Psychometric evaluation of the Ways of Coping Questionnaire as applied to clinical and nonclinical groups

Stress, Coping, and Adjustment of International Students during COVID-19: A Quantitative Study

The COVID-19 pandemic in 2020 caused unexpected and unprecedented disruptions worldwide. University students, especially international students, underwent unique challenges during this volatile era. This secondary quantitative data analysis study aimed to investigate the experiences, stress, adjustment, and ways of coping of university students during the COVID-19 pandemic. Data from 112 international university students and 112 domestic American university students were included in the statistical analyses. The differences in Student Adaptation to College Questionnaire (SACQ), Ways of Coping Questionnaire (WAYS), COVID-19-related questionnaire, and Perceived Stress Scale (PSS) between international and domestic students were analyzed using independent samples t-tests. Multiple regression models predicting PSS by SACQ, WAYS, and COVID-19-related questionnaire subscales were estimated for international and domestic students separately. The results showed that international students and American students did not report significant differences in their university adjustment, usage of coping strategy, and perceived stress level during the peak of the pandemic. Additionally, American students reported more factors impacting their perceived stress than international students. Implications of the findings as well as limitations and future directions were discussed.

Determinants of coping styles of people with Parkinson's Disease

Little is known about how people with Parkinson's disease (PD) cope with stressful life events. We examined the determinants of specific coping strategies and whether specific choices have any impact on quality of life (QoL). We recruited patients with PD who had been seen at a neurology outpatient clinic at least once during the past year as part of the PRIME-NL cohort study. Coping was measured using the Ways of Coping Questionnaire (WCQ) and QoL was measured using the Parkinson's Disease Questionnaire (PDQ-39). 977 out of 988 participants completed the questionnaires and 935 participants were diagnosed with PD. Factor analysis was undertaken to test if ways of coping were similar or different to previous findings in a PD population. We used linear regression analyses to examine predictors of coping styles. We then used multivariable linear regression to test how coping style was associated with the domains of QoL conditional on potential confounders. The five coping styles identified by the factor analysis were: "taking action and emphasizing the positive", "distancing and fantasizing", "goal oriented and planful problem solving", "seeking social support" and "avoidance and acceptance". Age, gender, education and anxiety were associated with the type of coping strategy. For example, higher education was associated with more active coping strategies (e.g. β = 4.39, p < 0.001 for goal oriented). Conditional on other confounders, most coping strategies had little effect on QoL domains. These findings demonstrate that coping behavior of people with PD is influenced by psychological status and personal traits. However, there was only a modest effect of coping behavior on QoL. Future research needs to test whether the enhancement or discouragement of certain coping strategies is feasible and can enhance QoL.

Ethnic Differences in Response to COVID-19: A Study of American-Asian and Non-Asian College Students

Asian American students have experienced additional physical and emotional hardships associated with the COVID-19 pandemic due to increased xenophobic and anti-Asian discrimination. This study investigates different coping patterns and risk factors affecting Asian and non-Asian college students in response to COVID-19 challenges by studying the differences in their responses within four domains after the onset of the pandemic: academic adjustment, emotional adjustment, social support, and discriminatory impacts related to COVID-19. We first employed a machine learning approach to identify well-adjusted and poorly adjusted students in each of the four domains for the Asian and non-Asian groups, respectively. Next, we applied the SHAP method to study the principal risk factors associated with each classification task and analyzed the differences between the two groups. We based our study on a proprietary survey dataset collected from U.S. college students during the initial peak of the pandemic. Our findings provide insights into the risk factors and their directional impact affecting Asian and non-Asian students' well-being during the pandemic. The results could help universities establish customized strategies to support these two groups of students in this era of uncertainty. Applications for international communities are discussed.

Asian American University Students' Adjustment, Coping, and Stress during the COVID-19 Pandemic

The COVID-19 outbreak caused global disruptions in all aspects of life. Social distancing regulations were enforced in an attempt to halt virus spread. Universities across the country closed for in-person instruction and activities, transitioning to remote learning. University students faced unprecedented challenges and stressors, especially Asian American students due to COVID-19-associated xenophobic attitudes, harassment, and assault against people of Asian complexions. The purpose of this study was to examine the experiences, coping, stress, and adjustment of Asian American students during the COVID-19 pandemic. Secondary analyses were conducted on the survey responses of 207 participants (n = 103 Asian American university students, n = 104 non-Asian American students) from a larger-scale study, which focused on adaptation to the university, perceived stress, ways of coping, and COVID-19-specific factors. A series of independent samples t tests and regression analyses showed significant relationships between some university adjustment factors, ways of coping methods, and race with perceived stress and COVID-19 factors. Implications, limitations, and ideas for future directions in research are discussed.

The pandemic coping scale – validity and reliability of a brief measure of coping during a pandemic

This study assessed the validity and reliability of the Pandemic Coping Scale (PCS), a new brief measure of coping with pandemic-related stressors.

Student adaptation to college and coping in relation to adjustment during COVID-19: A machine learning approach

The COVID-19 pandemic has presented unprecedented challenges for university students, creating uncertainties for their academic careers, social lives, and mental health. Our study utilized a machine learning approach to examine the degree to which students' college adjustment and coping styles impacted their adjustment to COVID-19 disruptions. More specifically, we developed predictive models to distinguish between well-adjusted and not well-adjusted students in each of five psychological domains: academic adjustment, emotionality adjustment, social support adjustment, general COVID-19 regulations response, and discriminatory impact. The predictive features used for these models are students' individual characteristics in three psychological domains, i.e., Ways of Coping (WAYS), Adaptation to College (SACQ), and Perceived Stress Scale (PSS), assessed using established commercial and open-access questionnaires. We based our study on a proprietary survey dataset collected from 517 U.S. students during the initial peak of the pandemic. Our models achieved an average of 0.91 AUC score over the five domains. Using the SHAP method, we further identified the most relevant risk factors associated with each classification task. The findings reveal the relationship of students' general adaptation to college and coping in relation to their adjustment during COVID-19. Our results could help universities identify systemic and individualized strategies to support their students in coping with stress and to facilitate students' college adjustment in this era of challenges and uncertainties.

Clinical Markers of 6 Pre-dominant Coping Behaviors in Living With Parkinson Disease: A Convergent Mixed Methods Study

People with Parkinson's disease (PwP) experience a variety of symptoms and fluctuations in these, which they have to cope with every day. In tailoring a person-centered treatment to PwP there is a lack of knowledge about the association between pre-dominant coping behaviors and clinical markers among PwP. To describe and compare specific clinical markers between 6 suggested coping behaviors. Thirty-four PwP, who previously had been classified into 6 different pre-dominant coping behaviors, were included in this mixed methods study. Six primary variables were included in the descriptive analysis; motor function (UPDRS-III), non-motor symptoms score (NMS-Quest), change in bradykinesia score, apathy score (LARS), personality traits (NEO-FFI), and cognitive status (evaluated by a neuropsychologist). The merged results of this mixed methods study indicate that clinical markers as apathy, burden of non-motor symptoms, cognitive impairments and personality traits, have the potential to impact the coping behavior in PwP. In a clinical setting the markers; NMS-burden, degree of apathy, cognition, and personality traits may indicate specific coping behavior. Three of the six suggested typologies of coping behaviors differed from the other groups when comparing descriptive data. In order to improve patient care and guide the development of person-centered therapies, each PwP should be approached based on those typologies.

To support self-management for people with long-term conditions - The effect on shared decision-making, empowerment and coping after participating in group-learning sessions

Introduction

Interventions that support patients to handle the emotional and medical aspects of a long‐term health condition is important. One way is to use peer‐support groups, to help patients solving problems, increasing their knowledge and making decisions.

Aim

was to investigate the impact on shared decision‐making, empowerment and coping after participation in group‐learning sessions for patients with long‐term conditions (N = 42).

Design

An intervention following a health education programme based on group‐learning sessions was established. Eight different programmes were held in five different departments at a regional county hospital in Sweden.

Methods

Questionnaires were analysed using paired‐sample t‐test.

Results

Results showed that patients might have better opportunities to be more active during their patient encounter after attending the group learning sessions. Interventions directed to patient activation may be one key in future healthcare management, especially concerning long‐term conditions. Empowering patients is central in healthcare, and using different approaches is important.

A Critical Appraisal of the Evidence Supporting the Factor Structure of Extant Coping Instruments

This paper evaluated the evidence supporting the factor structure of extant coping instruments based on modern psychometric standards. Our literature search identified nine coping instruments that are routinely used to measure coping strategies in adult populations. While nearly 10 thousand papers have been published using these instruments, only 39 studies have investigated their psychometric validity. Our findings revealed that the majority of these studies did not follow current psychometric recommendations for establishing internal validity in part because they did not account for the ordinal nature of the data. Further, studies employing exploratory factor analysis used methods for identifying the number of factors to retain that have been found to have a low accuracy in a simulation study while those employing confirmatory factor analysis reported model fit statistics that did not meet widely accepted benchmarks. Hence, conflicting results were found within and across the nine coping instruments. Recommendations are made for improving future validation studies.

Coping strategies used by mothers and fathers following diagnosis of congenital heart disease

BACKGROUND

Parents of children with congenital heart disease (CHD) exhibit high rates of mental health difficulties, which can influence child developmental and behavioural outcomes. While extensive research has focused on CHD-related stressors that contribute to parental mental health difficulties, few studies have investigated parental coping strategies that may mitigate or heighten risk. This study aimed to identify parental coping strategies following diagnosis of CHD and compare use of coping strategies among different groups (mothers vs. fathers; prenatal vs. postnatal diagnosis).

METHODS

A diverse sample of 34 parents (20 mothers and 14 fathers) of young children with CHD participated in semistructured interviews focused on their responses to CHD-related stressors. Coping strategies were identified from qualitative data and categorized according to the COPE Inventory, an instrument that assesses common adult responses to stress. Coping strategies deemed as unique to parenting a critically ill child were identified. χ² and independent sample t tests evaluated group differences.

RESULTS

Parents described using between 1 and 10 different adaptive and maladaptive strategies measured by the COPE Inventory. Most parents (82.35%) also described coping strategies that may be unique to parenting a critically ill child. Mothers were more likely than fathers to report a focus on and venting of emotions (70% vs. 21.43%) and behavioural disengagement (25% vs. 0%). Compared with parents receiving a postnatal CHD diagnosis, those receiving a prenatal diagnosis described a greater variety of coping strategies (6.23 vs. 4.52) and more often reported positive reinterpretation and growth (69.23% vs. 14.29%), behavioural disengagement (38.46% vs. 0%) and denial (38.46% vs. 0%).

CONCLUSIONS

Parents of children with CHD utilize a variety of coping strategies, some of which are maladaptive. Interventions tailored to the needs of mothers and fathers of young children with CHD, including those receiving a postnatal diagnosis, are needed to promote adaptive coping and optimize family psychosocial outcomes.

Identification of Pre-Dominant Coping Types in Patients with Parkinson’s Disease: An Abductive Content Analysis of Video-Based Narratives

Background: People with Parkinson’s disease suffer from a range of various symptoms. Altered movement patterns frequently represent the prevailing symptom experience and influence the everyday life of the affected persons. Objective: This qualitative study explores how persons with Parkinson‘s disease experience everyday life with a complex symptom profile and how they manage the consequential challenges in their daily life, as well as the motivation and consequences of these coping behaviours. Methods: Thirty-four patients with Parkinson’s disease were interviewed as an integrated part of the method Video-based Narrative. The interviews were analysed by means of qualitative content analysis according to Graneheim & Lundman. Results: The analysis identified six predominant coping types with different behavioural traits: The convincing behaviour, The economizing behaviour, The encapsulating behaviour, The evasive behaviour, The adaptable behaviour, and The dynamic behaviour. The strategies embedded in each of the six types are diverse, but all participants seek to maintain their integrity in different ways leading to the main motivation “To stay the same person”. Conclusion: Healthcare professionals should be aware of the patients‘ various coping behaviour in order to offer a person-centred approach. Psychoeducational interventions to promote coping skills may be essential in incorporating disease-related changes in the conduct of everyday life with Parkinson’s disease to maintain integrity.

A dyadic perspective on assessment in Alzheimer's dementia: Supporting both care partners across the disease continuum

Written from a dyadic strength-based perspective, this article first provides a brief overview of the Education, Information, and Support section of the 2018 Alzheimer's Disease Dementia Care Practice Recommendations.1 Subsequent sections present a comprehensive overview of available valid and reliable psychosocial measures that assess a selection of important domains for dementia care planning that can be used by families from early stage until end-of-life. Measures selected for the purposes of this article will focus on concepts that are strength-based and most relevant to care dyads as they navigate the difficult disease trajectory: readiness, knowledge, coping, dyadic relationship, care values and preferences. We will also highlight measures that have traditionally targeted the family care partner but can potentially be considered for use with the care partner with dementia, with adjustments, beyond the early stages. Part of this discussion will include various strategies for including persons with dementia in all aspects of their own care using a strength-based perspective, potentially enabling them to answer questions more reliably across disease stages. Last, gaps in existing measures will be identified to provide options to better assess areas of need most meaningful to families, and in ways that positively contribute to the successful aging of those living with dementia and their care partners.

Coping Processes, Self-Efficacy, and CPAP Use in Adults With Obstructive Sleep Apnea

Background: Coping strategies are predictive of 1 week CPAP use. Coping strategies may predict longer-term CPAP use among adults with obstructive sleep apnea (OSA). Objectives: To investigate the influence of two coping styles (active and passive) and individual coping processes on CPAP use at 1 week and 1 month; and explore the association between self-efficacy and coping on CPAP use. Participants: CPAP-naïve adults (52.3% male, 90.9% White) newly diagnosed with OSA (AHI ≥ 5 events/hr) from two U.S. clinical sleep centers (n = 66). Methods: A post-hoc analysis from a prospective, longitudinal study that examined influential factors on CPAP use among CPAP-naïve patients with newly diagnosed OSA. The Ways of Coping Questionnaire and the Self-Efficacy Measure for Sleep Apnea were completed immediately after CPAP titration polysomnography. Objective 1 week and 1 month CPAP use (mean hr/night) were the primary outcomes. Descriptive analyses and stepwise multiple linear regression analyses modeling for CPAP use (mean hr/night). Results: Active coping was significantly associated with greater CPAP use (mean hr/night) at 1 week, but not at 1 month (p = 0.0397; p = 0.0556, respectively). Higher Planful Problem Solving was significantly associated with greater average CPAP use at 1 week and 1 month (p = 0.0117, p = 0.0378, respectively). Self-efficacy was significantly associated with greater average CPAP use at 1 week (p = 0.0056) and 1 month (p = 0.0056). Conclusions: Self-efficacy and Planful Problem Solving coping are promising behavioral intervention targets to promote CPAP use in newly diagnosed OSA.

Factor Structure of the Ways of Coping Questionnaire in Parkinson's Disease

The Ways of Coping Questionnaire (WCQ) is used extensively in health research, but the measurement properties and suitability of the WCQ for people with Parkinson's disease (PD) have not been psychometrically assessed. If the WCQ does not align with its original 8-factor structure in a PD population, the use of the WCQ subscales may not be appropriate. The present study used confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and multiple-group EFA to determine the ideal factor structure of the WCQ in a PD sample. The original 8 factors of the WCQ were not reproduced. EFA revealed a 6-factor structure, including Distancing, Faith, Avoidance, Seeking Social Support, Planful Problem Solving, and Confrontive coping. As motor symptom severity may impact coping, the stability of the 6-factor structure was examined across motor symptom severity (mild and moderate), remaining consistent. Higher levels of overall motor severity were associated with increased use of faith and avoidance style coping. These findings suggest that the 6-factor structure of the WCQ may be more appropriate for assessing coping styles in PD.

The COPE-48: An adapted version of the COPE inventory for use in clinical settings

The Coping Orientation to Problems Experienced inventory (COPE) is one of the most frequently used tools for assessing coping styles. However, there is a lack of information about its psychometric properties in applied settings. The aim of this study is to analyze the psychometric properties and internal structure of the COPE in an adult clinical sample attending a primary care mental health unit and to develop an adapted version to increase its reliability and clinical utility. We administered the questionnaire to 301 participants (37.5% men) aged 18-69 years. The most prevalent principal diagnoses were adjustment (39.9%) and mood disorders (35.9%). The principal component analysis yielded a nine factor solution accounting for 61.23% of the total variance. This shortened version of the COPE provides a theoretically and empirical consistent inventory, improves the factor structure and increases the reliability of the scales with a mean alpha value of .81. This version, the COPE-48, offers good psychometric properties, it takes about 20min to administer, allowing a reliable and parsimonious evaluation. Its administration in applied settings could help with identifying which coping strategies are used and which can be modified and promoted by psychological treatment.

Assessing the Structure of the Ways of Coping Questionnaire in Fibromyalgia Patients Using Common Factor Analytic Approaches

The Ways of Coping Questionnaire (WCQ) is a widely used measure of coping processes. Despite its use in a variety of populations, there has been concern about the stability and structure of the WCQ across different populations. This study examines the factor structure of the WCQ in a large sample of individuals diagnosed with fibromyalgia. The participants were 501 adults (478 women) who were part of a larger intervention study. Participants completed the WCQ at their 6-month assessment. Foundational factoring approaches were performed on the data (i.e., maximum likelihood factoring [MLF], iterative principal factoring [IPF], principal axis factoring (PAF), and principal components factoring [PCF]) with oblique oblimin rotation. Various criteria were evaluated to determine the number of factors to be extracted, including Kaiser's rule, Scree plot visual analysis, 5 and 10% unique variance explained, 70 and 80% communal variance explained, and Horn's parallel analysis (PA). It was concluded that the 4-factor PAF solution was the preferable solution, based on PA extraction and the fact that this solution minimizes nonvocality and multivocality. The present study highlights the need for more research focused on defining the limits of the WCQ and the degree to which population-specific and context-specific subscale adjustments are needed.

Effect of acupuncture and its influence on cerebral activity in functional dyspepsia patients: study protocol for a randomized controlled trial

BACKGROUND

Functional dyspepsia (FD) is a prevalent gastric disorder that is difficult to manage due to lack of satisfactory treatments. Acupuncture has been studied with regard to the rising need for treating FD, but the mechanism verifying its efficacy has not yet been fully revealed. The aim of this study is to explore the efficacy and mechanism of acupuncture for FD compared with a sham group.

METHODS/DESIGN

We describe a proposal for a randomized, assessor-blind, sham-controlled trial with 70 eligible participants who will be randomly allocated either into an acupuncture or a sham group. Participants in the acupuncture group will receive 10 sessions of real acupuncture treatment and those in the sham group will be treated with identical sessions using a Streitberger needle. Functional magnetic resonance imaging (fMRI) and metabolomics studies will be implemented before and after 4 weeks of treatment to investigate the mechanism of acupuncture. The primary outcome is a proportion of responders with adequate symptom relief and the secondary outcomes include the Nepean Dyspepsia Index - Korean version, Functional Dyspepsia-Related Quality of Life questionnaire, Ways of Coping Questionnaire, Coping Strategies Questionnaire, perception of bodily sensation questionnaire, State-Trait Anxiety Inventory, and the Center for Epidemiological Studies - Depression Scale. The outcomes will be evaluated before and after the treatment.

DISCUSSION

This is the first large-scale trial evaluating the efficacy and mechanism of acupuncture with fMRI and metabolomic methods. We will compare real acupuncture with the Streitberger sham needle to verify the specific effect of acupuncture. The results of this trial are expected to be relevant evidences affecting policy and decision-makers associated with routine healthcare.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02358486 . Date of Registration: 21 January 2015.

For fathers raising children with autism, do coping strategies mediate or moderate the relationship between parenting stress and quality of life?

In response to the dramatic change in the perception of fatherhood and the significant expansion in fatherhood research, this study came to fill the gap in literature and examine the possible mediation and moderation effects of coping in the relationship between fathers' of children with autism parenting stress and quality of life (QoL). Mediation and moderation effects were examined using multiple programs and software which included hierarchical regression, structural equation modeling and special Macros added to the analysis programs to confirm the findings. None of the investigated coping strategies could mediate or moderate the stress-QoL relationship among the 101 participating fathers. This study provides interesting information on how the stress-coping-QoL relationship among fathers of children with autism can be affected by the nature of their stress provoking situation, their individual characteristics, the environment and its demands and resources, and the way fathers perceive and apply their coping responses.

Rasch analysis of the coping inventory for stressful situations in individuals with moderate to severe traumatic brain injury

OBJECTIVE

To evaluate psychometric properties of the Coping Inventory for Stressful Situations (CISS) in individuals with traumatic brain injury (TBI).

DESIGN

Archival study using Rasch analysis.

SETTING

Postacute rehabilitation hospital.

PARTICIPANTS

Adults (N=331) 1 to 15 years after moderate to severe TBI, recruited consecutively.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

CISS.

RESULTS

Indices of unidimensionality and model fit supported the scale's proposed multidimensional structure consisting of Task, Emotion, and Avoidant coping style; 3 unidimensional scales showed better fit than a single combined scale. The 3 scales met Rasch expectations of reliability and separation for persons and items, as well as adequate response category functioning. The scales were generally well targeted but showed some evidence of ceiling effect for Task, and floor effects for Emotion and Avoidant coping; item difficulties did not fully capture extreme ranges demonstrated by some participants, suggesting that measurement of coping after TBI on the CISS would be improved with additional items at low and high ranges of difficulty. Results were generally equivalent for cross-sectional groups representing short-term (1y), intermediate (2y), and long-term (5-15y).

CONCLUSIONS

The CISS showed good psychometric properties as a measure of coping style among persons with moderate to severe TBI in acute and chronic phases of recovery, and showed evidence of multidimensionality as predicted by theory, consistent with 3 unidimensional scales. Added items tapping broader (or more accessible, less cognitively complex) ranges of coping responses would likely benefit the scale overall and improve correspondence with the response needs of people with TBI.

Breast cancer and coping among women of color: a systematic review of the literature

Breast cancer is the most commonly diagnosed form of cancer for women regardless of race/ethnicity. Women of color are diagnosed at later stages and experience greater mortality than their White counterparts. However, there has been comparatively little research on coping with breast among racial/ethnic minorities at time of diagnosis, during treatment, or in the course of survivorship. This is despite the fact that research has repeatedly shown that distress can impact disease progression and survival. The questions asked of this systematic literature review include: (1) What is known about coping with breast cancer among major racial/ethnic groups? (2) What are the strengths and gaps in research to date? Over 120 peer-reviewed published studies (1980-2012) were reviewed. A total of 33 met criteria for inclusion including 15 quantitative, 17 qualitative, and 1 mixed methods study. The majority of studies were small sample cross-sectional studies. Only five studies were longitudinal, and two randomized-controlled intervention trials sought to improve coping among survivors. The most common topic in both quantitative and qualitative studies was spirituality and coping among African American breast cancer patients. Thirteen studies included Latinas only or in combination with other groups. Only one quantitative and one qualitative study solely addressed the Asian American population exploring coping and adjustment. In the course of this systematic literature review, we elucidate what is known about coping with breast cancer among racial/ethnic minority women and identify priorities for future research.

The PRCI study: design of a randomized clinical trial to evaluate a coping intervention for medical waiting periods used by women undergoing a fertility treatment

BACKGROUND

Many medical situations necessitate a stressful period of waiting for potentially threatening test results. The medical waiting period is often associated with negative anticipatory anxiety and rumination about the outcome of treatment. Few evidence-based self-help coping interventions are available to assist individuals manage these periods. Theory and research suggest that positive reappraisal coping strategies may be particularly useful for this type of unpredictable and uncontrollable stressful context. The objective of this study is to investigate the effects of a Positive Reappraisal Coping Intervention (PRCI) on psychological well-being of women waiting for the outcome of their fertility treatment cycle.

METHODS/DESIGN

In a three-armed randomized controlled trial, the effectiveness of the PRCI will be tested. Consecutive patients undergoing in vitro fertilisation in a Dutch university hospital and meeting selection criteria will be invited to participate. Those who agree will be randomized to one of three experimental groups (N=372). The PRCI Intervention group will receive the intervention that comprises an explanatory leaflet and the 10 statements designed to promote positive reappraisal coping, to be read at least once in the morning, once in the evening. To capture the general impact of PRCI on psychological wellbeing patients will complete questionnaires before the waiting period (pre-intervention), on day ten of the 14-day waiting period (intervention) and six weeks after the start of the waiting period (post-intervention). To capture the specific effects of the PRCI during the waiting period, patients will also be asked to monitor daily their emotions and reactions during the 14-day waiting period. The primary outcome is general anxiety, measured by the Hospital Anxiety and Depression Scale. Secondary outcomes are positive and negative emotions during the waiting period, depression, quality of life, coping and treatment outcome. During recruitment for the RCT it was decided to add a fourth non-randomized group, a PRCI Control group that received the PRCI and completed the questionnaires but did not complete daily monitoring.

DISCUSSION

Positive reappraisal is one of the few ways of coping that has been shown to be associated with increased wellbeing during unpredictable and uncontrollable situations like medical waiting periods. A simple evidence based self-help intervention could facilitate coping during this common medical situation. This RCT study will evaluate the value of a self-help coping intervention designed for medical waiting periods in women undergoing fertility treatment.

TRIAL REGISTRATION

The study is registered at the Clinical Tials.gov (NCT01701011).

Applying a coping with stress questionnaire for cancer patients to patients with non-cancer chronic illnesses

One of the few instruments to evaluate coping skills among patients with chronic illnesses is the Cuestionario de Afrontamiento al Estrés para Pacientes Oncológicos (CAEPO), created initially for cancer patients. We evaluate how well CAEPO applies to patients with non-cancer chronic illnesses. A total of 344 patients (115 with chronic hepatitis C, 120 with inflammatory bowel disease and 109 with recurrent vertigo) completed the CAEPO. Exploratory factor analysis and Cronbach's alpha provide only partial support for the seven factors suggested by the original CAEPO. A streamlined version with fewer dimensions and items may be a better solution for identifying coping strategies among these patients.

Associations between adults' recalled childhood bullying victimization, current social anxiety, coping, and self-blame: evidence for moderation and indirect effects

Prior studies have shown that bullying victimization is common during childhood and may have negative effects over the short term. Evidence is also emerging that childhood bullying victimization in the form of teasing may precipitate social anxiety in adulthood. The present study extended the field by testing for associations between adults' recall of four common subtypes of childhood bullying victimization and their current social anxiety. It also provided the first test of whether coping moderated those associations, if they were indirect effects through self-blame, and if sex differences existed. Data were collected from 582 students aged 23+ years at two universities in the UK. Collectively, and for social exclusion and relational victimization uniquely, the subtypes of bullying victimization did predict social anxiety. Evidence for hypothesized moderation and indirect effects was obtained but these varied by subtype of victimization (but not sex). The theoretical and practical implications of these results were discussed.

Exploring Factors That Affect Score Reliability and Variability

One instrument cited in the literature as an effective measure of approaches to coping is the Ways of Coping Questionnaire (WAYS; Folkman & Lazarus, 2005 ). This study is a reliability generalization (RG) study of the WAYS that strives to further distill psychometric properties of the scores generated by this measure. Results from this meta-analytic investigation of 130 previously published research studies indicate that the Confrontive Coping and Distancing subscales generate the most variable reliability coefficients across studies. Regression analyses suggest that the variables type of scoring, sample size, population type, sample source, gender homogeneity, and racial homogeneity were most important in determining reliability estimates on the Seeking Social Support, Escape-Avoidance, Planful Problem Solving, and Positive Reappraisal subscales. Implications for the use of the WAYS are offered.

Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training

BACKGROUND

Working in a hospital during an extraordinary infectious disease outbreak can cause significant stress and contribute to healthcare workers choosing to reduce patient contact. Psychological training of healthcare workers prior to an influenza pandemic may reduce stress-related absenteeism, however, established training methods that change behavior and attitudes are too resource-intensive for widespread use. This study tests the feasibility and effectiveness of a less expensive alternative - an interactive, computer-assisted training course designed to build resilience to the stresses of working during a pandemic.

METHODS

A "dose-finding" study compared pre-post changes in three different durations of training. We measured variables that are likely to mediate stress-responses in a pandemic before and after training: confidence in support and training, pandemic-related self-efficacy, coping style and interpersonal problems.

RESULTS

158 hospital workers took the course and were randomly assigned to the short (7 sessions, median cumulative duration 111 minutes), medium (12 sessions, 158 minutes) or long (17 sessions, 223 minutes) version. Using an intention-to-treat analysis, the course was associated with significant improvements in confidence in support and training, pandemic self-efficacy and interpersonal problems. Participants who under-utilized coping via problem-solving or seeking support or over-utilized escape-avoidance experienced improved coping. Comparison of doses showed improved interpersonal problems in the medium and long course but not in the short course. There was a trend towards higher drop-out rates with longer duration of training.

CONCLUSIONS

Computer-assisted resilience training in healthcare workers appears to be of significant benefit and merits further study under pandemic conditions. Comparing three "doses" of the course suggested that the medium course was optimal.

Testing the psychometric properties of the Ways of Coping Questionnaire (WCQ) in Turkish university students and community samples

Ways of Coping Questionnaire (WCQ) has been extensively used to assess coping styles in the clinical or non-clinical context. The present study investigates the psychometric properties of WCQ in Turkish culture and attempts to get its shorter version by using three separate and independent samples (two groups of university students and one community sample). The constructive study was conducted with a sample of full-time university students (N = 472) and it indicated that the most relevant factor structure was seven-factor model. The factors were planful problem-solving, seeking refuge in supernatural forces, keep to self, seeking social support, seeking refuge in fate, escape/avoidance and accepting responsibility. After that, confirmatory factor analysis was performed to test the adequacy of these factors with two different samples. Study 1 was conducted with a sample of university students (N = 485) and Study 2 was conducted with a sample of community (N = 416). Results demonstrated that seven-factor solution revealed better results in both samples in terms of goodness of fit indexes in confirmatory factor analysis. The results of reliability and validity analysis revealed that psychometric properties of WCQ were acceptable. In addition to getting shorter version of WCQ, the present study enhances cross-cultural information that increases awareness about the coping styles in a non-western culture.

The prevalence of childhood adversity among healthcare workers and its relationship to adult life events, distress and impairment

OBJECTIVE

We investigated the prevalence of childhood adversity among healthcare workers and if such experiences affect responses to adult life stress.

METHODS

A secondary analysis was conducted of a 2003 study of 176 hospital-based healthcare workers, which surveyed lifetime traumatic events, recent life events, psychological distress, coping, social support, and days off work due to stress or illness.

RESULTS

Sixty eight percent (95% CI 61.1-74.9) of healthcare workers had one or more experience of violence, abuse or neglect, 33% (95% CI 26.1-40.0) before the age of 13. Compared to healthcare workers who did not experience childhood adversity, those who did reported more recent life events (median 11 vs. 5 over the previous 6 months, p<.001) and greater psychological distress (median score 17 vs. 13, p<.001). The relationship between life events and psychological distress was not linear. Most healthcare workers without childhood adversity (73%) reported a low number of life events which were not associated with psychological distress. Most healthcare workers with childhood adversity (81%) reported a higher number of life events, for which the correlation between events and distress was moderately strong (Spearman's rho=.50, p<.001). Childhood adversity was also associated with more missed work days. Each of these outcomes was higher in 22 healthcare workers (13%) who had experienced more than one type of childhood adversity.

CONCLUSIONS

Childhood adversity is common among healthcare workers and is associated with a greater number of life events, more psychological distress and impairment.

The relationship between function, quality of life and coping in patients with low-grade gliomas

OBJECTIVES

The principal aim of the study was to describe function, quality of life and coping with illness-related problems in patients with low-grade gliomas (LGG), to evaluate the need of support. A second aim was to investigate how function, quality of life and coping were related.

MATERIALS AND METHODS

Thirty-nine patients with a diagnosis of LGG answered the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30) and the Ways of Coping Questionnaire (WCQ). The patients' level of function was assessed in accordance with the WHO performance status scale.

RESULTS AND DISCUSSION

Nearly all patients were capable of self-care, but less than half were able to carry out normal activities without restriction. Problems with fatigue, sleep disturbances and pain were most frequent. Most difficulties were reported in the domains, Role, Cognitive and Emotional functioning. Seventeen patients (45%) had scores indicating low overall quality of life. Ratings of overall quality of life and fatigue had the strongest relationship. The trend in the results suggested that mental problems have a stronger impact on quality of life than physical ones. Emotion-focused coping dominated. There was a significant relationship between coping by escape-avoidance and lower level of emotional functioning.

CONCLUSIONS

The results of this study indicate that a multidisciplinary team is needed for assessment and treatment of the different problems in patients with LGG. Furthermore, special attention should be paid to patients who use coping by escape-avoidance, as this is associated with emotional distress.