Coping Strategies in Liver Patients as a Function of Relatives' Anxiety Level

Abstract

ObjectiveTo determine whether differences in the coping strategies used by liver patients during the pretransplantation phase were a function of their relatives' level of anxiety. Materials and MethodsWe assessed 75 pre–liver transplantation patients and 75 relatives (one per patient). To assess relatives' anxiety status, we used the Hospital Anxiety and Depression Scale (HADS), and the Questionnaire of Coping with Stress in Cancer Patients (CAEPO) to study patients' coping strategies. Three subgroups of relatives were established as a function of their scores on the HADS anxiety subscale: normal anxiety (G1), dubious anxiety (G2), and clinical anxiety (G3). To verify intergroup differences in the coping strategies used by the patients, we used the nonparametric Kruskal-Wallis H test. We also performed pairwise comparisons with nonparametric Mann-Whitney U test (with Bonferroni's correction) and Cohen's d as an effect size index. ResultsFocusing on the most relevant effect sizes, the pairwise contrasts indicated the following differences: a) normal anxiety (G1) and dubious anxiety (G2): seeking social support (d = 0.502); b) normal anxiety (G1) and clinical anxiety (G3): coping and active fighting (d = 0.607), self-control and emotional control (d = 0.658), and seeking social support (d = 0.944); and c) dubious anxiety (G2) and clinical anxiety (G3): coping and active fighting (d = 0.743), self-control and emotional control (d = 0.722), and seeking social support (d = 0.515). ConclusionIn general, during the pre–liver transplantation study, the liver patients whose relatives showed clinical levels of anxiety used these three healthy coping strategies to a lesser extent: coping and active fighting, self-control and emotional control, and seeking social support.