, 56.1% KTRs] completed the Patient Activation Measure (PAM-13). Participants were categorised into ‘low’ and ‘high’ activation based on their PAM-13 score (levels 1–2 as low; 3–4 as high). Coping strategies were assessed using the Brief-COPE questionnaire and categorised into adaptive coping (active coping, information support, positive reframing, planning, emotional support, humour, acceptance and religion) and maladaptive coping (venting, self-blame, self-distraction, denial, substance use and behavioral disengagement) strategies. Chi-square tests were conducted to compare coping strategies used by low- and high-activated patients.RESULTSMost participants were classified as having ‘high’ activation levels (n = 164, 77%). Table 1 shows the three most frequently used adaptive and maladaptive coping strategies across activation levels. A significantly greater proportion of those with high activation used acceptance (P = 0.006), active coping (P = 0.045) and positive reframing (P = 0.031) as coping strategies. No significance was observed between maladaptive coping strategies and activation level.Adaptive coping strategiesMaladaptive coping strategiesHigh activationLow activationHigh activationLow activation1Acceptance (79.5%)Acceptance (58.5%)Self-distraction (53%)Self-distraction (47.6%)2Religion (60.5)Religion (30.8%)Behaviour Disengagement (37.5%)Substance Use (40%)3Active Coping (48.2%)Information Support (30%)Substance Use (31.6%)Self-Blame (37.5%)CONCLUSIONThe most commonly reported coping strategy was ‘acceptance’ for individuals with high and low activation. The findings suggest that a higher proportion of people with high patient activation used adaptive coping strategies. Worryingly, regardless of activation level, about a third of participants used substance use (i.e. alcohol and drugs) as a form of coping. Identifying people with lower activation in KD can indicate the need for additional support to help them cope in challenging circumstances. Interventions to improve activation may assist in developing effective coping strategies.

Study ObjectivesCoping with stress is important because stress disturbs sleep. However, only a few longitudinal studies have investigated the association between coping and insomnia. We examined whether individuals with insomnia symptoms used more maladaptive coping strategies than individuals without insomnia symptoms, and evaluated the association between insomnia symptoms and coping strategies.MethodsIn this prospective cohort study, Japanese workers were enrolled and observed over a 2-year period. During both years, self-administered questionnaires on coping and insomnia symptoms were administered. Coping was assessed using the Brief-Coping Orientation to Problems Experienced, and insomnia symptoms were examined using the Athens Insomnia Scale. Generalized estimating equation modeling identified the effects of coping strategies on insomnia severity.ResultsIn total, 1358 of 1855 workers at baseline were followed up. Individuals with insomnia symptoms showed a higher use of maladaptive coping strategies and less use of humor and instrumental support than individuals without insomnia symptoms. Active coping, humor, emotional support, and instrumental support were negatively associated with insomnia severity. In contrast, venting, substance use, behavioral disengagement, and self-blame were positively associated with insomnia severity.ConclusionsThis study showed that individuals with insomnia symptoms use both adaptive and maladaptive coping strategies and are more likely to use maladaptive strategies than individuals without insomnia symptoms. In the future, interventions focused on educating people about adaptive coping strategies should be conducted to determine whether coping strategies may prevent insomnia symptoms.

e24129 Background: Few studies have examined the coping mechanisms among patients with advanced cancer seen by palliative care. The objective of the study was to evaluate coping strategies in advanced cancer patients and identity risk factors for maladaptive coping. Methods: The authors conducted a secondary analysis of a cross-sectional survey on chemical coping. We prospectively enrolled patients with advanced cancer from a Supportive Care Clinic and documented the patient demographics, symptom expression (Edmonton Symptom Assessment System), Zubrod performance status, substance use history including tobacco, and coping strategies (the Brief COPE Questionnaire). Univariate and multivariate analyses were performed to identify risk factors for the use of maladaptive coping strategies. Results: Among 399 patients, the most common malignancies were gastrointestinal (21%) and breast (19%). Cancer patients frequently incorporated adaptive coping strategies including acceptance (86.7%), emotional support (79.9%), religion (69.4%), active coping (62.4%), instrumental support (48.4%), positive reframing (48.6%), planning (49.6%), and infrequently, humor (18.5%). Common maladaptive strategies included self-distraction (36.6%) and venting (14.5%), while self-blame (6.3%), denial (4.5%), behavioral disengagement (1.8%), and substance use (1.0%) were infrequently reported. On univariate analysis, venting was significantly associated with anxiety and depression, female gender, and tobacco use; and self-distraction was significantly associated with younger age, gender, depression, dyspnea, and a post-secondary education (P<0.05 for all). On multivariate analysis, male gender (OR -1.22, p<0.0001) and smoking (non-smoker vs everyday OR -1.9, P=0.008 ) remained significant for maladaptive venting; and age (HR -0.026, p=0.005), male gender (OR -0.65, p=0.004), dyspnea (OR -0.12, p=0.01) and post-secondary education (OR 0.596, p=0.022) remained significant for self-distraction. Conclusions: The vast majority of patients with advanced cancer seen by palliative care reported using adaptive coping strategies. We identified subgroup of patients who may be more likely to use maladapative coping strategies and may benefit from further psychological support.

Personality is defined as a set of general, consistent, and distinct patterns of behavior displayed as a reaction to the environment.. As personality traits differ across individuals, so do stress coping strategies. Therefore some people use healthier coping strategies (e.g., Active coping, Positive reframing, Planning, Humor etc.) as compared to others, who might employ Self-distraction, Denial, Substance use, Behavioral disengagement etc. The present study aimed to assess whether personality traits (e.g., neuroticism, extraversion, conscientiousness etc.) determine the choice of a specific coping strategy (adaptive or maladaptive). Methodology The sample included 255 participants (Mage=26.45years, SD=4.4years), 169 women and 86 men. The measuring instrument was a self-report questionnaire; The Brief Big Five Inventory (BFI) questionnaire was used to measure the 5 personality traits while The Brief Cope questionnaire was used to measure the stress management techniques. Results showed that Neuroticism correlated positively with less adaptive coping strategies, such as self-blame (r=.32 p<.01), substance use 80 POLIS No. 18, ISSUE 2/ 2019 (r=.17, p<.01), venting (r=.15, p<.05) and behavioral disengagement (r=.12, p<.05) but negatively correlated with adaptive coping strategies such as humor (r= -.18, p<.01) and active coping (r= -.31, p<.01). Extraversion positively correlated with several adaptive coping strategies such as active coping (r=.19, p<.01), positive reframing (r=.21, p<.01) planning (r=.17, p<.01), humor (r=.27, p<.01) etc. Conscientiousness was also positively correlated with several adaptive coping strategies such as planning (r=.39, p<.01), religion (r=.16, p<.05) and active coping (r=.24, p<.01), and negatively correlated with maladaptive coping strategies such as denial (r= -.16, p<.05) and substance use (r= -.24, p<.01). Agreeableness was positively correlated with several adaptive coping strategies (e.g., use of instrumental support (r=.22, p<.01), active coping (r=.24, p<.01), and negatively correlated with maladaptive coping strategies such as behavioral disengagement, (r= -.12, p<.05) and substance use (r= -.15, p<.05). Openness to experience also showed positive significant relationships with several adaptive strategies such as active coping (r=.23, p<.01), positive reframing (r=.23, p<.01), planning (r=.27, p<.01), humor (r=.19, p<.01), etc.. Results supported the claim that personality characteristics are relevant in the choice of coping strategies, particularly as regards the distinction between healthy and unhealthy coping. Findings are discussed in the context of theoretical and practical implications.

BackgroundCoping strategies are composites of cognitive and behavioral efforts to manage the internal and external demands of stressful situations. They have been documented to relate to general well-being and mental health. However, not all types of coping are created equal, and adaptive versus maladaptive strategies seem to have understudied differential impacts, notably with accumulated adversities.MethodsWe examined coping strategies in a sample of 489 Lebanese university students during accumulating crises, including socio-political unrest and the COVID- 19 pandemic. They were asked to fill out an online survey including standardized questionnaires of well-being (WEMWBS), depression (PHQ- 9), anxiety (HAM-A), intolerance of uncertainty (IUS), and coping (Brief COPE), in addition to demographics and questions about their attitudes and future perspectives.ResultsThe results highlight that adaptive coping strategies positively correlate with psychological well-being, whereas maladaptive ones are associated with higher levels of psychopathology. Specifically, it was shown that a positive association exists between anxiety, depression, intolerance of uncertainty, and maladaptive coping strategies while evidencing a negative association between the latter and well-being. Our multinominal regression showed that anxiety, intolerance of uncertainty and well-being were associated with low levels of adaptive coping when taking adaptive coping as a dependent variable.ConclusionOur study mainly highlights the relation between coping, uncertainty, and mental health. Although intended to help relieve tension, maladaptive strategies might worsen it instead. We emphasize previous findings to promote healthy adaptive coping strategies in times of unprecedented crises.

Morticians face unique occupational stressors due to repeated exposure to death, grief, and trauma, which may predispose them to high levels of occupational stress and psychological distress. This study sought to evaluate the coping strategies employed by morticians working in selected mortuaries in Nairobi County, Kenya. The objectives were to identify the adaptive and maladaptive coping mechanisms used, to explore the role of spirituality and social support in coping, and to assess implications for mental health interventions. A convergent mixed methods design was adopted to strengthen the reliability of findings by combining both quantitative and qualitative data. Quantitative data were collected using the Brief COPE Inventory (Carver, 1997) administered to 18 participants, while qualitative insights were gathered through semi-structured interviews with a purposively selected subset of morticians. Data analysis was conducted separately and then integrated during interpretation to allow for triangulation. The quantitative findings revealed a predominant reliance on adaptive coping strategies, including acceptance (90%), religion (90%), emotional support (84.29%), positive reframing (82.86%), and instrumental support (81.43%). In contrast, maladaptive coping strategies were less frequent, with denial (37.14%), self-blame (38.57%), and substance use (30%) reported among participants. The qualitative analysis reinforced these patterns, identifying emotion-focused coping (50%), meaning-making through spirituality (22.2%), and problem-focused strategies (16.6%) as dominant themes. A minority of participants reported avoidant strategies, including emotional suppression and substance use (5.5%). The integration of findings suggests that morticians balance adaptive strategies rooted in spirituality, social support, and positive reframing, while a minority resort to maladaptive coping mechanisms. These results highlight the duality of coping among morticians, resilience on one hand and vulnerability on the other. Based on these findings, interventions such as Stress Inoculation Therapy (SIT), structured peer support groups, and workplace wellness programs are recommended to strengthen adaptive coping, reduce reliance on maladaptive strategies, and ultimately enhance resilience among morticians working in high-stress environments.

Schizophrenia is a disease that not only puts a burden on the afflicted individual but also poses a significant challenge to their caregivers. Caregivers of patients with schizophrenia use coping strategies to deal with these struggles. This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia. This was a descriptive correlational study. Participants were 57 family caregivers of patients with schizophrenia who were referred to the general hospital in Malang Districts. They were selected through a purposive sampling method. The data collection tools were demographic and brief cope (BC). The scores of family caregivers using different types of coping strategies were: Self Direction 41.23%, Active Coping 85.75%, Denial 26.32%, Use of Emotional Support 89.25%, Use of Instrumental Support 96.49%, Behavioral Disengagement 35.09%, Venting 28.95%, Positive Reframing 95.18%, Planning 95.18%, Humor 95.18%, Acceptance 94.30%, Religion 91.45%, Self-Blaming 26.54%. The results showed that the most used adaptive coping strategy was instrumental support. Family caregivers of patients with schizophrenia have used adaptive and maladaptive coping strategies. Mental health professionals should make a program that supports family caregivers in making adaptive coping strategies.
 Keywords: caregivers, family, schizophrenia

Employees commonly report feeling stressed at work. Examine how employees cope with work and personal stress, whether their coping strategies are adaptive (protective to health) or maladaptive (detrimental to health), and if the manner in which employees cope with stress influences perceived stress management. In this cross-sectional study, a random sample of 2,500 full-time university non-student employees (i.e. faculty, salaried professionals, and hourly non-professionals) were surveyed on health related behaviors including stress and coping. Approximately 1,277 completed the survey (51% ). Hierarchical logistic regression was used to assess the ability of adaptive and maladaptive coping strategies to predict self-reported stress management, while controlling for multiple demographic variables. Over half of employees surveyed reported effective stress management. Most frequently used adaptive coping strategies were communication with friend/family member and exercise, while most frequently used maladaptive coping strategies were drinking alcohol and eating more than usual. Both adaptive and maladaptive coping strategies made significant (p < 0.05) contributions to predicting employee's perceived stress management. Only adaptive coping strategies (B = 0.265) predicted whether someone would self-identify as effectively managing stress. Use of maladaptive coping strategies decreased likelihood of self-reporting effective stress management. Actual coping strategies employed may influence employees' perceived stress management. Adaptive coping strategies may be more influential than maladaptive coping strategies on perceived stress management. Results illustrate themes for effective workplace stress management programs. Stress management programs focused on increasing use of adaptive coping may have a greater impact on employee stress management than those focused on decreasing use of maladaptive coping. Coping is not only a reaction to stressful experiences but also a consequence of coping resources. Thereby increasing the availability of resources in the workplace to facilitate the use of adaptive coping strategies is necessary for successful stress management and, ultimately, healthier employees.

This review analyzes 47 studies (N=12,487 refugees) published between 2010-2024 to compare the effectiveness of adaptive and maladaptive coping strategies in addressing trauma and stress among Middle Eastern refugees. The results of the analysis, utilizing a random effects model, affirm that adaptive coping strategies are positively correlated with psychological well-being (r = 0.62, p &lt; 0.001) and social adjustment (r = 0.58, p &lt; 0.001) of Middle Eastern refugees. Conversely, maladaptive strategies are associated with an increase in symptoms of depression (r = 0.45, p &lt; 0.001) and anxiety (r = 0.52, p &lt; 0.001). Furthermore, the moderator analysis reveals that social support enhances the positive effects of adaptive strategies (β = 0.34, p &lt; 0.01). At the same time, trauma conditions exacerbate the negative impact of maladaptive strategies among refugees (β = 0.41, p &lt; 0.001). Thus, these findings extend prior research by Alzoubi et al. (2019) and Paudyal et al. (2021), which focused solely on a single type of coping strategy, by providing insights into the complex interactions between various strategies and contextual factors affecting the coping mechanisms of Middle Eastern refugees as a novel contribution. Additionally, this research uniquely emphasizes, lacking in previous literature, that a combination of problem-focused and emotion-focused coping strategies can result in better adaptation outcomes for trauma-affected Middle Eastern refugees compared to the use of a singular strategy (d = 0.76, p &lt; 0.001).

Aim: To identify coping strategies nurses working in clinical practice use to manage workload, and, subsequently, to determine whether the choice of coping strategies is related to self-esteem. Design: Quantitative cross-sectional study. Methods: The sample consisted of 509 nurses. Two coping strategies questionnaires – Brief COPE and Rosenberg Self-Esteem Scale – RSES were used to collect data. The data were evaluated by descriptive statistical methods and analysed via ANOVA. Results: Nurses prefer to adopt a range of adaptive coping strategies rather than maladaptive coping strategies. The most frequently chosen adaptive coping strategies used by nurses in clinical practice are acceptance, planning, and active coping. We found that selection of coping strategies is closely related to self-esteem. We registered a significant difference in preferences for adaptive and maladaptive coping strategies as follows: nurses with high self-esteem scores (RSES) preferred adaptive coping strategies: active coping (p = 0.017), positive reframing (p = 0.001), planning (p = 0.020), and acceptance (p = 0.045). We identified selection of maladaptive coping strategies in nurses with average and low self-esteem scale results, i.e.: denial (p = 0.000), disengaged behaviour (p = 0.001), and self-blaming (p = 0.000). Conclusion: The results of the study suggest that it is important to support nurses' self-esteem since this influences choice of adaptive coping strategies. These are an effective means of coping with the burden on nurses, which directly affects the quality of nursing care provided to patients in clinical practice.

We performed a cross-sectional study in order to determine the association between stress coping strategies and stress, depression, and anxiety, in which the Mexican population was invited to answer these variables by an electronic questionnaire. A total of 1283 people were included, of which 64.8% were women. Women presented higher levels of stress, depression, and anxiety than men; likewise, women showed a higher frequency of some maladaptive coping strategies (behavioral disengagement and denial) and lower levels of some adaptive ones (active coping and planning); additionally, maladaptive coping strategies were positively correlated with stress and depression in both sexes: self-blame, behavioral disengagement, denial, substance use, and self-distraction. Likewise, there were negative correlations between stress and depression and the adaptive strategies: planning, active coping, acceptance, and positive reframing. For women, religion presented negative correlations with stress, depression, and anxiety, and humor showed low positive correlations with stress, anxiety, and depression. In conclusion, most adaptive and maladaptive coping strategies are common in both sexes with the exception of religion, which seems to be adaptive in women and neutral in men, and humor, which seems to be adaptive in men and maladaptive in women. In addition, emotional and instrumental support seem to be neutral in both sexes.

Pain beliefs, coping, and adjustment to chronic pain: Let's focus more on the negative

Introduction Dissatisfaction with conservative treatments of various types of dorsopathies results in increased number of surgical interventions to eliminate the accompanying clinical manifestations. Patients' psychosocial characteristics are likely to impact treatment satisfaction, and personality traits as cognitive status, depression, anxiety and coping strategies of the patient have a role. The objective of the study was to assess the impact of the coping strategies of a patient on surgical treatment outcomes in older patients with dorsopathy. Material and methods The study included 149 patients with dorsopathy aged 60 years and over. The patients were divided into 2 groups. The first group (n = 54) consisted of patients with central stenosis of the spinal canal (M48.0) who underwent minimally invasive surgeries without stabilization. The second group included 95 patients with degenerative spondylolisthesis and unstable VMS (M43.1, M53.2). A variety of decompression and stabilization surgical technologies were employed for the patients. Results The majority of patients in the first group ( n = 46, 85 %) obtained satisfactory surgical outcome. Eight patient (15 %) had poor outcome. An inverse, moderate, statistically significant correlation was revealed between maladaptive coping strategies identified with Ways of Coping Questionnaire (distancing, avoidance), Stress Coping Questionnaire (behavioral avoidance of a problem), the Coping Strategy Indicator (avoidance) and surgical outcome. Surgical outcome was rated as satisfactory in 79 (83.2 %) cases and poor in 16 (16.8 %) patients of the second group (n = 95). Patients of the second group showed a greater number of coping strategies having a statistically significant correlation with treatment outcome. Patients with adaptive strategies resulting from decompression and stabilization operations had a more favorable outcome. Maladaptive coping strategies such as confrontation, avoidance and behavioral avoidance of the problem had a negative impact on treatment outcome. Discussion A comprehensive analysis of the questionnaire data showed that the more aggressive the intervention was with the use of fixation constructs, the greater the impact of the patient's coping strategies on the outcome of treatment observed. This relationship was not found in decompression cases with maladaptive strategies being most significant. Conclusion We can conclude about the predictive value of coping strategies based on the impact of the severity of adaptive and maladaptive coping strategies on the outcome and satisfaction with the surgical treatment of dorsopathies in older patients. This factor is essential for the preoperative stage to facilitate personalized treatment options for the complex group of patients.

Few studies examine how patients with advanced cancer cope with stress. The objective of our study was to evaluate coping strategies adopted by patients with cancer and their relationship with symptom burden. A secondary data analysis of a prospective cross-sectional survey of patients with cancer and tobacco use was conducted, which examined demographics, symptom burden (Edmonton Symptom Assessment System), and coping strategies (the Brief COPE Questionnaire). Demographic characteristics were summarized by standard summary statistics; we also examined associations between patient characteristics and coping strategies using t-test, rank-sum test, chi-squared test, or Fisher's exact test depending on the distribution of data. Among 399 patients, the majority were female (60%), Caucasian (70%), the mean age was 56.5 (±12.0) years, and the most common malignancies were gastrointestinal (21%) and breast (19%). Patients with cancer adopted multiple adaptive coping strategies, most frequently acceptance (86.7%) and emotional support (79.9%), with humor (18.5%) being the least. Common maladaptive strategies included venting (14.5%) and self-distraction (36.6%), while substance use (1.0%) was infrequently reported. Of the adaptive strategies, female gender was significantly associated with higher engagement with emotional and instrumental support, positive reframing, religious coping, and acceptance (P < .05 for all). College educated patients reported significantly higher implementation of humor, planning, and acceptance. Maladaptive coping strategies such as denial were associated with increased pain and depression, while patients adopting emotional-focused strategies rated decreased emotional distress. The majority of patients with advanced cancer reported adopting multiple, adaptive coping strategies, and a minority utilized maladaptive or avoidant strategies, rarely substance use, and may need additional psychological support.