Problem-focused Strategies Research Articles

The COVID-19 Pandemic Experience in Multiple Sclerosis: The Good, the Bad and the Neutral.

IntroductionWhile the current COVID-19 pandemic has affected the lives of many, there is a paucity of information on the impact on people with multiple sclerosis (MS). This study sought to gain insight into the impact of the current situation on people with MS and the factors that influence this.Methods324 MS patients participated in this online cross-sectional survey during the COVID-19 lockdown period. A mixed methods design was used, with quantitative information collected on MS-related factors as well as COVID-19 impact and an open-ended, qualitative response looking for reasons behind the self-reported COVID-19 impact.ResultsWe found that 48% of the participants reported that COVID-19 had a neutral impact on their lives and 16% reported a positive impact. However, 36% reported a negative impact, and had greater levels of MS- and non-MS-related worries, and higher levels of bother related to psychological and cognitive symptoms and fatigue than the groups reporting a neutral or positive impact. Significant predictors of this adversely affected group were age, type of MS and presence of psychological symptoms. Antidepressant medication use, time since diagnosis, gender, location, living arrangements or employment status did not predict impact. Open-ended responses explaining personal COVID-19 impact indicate that coping strategies may contribute to these findings. In particular, active, problem-focused approaches were reported by the majority of people who reported a positive impact, as well as a third of those who reported a neutral impact.ConclusionThese findings suggest that younger people, those with progressive types of MS, and those with psychological symptoms are particularly vulnerable to the negative effects of a COVID-19 pandemic induced lockdown. Coping strategies provide further insight into these findings with those reporting active problem-focused approaches seemingly faring better than those who do not state any coping strategies. These results also have implications for understanding other like neurological conditions that share many similarities with MS and how best to direct support.

Teacher coping profiles in relation to teacher well-being: A mixed method approach

The aim was to investigate teachers’ coping profiles and their relations to teacher well-being. Questionnaire data was collected from 107 Finnish teachers. Theory-driven content analysis of teachers’ responses revealed three coping categories: problem-focused, emotion-focused and mixed problem- and emotion-focused. Next, teachers were categorized into four coping profiles by using latent profile analysis: Low-coping users (21%), Problem-focused-coping users (15%), High-coping users (12%) and Emotion-focused-coping users (52%). Low-coping-user teachers reported less stress and fewer depressive symptoms and sleep problems compared to Emotion-focused-coping users. Using a compact amount of coping strategies and problem-focused strategies aside of emotion-focused might be beneficial for teacher well-being.

The perceived impact of multiple sclerosis and self-management: The mediating role of coping strategies.

Low level of self-management in people with multiple sclerosis (MS) is considered to be a predominant factor that leads to poor rehabilitation efficacy. Studies focusing on the relationship between self-management and psychological variables that can be modified could contribute to expanding the knowledge needed to propose interventional programs aiming at patient activation. This study aimed to analyze whether coping strategies play a mediating role in the association between the perceived impact of MS and level of self-management in people with MS. The cross-sectional study included 382 people with MS. The participants completed the Multiple Sclerosis Self-Management Scale-Revised, Multiple Sclerosis Impact Scale-29, and Coping Inventory for Stressful Situations. The study hypothesis was evaluated using mediation analysis. The STROBE checklist specifically prepared for cross-sectional research was applied in this study for reporting. Results indicate that the emotion- and problem-focused strategies of coping can be treated as mediating the association between the MS impact and level of self-management in people with MS. A negative relationship was found between the perceived MS impact and problem-oriented coping, while a positive relationship was found between problem-oriented coping and self-management. Furthermore, a positive relationship was found between the MS impact and emotion-oriented coping, while a negative relationship was found between emotion-oriented coping and self-management. The indirect role of avoidance-oriented coping was not significant. Our study confirms the role played by coping strategies in individuals' self-management. In MS, self-management determined by perceived MS impact can be controlled by decreasing emotional-coping while increasing problem-coping strategies. Our study imparts new knowledge regarding the potential interventions for improving the level of self-management in people with MS. It indicates that recognition of individuals' illness perceptions as well as maladaptive coping strategies can help health professionals identify those who might be having lower level of self-management.

Suffering yet surviving: Narratives of women living with obstetric fistula in the Northern Region of Ghana

ABSTRACT Drawing on the insights of Bronfenbrenner’s ecological systems and Lazarus’ coping theories, this article highlights the challenges and coping strategies of women living with obstetric fistula in the Northern Region of Ghana. Employing the convenience sampling technique, 55 women were purposively recruited to participate in the study. Focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted to collect data. With the permission of participants, the FGDs and IDIs were audio-recorded and transcribed. The data were analyzed to identify emerging themes that addressed the objectives of the study. The findings indicated that participants encountered varied challenges (physiological issues; abandonment and divorce; psychological problems; financial constraints; and difficulty accessing healthcare). Furthermore, it was found that the women included in this study adopted both problem-focused and emotion-focused coping strategies. Evidence showed that the problem-focused strategies were begging for assistance and seeking support from the Fistula Kpandai support group. Maintaining personal hygiene and optimistic motivation were the emotion-focused strategies employed by the participants. Based on the findings of the study, implications are discussed.

Problem-focused coping underlying lower caregiver burden in ALS-FTD: implications for caregiver intervention

Objective: Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder which includes cognitive and behavioral symptoms akin to frontotemporal dementia (FTD). Despite the necessity of caregiver intervention to assist with the management of cognitive and behavioral symptoms, there has been a lack of research on the topic. A focus on caregiver coping may offer a promising foundation to guide the development of interventions as part of ALS care. Accordingly, the aim of the present study was to examine the relationships between caregiver coping, psychological morbidity and burden of care in the context of ALS cognitive and behavioral symptoms. Methods: Fifty-five patient-caregiver dyads were recruited from specialized ALS and FTD clinics. Specific coping strategies were examined using the COPE Inventory/Brief COPE and psychological morbidity and burden were assessed using the Depression, Anxiety, and Stress Scale–21 and Zarit Burden Interview. The relationship between coping, psychological morbidity and burden of care were analyzed using univariate and multivariate methods. Results: High-burden caregivers were more likely to be caring for patients with a diagnosis of ALS-FTD (p =.0001). Caregivers used problem-focused strategies (particularly planning) more frequently (M = 71.4, SD = 15.3) compared to emotion-focused (M = 60.8, SD = 12.3) and dysfunctional coping strategies (M = 42.2, SD = 8.6). A diagnosis of ALS-FTD (p=.0001) and problem-focused strategies (p=.024) emerged as significant predictors of caregiver burden. Caregiver anxiety, depression and stress were not predictive of caregiver burden (p=.151). Conclusions: Timely provision of caregiver support optimizing problem-focused coping strategies as part of multidisciplinary ALS care, particularly for caregivers of ALS-FTD patients may mitigate caregiver burden.

Associations of emotional burden and coping strategies with sick leave among healthcare professionals: A longitudinal observational study

ObjectivesTo investigate 1) whether care-related regrets (regret intensity, number of recent regrets) are associated with sick leave, independently of personality traits, perceived safety climate, and physical activity; and 2) whether these associations were mediated or moderated by coping strategies. MethodsUsing a longitudinal international observational study (ICARUS), data were collected by the means of a weekly web survey. Descriptive and generalized estimation equations were performed. ResultsA total of 276 newly practicing healthcare professionals (nurses, physicians, others) from 11 countries were included in this study. The average proportion of weeks with at least one day of sick leave was 3.2%. Nurses’ sick leave increased with number of care-related regrets (Relative Risk [RR]=1.52; 95% Confidence Interval [CI]=[1.18; 1.95], p=.001), while physicians’ sick leave increased with intensity of care-related regret (RR=1.21; 95%CI=[1.00; 1.21], p=.049). Coping was associated with lower risk of sick leave for nurses (RR problem-focused strategies = 0.53; 95%CI=[0.37; 0.74], p=.001, and RRphysical activity=0.68; 95%CI:[0.54; 0.85], p<.001), but not for physicians. Nevertheless, the association of regret with sick leave remained significant even when adjusting for coping. Finally, this study did not find evidence of moderation by the coping strategies. ConclusionRegrets are associated with increased risks of sick leave, even in young healthcare professionals. Use of coping strategies partially mediated these associations in nurses. The results of this study should be used to inform interventions to reduce emotional burdens and enhance protective coping strategies.

Coping strategies among medical professionals during COVID-19 outbreak

BACKGROUND: COVID -19 pandemic is a very stressful situation for doctors, who face the risk of infection in daily life. Coping is the process by which a person deals with stressful situations or demands. Identifying the coping strategies of our medical professionals will help us to understand their coping styles and to deliver effective interventions to enhance their mental well-being. METHODS: An online survey form with socio-demographic profile and BRIEF COPE tool for assessing different coping strategies was sent to interns, residents, and teaching faculty. The coping strategies were divided into emotion-based, problem-based, and dysfunctional coping, and spearman's correlation was done to determine any correlation between sociodemographic variables and the coping strategies. RESULTS: A total of 84 valid and complete responses were included in the study. There is a variable distribution of mean scores for problem-focused, emotion-focused, and dysfunctional strategies. Age and marital status had a positive correlation with problem-focused and emotion-focused strategies meaning that older adults and married people used these strategies predominantly. Higher designation used problem-focused coping predominantly. Dysfunctional coping strategies had no correlation with any of the sociodemographic variables. CONCLUSION: Sociodemographic factors affecting the coping mechanisms in medical professionals differ from those of the general population seen in previous studies. Within the group of medical professionals, those with higher age, higher designation and married had predominantly adaptive strategies. Interventions targetting maladaptive components of emotion-focused strategies and dysfunctional strategies should be aimed at a younger age group, unmarried people, interns, and residents among the medical professionals to better cope with this COVID scenario.

Coping strategies among medical professionals during COVID-19 outbreak

BACKGROUND: COVID -19 pandemic is a very stressful situation for doctors, who face the risk of infection in daily life. Coping is the process by which a person deals with stressful situations or demands. Identifying the coping strategies of our medical professionals will help us to understand their coping styles and to deliver effective interventions to enhance their mental well-being. METHODS: An online survey form with socio-demographic profile and BRIEF COPE tool for assessing different coping strategies was sent to interns, residents, and teaching faculty. The coping strategies were divided into emotion-based, problem-based, and dysfunctional coping, and spearman's correlation was done to determine any correlation between sociodemographic variables and the coping strategies. RESULTS: A total of 84 valid and complete responses were included in the study. There is a variable distribution of mean scores for problem-focused, emotion-focused, and dysfunctional strategies. Age and marital status had a positive correlation with problem-focused and emotion-focused strategies meaning that older adults and married people used these strategies predominantly. Higher designation used problem-focused coping predominantly. Dysfunctional coping strategies had no correlation with any of the sociodemographic variables. CONCLUSION: Sociodemographic factors affecting the coping mechanisms in medical professionals differ from those of the general population seen in previous studies. Within the group of medical professionals, those with higher age, higher designation and married had predominantly adaptive strategies. Interventions targetting maladaptive components of emotion-focused strategies and dysfunctional strategies should be aimed at a younger age group, unmarried people, interns, and residents among the medical professionals to better cope with this COVID scenario.

Coping Styles and Sources of Stress of Undergraduate Health Science Students: An Integrative Review

Background and aim: Tertiary education provides many personal and social benefits. However, students, particularly those from professional and health science disciplines are known to face significantly greater stress throughout their undergraduate degrees. In this integrative review sources of stress for students and the strategies they use to cope with the stress are explored. Method: Various databases were searched using common key phrases such as “stressors among undergraduate health science students” and “coping mechanisms utilised by undergraduate health science students”. Thirty-three articles were selected based on predetermined inclusion and exclusion criteria. The content in the articles were analysed to identify themes. Results: Academic stress was the primary source of stress for health science students. Other sources of stress included interpersonal interactions and clinical training. Students primarily used problem-focused strategies to cope with stress. Other strategies included avoidance and the use of social support networks. Conclusion: Health science students experience stress from academic tasks, interpersonal stress and stresses emanating from clinical training. They utilize problem-focused coping strategies, as well as avoidance and seeking social support when faced with stressful situations. Students would benefit from regular screening for stress-related conditions, and interventions to teach them more adaptive ways to deal with stress.

Activity matters: Physical exercise and stress coping during the 2020 COVID-19 state of emergency

Recent studies have demonstrated that social isolation during the 2020 COVID?19 pandemic has significantly impacted the mental and physical health of people worldwide. However, it remains unknown whether physical activity can improve mental health in a state of emergency. The present study aimed to examine the importance of physical exercising and stress management mechanisms (problem-focused, emotion-focused, and avoidant) in the context of mental health indicators (depression, anxiety, and nonspecific stress) in conditions of social isolation during COVID?19-induced lockdown in Serbia. The sample consisted of 680 adults (66% female), mean aged 35.91 years (SD = 12.45). The results indicated a significant relation between physical exercising and a reduced stress response and confirmed the usefulness of the already well-known problem-focused strategies. Avoidant and emotionfocused coping were associated with poorer mental health outcomes. However, as a moderator, physical activity lowered anxiety levels in individuals prone to emotion-focused coping.

EMOTIONAL EXPERIENCES OF UNDERGRADUATE MEDICAL STUDENTS: A QUALITATIVE PERSPECTIVE

OBJECTIVES: To explores the distressful emotional experiences and coping strategies of undergraduate medical students from a public-sector medical college of Khyber Pakhtunkhwa, Pakistan. METHODS: A qualitative narrative inquiry based on cognitive appraisal theory of emotion was conducted from May 2018 to October 2019. Semi-structured interviews were conducted with a purposive sample of 15 undergraduate students of a public-sector medical college of Khyber Pakhtunkhwa, Pakistan having high risk of psychological distress, as identified through Kessler psychological distress scale. The narratives were transcribed verbatim and analyzed using framework analysis. RESULTS: Out of 15 students, 8 (53.3%) were females and 7 (46.7%) were males. All students were residing in hostels. Out of 15 students, 4 (26.7%) were from first professional year, 2 (13.3%) were from 4th year and 3 (20.0%) each from 2nd, 3rd & final professional year MBBS class. The participants reported intrapersonal, interpersonal and systemic experiences resulting in feelings of shame, inadequacy, insult, anger and sadness. The severity of distress reduced from first to final professional year. They adopted various coping strategies for example, some kept quiet and/or submitted, while others confronted and/or looked for means to divert attention. Some cried out loud and others prayed and/or used sleeping pills. CONCLUSION: The undergraduate medical students experience emotionally difficult and diverse intrapersonal, interpersonal and systemic situations. They use emotions-focused, problem-focused and meaning-focused strategies to cope up in such situations. Medical students need to be protected from preventable causes of morbidity and mortality. The institutions should offer student counseling services in the campuses.

Deflating power imbalance through personal identity enhancement

PurposeThe purpose of the paper is to identify how the intersection of power, context, subjectivity and directionality makes it possible for the targets of workplace bullying to deflate power imbalance between them and the perpetrators.Design/methodology/approachThe paper is based on nine in-depth interviews with self-reported targets from different public sector organizations in India. The targets were purposively selected keeping in mind that they made deliberate attempts to counter bullying. Constructivist grounded theory approach was used to analyze the data.FindingsSix themes emerged as sources of power imbalance and eight themes as the way of deflating power imbalance. The core category that emerged was “enhancing personal identity”, which was the underlying phenomenon leading to deflation of power imbalance, through the intersection of power, context, subjectivity and directionality.Research limitations/implicationsThe study indicates that power, context, subjectivity and directionality of bullying help the targets to identify effective strategies of deflating power imbalance. In the process, the targets indulge in personal identity enhancement. It further reinforces the understanding that power does not remain static and may shift from the perpetrator to the target of bullying.Practical implicationsThe study provides various tactics that targets can use to counter workplace bullying. It implies that targets need not always leave the organization or succumb to the situation in order to deal with bullying. It encourages the targets of bullying and those who deal with bullying targets to indulge in personal identity enhancement through problem-focused strategies of tackling workplace bullying.Originality/valueIt also furthers our understanding of workplace bullying from the point of intersection of the four aspects of the phenomenon – power, context, subjectivity and directionality – which allows the targets of bullying to enhance their personal identity.

An Investigation of Coping Strategies Used by College Students With Intellectual Disability

Abstract Attending college can lead to many benefits including better outcomes in adult life for college graduates. This concept is applicable to all students, including students with intellectual disability who are attending institutions of higher education programs to refine social, academic, employment, and independent living skills. Similar to their typical peers, students with intellectual disability enrolled in postsecondary education programs endure levels of stress that result in the application of coping strategies necessary to navigate various social domains of college life, including romantic relationships, friendships, roommate relationships, and social media interactions. The present study utilizes survey and interview data to examine which coping strategies are used by college students with mild intellectual disability. When faced with stressful situations, almost one-third of study participants chose Planful Problem Solving as their first choice coping strategy in the Romantic domain, and almost half of respondents used it to deal with stressful situations related to Friendships. More than a third of college students with intellectual disability chose Confrontive Coping as their preferred strategy in the Roommate and Social Media domains. Findings are consistent with previous research, which suggests that young adults with intellectual disability use Problem-Focused strategies most frequently when dealing with stressful situations. Implications for research and practice are also presented and discussed.

The Interplay of IT Users’ Coping Strategies: Uncovering Momentary Emotional Load, Routes, and Sequences

Despite the positive aspects of information technology (IT) use, it is common for users to experience negative IT incidents. Examples of negative IT incidents include getting lost in an unfamiliar country due to a dysfunctional map application and missing a monetary insurance benefit due to the failure of an activity tracker application. Such incidents can harm IT providers by giving rise to user dissatisfaction, discontinued use, switching, and negative word-of-mouth. To minimize this harm, it is important to understand how users cope after negative incidents. Specifically, information systems (IS) researchers have called for research that uncovers the complex interplay of IT users’ coping strategies (e.g., users’ coping efforts after employing one strategy and combinations of several consecutive strategies). To address these calls, we conducted a mixed methods study that examined mobile application users’ coping strategies after highly negative incidents. We developed a model that explains how users navigate between problem-focused strategies, emotion-focused strategies, and appraisals. As theoretical contributions, we identify coping sequences and distinct routes from the coping strategies, uncover the role of momentary emotional load, and present IT-specific insights. As practical implications, we identify favorable and unfavorable coping strategies and sequences from both the IT providers’ and the users’ perspectives.

Effects of Direct-Acting Antiviral Agents on the Mental Health of Patients with Chronic Hepatitis C: A Prospective Observational Study.

In chronic hepatitis C (CHC) patients, interferon-based treatments showed toxicity, limited efficacy, and psychiatric manifestations. Direct-acting antiviral (DAA) agents appeared safer, though it remains unclear if they may exacerbate or foster mood symptoms in drug-naïve CHC patients. We evaluated 62 CHC patients’ mental status, before and 12 weeks after DAA therapy, by assessment scales and psychometric instruments. We subdivided patients into two groups, CHC patients with (Group A) or without (Group B) a current and/or past psychiatric history. After DAA treatment, Group A patients showed low anxiety and improved depression, no variation in self-report distress, but worse general health perceptions. No significant difference emerged from coping strategies. Depression and anxiety improved in Group B, and no change emerged from total self-reported distress, except for somatization. Moreover, Group B increased problem-focused strategies for suppression of competing activities, and decreased strategies of instrumental social support. Contrarily, Group B reduced significantly emotion-focused strategies, such as acceptance and mental disengagement, and improved vitality, physical and social role functioning. DAA therapy is safe and free of hepatological and psychiatric side effects in CHC patients, regardless of current and/or past psychiatric history. In particular, patients without a psychiatric history also remarkably improved their quality of life.

Mediating Role of Stress-Coping Responses in the Association of Resiliency and Hardiness With the Life Satisfaction of Married People

Background: Higher levels of resiliency and hardiness are associated with greater life satisfaction. However, there is limited information on the mediating role of married people responses to stressful life situations. Objectives: This study was carried out to determine the mediating role of stress-coping strategies in the association of resiliency and hardiness with the life satisfaction of married people. Materials &amp; Methods: In this cross-sectional study, the statistical population included all married students of the Islamic Azad University of Rasht City (north of Iran) in the 2018-2019 academic year. They were selected using a purposive sampling method. A total of 282 students were selected as a sample. To measure the variables, Billings and Moos’s coping responses inventory, the satisfaction with life scale, the Connor-Davidson resilience scale, and Ahvaz hardiness inventory were used. SPSS AMOS software, 24 full version was used for data processing. Results: According to the results of path analysis, resiliency has a significant effect on life satisfaction only through problem-focused and cognitive reappraisal-based coping responses (P&lt;0.01) and it can explain 11% of the variance. Also, the indirect effect of hardiness on life satisfaction was not significant and this variable was deleted from the path, and the modified model was re-fitted. Conclusion: In dealing with stressful situations in life, the resilient actions of people who use problem-focused and cognitive reappraisal-based strategies lead to life satisfaction with more confidence.

Difference of Motive and Coping Strategy between Anger and Sadness

Purpose: Current study aimed at exploring the effects of ambient anger versus sadness on motive type and coping strategy type when consumers make decision. It focused on whether the negative affects of the anger and the sadness differentially induce approach versus avoidance motive at the place of making decision, and also explored the coping strategy differences between the consumers under the anger and those under the sadness, that is, which strategy is more used between problem-focused strategy and affect-focused strategy when they are under each negative affect. Research design, data and methodology: The experimental groups were divided into two types of group such as the anger-felt group and the sadness-felt group. The experiment was performed with the between-subjects design based on the anger and the sadness. Questionnaire data were collected from undergraduate students assigned to each of the anger group and the sadness group operated by the scenario method, and the data were used to verify research hypotheses by t-test. Results: - First, the anger induced the approach motive more rather than the avoidance motive in making decision. Second, to cope the negative affects, consumers under the anger used problem-focused strategy more than affect-focused strategy, while those under the sadness used affect-focused strategy more than problem-focused strategy. Therefore, this article contributes to the theory related to motive and making decision taken place to consumers under ambient negative emotions. Conclusions: Focusing on the results of this study, there could be managerial implications to brand or product marketing managers. Checking which affect consumers previously felt between anger and sadness when they are under negative affects is at issue to the brand or product marketers when they appeal their brand or product to the consumers. The marketers should build and communicate the messages about their product or brand in the respect of the points of showing problem solution or the best way to handle things to appeal the consumers under the anger. And they should develop and communicate the messages about their product or brand emphasizing the aspects of letting consumers' sad feelings out somehow or controlling their emotions to the consumers under sadness.

Coping During Pregnancy Following Exposure to a Natural Disaster: The QF2011 Queensland Flood Study

IntroductionThis study investigated how coping strategies moderated the impact of disaster-related objective hardship on subjective distress in pregnant women. MethodsThe objective hardship (exposure severity), subjective distress (Peritraumatic Distress Inventory, Peritraumatic Dissociative Experiences Questionnaire and Impact of Event Scale-Revised) and coping styles (Brief COPE) of pregnant women (N = 226) exposed to the 2011 Queensland, Australia flood were assessed. Moderation analyses were used to assess how coping strategies moderated the relationship between objective hardship and subjective distress levels. ResultsWe found that the more severe the objective flood exposure, the greater the women's subjective distress. The moderation analyses were significant for the Brief COPE's three coping styles (i.e., problem-focused coping, emotion-focused coping, and dysfunctional coping). For women experiencing high levels of objective hardship, problem-focused (∆R2 = 1.7%) and dysfunctional coping (∆R2 = 1.5%) elevated subjective distress levels. For women experiencing low or moderate levels of objective hardship, emotion-focused coping reduced levels of subjective distress (∆R2 = 1.3%). A three-way interaction between objective hardship, emotion-focused coping, and dysfunctional coping approached significance (∆R2 = 1.0%), indicating a protective role of emotion-focused coping under high levels of objective hardship, for women who frequently use maladaptive coping strategies. LimitationsSample was generally high SES and no measure of social support was available. ConclusionResults suggest that both problem-focused and dysfunctional coping strategies were maladaptive for women with relatively high exposure levels. Overall, emotion-focused coping strategies were more likely than problem-focused or dysfunctional strategies to reduce pregnant women's subjective distress following the flood.

Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic.

ABSTRACTThe care of patients with endometriosis has been complicated by the coronavirus disease 2019 (COVID-19) pandemic. Medical and allied healthcare appointments and surgeries are being temporarily postponed. Mandatory self-isolation has created new obstacles for individuals with endometriosis seeking pain relief and improvement in their quality of life. Anxieties may be heightened by concerns over whether endometriosis may be an underlying condition that could predispose to severe COVID-19 infection and what constitutes an appropriate indication for presentation for urgent treatment in the epidemic. Furthermore, the restrictions imposed due to COVID-19 can impose negative psychological effects, which patients with endometriosis may be more prone to already. In combination with medical therapies, or as an alternative, we encourage patients to consider self-management strategies to combat endometriosis symptoms during the COVID-19 pandemic. These self-management strategies are divided into problem-focused and emotion-focused strategies, with the former aiming to change the environment to alleviate pain, and the latter address the psychology of living with endometriosis. We put forward this guidance, which is based on evidence and expert opinion, for healthcare providers to utilize during their consultations with patients via telephone or video. Patients may also independently use this article as an educational resource. The strategies discussed are not exclusively restricted to consideration during the COVID-19 pandemic. Most have been researched before this period of time and all will continue to be a part of the biopsychological approach to endometriosis long after COVID-19 restrictions are lifted.

The role of coping strategies in the pathway between child maltreatment and internalizing and externalizing behaviors

BackgroundChild maltreatment has been repeatedly linked to internalizing and externalizing disorders, though few studies have examined the mechanisms of this pathway. Furthermore, children cope with difficult demands from their environments in a variety of ways, using emotion-focused (e.g., crying and verbal aggression), avoidant (e.g., disengaging), or problem-focused (e.g., seeking help from an adult) strategies. ObjectiveThe current investigation examined if the coping strategies children employ when faced with everyday environmental stresses are a potential mechanism in the pathway between child maltreatment and internalizing and externalizing symptoms. Participants and settingParticipants included 198 maltreated and 222 non-maltreated children ages 4–12 who attended a day summer camp for 2 consecutive years. MethodsThe study utilized a longitudinal design by following the children at two time points to determine if coping at Time 1 mediated the pathway between maltreatment and internalizing and externalizing symptoms at Time 2 (measured one year later). ResultsResults from path analyses showed that maltreatment was associated with increased emotion-focused (b = .20, SE = .05, p < .001) and decreased problem-focused coping (b = -.25, SE = .05, p < .001). Results also indicated that emotion-focused coping represents a mechanism by which maltreated children are at increased risk for externalizing behaviors (with an indirect effect estimate of 0.023, SE = 0.053; CI: 0.004, 0.23). ConclusionsThe results highlight the impact maltreatment can have on coping strategies and that these strategies can play an important role in the development of psychopathology. This has important implications for clinicians, who could integrate reducing emotion-focused coping into intervention efforts for maltreated children