Adverse Coping Research Articles

Association of shared decision-making with financial toxicity and coping actions in adult patients with cancer: a nationwide study in China

Abstract Objective Evidence on the impact of shared decision-making (SDM) on the financial toxicity (FT) of patients with cancer in real clinical settings is lacking. Using a nationwide patient survey in China, we aimed to identify the prevalence of SDM, FT as well as its consequent coping actions, and investigate their associations in adult patients with cancer. Methods A cross-sectional survey was administered to patients with cancer near discharge at 33 tertiary public cancer hospitals across China between January and March 2021. The FT was measured using the COST (comprehensive score for financial toxicity) tool and was categorized into 3 groups: no (COST 26-44), mild (COST 14-25), and moderate or severe (COST 0-13) FT. SDM was measured using 2 items from patient’s perspective. The surveyed questionnaire also included patient’s coping actions, demographics, and clinical information. Multinomial logistic regression was used to investigate the association between SDM and FT, and for sensitivity analysis, linear regression was also used taking the COST score as a dependent variable. Pearson’s chi-square tests were used for association analyses of coping actions with FT and SDM. Results A total of 5008 adult patients with cancer were included, of which 26.18%, 54.13%, and 19.69% patients were categorized as no FT, mild FT, and moderate or severe FT with the average COST score of 21.0 for all patients. Besides, 3943 (78.73%) patients reported a better SDM. Better SDM had significantly lower odds of developing high FT than worse SDM (adjusted ORmild vs no 0.50, 95% CI 0.39-0.56; adjusted ORmoderate or severe vs no 0.63, 95% CI 0.50-0.80). In sensitivity analysis, better SDM was significantly associated with higher COST scores (β: 1.34, 95% CI 0.85-1.83), which indicated lower FT. Patients with higher FT were more likely to take adverse coping actions including treatment nonadherence, limiting basic health service expense, reducing leisure activity expense, and loan. Conclusions Adult patients with cancer reporting worse SDM tended to experience higher FT and those with higher FT tended to take adverse coping actions. Understanding the impact of SDM on FT is crucial to inform early interventions designed to mitigate FT and consequent coping actions in cancer care practice.

Relationship between moral resilience and secondary traumatic stress among ICU nurses: A cross-sectional study.

Since the outbreak of COVID-19, researchers worldwide have focused more on the issue of secondary traumatic stress (STS) experienced by nurses. This stress has an adverse effect on the health of nurses and the quality of nursing care, potentially undermining the stability of the nursing team and hindering the ability to meet the growing demand for nursing services. The impact of the COVID-19 pandemic, and the rise in global demand for ICU nursing, has placed a significant strain on ICU nurses, severely damaging their mental and physical health. Notably, ICU nurses also face high levels of moral distress, and moral resilience can effectively alleviate this distress and improve the quality of care. This study aimed to examine the levels of moral resilience and STS among ICU nurses, to explore their relationship and identify the factors influencing STS. This cross-sectional study involved 229 ICU nurses from two tertiary hospitals in Xi'an, China, who participated between November and December 2023. The data were collected through email using anonymous electronic questionnaires, encompassing a self-designed demographic- and work-life-related characteristic questionnaire; the Rushton Moral Resilience Scale; and the Secondary Traumatic Stress Scale. Descriptive statistics, t-tests, analysis of variance and hierarchical regression analysis were performed to analyse the data. The findings of the study indicated that ICU nurses' moral resilience and STS scores were at an intermediate level. Hierarchical regression analysis indicated that STS was negatively correlated with the subscales of the Rushton Moral Resilience Scale, specifically moral adversity coping (β, -0.156; 95% CI, -1.241 to -0.039) and relational integrity (β, -0.245; 95% CI, -1.453 to -0.388), which are significant predictors of STS. Additionally, good sleep quality (β, -.396; 95% CI, -14.948 to -7.117) and seeking psychological counselling because of work difficulties (β, .107; 95% CI, 0.237-9.624) emerged as significant predictors of STS among ICU nurses, with the model's explanation of the variance in STS increasing to 45.5%, △R2 = .167, F = 16.482 (p < .001). This study found that ICU nurses have moderate levels of moral resilience and STS, which are negatively correlated. This suggests that improving the moral resilience of ICU nurses may help reduce their STS levels. The study revealed that ICU nurses' moral resilience and secondary traumatic stress levels were at a moderate level, indicative of the need to take measures to enhance their moral resilience and reduce their secondary traumatic stress, as their presence not only affects the health of ICU nurses but also diminishes the quality of care and increases turnover rates.

Child marriage and education in the context of a global pandemic: Exploring the gendered implications of COVID‐inspired school closures in Ghana

AbstractThis article aims to cast light on the negative but silent effects of the COVID‐19 pandemic on girls' education and welfare in Ghana. Since the pandemic emerged in 2019, unprecedented changes have occurred in ordinary people's health, education and social life. As a response to the pandemic, governments globally implemented social distancing regimes, lockdowns and school closures to curtail the spread of the virus. While this approach did help in curtailing the spread of the pandemic, implementing lockdowns and school closures in Ghana had unintended consequences: they amplified gendered inequalities in access to education. Drawing on one‐on‐one semi‐structured interviews with (i) 10 teachers and one head teacher, 13 parents of child brides, and 11 child brides (aged 15–19), and (ii) Focus group discussions (FGDs) with 15 community leaders in a rural Ghanaian setting (Mion), this article provides empirical evidence to show how the pandemic has disrupted the lives and education of 11 girls. In particular, school closures and rising poverty due to the pandemic led to increased child marriage. These 11 schoolgirls were seen as a burden by their parents, and, consequently, married off to older men as an adverse coping strategy. Furthermore, some of the girls themselves requested to be married, due to rising household chores occasioned by the school closures. Finally, the school closures also offered the community the justification to reactivate deeply held notions about the value of a girl's education as a basis for marrying them off.

Coping during COVID-19: how attitudinal, efficacy, and personality differences drive adherence to protective measures

ABSTRACT Introduction: COVID-19 has had a devastating impact on people’s lives since its initial outbreak and global spread in 2020. While the U.S. government and public health officials have recommended best practices such as social distancing, wearing a mask, and avoiding large public gatherings, these orders have been met with varying levels of acceptance from the public. Given the disparate compliance, this study builds on Social Cognitive Theory (SCT) to explore individual differences and personal motivation factors in order to better understand what may influence one’s likelihood to adhere to COVID-19 protective measures. Methods: A U.S. national survey (N = 2,049) was conducted April–May 2020, roughly one month after stay-at-home orders were issued in some states. Participants were asked to report their likelihood of taking individual and community protective measures. Multivariate hierarchical linear regressions were run to analyze the extent to which participants’ concerns about COVID-19’s impact, individual and collective self-efficacy, coping behaviors, and personality traits influenced the dependent variables. Results: Findings showed that COVID-19-related health concerns, collective efficacy, and proactive coping strategies were positively related to participants’ likelihood of taking protective measures. Those with greater concerns about their general well-being and the economy, adverse coping strategies like denial and joking, as well as sensation-seeking personalities, were less likely to take protective measures. Conclusion: The discussion considers how individual differences fit into broader global efforts to stem COVID-19. Practical implications for public health messaging are that communication may focus on facilitating efficacy in order to boost compliance with protective measures.

Internalised Weight Stigma Mediates Relationships Between Perceived Weight Stigma and Psychosocial Correlates in Individuals Seeking Bariatric Surgery: a Cross-sectional Study

PurposeResearch suggests that internalised weight stigma may explain the relationship between perceived weight stigma and adverse psychological correlates (e.g. depression, disordered eating, body image disturbances). However, few studies have assessed this mechanism in individuals seeking bariatric surgery, even though depression and disordered eating are more common in this group than the general population.Materials and MethodsWe used data from a cross-sectional study with individuals seeking bariatric surgery (n = 217; 73.6% female) from Melbourne, Australia. Participants (Mage = 44.1 years, SD = 11.9; MBMI = 43.1, SD = 7.9) completed a battery of self-report measures on weight stigma and biopsychosocial variables, prior to their procedures. Bias-corrected bootstrapped mediations were used to test the mediating role of internalised weight stigma. Significance thresholds were statistically corrected to reduce the risk of Type I error due to the large number of mediation tests conducted.ResultsControlling for BMI, internalised weight stigma mediated the relationship between perceived weight stigma and psychological quality of life, symptoms of depression and anxiety, stress, adverse coping behaviours, self-esteem, exercise avoidance, some disordered eating measures and body image subscales, but not physical quality of life or pain.ConclusionAlthough the findings are cross-sectional, they are mostly consistent with previous research in other cohorts and provide partial support for theoretical models of weight stigma. Interventions addressing internalised weight stigma may be a useful tool for clinicians to reduce the negative correlates associated with weight stigma.Graphical abstract

Adversity coping capability and its associations with mental health and family wellbeing amid the COVID-19 pandemic in Hong Kong

BackgroundAdversity coping capability (ACC) is important amid the COVID-19 pandemic. We examined the associations of ACC as measured by our one-item ACC scale (ACC-1) with mental health, family well-being and validity of ACC-1 in Hong Kong.MethodsA cross-sectional survey was conducted on Hong Kong Chinese adults aged ≥ 18 years by landline, mobile phone, and online survey from February to March 2021, when the fourth wave of COVID-19 was under control. ACC-1 consisted of the question: “How do you rate your capability to cope with adversities?” with higher scores (0–10) indicating stronger ACC. The associations of ACC with socioeconomic characteristics, resilience, mental health, and family wellbeing were examined by linear regression coefficients (βs). Data were weighted by sex, age, and education of the general population.ResultsOf 7441 respondents, after weighing, 52.2% were female and 79.1% were aged 18 to 64 years. ACC-1 showed good construct validity, with higher ACC being associated with higher levels of resilience (adjusted β = 0.29), personal happiness (0.55), family happiness (0.42), family wellbeing (0.41), and family communication quality (0.41), and lower levels of depressive symptoms (-0.30), anxiety (-0.30), loneliness (-0.15); incremental validity with additional contributions of ACC to mental health and family wellbeing; and known-group validity with older age and favorable socioeconomic characteristics showing higher ACC (all P < 0.02). Females (mean ± standard deviation: 6.04 ± 1.82 vs 6.15 ± 1.96 [male]) and unemployed respondents (5.30 ± 1.99 vs 6.11 ± 2.03 [in paid employment]) had lower ACC (all P ≤ 0.02).ConclusionsWe have first shown that stronger ACC was associated with better mental health and family wellbeing, and the results support ACC-1 as a simple and valid measure of ACC.

A tale of triple disadvantages: Disability, chronic poverty and gender inequality in rural Bangladesh

This study focuses on the interaction between disability, chronic poverty and gender in rural Bangladesh, relying on analysis of the Chronic Poverty and Long Term Impact Study conducted between 1997 and 2010. A series of logistic regressions investigate the relationship between disabilities and chronic poverty among women with their employment, education, assistance and household coping strategies. The results indicate that primary schooling is lower among girls compared with boys in chronically poor households, with implications for the intergenerational transmission of poverty. Even where the probability of employment for chronically poor women with disabilities is positive, these women are potentially unlikely to be engaged in work that safeguards their rights or contributes to poverty escapes. Moreover, in the face of shocks, poverty becomes stickier, in the absence of effectively targeted safety nets coupled with adverse coping strategies that prolong poverty. The article concludes with a call for ensuring that intersectionality is more firmly embedded into existing social protection programmes.

Student Pharmacists’ Emotional Responses and Coping During the COVID-19 Pandemic

Introduction: Health professions students, including student pharmacists, have been impacted by the coronavirus disease 19 (COVID-19 pandemic) as schools have transitioned to remote learning and cancelled milestone events. During times of crises, media consumption and hobby participation also impact well-being. The adverse emotional responses and coping strategies of student pharmacists amidst the COVID-19 pandemic have not been evaluated, nor have factors that may contribute to emotional responses. The purpose of this study is to determine Doctor of Pharmacy students’ emotional responses and coping precipitated by the COVID-19 pandemic, and the influence of media use, working status, and participation in hobbies. Methods: An anonymous online survey was administered to student pharmacists from May 21 to June 7, 2020 at one school of pharmacy in Kentucky. Measures included gender, working status, media source and use, hobby participation, emotional responses, and the Brief COPE to measure coping reactions. Results: A total of 550 student pharmacists from the University of Kentucky College of Pharmacy were invited to participate the study. Participants (n = 77, 14% response rate) identified feelings of anxiety, fear, sadness, and anger related to the COVID-19 pandemic. Participants who consumed less than one hour of media per day were less likely to feel fear than those who consumed more. Students who continued to work during the pandemic reported less fear and sadness compared to those who did not. Those who participated in hobbies were less likely to report feelings of sadness. Student pharmacists reported using approach coping more frequently than avoidant. Conclusion: Life-disorienting events, like the COVID-19 pandemic, can negatively affect student pharmacists’ well-being. Pharmacy schools should prepare student pharmacists for times of both major and minor crises.

60대 은퇴 남성의 역경대처 경험: 경제적 어려움을 중심으로

60대 은퇴 남성의 역경대처 경험: 경제적 어려움을 중심으로

Perbedaan Adversity Quotient ditinjau dari Coping Stress dan Self Efficacy

This study aimed to determine the difference adversity quotient in terms of coping stress and self-efficacy of tenth grade students in SMA Swasta Medan. The population of this study was all of the students of tenth grade in SMA Swasta Medan. The subjects used in this study were 146 students who were selected using the disproportionate stratified random sampling method. This study was a comparative quantitative, data collected used Likert Scale which is adversity quotient (AQ), coping stress (CS), and self-efficacy (SE) scale. In this study the data analysis technique used is analysis of varians (ANOVA). The assumptions test consisted of an normality test, a homogenity test, and a hypothesis test.The result of data analysis showed a significant difference adversity quotient in terms of coping stress with Sig .000 &lt; p = .05 and a significant difference adversity quotient in terms of self-efficacy with Sig .000 &lt; p = .05 that owned by the students. The conclusion obtained from this study is a proven hypothesis, namely the difference between adversity quotient (AQ) in terms of coping stress (CS) and adversity quotient (AQ) in terms of self-efficacy (SE), where the contribution percentage of coping stress (CS) in influencing adversity quotient (AQ) was 16.6% and self-efficacy (SE) in influencing adversity quotient (AQ) was 19.5%, the rest was developed by other factors that were not appropriate by the researcher.

Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients.

BACKGROUNDIrritable bowel syndrome (IBS) is a common digestive system disease with a high incidence rate and is common in women. The cause of IBS remains unclear. Some studies have shown that mental and psychological diseases are independent risk factors for IBS. At present, the treatment of IBS is mainly symptomatic treatment. Clinically, doctors also use cognitive behavioral therapy to improve patients' cognitive ability to diseases and clinical symptoms. In recent years, exercise therapy has attracted more and more attention from scholars. Improving the symptoms of IBS patients through psychosomatic treatment strategy may be a good treatment method.AIMTo explore the effects of an intervention of cognitive behavioral therapy combined with exercise (CBT+E) on the cognitive bias and coping styles of patients with diarrhea-predominant irritable bowel syndrome (IBS-D); and to provide a theoretical reference for the management of IBS.METHODSSixty IBS-D patients and thirty healthy subjects were selected. The 60 IBS-D patients were randomly divided into experimental and control groups. The experimental group was treated with the CBT+E intervention, while the control group was treated with conventional drugs without any additional intervention. The cognitive bias and coping styles of the participants were evaluated at baseline and after 6 wk, 12 wk and 24 wk using the Automatic Thoughts Questionnaire (ATQ), Dysfunctional Attitudes Scale (DAS) and Pain Coping Style Questionnaire (CSQ) instruments, and the intervention effect was analyzed using SPSS 17.0 statistical software.RESULTSAt baseline, the scores on the various scales showed that all subjects had cognitive bias and adverse coping styles. The IBS Symptom Severity Scale (IBS-SSS) scores, ATQ total scores, DAS scores and CSQ scores of the two groups were not significantly different (P > 0.05). Compared with baseline, after 6 wk of the CBT+E intervention, there were significant differences in the ATQ scores, the dependence and total scores on the DAS, and the catastrophization, distraction and prayer scores on the CSQ (P < 0.05). After 12 wk, there were significant differences in the scores for perfectionism on the DAS and in the scores for reinterpretation, neglect and pain behavior on the CSQ in the experimental group (P < 0.05). After 24 wk, there were significant differences in the vulnerability, dependence, perfectionism, and total scores on the DAS and in the catastrophization, distraction and prayer scores on the CSQ in the experimental group (P < 0.01). The IBS-SSS scores were negatively correlated with the ATQ and DAS total scores (P < 0.05) but were positively correlated with the CSQ total score (P < 0.05).CONCLUSIONIntervention consisting of CBT+E can correct the cognitive bias of IBS-D patients and eliminate their adverse coping conditions. CBT+E should be promoted for IBS and psychosomatic diseases.

Adverse Childhood Experiences, Smoking and Alcohol Use, and Allostatic Load Among People Living with HIV.

Allostatic load is an indicator of multisystem physiologic dysregulation that may arise from prolonged or accumulated exposure to stress, including adverse childhood experiences (ACEs) and chronic stressors persisting into adulthood. People living with HIV (PLWH) may be particularly vulnerable given their high burdens of adversity across the life course. Using data from a cohort of middle aged PLWH, we examined associations between ACEs and two measures of allostatic load. In order to determine whether the negative impact of ACEs on allostatic load operates through increasing the adoption of adverse coping behaviors, we tested for mediation by smoking and alcohol use. PLWH who had experienced 4 or more ACEs had on average higher allostatic load in adulthood compared to those who experienced fewer. Neither smoking nor alcohol use mediated this relationship, however, suggesting alternative mechanisms may be at play.

3529 The main effects of threat appraisal on the well-being of African Americans living with HIV/AIDS in the Washington, D.C. metropolitan area, and the role of religious social support as a buffer

3529 The main effects of threat appraisal on the well-being of African Americans living with HIV/AIDS in the Washington, D.C. metropolitan area, and the role of religious social support as a buffer

Coping with the Supply-Side Effects of Free Maternal Healthcare Policies in Seven sub-Saharan African Countries: A Systematic Review.

Free maternal healthcare policies (FMHP) result in enormous supply-side effects on care delivery in sub-Saharan Africa (SSA). This review synthesises the mechanisms adopted by supply-side actors to cope with the effects of FMHP and the results of coping mechanisms on policy objectives in seven SSA countries. We searched bibliographic databases for articles published in English for research that reported supply-side effects of FMHP, coping mechanisms, and effects of various coping mechanisms on attainment of reform objectives. Out of 215 studies identified, nine qualified for inclusion. Selected studies were exploratory in design and based on either mixed or qualitative methods. While local health system authorities and health facilities coping mechanisms that were intended to enhance implementation, facility managers and staff engaged in self-interest adaptation decisions and behaviours. Lack of explicit policy commitment to enhancing organisational and managerial capacity of local health authorities contribute to sustaining negative supply-side effects and adverse coping mechanisms. Without due consideration to governance and health system strengthening, FMHP are prone to perverse outcomes that undermine intended benefits. Context-specific empirical studies are needed to further conceptualise the supply- side effect - coping mechanism - consequential effect nexus of the policy.

Mindfulness and acceptance-based training for Chinese athletes: The mindfulness-acceptance-insight-commitment (MAIC) program

Over the last decade, mindfulness and acceptance-based approaches to mental training have been widely applied in the field of sport psychology. In order to develop a context-sensitive mindfulness and acceptance-based training program for Chinese athletes, the Mindfulness-Acceptance-Insight-Commitment (MAIC) program was developed. The MAIC is based on the Mindfulness-Acceptance-Commitment approach (MAC) and includes integrated elements of indigenous Chinese culture such as the acceptance-based adversity coping, social-oriented values, and insight. The current article will briefly revisit and discuss the theoretical considerations, the main components, the applications and reflect on the MAIC program.

A Literature Review of Job Crafting and Its Related Researches

Job crafting is a hot topic in the field of organizational behavior researches and human resource management. Job crafting is a bottom to up behavior, which is different from traditional up to bottom job design, representing the staff’s proactivity. Under job crafting, staffs incline to redefine and reshape the job content, working mode and cooperation relationship with teammates. Besides, job crafting can optimize organizational design and working relationship, which improves the staff’s working identification and adversity coping ability. Based on the previous research results, this article attempts to summarize the definition, measurement, antecedents and consequences of job crafting. Meanwhile, this article also puts forward future research directions of job crafting.

Pro-poor adaptation for the urban extreme poor in the context of climate change

PurposeThe purpose of this paper is to examine pro-poor urban asset adaptation to climate variability and change. It constructs a conceptual framework that explores the appropriate asset adaptation strategies for extreme poor households as well as the process of supporting these households and groups in accumulating these assets.Design/methodology/approachQualitative data are obtained from life histories, key informant interviews (KIIs) and focus-group discussions (FGDs). These data are collected, coded and themed.FindingsThis research identifies that households among the urban extreme poor do their best to adapt to perceived climate changes; however, in the absence of savings, and access to credit and insurance, they are forced to adopt adverse coping strategies. Individual adaptation practices yield minimal results and are short lived and even harmful because the urban extreme poor are excluded from formal policies and institutions as they lack formal rights and entitlements. For the poorest, the process of facilitating and maintaining patron–client relationships is a central coping strategy. Social policy approaches are found to be effective in facilitating asset adaptation for the urban extreme poor because they contribute to greater resilience to climate change.Originality/valueThis study analyses the empirical evidence through the lens of a pro-poor asset-adaptation framework. It shows that the asset-transfer approach is an effective in building household-adaptation strategies. Equally important is the capacity to participate in and influence the institutions from which these people have previously been excluded.

The Influence of Financial Self-Efficacy and Financial Socialization on Student's Financial Stress and Coping Choices

College is the overwhelming choice for high school graduates in the United States with over 2.2 million 2016 high school graduates enrolled in college (BLS, 2016). Those 2.2 million students represent about 70% of 2016 high school graduates (BLS, 2016). These new undergraduate college students face considerable opportunities and challenges. The many changes facing college students have been termed ecological transitions (Bronfenbrenner, 1979). The ecological transitions facing college students include less parental supervision, more autonomy and new interpersonal relationships (Holinka, 2015). Increased academic expectations, both real and perceived, influence feelings of stress (Holinka, 2015). The rate of increase in college student stress has been described as “alarming” (King, Vidourek, Merianous, & Singh, 2014, p. 133). The initiators of this stress, stressors, take many forms including academic pressures and lifestyle changes (Friedlander, Reid, Shupak, & Cribbie, 2007). It is well documented these academic and lifestyle changes do indeed create a feeling of stress in many college students (King, Vidourek, Merianous, & Singh, 2014). The negative impact of stress on health includes decreased mental acuity, depression, suicide and many physical ailments including musculoskeletal disorders (Bauer, Chesin, & Jeglic, 2014; Ekpenyong, Daniel, & Aribo, 2013; Lester, 2014; Pedersen, 2012; Pelletier, Lytle, & Laska, 2016). Students often choose to cope with their stress with risky lifestyle choices such as binge drinking, drug use and promiscuity (Lester, 2014; Pedersen, 2012; Pelletier, Lytle, & Laska, 2016). Feelings of stress have been shown to be mitigated by high levels of self-efficacy. Self-efficacy is the belief that a person can accomplish what they set out to do (Bandura, 1997). Similarly, feelings of stress can be mitigated by positive socialization by parents, other family members, teachers and social networks. The impact of stress is considerable and well documented. This research seeks to further understand how a student’s financial self-efficacy and financial socialization may impact those feelings of financial stress and their coping choices. This deeper understanding may provide insight into the steps parents, educators, counselors and others may take to mitigate a college student’s sense of financial stress thus limited their feeling of need to choose adverse coping options.

Women Living with HIV/AIDS

The main aim of this review article is to outline the factors linked to vulnerability of women to HIV infection and to understand the challenges and possible management of HIV among women. The review is a theoretical endeavour to understand women’s experiences of living with HIV. This review primarily focuses on studies in the Indian set-up, but to further substantiate the arguments and describe the relevant concepts it also takes into account literature from other cultures. On the basis of studies included in this article, it can be surmised that women are more susceptible to HIV due to cultural barriers, health vulnerabilities and social structures. They show less awareness about the treatment facilities, prevention strategies and perceived risk of infection. Women have to face numerous challenges after the infection, such as lack of social support, a higher level of stigma and discrimination, decreased quality of life, mental health issues and adverse coping. To prevent the spread of HIV among women as well as men, it is necessary to plan strategies which deal with empowerment of women, education and awareness regarding the vulnerabilities and knowledge and challenges of HIV infection. There is also a need to address the management of HIV among the infected and even those at risk. This article describes the possible interventions based on existing literature. The review also attempts to suggest certain future directions for the research.

A Study of Adverse Childhood Experiences, Coping Strategies, Work Stress, and Self-Care in the Child Welfare Profession

ABSTRACTThis mixed-method study examines child welfare professionals’ adverse childhood experiences (ACE) and coping strategies they use to mitigate work stress. Survey data are from 104 child welfare services professionals in a Midwestern state. Participants reported high stress levels and frequent unhealthy coping strategies. Their ACE scores were higher than those of the general population. Quantitative analyses showed that the relativity of ACE to their career choice and unhealthy coping strategies also predicted their work stress. Qualitative analysis revealed challenges these workers face in self-care when dealing with work stress. Implications for child welfare staff, supervisors, and educators are suggested.