Use Of Coping Behaviors Research Articles

Development of the Presbyopia Impact and Coping Questionnaire.

IntroductionPresbyopia is a progressive, age-related visual condition that is characterized by reduced ability to focus on near/close objects, causing impacts on individuals’ daily function and health-related quality of life. The Presbyopia Impact and Coping Questionnaire (PICQ) is a new patient-reported outcome (PRO) instrument that assesses presbyopia impact and use of coping behaviors among presbyopic individuals.MethodsTo document the impacts of presbyopia and associated coping behaviors, concept elicitation (CE) interviews were conducted with 20 presbyopic participants. Results from the CE interviews were used to develop draft items for additional testing. Following item generation, the draft PICQ was cognitively debriefed with 20 participants. Data from a phase 2 controlled clinical trial were used for psychometric analyses of the PICQ. The PICQ was administered at site visits throughout a 28-day treatment period. Confirmatory factor analysis (CFA) methods were used to guide the development of the scoring algorithm. The reliability (internal consistency, test–retest), construct validity (convergent and discriminant validity, known-groups methods), and responsiveness (Guyatt's responsiveness statistic [GRS]) of the PICQ scores were evaluated. Finally, anchor-based and distribution-based methods were used to inform thresholds for interpreting meaningful within-patient change.ResultsCE interviews identified the important and relevant presbyopia-related impacts and coping behaviors and 22 items were drafted and cognitively debriefed. Following minor revisions and item addition/deletion, a version of the PICQ including 23 items was subjected to psychometric testing. The analysis sample included 151 participants. The CFA established two PICQ domain scores, Coping and Impact, on 0-to-4 scales that demonstrate good model fit (root mean square error of approximation = 0.06, comparative fit index = 0.98, Tucker-Lewis index = 0.98, standardized root mean square = 0.07). Cronbach’s alphas for the Coping and Impact scores were 0.89 and 0.84, respectively. Test–retest intraclass correlation coefficients were 0.77 for Coping and 0.67 for Impact. The pattern of results assessing construct validity was acceptable for the PICQ Coping and Impact scores, with the magnitude of correlations and effect sizes generally meeting a priori expectations. The corresponding GRS effect sizes for the PICQ Coping scores were −1.23 (i.e., large) for Patient Global Impression of Change (PGIC) and −0.72 (i.e., medium) for uncorrected near visual acuity (UNVA). The GRS effect sizes for the PICQ Impact scores were −0.60 (i.e., medium) for PGIC and −0.35 (i.e., small) for UNVA. Across three sets of anchor-based analyses for interpreting individual-level change, a responder threshold of −1.00 was identified for both PICQ Coping and PICQ Impact scores.ConclusionsThe totality of evidence from the qualitative and quantitative research establishes that the PICQ scores produced are valid and reliable measures of presbyopia impacts and coping behaviors that are important and relevant for assessing presbyopia treatment outcomes.ClinicalTrials.gov identifierNCT02780115; date of registration May 19, 2016.

Coping Through COVID-19: A Mixed Method Approach to Understand How Palliative Care Teams Managed the COVID-19 Pandemic.

While previous work documented a substantial increase in patient mortality consultations and workload for palliative teams, little is known about how these team members managed their mental and physical health during the COVID-19 pandemic. We investigated how job resources (coworker and supervisor support) and personal resources (coping strategies) reduced perceptions of burnout and increased perceptions of well-being. An anonymous electronic survey was sent to all members (N = 64) of the palliative medical team among 14 hospitals of a New York State health system. Data were collected between September 2020 to October 2020. Measures included validated scales for burnout (Oldenburg Burnout Inventory), coping strategies (Cybernetic Coping Scale), subjective well-being (BBC Subjective Well-being scale), and coworker/supervisor support (7 items from Yang et al). Results indicated devaluation coping tactics were used to reduce perceptions of burnout and to increase perceptions of physical health. Higher burnout was identified when using avoidance coping techniques. Furthermore, coworkers and supervisor(s) support significantly reduced disengagement when compared to coworker support alone. COVID-19 exacerbated burnout experienced by palliative care teams, yet the use of coping behaviors (devaluation/avoidance) and external resources (coworker and supervisor support) utilized by these teams were found to have positive effects. Further research should investigate these antagonizing factors to help preventing and addressing burn out during times of crises and in the everyday of palliative care teams.

Racial/Ethnic Differences in Stress, Coping, and Distress Among Mothers With a Child in the ICU.

Having a child in the intensive care unit (ICU) is a stressful event that can cause negative mental health outcomes for parents, but little is known about the experience of parental stress among members of racial/ethnic minority groups. To examine the stress and coping process in a racially/ethnically diverse sample of mothers of a child who was acutely admitted to an ICU. Participants (N = 103) completed a cross-sectional self-report survey; 86.4% completed it within a week of their child's ICU admission. Analysis of variance was used to examine racial/ethnic differences in perceived ICU-related stressors, coping behaviors, and distress level. Linear regression was used to examine the moderating effects of race/ethnicity on the relationships between stressors, coping behaviors, and distress. Mothers across racial group experienced similar stressors during the acute phase of their child's ICU admission. African American mothers reported greater overall use of coping behaviors, particularly avoidance coping, and experienced higher levels of distress than did Hispanic or non-Hispanic White mothers. Hispanic mothers experienced the least distress. The interaction of race/ethnicity and emotion-focused coping moderated the stress and coping process. Racial and ethnic diversity in sampling should be a priority in future studies of the stress and coping process of mothers with a child in an ICU. Critical care nurses should minimize known stressors for these mothers and encourage and support their preferred coping behaviors, recognizing that these may differ across racial/ethnic groups.

HOUSEHOLD ECONOMIC CONSEQUENCES OF RHEUMATIC HEART DISEASE IN UGANDA

Background: Rheumatic heart disease (RHD) has declined dramatically in wealthier countries in the past three decades, but it remains endemic in many lower-resourced regions and can have significant costs to households. The objective of this study was to quantify the economic burden of RHD among Ugandans affected by RHD. Methods: This was a cross-sectional cost-of-illness study that randomly sampled 87 participants and their households from the Uganda National RHD registry between December 2018 and February 2020. Using a standardized survey instrument, we asked participants and household members about outpatient and inpatient RHD costs and financial coping mechanisms incurred over the past 12 months. We used descriptive statistics to analyze levels and distributions of costs and the frequency of coping strategies. Multivariate Poisson regression models were used to assess relationships between socioeconomic characteristics and utilization of financial coping mechanisms. Results: Most participants were young or women, demonstrating a wide variation in socioeconomic status. Outpatient and inpatient costs were primarily driven by transportation, medications, and laboratory tests, with overall RHD direct and indirect costs of $78 per person-year. Between 20 and 35 percent of households experienced catastrophic healthcare expenditure, with participants in the Northern and Western Regions 5-10 times more likely to experience such hardship and utilize financial coping mechanisms than counterparts in the Central Region, a wealthier area. Increases in total RHD costs were positively correlated with increasing use of coping behaviors. Conclusion: Ugandan households affected by RHD, particularly in lower-income areas, incur out-of-pocket costs that are very high relative to income, exacerbating the poverty trap. Universal health coverage policy reforms in Uganda should include mechanisms to reduce or eliminate out-of-pocket expenditures for RHD and other chronic diseases.

Associations Between Trauma Type, Timing, and Accumulation on Current Coping Behaviors in Adolescents: Results from a Large, Population-based Sample.

The development of adolescents' coping in response to stress is critical for adaptive functioning; these coping strategies may be shaped by numerous environmental factors during childhood, including experiences such as exposure to trauma. Childhood trauma has been shown to undermine contemporaneous coping, but how does a history of exposure to trauma and the characteristics of that trauma (type, timing, and accumulation) relate to current coping among adolescents? We addressed this question using a nationally-representative sample of 9427 adolescents (ages 13-18; 48.9% female; 66% White). Adolescents reported on their lifetime exposure to 18 different traumas, including witnessing or experiencing interpersonal violence, accidents, disasters, and violent or accidental loss of loved ones, as well as their current use of coping behaviors when under stress (problem-focused, positive emotion-focused, and negative emotion-focused coping strategies). The study's results highlight that exposure to nearly all forms of trauma was unrelated to problem-focused and positive emotion-focused coping behaviors, but strongly associated with increased negative emotion-focused coping. Use of each coping style did not vary with age at first exposure to trauma, but increased with the number of lifetime traumatic events experienced. The findings suggest that the extent of prior exposure to trauma, including variations across type and timing, may be related to a particular form of coping that has been linked to increased risk for mental health problems. Study results highlight coping strategies as a potential target for prevention and treatment efforts, and indicate a need to better understand the malleability and trajectory of coping responses to stress for promoting healthy youth development.

Depressive Symptoms and Coping Behaviors among Individuals with Irritable Bowel Syndrome in Japan.

Objective Irritable bowel syndrome (IBS) is associated with a high prevalence of psychological disorders. Coping, which is used to manage stressful events, can have adaptive or maladaptive effects on a patient's health status. However, these coping behaviors have not been well studied in individuals with IBS. The association between the use of coping behaviors and the reported levels of depressive symptoms was examined in individuals with IBS. Methods Among 993 volunteers (382 men and 611 women) who participated in the Iwaki Health Promotion Project in 2013, we included 58 subjects who fulfilled the Rome III criteria for IBS in our analysis. Coping behaviors were assessed using the Brief Scale for Coping Profile (BSCP). The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess the four dimensions of depressive symptoms (depressed affect, somatic symptoms, interpersonal problems, and lack of positive affect) and the prevalence of probable depression using a cut-off score of 16. Results Among the 58 subjects with IBS, 22 (36.1%) exhibited probable depression. After adjustment for confounders, "active solution" was found to be significantly associated with somatic symptoms. Under the same conditions, "avoidance and suppression" was significantly associated with the CES-D total score, depressed affect, somatic symptoms, and (lack of) positive affect. There were no other significant relationships between depressive symptoms and the BSCP sub-scale scores. Conclusion These findings indicate that coping behaviors may influence the experience of depressive symptoms among individuals with IBS. Psychological therapy may reduce depressive symptoms as well as the severity of IBS symptoms. Additional studies are needed to examine the relationships between coping behaviors and depressive symptoms using a longitudinal study design.

Frequency and extent of employing food insecurity coping strategies among rural households: determinants and implications for policy using evidence from Swaziland

With the advent of climate change, the quest of improving household food security levels in developing countries where the majority predominantly relies on rain-fed agriculture continues to be a challenge. While some countries in Sub-Saharan Africa have made significant advances, Swaziland continues to suffer from the effects of more frequent droughts experienced recently than in previous periods, forcing households to rely on various food insecurity coping strategies. Ranked 35th out of 78 nations, Swaziland’s Global Hunger Index (GHI) score increased by 38 % from 10.4 to 14.4 between 1990 and 2013. These indicators point to the need for empirical evidence to inform the process of developing comprehensive and self-sustaining rural development interventions aimed at reducing households’ vulnerability to food-related shocks. To this end, this paper uses national survey data to examine the main factors associated with food insecurity and subsequent use of coping behaviours by a sample of 979 rural households. About 70 % of the sampled households were found to have employed food insecurity coping strategies after experiencing food or income shocks in the recent past. The lognormal Tobit results revealed that the frequency and extent of employing food insecurity coping strategies were significantly associated with gender of household head, household size, dependency ratio, education, household income, land area cultivated, technology adoption, morbidity, and location of households in terms of agro-ecological zone. Given these findings, the paper concludes by highlighting the required policy intervention avenues.

Behavior Assessment Battery: A Pilot Study of the Affective, Behavioral, and Cognitive Correlates Surrounding Spasmodic Dysphonia

This study investigates if adults with adductor spasmodic dysphonia (ADSD) report to experience anxiety and voice problems in particular situations, indicate the presence of negative speech-associated attitude, and/or the use of coping behaviors, by means of the Behavior Assessment Battery (BAB) modified for voice. Thirty-two participants with ADSD and 32 adults without a voice disorder participated in this study. Each person completed four different BAB-Voice subtests. These standardized self-report tests are adaptations of the original BAB for people who stutter and explore an individual's speech-related belief, negative emotional reaction to and speech problems in particular speech situations, and the use of concomitant behaviors. Individuals with spasmodic dysphonia (SD) scored statistically significantly higher compared to typical speakers on all BAB subtests, indicating that individuals with SD report being significantly more anxious and experiencing significantly more voice problems in particular speech circumstances. They also reported a significant amount of negative speech-associated attitude and the use of a significant number of coping behaviors. Internal reliability was good for three of the four BAB subtests. The BAB is capable of reflecting the dimensions that surround the disorder of SD. The self-report measures have the potential to augment the observations made by the clinician and may lead to a more diverse and all-encompassing therapy for the person suffering from SD. Future research with a revised version of the BAB-Voice will continue to explore the validity, reliability, and replicability of the initial data.

Occupational stressors, stress perception levels, and coping styles of medical surgical RNs: a generational perspective.

The purpose of this study was to compare the occupational stressors, the perceived stress levels, and coping styles of 3 generations of medical-surgical (MS) nurses. The literature supports that the nurse's role is stressful based on a variety of factors including physical labor, human suffering, work hours, staffing, and interpersonal relationships. Data indicate that there are generational differences in the response to stress. The 3 predominant nursing generations coexisting in the nursing workforce add to the complexity of the recognition and coping skills to address stress. A correlational design was used. A convenience sample of MS nurses participated in this study by completing 4 questionnaires. Occupational stressors were found to be significant predictors for perceived stress among all generations of nurses in this sample. Also, the higher the level of stress perception among nurses, the higher the use of coping behaviors. Generation Y reported a higher level of perceived stress and higher use of escape avoidance coping behaviors, while baby boomers reported higher use of self-controlling coping behaviors. By identifying the needs of each of the generational cohorts, nurse leaders, nurse educators, and policy makers can better assist the nursing workforce to remain at the bedside, improve patient outcomes, and maintain a positive work environment.

A preliminary examination of the specificity of the functions of nonsuicidal self-injury among a sample of university students

To examine whether individuals who engage in NSSI report different coping behaviors and regulatory needs compared to a non-injuring comparison group, we surveyed 1107 undergraduates using a Functions Index. Individuals who engaged in NSSI indicated greater use of coping behaviors for anti-dissociation, interpersonal influence, and self-punishment than the non-NSSI group.

Self-Administered Acupuncture as an Alternative to Deliberate Self-Harm: A Feasibility Study

The aim of this mixed methods feasibility study was to demonstrate the acceptability, practicality, and safety of training patients who regularly use deliberate self harm (DSH) to self-administer acupuncture as an alternative coping skill for emotional distress. Ten adult patients with a diagnosis of emotionally unstable personality disorder who regularly self-harmed were recruited to the study following baseline assessment by a psychiatrist. An acupuncturist taught participants to self-acupuncture. During the 6-week intervention participants recorded their emotional distress, coping behaviors, thoughts, and feelings in a diary. Face-to-face interviews were used to explore participants' motives for DSH and their experience of acupuncture. Framework analysis was conducted on interview transcripts and diary entries to identify common themes. Mood at baseline and six weeks was measured using the BDI and changes in the use of coping behaviors and acupuncture were measured using diary entries. Subjects used acupuncture regularly through the six-week intervention and over this period there was a reduction in the frequency of DSH. Qualitative analysis identified two broad themes relating to the process and the effects of acupuncture. There was wide variation in the effects experienced by subjects which broadly mapped onto to the wide range of motives behind DSH. BDI scores showed a near significant reduction (p = 0.055) from 44.4. to 34.4 over the 6-week intervention. Patients presenting with deliberate self harm can be safely trained to self-administer acupuncture as an alternative coping skill. Acceptability and effectiveness may vary between patients depending on the complex motives underlying their self-harming behavior. While the pilot study was designed to explore the feasibility of the intervention, results from this limited sample suggest that use of self-administered acupuncture may reduce the frequency of self harming behavior and reduce emotional distress as measured using the BDI.

Stress, coping, and depression: Testing a new hypothesis in a prospectively studied general population sample of U.S.-born Whites and Blacks

The scarcity of empirically supported explanations for the Black/White prevalence difference in depression in the U.S. is a conspicuous gap in the literature. Recent evidence suggests that the paradoxical observation of decreased risk of depression but elevated rates of physical illness among Blacks in the U.S. compared with Whites may be accounted for by the use of coping behaviors (e.g., alcohol and nicotine consumption, overeating) among Blacks exposed to high stress levels. Such coping behaviors may mitigate deleterious effects of stressful exposures on mental health while increasing the risk of physical ailments. The racial patterning in mental and physical health outcomes could therefore be explained by this mechanism if a) these behaviors were more prevalent among Blacks than Whites and/or b) the effect of these behavioral responses to stress was differential by race. The present study challenges this hypothesis using longitudinal, nationally-representative data with comprehensive DSM-IV diagnoses. Data are drawn from 34,653 individuals sampled in Waves 1 (2001-2002) and 2 (2004-2005) as part of the US National Epidemiologic Survey on Alcohol and Related Conditions. Results showed that a) Blacks were less likely to engage in alcohol or nicotine consumption at low, moderate, and high levels of stress compared to Whites, and b) there was a significant three-way interaction between race, stress, and coping behavior for BMI only (F = 2.11, df = 12, p = 0.03), but, contrary to the hypothesis, elevated BMI was protective against depression in Blacks at low, not high, levels of stress. Further, engagement in unhealthy behaviors, especially at pathological levels, did not protect against depression in Blacks or in Whites. In sum, the impact of stress and coping processes on depression does not appear to operate differently in Blacks versus Whites. Further research testing innovative hypotheses that would explain the difference in Black/White depression prevalence is warranted.

Stress, Coping, and Psychological Health of Vocational High School Nursing Students Associated With a Competitive Entrance Exam

An important issue for the nursing education system in Taiwan is to reinforce nursing education to enhance competence levels for entry to nursing specialties. Consequently, to meet the prospective demands of technical manpower, not only do nursing students in college and vocational schools pursue further studies, but they also take competitive entrance exams. Using a descriptive cross-sectional design, the study examined the following among nursing students in vocational high schools: (1) perception and sources of entrance exam stress and use of coping behaviors; (2) the effect of difference in entrance exam stress levels on coping behaviors used, and (3) measurement of coping function to determine which coping behavior works best for buffering the impact of stress on psychological health during a preparatory stage of a college and university entrance exam. The subjects were 441 third-year nursing students of vocational high schools in northern Taiwan, recruited by convenience sampling. Three measurements were adopted: Stress perceived scale, Coping behavior inventory, and a Chinese health questionnaire. Results showed that the five main stressors of entrance exam stress, in descending order, were taking tests, the student's own aspirations, learning tasks, teacher's aspirations and parent's aspirations. Students generally used problem-focused coping strategies including optimistic action and social support to deal with the entrance exam stress, but use of emotion-focused coping strategies including avoidance and emotional disturbance was significantly increased as perceived level of stress rose. Two-way analyses of variance (2-way ANOVA) revealed that problem-focused coping had a positive main effect of alleviating psychological distress. A significant interaction was observed between stress perceived and problem-focused coping used for psychological health. Further examination of the interaction effect showed that problem-focused coping behaviors were potentially more adaptive in relation to psychological health at the lower and moderate stress levels (25 - 75%T) than that at the extreme stress level (> 75%T). Conversely, emotion-focused coping had a negative main effect or impairing psychological health. No interaction effect was found between stress perceived and emotion-focused coping used, suggesting that the relationship between emotion-focused coping and psychological distress was consistent across various stress levels.

Coping behaviors and relapse precipitants in opioid dependence: A study from North India

This study was undertaken to evaluate the reasons for lapse, relapse and the coping behaviors in a group of recently abstinent subjects with opioid dependence. Retrospective qualitative and quantitative evaluation of the reasons for lapse, relapse and coping behaviors were done using structured questionnaires and semi-structured interviews. Eighty-four subjects from inpatient and outpatient settings of a Drug Dependence Treatment Centre, who had used illicit opioids after at least 3 weeks abstinence in the last 6-month period, were included. Coping behaviors, reasons for lapse and relapse were assessed and it was found that environmental factors are important for first use and physiological experiences related to drug use for regular use. There were significant differences in the use of coping behaviors by the currently abstinent and currently using subjects in the index abstinence. The study provides information about coping behaviors and reasons for lapse/relapse in an Indian setting.

Perceptions, Stratégies Adaptatives Et Attentes Des Femmes Agées Aidantes Familiales Dans La Perspective Du Virage Ambulatoire

This article presents the results of an exploratory study funded by the Social Sciences and Humanities Research Council of Canada. The objectives of this research were to explore (a) the perception by elderly women caregivers of the shift to ambulatory care; (b) their use of coping behaviours in the face of this major change within the health care system; and (c) their perceptions of health care services. In a theoretical framework of stress and coping, and using standardized questionnaires and open-ended questions, 40 home interviews were initially conducted with elderly women, each of whom was caring for her spouse after his discharge from hospital. Additional data were collected through focus groups. Quantitative and qualitative analyses revealed that elderly women caregivers perceive ambulatory care in a positive manner and as a change involving challenges only when they feel in control of the health care situation and when the care does not necessitate specialized abilities. When the care to be provided is complex and requires continued involvement and specific competence on the caregiver's part, the situation results in insecurity for elderly women. Caregivers use cognitive coping strategies to deal with their problems and are not inclined to use formal services in their social support network. Participants in this study wished to be better informed about the health care system in general ("how the system works") so that they could acquire a sense of predictability. Other expectations of elderly women caregivers concerned the importance of continuity in health services delivery, better preparation for the transition from hospital to home and availability of psychological support for themselves. These results suggest a critical analysis of the present paradigm guiding health care services, in which family caregivers are considered as resources or coworkers instead of coclients.

Coping Behavior to Avoid Visitor Encounters: Its Relationship to Wildland Privacy

Too many visitor encounters can detract from the privacy sought in wildland environments. Coping behavior to avoid or adjust to visitor encounters is one procedure for reducing encounters and maintaining wildland privacy. This paper examines the degree to which backpackers in Great Smoky Mountains National Park used six physical and six social coping behaviors to avoid encounters/interactions with other backpackers. The influences of solitude importance, encounter norms, and level of backpacker experience on visitor use of coping behaviors were analyzed also. Most respondents used social coping behaviors infrequently, except for reducing social interactions with backpackers in other parties. However, physical coping behaviors were used more often than social coping behaviors. The importance of solitude to visitors was related significantly to adoption of all six physical coping behaviors but to none of the social coping behaviors. Visitors who had lower encounter norms and who were more sensitive to actual encounters experienced participated significantly more often in 10 of the 12 coping behaviors. Level of past experience had little influence on use of coping behaviors. The findings are interpreted in the context of coping behavior as a means of avoiding or adjusting to visitor encounters in wildland recreation areas. The role that coping behavior may serve to control environmental conditions and desired level of wildland privacy is discussed, also.

The life events and coping inventory: an assessment of stress in children.

This article reports the development of the Life Events and Coping Inventory (LECI), an instrument that assesses the experience of life stress and the use of coping behaviors in 12-14 year old children. Six hundred eighty-one child Ss participated in item generation, item rating, reliability procedures, and validity procedures for the LECI. Indices of life stress were correlated at a statistically significant level (p less than 0.01) with measures of state and trait anxiety, psychosomatic symptoms, depression and a variety of behavior problems. A broad range of coping strategies was evidenced, with strategies that provide distraction from the stress event the most useful. The results are discussed in light of current theoretic literature on stress and well-being.

Effects of Information on Postsurgical Coping

This study examined the effects of providing patients with selected types of information prior to surgery and the reported frequency of use of coping behaviors following surgery. The relationship of the reported frequency of coping behaviors and outcomes of surgery was also explored. A total of 111 patients were randomly assigned to three groups. One received procedure information; a second, procedure and sensation information; and a third group, procedure and sensation information, plus information on selected coping strategies. Results showed no evidence that the type of information provided for patients prior to surgery increased the reported frequency of coping behaviors or that the reported frequency of coping behaviors was related to improved outcomes as evaluated by pain intensity, distress, or selected physical complications.

Self-reported coping behavior of wives of alcoholics and its association with drinking outcome.

The frequency of the use of coping behavior by wives of alcoholics was found to be related to their husband's drinking outcome. In general, a high frequency of coping behavior was associated with a poor outcome, but some components of coping behavior were more likely than others to be linked with a poor prognosis.