Desafios acadêmicos e estratégias de enfrentamento na formação inicial de professores: revisão sistemática da literatura,

Relationship of coping strategies with mood symptoms, disease related characteristics and demographic variables in patients with multiple sclerosis: A systematic review study

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.

Introduction : Internet addiction has negative consequences, including physical, psychological, social and educational problems. The current research intended to assess the mediation role of coping strategies in relation with psychological needs and internet addiction. Methods : This cross-sectional study assessed 375 students (129 male, 244 female) from Karaj Islamic Azad University in 2018 selected by stratified sampling. Data collected by self-report method. Research instruments were internet addiction test, satisfaction of psychological needs questionnaire and coping response scale. Data were analyzed by SPSS v.19 and using descriptive statistics, Pearson correlation coefficients and Concurrent hierarchical Regression analysis. Results : Pearson correlation coefficients showed negative correlations between autonomy, relatedness, competence and internet addiction (P<0.01). There is negative correlation between autonomy, relatedness, competence and maladaptive coping strategy (P<0.01) and positive correlation between maladaptive coping and internet addiction (P<0.01). Also, Hierarchical regression analysis by Baron and Kenny method showed that maladaptive coping is mediator between and satisfaction of psychological needs and internet addiction.Conclusion: in general, this results indicate that high level of satisfaction of psychological needs are associated with low level of internet addiction and unsatisfied of psychological needs has positive impact in maladaptive coping strategy, subsequently maladaptive coping increases internet addiction.Declaration interest: None.

Emergency healthcare professionals (EHPs) face significant occupational stressors requiring the skilled use of adaptive coping strategies. Some EHP resort to maladaptive coping (MC) strategies that negatively impact their mental health, yet MC strategies are not clearly defined in the literature. Examining factors that predispose EHP to MC can support interventions to improve coping and well-being. This systematic review examined MC among EHP working in pre-hospital and hospital-based settings. The primary aim was to identify factors associated with MC strategies used by EHP. Embase, Ovid, CINAHL Plus, PsychInfo, and the Cochrane Library were systematically searched for quantitative studies measuring MC use among EHP. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 checklist was used to guide the review. Studies were included if they: (a) targeted licensed healthcare professionals providing patient care, (b) occurred in emergency department or pre-hospital emergency setting, and (c) examined provider coping. Studies were excluded if they: (a) did not include EHPs, (b) did not differentiate results in mixed samples, (c) did not clearly measure coping strategies, (d) failed to include MC strategies in the results, or (e) were not available in full text. Risk of bias and study quality was appraised using Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Bandura's Social Cognitive Theory (SCT) guided the final synthesis, drawing conclusions from the evidence to identify factors associated with MC in EHP. A total of 14 cross-sectional studies, published between 2003 and 2021, were included in the review. Included studies were conducted in either pre-hospital, hospital, or a combination of both settings. Most studies included mixed samples or emergency physicians. A variety of coping strategies were significantly correlated with poor mental health outcomes including venting, denial, disengagement, self-blame, and substance use. Among personal factors, EHPs who were female, older than 50, living alone, with personal trauma history were significantly more likely to use MC strategies. Additionally, EHP with children, work experience, higher life satisfaction, and resilience were negatively associated with MC. Environmental factors positively associated with MC included work stress, workload, and poor benefits. Trauma exposure had a positive, but non-significant relationship. Emergency healthcare professionals use a variety of coping strategies, many of which are maladaptive and significantly related to poor mental health outcomes. Several personal and environmental factors contribute to behavior that reflect the use of MC strategies, but findings are sparse. Researchers should consider current limitations and challenges, particularly mental health stigma, when designing future studies. The evidence in this review suggests that certain factors predispose EHP for use of MC strategies. This review highlights an important research gap necessitating more robust studies to identify MC risk factors among EHP in chronically high-stress environments.

Adolescents employ various coping strategies to manage stress, which can impact their short and long-term mental health. Economically disadvantaged adolescents are more prone to developing maladaptive coping mechanisms due to the persistent stressors associated with poverty. In Nepal, there is a lack of research on how adolescents experiencing or at risk of depression and anxiety cope with adverse situations. This study aims to explore how adolescents affected by poverty and at risk of experiencing mental health problems navigate difficulties within their homes, peer groups, and school environments. The study focused on adolescents aged 11 to 19 residing in informal squatter settlements in Kathmandu, Nepal. In-depth narrative interviews were conducted with 30 adolescents experiencing or at risk of depression and/or anxiety. In addition, journal entries documenting their experiences were collected weekly for 3–5 weeks post-interviews. Thematic and plot analysis were employed to identify the coping strategies utilised by adolescents in this context, which were then categorised according to coping theory. The results indicated that adolescents employed a combination of adaptive and maladaptive coping strategies across different settings (home, school, and peer interactions), with variation in coping strategies used within each setting. Problem solving emerged as the most prevalent coping strategy across all settings. Adolescents tended to exhibit more submission and helplessness at home, more isolation and opposition among peers, and more accommodation and opposition at school. Adolescents aged 14–16 displayed more maladaptive coping strategies compared to younger (11 to 13 years) and older adolescents (17 to 19 years). While girls and boys utilised similar adaptive and maladaptive coping strategies, girls leaned more towards avoidance-escape and helplessness, whereas boys favoured opposition and isolation. The results highlight the range of adaptive and maladaptive coping strategies used by adolescents to manage stress in circumstances of urban poverty in Nepal. The study recommends focused psychological interventions which equip adolescents with adaptive coping strategies and stress appraisal techniques that help them manage difficulties effectively.

When external requirements conflict with teachers’ personal beliefs and values, the resulting internal struggles can lead to identity tensions. Contributing to discussion on teachers’ identity development in a challenging context, this study investigated teacher identity tensions and related coping strategies in Hong Kong. We conducted 21 semi-structured interviews with qualified teachers and then performed a deductive thematic analysis of the data. We categorised the identity tensions as positioned on the micro or macro level, and distinguished the coping strategies as emotion-focused or problem-focused behaviours. The identity tensions and related coping strategies seemed to be associated with teachers’ career stages. We further found identity tensions to be related to the school’s sociocultural environment and to the specific political and societal forces in the region. The study demonstrated the need for continuous and differentiated support catering for teachers’ needs, and highlighted the specific social-political influences on professional identity development.

In theory, depression is thought to be associated with deficits in adaptive and excesses in maladaptive coping strategies. This study aimed to investigate associations between coping strategies and depression treatment outcomes. Participants (N = 126) completed measures of adaptive and maladaptive coping strategies before and after accessing evidence-based psychotherapies for depression. The primary outcome was self-reported depression severity measured with the Patient Health Questionnaire (PHQ-9). Hierarchical regression was used to investigate associations between coping strategies and post-treatment depression symptoms, controlling for therapeutic alliance and relevant demographics. Lower pre-treatment engagement coping and higher rumination predicted higher post-treatment depression, but both of these effects became non-significant after controlling for baseline depression severity. Similarly, correlations between change in rumination and change in depression were no longer significant after controlling for baseline severity. Deficits in adaptive (engagement) and excesses in maladaptive (rumination) coping strategies may simply be proxy indicators (epiphenomena) of depression severity. Lower pre-treatment engagement coping predicted higher post-treatment depression Higher pre-treatment rumination predicted higher post-treatment depression Change in rumination during treatment correlated with change in depression symptoms However, none of the above associations remained statistically significant after controlling for baseline depression severity.

This study examined relationships between coping strategies and psychological quality of life (QOL) among people living with HIV/AIDS (N = 141). Participants completed baseline assessments, which included a demographic survey, the Brief COPE, the MOS-HIV, and a medical history questionnaire. Additionally, we obtained CD4 count information from medical charts. After controlling for demographic and AIDS-related factors, hierarchical multiple regression analyses indicated that maladaptive coping strategies used to deal with the stress of living with HIV/AIDS significantly lowers psychological quality of life as defined by cognitive functioning, mental health, and health distress. Developing adaptive coping skills to increase adaptive coping behaviors for dealing with living with HIV/AIDS may be a particularly effective intervention strategy to improve QOL. Future research must use methodological designs that can evaluate the influence of coping on QOL over time.

The paper focuses on the relationship between the dimensions of affective attachment and a three-dimensional model of coping strategies (problem-focused coping, emotion-focused coping and avoidance: distraction and social diversion). To analyze this problem, the Coping in Stressful Situations questionnaire (CISS, Endler &amp; Parker, 1990) along with the Questionnaire for Attachment Assessment (UPIPAV -R, Hanak, 2004; Hanak 2011) was used on a sample of 152 students of the Faculty of Philosophy.The results indicate the existence of significant correlations between coping strategies and the dimensions of attachment. Specifically, there is a negative correlation between problem-focused coping and unresolved family trauma, fear of using an outside secure base and a negative working model of self, while there is a positive correlation with the ability to mentalize. There is a positive correlation between emotion-focused coping and distraction strategies, and fear of using an outside secure base, a negative working model of self and negative working model of others, and poor anger management where there is a positive correlation between emotion-focused coping and unresolved family trauma. Finally, there is a negative correlation between social diversion and unresolved trauma, and a negative working model of self and a positive one between fear of using an outside secure base. The results of the regression analysis indicate that the aforementioned dimensions of affective attachment, as predictors explain 21,1% of the variance of problem-focused coping, 13,3% of the variance of the distraction strategy, 24,6% of the variance of the strategy of social diversion, and as much as 49,9% of the variance of emotion-focused coping.Even though drawing any conclusions requires a greater sample, we could say that the participants are more prone to maladaptive coping if they display more pronounced dimensions of affective attachment typical of insecure patterns of attachment (a negative working model of self and a negative working model of others, unresolved family trauma, fear of using an outside secure base and poor anger management).

The value of psychological principles has become apparent in medical settings, especially with the rise of patient-centered care. We aimed to provide a curriculum informing medical providers about the theoretical basis and clinical utility of the social-cognitive model of stress and coping. This workshop was delivered to an interprofessional team of faculty and trainees. Our initial pedagogical approach was to relate the concepts of cognitive appraisals and coping strategies to participants' own stress responses. We then used didactic presentation and small-group activities to explore ways to promote adaptive coping with patients to improve health outcomes. Learners participated in a mindfulness exercise, conceptualized coping strategies given a hypothetical case scenario, and, in small groups, role-played a patient encounter to construct an effective coping repertoire for the patient. Participants completed a prework self-assessment and workshop evaluation form. The 2.5-hour workshop had 48 participants from five professions (medicine, education, physician assistant, pharmacology, psychology). We received 35 evaluations (73% response rate). Learners reported increased real-world skills (M = 8.0 out of 10) and feeling better prepared for working in interprofessional settings (M = 7.6 out of 10). Qualitative feedback suggested that participants recognized the importance of individual differences in coping with stress and felt they could categorize strategies into emotion- or problem-focused coping. This workshop provided participants with basic knowledge about the social-cognitive model of stress and coping and allowed them to practice newly learned skills in a role-play as an interprofessional medical care team.

Mindfulness has been theoretically and empirically associated with psychological health. One commonly investigated mechanism underlying the association between mindfulness and psychological health is adaptive coping. Despite research demonstrating the relationship between trait mindfulness and averaged use of adaptive (and maladaptive) coping strategies, little work has examined the potential association between mindfulness and flexibility in coping. Among various conceptualizations, coping flexibility can be operationalized in terms of within-situational coping variability, referring to the extent of use of different strategies to varying degrees in a given situation, and within-strategy temporal variability, which refers to the extent of use of a particular coping strategy across different situations over time. Using a diary study approach, the present study examined the association between trait mindfulness and the two forms of coping variability. One hundred and ninety-two undergraduates from a Singaporean university were recruited and administered questionnaires and diary logs, in which they reported on use of seven different coping strategies in response to six stressors sampled over a period of 3 weeks. Consistent with hypotheses, factor analysis differentiated within-situational coping variability, within-strategy temporal variability, and averaged use of adaptive and maladaptive coping strategies as distinct constructs. Higher trait mindfulness was associated with lower ruminative self-criticism and greater use of adaptive coping. Importantly, trait mindfulness predicted higher within-situational coping variability, over and above personality traits as well as the average use of adaptive and maladaptive coping strategies. Overall, the study lends support to the idea that mindfulness facilitates adaptive coping in the context of daily life and provides preliminary evidence for the association between mindfulness and greater coping flexibility.

Cancer is a serious event in a person's life. However, certain coping strategies in relation to selected social, emotional, and personality factors appear to manage the disease. Sources of social support were tested in cancer survivors (N = 696) using hierarchical linear regression. Selected personality variables in terms of sociodemographic, clinical, and emotional factors were used as predictors of adaptive and maladaptive coping strategies. It was found that adaptive coping strategies were more frequent in younger patients, in patients who attended cancer support groups and those with a greater level of optimism. Maladaptive coping was related to the higher level of experience of pain and sadness, neuroticism, and pessimism. The absence of a relapse and the time since the disease had been diagnosed were also important factors in coping with cancer. The results point to the importance of considering various individual factors in the process of intervention to facilitate adaptive coping and to reduce maladaptive coping.

Intimate partner violence (IPV) is a complex phenomenon of abusive partners’ behavior and is a serious public health problem that affects women’s health. It includes physical assaults, psychological aggressions, sexual abuse, and controlling behavior. Over the years, IPV was thought to be associated with chronic psychological stress. Although Chinese women have been shown using a variety of strategies to appraise, as well as cope with their abuse experience, not much is known about the relationships among psychological stress, appraisal of IPV as a stressor, coping strategies and emotional states in abused Chinese women.&#13;\n&#13;\nThis study aimed (a) to differentiate women’s cognitive appraisal of IPV as a “threat” or a “challenge”; (b) to examine the relationship among women’s cognitive appraisals, coping strategies and emotional states; (c) to investigate the effect of cognitive appraisal and coping strategies on the relationship between IPV severity and emotional states.&#13;\n&#13;\nA cross-sectional, quantitative study was conducted. A total of 200 abused and 100 non-abused community-dwelling Chinese women aged 18 or above were recruited via poster advertisements in community centers and domestic violence support agencies in Hong Kong for this study. Participants were interviewed using a questionnaire to elicit their violence experience, cognitive appraisal, coping strategies, psychosocial readiness, social stress, self-efficacy and emotional states.&#13;\n&#13;\nAmong the abused women group, 23.3% and 34.7% of them appraised IPV as a “threat” and “challenge” respectively, while 11.4% reported the co-existence of “threat” and “challenge” appraisal. Although abused women used a variety of coping strategies to cope with partner’ abusive behavior, however, their efforts were perceived as somewhat helpful. A proposed model, conceptualized from the transactional model of stress and coping, the stress process model and the psychosocial readiness model, was tested using structural equation modeling. It revealed that violence severity had a significant impact on women’s adaptational outcomes, i.e. emotional states in terms of psychological symptoms and distress intensity, and self-efficacy. This relationship was significantly mediated by cognitive appraisal and coping strategies. The psychosocial readiness of abused women was also found as a crucial mediator in the relationship of violence severity and coping strategies. Besides, a significant indirect effect of social stress on the relationship between IPV severity and adaptational outcomes was observed. Furthermore, financial difficulties had a significant effect on cognitive appraisal of abused women. It indicated that an increase in financial difficulties therefore increased the threat appraisal of abused women and in turns affecting their coping strategies and adaptational outcomes. However, immigration status had no effect on cognitive appraisal, psychosocial readiness, coping strategies social stress and outcomes among Chinese abused women.&#13;\n&#13;\nThis study identified the mediating effects of cognitive appraisal and coping strategies on abused women’s self-efficacy and emotional states. The findings of this study advanced the current knowledge of cognitive appraisal and coping in women survivors of IPV. Intervention focus on coping may be effective in buffering the violence-related psychological stress and, special attention shall be paid to the psychosocial readiness of abused Chinese women to facilitate the effectiveness of coping strategies.

Exposure to terrorism seriously threatens the well-being of children and adolescents. Israeli citizens have witnessed massive ongoing terrorist attacks during the last few years. The present research, conducted among 330 Israeli adolescents, examined coping strategies in relation to terrorist attacks. We found that adolescents utilize more productive than non-productive coping strategies when dealing with terrorist attacks. Moreover, they rarely seek professional help. Male adolescents use more non-productive coping strategies and female adolescents seek more social support as a coping strategy. The impact of exposure to media reports and life satisfaction on adolescents' use of coping strategies is discussed, and potentially effective approaches to coping with terrorist attacks are proposed.

With the mental wellbeing of billions of people at risk due to climate change, more research is required to better understand mental health and psychological implications of climate vulnerability. This research contributes to understanding how people in climate vulnerable populations psychologically cope with stress with crucial implications for adaptation efforts. We conducted n = 60 qualitative in-depth interviews with men and women in Bhola, Bangladesh to elicit the lived experiences of a climate vulnerable population. We analysed data following the tenets of Grounded Theory. Through our inductive analysis, we found coping strategies where participants highlighted what they did when encountering stress, such as ‘Resignation’ or ‘Help Seeking'. Barriers to coping were, among others, limited ‘Efficacy', ‘Time’ or ‘Stigma'. We categorized coping strategies with barriers as high-barrier coping strategies and, those without reported barriers, as low- barrier coping strategies. High-barriers restricted participants - especially women - in their coping efforts and led them to using low-barrier coping strategies. Some low-barrier coping strategies can be interpreted as maladaptive if used frequently, as they are unhealthy and draw upon resources needed to adapt for the future. Maladaptive coping strategies can thus impede long-term adaptation by reducing motivation and the ability and willingness to act. To enable adaptive coping, we recommend lifting the barriers to coping through community-led interventions where community workers create platforms for sharing problems and knowledge, such as group support meetings. Sharing and discussing could strengthen efficacy and open new opportunities for functional, adaptive coping. As the negative impacts of climate change will be felt globally with more intensity and frequency, enabling adaptive coping and removing barriers to coping in frontline communities will be essential to supporting physical and mental wellbeing. Key messages • Barriers to adaptive coping strategies can lead people to using maladaptive low-barrier coping strategies, which draw upon resources needed for long-term adaptation. • Enabling adaptive coping by lifting barriers to coping in climate vulnerable populations is crucial to strengthen adaptation efforts.