Common Coping Mechanisms Research Articles

Local knowledge and practice in disaster relief: A worldwide cross-cultural comparison of coping mechanisms

There is a growing interest and urgency in understanding and incorporating local knowledge and strategies into sustainable climate change adaptation. This is particularly important because as populations age and new technologies come on the scene, much local knowledge is lost to newer generations. For this reason, we have systematically examined 90 societies from the ethnographic record to explore and document the strategies that people in the past have implemented in response to serious natural hazards. Our review reveals a rich diversity of coping mechanisms and contingency plans used by societies around the world in response to different hazards, particularly floods and droughts. We collect, classify, and compare different types of coping mechanisms, focusing on four major types: technological, subsistence, economic and religious. We find that most societies employ multiple types of coping mechanisms, although our data suggest that technological coping mechanisms are the most common coping mechanisms in response to fast-onset hazards, whereas religious coping mechanisms are the most common mechanism used in response to slow-onset hazards. We also find that religious and nonreligious coping strategies are not antithetical to each other. In fact, an increased number of religious coping mechanisms is associated with an increased number of “practical”, nonreligious coping mechanisms.

Perceived stress, sources of stress and coping strategies among undergraduate medical students of Nepal: a cross-sectional study

Background: Medical students are subjected to various stressors throughout their training, which has a considerable impact on their physical and mental health. Some students have positive ways of coping, while others take to maladaptive coping measures. This study aims to assess severity, sources of stress, and coping strategies among medical students of a non-Western low-income country from South Asia. Methods: A self-administered questionnaire-based cross-sectional study was carried out. Demographic variables were collected and stress level was assessed using PSS 14 (Perceived Stress Scale 14). The sources of stress were assessed using MSSQ (Medical Student Stressor Questionnaire) and coping strategies were evaluated using the Brief-Coping Orientation to Problems Experienced 28. Results: The response rate was 95%. The mean PSS score was 27.85. Overall, 55% of students were stressed (male 52%, female 60%), the difference among gender was not significant. Basic science students perceived higher levels of stress than clinical clerkship students. Academic related stressors caused higher stress, whereas other variables caused moderate stress. The major stressors were examinations, inadequate time to study, poor marks, extensive amount of learning content, and the need to performing well in the exam. The five most common coping strategies used were active coping, acceptance, planning, self-distraction, and instrumental support. The least common coping mechanism was substance use. All MSSQ domains positively correlated with the total PSS score. Students with higher PSS scores were likely to use behavioral disengagement, venting, and self-blame as the primary coping strategies. Conclusions: Stress level among the medical students is high and mainly in relation to academia. Inadequate guidance from teachers contributed significantly. Stressed students were likely to use maladaptive coping strategies. Strategies to enhance teacher-student communication and adaptive coping measures should be implemented. Further studies should be done to evaluate the effects of stress on the academic outcomes of students.

Women experiencing homelessness in Dire Dawa city: Coping mechanisms and suggestions to stakeholder, 2021.

In Ethiopia, the number of homeless girls and women is increasing, and the government has yet to devise a strategy to address the issue of teenage homelessness. They are influenced by numerous dimensions of health, including physical health, mental health, and social isolation. At all stages of homelessness, the stakeholders and homeless people must work together to address the issue. As a result, this study will be helpful to generate relevant data that may guide policymakers in designing solutions for this underserved group of people. To explore coping mechanisms and suggestions to stakeholders among women experiencing homelessness in Dire Dawa city, eastern Ethiopia, 2021. A community-based phenomenological qualitative study was conducted at Dire Dawa city. Data were collected from women experiencing homelessness and key informants through focus group discussion and in-depth interviews using a semi-structured tool. A total of 31 women experiencing homelessness (13 in-depth interviews and 3 focus group discussion with 6 participants in each) and 2 key informants participated in this study. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti 7. The thematic analysis follows six steps: familiarization, coding, generating themes, reviewing themes, naming themes, and writing up. Two major themes were driven: coping mechanisms and suggestions to stakeholders. There are three subthemes under the coping mechanism (begging, survival sex, and child prostitution) while there are a total of seven subthemes under suggestions to stakeholders (integration and collaboration, special attention to children, family education, shelter and job, schooling, sexual education, and addiction rehabilitation). Child prostitution and survival sex are a very common coping mechanism which is practiced by women experiencing homelessness. Changing society's mindset and paying special attention to children is critical. Furthermore, the government and various stakeholders should work together to develop a rehabilitation program for street children who have been exposed to substance use.

Effects of a temporary suspension of community-based health insurance in Kwara State, North-Central, Nigeria.

Introductiona subsidized community health insurance programme in Kwara State, Nigeria was temporarily suspended in 2016 in anticipation of the roll-out of a state-wide health insurance scheme. This article reports the adverse consequences of the scheme´s suspension on enrollees´ healthcare utilization.Methodsa mixed-methods study was carried out in Kwara State, Nigeria, in 2018 using a semi-quantitative cross-sectional survey amongst 600 former Kwara community health insurance clients, and in-depth interviews with 24 clients and 29 participating public and private healthcare providers in the program. Both quantitative and qualitative data were analyzed and triangulated.Resultsmost of former enrollees (95.3%) kept utilizing programme facilities after the suspension, mainly because of the high quality of care. However, majority of the enrollees (95.8%) reverted to out-of-pocket payment while 67% reported constraints in payment for healthcare services after suspension of the program. In the absence of insurance, the most common coping mechanisms for healthcare payment were personal savings (63.3%), donations from friends and families (34.7%) and loans (11.8%). Being a male enrollee (odd ratio=1.61), living in a rural community (odd ratio =1.77), exclusive usage of Kwara Community Health Insurance Programme (KCHIP) prior to suspension (odd ratio=1.94) and suffering an acute illness (odd ratio=3.38) increased the odds of being financially constrained in accessing healthcare.Conclusionafter the suspension of the scheme, many enrollees and health facilities experienced financial constraints. These underscore the importance of sustainable health insurance schemes as a risk-pooling mechanism to sustain access to good quality health care and financial protection from catastrophic health expenditures.

Nurses’ experiences, coping and support in the death of a child in the emergency department: A qualitative descriptive study

BackgroundA child’s death in the Emergency Department (ED) is usually unexpected and traumatic. Understanding nurses’ experiences encountering such death is crucial in determining how they cope to provide quality nursing care to dying children and their families. PurposeTo report ED nurses’ experiences with children’s death, coping strategies and support needs. ProceduresA qualitative descriptive design. Twenty-four registered nurses who had cared for a child who died in the ED took part in semi-structured interviews. Interviews were audiorecorded, and analyzed using thematic analysis. FindingsThree themes were generated: ‘nature of emergency department work’, ‘working with families’ and ‘coping and support’. This paper reports on the theme ‘coping and support’.Although children’s deaths were traumatizing and affected nurses personally and professionally, constant time pressure allowed limited reflection time. Common individual coping mechanisms used by participants included external strategies through support from other staff members including peer-support and informal supervision, and internal strategies through personal coping strategies. Participants expressed need for greater support and education/training to effectively deal with pediatric death, children’s families, and their own grief. ConclusionsChildren’s deaths and nature of ED care affected nurses. Adequate support and deathrelated education were urged by participants to promote high-quality care provision.

356EMF Shame and Error in EMS: A Qualitative Analysis of Culture and Attitudes in Prehospital Emergency Care

The shame reaction is a highly negative emotional reaction shown to have long-term deleterious effects on medical providers’ mental health. Prior studies have focused on in-hospital personnel, so very little is known about what drives shame reactions in emergency medical services (EMS), a field with very high rates of post-traumatic stress disorder, burnout, anxiety, and depression.The objective of this study was to describe emotions, processes, and resilience associated with self-identified adverse events in the work of out-of-hospital providers. We conducted a qualitative study using a modified critical incident technique. Participants were voluntarily recruited from two EMS agencies in North Carolina: one urban and one rural. They provided an open-ended, written reflection in which they were asked to self-identify a particular event in their EMS career that felt emotionally difficult. In-person or video in-depth interviews about these events were then conducted in a semi-structured fashion using an iterative interview guide. The codebook was developed through a mix of inductive and deductive analysis strategies and discussed within the research team and a content expert for validation. Interviews were transcribed and data was analyzed following a thematic content analysis approach for types of cases identified as emotionally difficult, common emotional responses and coping mechanisms, and the lingering impact of these experiences on study subjects. Eight interviews were conducted with EMS personnel: five from an urban agency and three from a rural agency. Participants commonly identified complex medical cases as being emotionally difficult, which led to the most robust shame reactions. Shame reactions were more common when EMS providers committed self-perceived errors in patient care, whereas guilt reactions were more common when patient outcomes seemed “inevitable” despite any intervention. Common themes related to coping mechanisms included both personal mechanisms which tended to be less successful compared to interpersonal mechanisms, particularly when emotions were shared with colleagues. This reflected a perceived culture change within EMS in which sharing emotions with colleagues was seen as a departure from the “old school” where emotions tended to be kept to oneself. Feelings of inadequacy, low self-worth, and being “not good enough” were frequently identified as lingering emotions after difficult cases that were hard to move on from, corresponding to longstanding shame in these providers. Recovery and resilience varied but tended to be positively associated with a culture in which sharing with colleagues was encouraged, and personal introspection on root causes for the sentinel event. EMS providers often identify complex patient cases as those leading to emotions such as shame and guilt, with shame reactions being more common when a perceived error was committed. Coping mechanisms were varied, but individuals often relied on their co-workers in a sharing environment to adequately process their negative feelings, which was seen as a departure from past practices in EMS personnel. Our hope is that future studies will be able to utilize these findings to identify targets for intervention on negative mental health outcomes in EMS personnel.

Perceived Stress Levels and Stressors in Undergraduate Pharmacy Students’ at a Nigerian Tertiary Institution

Background: While everyone can be affected by stress, there is evidence to suggest that students might be more prone.Objective: To assess perceived stress levels and well-being among undergraduate pharmacy students’ of Ahmadu Bello University, in addition to identifying common stressors and coping mechanisms used by the students.Methods: A survey was conducted on second to fifth year undergraduate pharmacy students of the institution from August to November 2019. A self-administered questionnaire was used to collect data about the students’ socio-demographic characteristics, stress levels (Perceived Stress Scale-10), well-being (World Health Organization-5 well-being index), stressors and coping strategies. Student t-tests, analysis of variance (ANOVA) and Pearson’s bivariate correlation were used to compare means and correlations between variables. P < 0.05 was considered as statistically significant.Results: Of the 350-questionnaire distributed, 328 were returned producing a 93.7% response rate. Majority of respondents were males (63.1%), and in their third year of study (29.3%). The mean PSS-10 score was 18.4 ± 4.9, and a statistically significant difference in scores were seen across gender (p= 0.001). Over half of the participants (72.8%) also scored 51% or higher on the WHO-5 index. Their most common stressors were volume of course materials 184 (56.1%) and financial constraints 158 (48.2%) respectively. More than half of respondents (64.5%) also sought for emotional support from their families to cope with stress. A statistically significant (p<0.001) negative weak correlation (-0.3) was seen when PSS-10 and WHO-5 scores were compared.Conclusion: Perceived stress levels in female undergraduate pharmacy students were higher than those in their male counterparts, and most of the students had at least good well-being.

Association of Psychological Distress, Contextual Factors, and Individual Differences Among Citizen Responders.

BackgroundLittle is known about the psychological risks of dispatched citizen responders who have participated in resuscitation attempts.Methods and ResultsA cross‐sectional survey study was performed with 102 citizen responders who participated in a resuscitation attempt from July 23, 2018, to August 22, 2018, in the Capital Region of Denmark. Psychological distress, defined as symptoms of posttraumatic stress disorder, was assessed 3 weeks after the resuscitation attempt and measured with the Impact of Event Scale‐Revised. Perceived stress was measured with the Perceived Stress Scale. Individual differences were assessed as the personality traits of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience with the Big Five Inventory, general self‐efficacy, and coping mechanisms (Brief Coping Orientation to Problems Experienced Inventory). Associations between continuous variables were examined with the Pearson correlation. The associations between psychological distress levels and contextual factors and individual differences were analyzed in multivariable linear regression models to determine factors independently associated with psychological distress levels. The mean overall posttraumatic stress disorder score was 0.65 of 12; the mean perceived stress score was 7.61 of 40. The most common coping mechanisms were acceptance and emotional support. Low perceived stress was significantly associated with high general self‐efficacy, and high perceived stress was significantly associated with high scores on neuroticism and openness to experience. Non–healthcare professionals were less likely to report symptoms of posttraumatic stress disorder.ConclusionsCitizen responders who participated in resuscitation reported low levels of psychological distress. Individual differences were significantly associated with levels of psychological distress and should be considered when engaging citizen responders in resuscitation.

THE LIVED EXPERIENCES OF TEACHER AND STUDENTS IN PE AMIDST THE PANDEMIC

Conducting classes remotely to shift in teaching paradigm of learning due to the on-going pandemic has posed many challenges to the education sector. Despite these efforts, several arguments are associated with remote learning especially with online classes or e-learning amidst the pandemic. The study aimed to unveil the lived experience of teachers and student who are taking remote learning in physical education subject. The respondents must had experience and engaging in remote learning. This study employed both qualitative and quantitative methods of research. The respondents must had experience and engaging in remote learning. This study answered the following: What is the demographic profile of teachers and students? What are the challenges encountered by teachers and students? What are the coping mechanisms of teachers and students during remote learning? Is there a relationship between challenges encountered and coping mechanisms of teachers and students? How do the profile of the teachers and students relate to the challenges encountered and their coping mechanisms? For the qualitative part, an Interpretative Phenomenological Analysis (IPA) method was used to interpret the meanings of experiences of human life, and focused on research question “What it is like to experience remote teaching and learning in physical education amidst the pandemic?”. Considering the results of the study, it can be said that the major problems faced by both teachers and students are the poor internet connection. This hampers the communication between the two as well as the communication among students. This breeds to a series of problems that stem from the lack of connectivity. Moreover, the most common coping mechanisms employed by both groups are engaging into activities that will help them distress.

Prevalence, associated factors and prevention of burnout in psychiatry trainees in Central and North West London NHS Foundation Trust

AimsTo assess burnout, resilience, professional quality of life and coping mechanisms in Central and North West London psychiatry traineesObjectivesTo determine Key factors associated with stress and burnout in workplace Effects of burnout on patient care and doctors Coping mechanisms used by traineesBackgroundBurnout is a well established condition that has been recently reported to affect a third of doctors. Psychiatrists in particular represents a high risk group among doctors for experiencing burnout, alcohol and drug use, posing suicide risk and other forms of work related stress.MethodThe study comprised of a cross sectional questionnaire survey which included measure of stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). During October to December 2019, core trainee and specialty trainee doctors in CNWL were asked to complete an online survey via emails.ResultWe collected data from 50 CNWL psychiatry trainees. The sample consisted of 20 females (40%) and 30 males (60%). Ages varied from 26–58 years old, with a median age of 28. Core trainees (CT1–3) were recorded as 72% and specialty trainees at 28%.Of those who responded, around half of the trainees (52%) experienced high levels of stress outside of work in their personal life. The most common causes that trainees felt makes psychiatry a stressful profession were violence and fear of violence, limited resources, dealing with confrontational patients, inability to affect systemic change and increasing culture of blame. Around half of respondents (54%) felt that they have experienced burnout but only 26% of respondents knew where to go to find resources to help cope with burnout. Physical exercise and speaking to colleagues were the most common coping mechanisms used by trainees to deal with stress.Free text responses on what can be improved in workplace to enhance a positive experience of work included improving multidisciplinary interactions, easily accessible resources and increasing staffing levels. 74% of respondents felt they continued to care about what happens to patients regardless of working conditions.ConclusionHalf of CNWL trainee doctors who responded have experienced burnout. Some factors associated with stress and burnout in doctors are unique to psychiatry profession. Free text responses were useful in identifying areas for improvement in work places and useful coping mechanisms, which can be used to inform prevention and implement interventions to tackle burnout.

Psychological Stress and its Associated Factors among In-school Adolescents in Ibadan, Nigeria

The study investigated psychological stress and its associated factors among in-school adolescents in Ibadan, Nigeria. This was a descriptive cross-sectional study that employed a multi-stage sampling to select and assess 400 students from ten secondary schools in Ibadan on their socio-demographic profile, knowledge, prevalence, coping mechanisms and associated factors of psychological stress. Brief-COPE and General Health questionnaires were adopted to assess the prevalence and coping mechanisms of psychological stress among the respondents. Findings revealed that more than half of the respondents (55.8%) had poor knowledge of psychological stress and only a few (6%) had a high level of being psychologically stressed among the in-school adolescents. The most common coping mechanism observed among the respondents was avoidance coping mechanism, specifically “going to the movies” (49.1%); and the factors significantly associated with the prevalence of psychological stress were school, family, physical factors, peer-pressure as well as romantic factors. Binary logistic regression analysis results showed that “Not supported by parents financially (OR: 2.681, 95% CI 1.0-7.1) and finding it difficult to keep up with school work (OR: 0.202, 95% CI 0.04-0.8)” was positively associated with the prevalence of psychological stress among in-school adolescents. The poor knowledge and prevalence of psychological stress observed among the in-school adolescents suggest constant sensitisations among students, parents, teachers and school counsellors

The Effects of Severe Psychological Stress Coupled with Binge Drinking on Markers of Skeletal Muscle Protein Synthesis

Acute exposure to a severe stressor can cause an increase in circulating glucocorticoid (GC) concentrations by approximately ten-fold, which can remain elevated for as long as ten days. Elevated GCs can promote skeletal muscle atrophy and diminish muscle strength. Unfortunately, a common coping mechanism in response to severe stress is the use and abuse of alcohol. Alcohol abuse also suppresses muscle protein synthesis; thus, the combination of stress and alcohol may exacerbate skeletal muscle impairments. The aim of this current study was to examine the combined effects of stress and alcohol on muscle protein synthesis signaling in skeletal muscle. Our hypothesis was that voluntary binge-patterned drinking preceded by acute stress would impair signaling of muscle protein synthesis compared to binge drinking alone. Male C57BL/6 mice (7 weeks old) were exposed to a single episode of 100 inescapable tail shocks. Following acute stress, mice were randomized into groups with temporary access to either water or alcohol during their active period daily for 5 days, a voluntary binge-patterned drinking protocol referred to as Drinking in the Dark (DID). On the fifth day, following DID, mice were euthanized, and muscles of interest were rapidly collected. The experimental set up resulted in 2 groups: Stress Alcohol (SA) (n=7) and Stress Water (SW) (n=8). Gastrocnemius was analyzed via western blotting and the canonical Akt-mTORC1 pathway of protein synthesis was assessed for changes in signaling. The SA group tended to have less phosphorylation of Akt (p=0.068), but there was no difference in the phosphorylation of mTOR between groups (p=0.838). The SA group tended to have less phosphorylation of p70S6 kinase (p=0.058), a downstream target of mTORC1. Similarly, phosphorylation of 4E Binding Protein 1 (p4EBP1) was significantly lower in SA (p=0.017). Our results suggest binge drinking in the context of stress may impair muscle protein synthesis along the Akt-mTORC1 pathway.

Type 2 Diabetes, Religious Beliefs and Psychological Interventions

This paper is a review regarding the relationship among Type 2 diabetes (T2D), religious beliefs andpsychological interventions. Specifically, the paper x-rayed the prevalent state of diabetes, followed bythe role of religious beliefs and psychological interventions in the management of the chronic disease forimproved health care, social support, protective health behaviours, stress reduction, positive coping skills,psychological adaptation, psychosocial functioning, greater optimism, self-esteem, life satisfaction andtreatment of depression and anxiety in people with type 2 diabetes. Overall, from the reviewed literature,religious beliefs and psychological interventions seem to be common coping mechanisms available to T2Dpatients where formal coping resources are not available.

The Impact of COVID-19 Safety Recommendations on Adults Age 60 and Older: A Qualitative Study

In March 2020, the United States Centers for Disease Control (CDC) began recommending social distancing and sheltering in place, in particular for older adults. This resulted in many older adults staying at home for long periods of time in relative isolation. Because there is little prior evidence of the emotional impact that this has on older adults, we conducted an exploratory qualitative study on how older adults felt during the first three to five weeks of the CDC recommendations. We fielded a web-based cross-sectional survey. Our analytic sample consisted of 673 respondents aged 60 and older who respondent to the prompt: “How are you feeling during this time of social distancing?”. We used a thematic bottom-up qualitative analysis, via MAXQDA, to analyze segments into general affect codes and detailed emotion subcodes, as well as coping mechanisms. Results showed that while many older adults reported neutral (9%) or positive (9%) affect, a larger proportion reported negative affect (42%) or reported mixed affect (35%). The most common negative emotions mentioned were anxiety and loneliness/boredom, while the most common positive emotions mentioned were optimism and feeling grateful. The most common coping mechanisms reported by participants included making life adjustments, keeping busy, prayer/spirituality, and mediation/mindfulness. This study provides an initial understanding into how older adults experienced and coped with the first stages of restricting social interactions. If social distancing continues to be a recommended disease-containment strategy, information about how older adults are coping can be critical for public health interventions. Implications will be discussed.

Impact of the COVID-19 national lockdown on pharmacy students’ productivity and their coping strategies in a developing country: An online survey in Nigerian universities

Background: The COVID-19 pandemic in Nigeria led to a national lockdown that resulted in the suspension of academic activities. Objective: To evaluate the impact of the COVID-19 national lockdown on pharmacy students’ productivity and their coping strategies. Methods: This study involved the cross-sectional collection of responses from undergraduate students of six Nigerian schools of pharmacy. Data was collected using a structured, validated questionnaire in the form of Google form. The data was entered into a statistical product and service solutions software (SPSS, version-25) for analysis. Results: A total of 808 students responded to the questionnaire. The majority of the students’ responses (757, 93.7%) showed that their reading duration had decreased during the lockdown. The most missed variable during the closure by students was ‘school life’ (303, 37.5%). The use of social media (133, 16.5%) was the most common coping strategy. The majority of the students, 544 (67.3%), agreed to participate in the virtual mode of learning. The cost of data was the main challenge to online learning by the students (288, 36.0%). Conclusion: This study shows that the productivity of pharmacy students decreased during the COVID-19 lockdown. Social media and business activities were the most common coping mechanisms of pharmacy students. Pharmacy students were willing to accept virtual learning despite possible challenges.

Public Librarian Job Stressors and Burnout Predictors

Librarians experience a significant amount of job-related stress, which can lead to the psychological condition of burnout. This article explores existing literature on the subject and also details a new study undertaken by the authors. The study explored stressors, coping mechanisms, and the relationship between burnout predictors and reported stressors. Subjects of the study indicated that patron issues were the most prevalent stressor, while exercising, meditation, and breathing were the most common coping mechanisms. Workload was the most reported predictor of burnout. One of the other major findings was that stress on the job had no relationship to the demographic variables of age, years of librarianship experience, or gender.

Voices of rural people: Community-level assessment of effects and resilience to natural disasters in Odisha, India

Globally, natural disasters have caused a large scale of damage and destruction every year, affecting millions of people, the economy, and development – and developing countries are the most severely affected. Odisha is one of India’s most disaster-prone states. This study explores the effects of, and resilience to, cyclones, floods, droughts, and heatwaves in Odisha, and identifies government strategies that help mitigate these natural disasters. We mainly used primary data collected through a qualitative study undertaken from April 2017 to June 2017 in three districts of Odisha. We conducted in-depth interviews and focus group discussions with community members and key stakeholders at different levels. In addition, our study analyzed secondary data on natural disasters using DesInventar, a disaster information management system data source. The findings show that floods, cyclones, and drought in recent years, along with heatwaves and lightning, have severely affected the people of Odisha. The impacts of these natural disasters are calamitous – particularly on livelihoods, food security, health, water, and sanitation. These natural disasters, which have affected agriculture, fisheries, prawn cultivation, roadside vendors, and daily wage laborers, have both short- and long-term effects on the livelihoods of people in Odisha, leaving them with scarce employment opportunities. The vulnerable and marginalized sections of the population have been the most severely affected, and common coping mechanisms have included selling off livestock, borrowing food, taking loans and mortgages, and migration. The government’s measures/programs, such as an Early Warning System, Public Distribution System, Multipurpose Cyclone Rehabilitation Centers, Seasonal Residential Care Centers, and Indira Awas Yojana, play a major role in mitigating the effect of disasters among rural communities. Our study indicates that natural disasters have impacted the population of the state socioeconomically, physically, and psychologically. The effect on livelihoods, directly and indirectly, exacerbates income, food security, and health. There is an urgent need to focus on reducing people’s underlying vulnerabilities by taking proactive measures, engaging the community in decision-making, and generating alternative and sustainable livelihoods.

\u2018Diabetes is a gift from god\u2019 a qualitative study coping with diabetes distress by Indonesian outpatients

BackgroundMore than two-thirds of patients diagnosed with type 2 diabetes mellitus (T2DM) in Indonesia encounter medical-related problems connected to routine self-management of medication and the social stigma related to T2DM. The current study aims to explore distress and coping strategies in Indonesian T2DM outpatients in a Primary Healthcare Centre (PHC) in Surabaya, East Java, Indonesia.MethodsWe conducted a qualitative study using two different data collection methods: focus group discussions and in-depth interviews. The guideline of interviews and discussions were developed based on seventeen questions derived from the DDS17 Bahasa Indonesia (a Bahasa Indonesia version of the Diabetes Distress Scale questionnaire), which covered physician distress domain, emotional burden domain, regimen distress domain and interpersonal distress domain.ResultsThe majority of the 43 participants were females and aged 50 or older. Our study discovered two main themes: internal and external diabetes distress and coping strategies. Internal diabetes distress consists of disease burden, fatigue due to T2DM, fatigue not due to T2DM, emotional burden (fear, anxiety, etc.) and lack of knowledge. Internal coping strategies comprised spirituality, positive attitude, acceptance and getting more information about T2DM. External diabetes distress was evoked by distress concerning healthcare services, diet, routine medication, monthly blood sugar checks, interpersonal distress (family) and financial concern. External coping strategies included healthcare support, traditional medicine, vigilance, self-management, social and family support and obtaining information about health insurance.ConclusionOur study shows that for Indonesian T2DM-patients, spirituality and acceptance are the most common coping mechanisms for reducing DD. Furthermore, our study revealed an overall positive attitude towards dealing with T2DM as well as a need for more information about T2DM and potential coping strategies. Finally, an important finding of ours relates to differences in DD between males and females, potential DD associated with health services provision and the specific challenges faced by housewives with T2DM.

ORIGINAL ARTICLE: CAUSE OF STRESS AND COPING MECHANISM AMONG MEDICAL STUDENTS YEAR 2013 – 2015 IN UNIVERSITAS AIRLANGGA

Abstract. Background: Stress is response and acknowledged as a natural respond to problems in daily life. Coping is defined as a process used to confront stress with various degree of effectiveness. Purpose: To correlate cause of stress and coping mechanism based on sex and year of admission among Universitas Airlangga medical students year 2013, 2014, and 2015. Method: This study was observational analytic study. Data were taken by self-administrated questionnaires (demographic, Medical Student Stressor Questionnaire, and BriefCOPE) Result: Respondents were dominated by female (60%) and out of 90 answers, the most frequent stressor was Academic Relater stressor (45.12%) regardless of the gender and admission year, and the most frequent coping mechanism is Planning (79.50%) and Religion for female students (80.75%) and 2013 students (78.75%). There was a significant correlation between stressor Intrapersonal and Interpersonal and Teaching and Learning Related also coping mechanism Planning, Humor, and Religion between male and female participants. There was also significant correlation between different admission year for coping mechanism Denial, Humor, and Self Blame. Conclusion: The most common stressor of the student year 2013, 2014, and 2015 with medical major in Universitas Airlangga is Academic Related and the most common coping mechanism is Planning.Keywords: medical student, academic stressor, coping mechanism, observational analytic study

Benefit finding among parents of young children with type 1 diabetes.

Benefit finding, perceived positive effects of adversity, has been associated with psychological well-being in people with chronic illnesses and with better adherence for adolescents with type 1 diabetes (T1D). Our qualitative research with parents of young children (< 6 years old) with T1D indicated that benefit finding (BF) is a common parental coping mechanism, but no tools exist to measure BF in parents. We determined psychometric properties of the Diabetes Benefit Finding Scale for Parents (DBFS-P), a 16-item questionnaire adapted from the validated adolescent version. Parents of young children with T1D (n = 172) were participants in a randomized trial of an online intervention. We examined the DBFS-P factor structure through principal component analysis (PCA); internal consistency through Cronbach's alpha; convergent validity via bivariate correlations between the DBFS-P and measures of parental depression, anxiety, T1D self-efficacy, and hypoglycemia fear; and discriminant validity via bivariate correlations between the DBFS-P and measures of parental somatization and child behavior problems. PCA revealed one factor (56.47% variance) with Cronbach's α = 0.95. Convergent validity of the DBFS-P was supported by significant correlations with parental depression (r = -0.35, P < 0.001), anxiety (r = -0.20, P = 0.008), T1D self-efficacy (r = 0.36, P < 0.001), and hypoglycemia fear (r = 0.27, P < 0.001). Non-significant correlations with parental somatization (r = -0.06, P = 0.42) and child behavior problems (r = -0.12, P = 0.14) support its discriminant validity. The DBFS-P demonstrated good psychometric properties as a tool for assessing BF among caregivers.