A longitudinal study on coping and emotional well-being in cardiac patients

Emotions and coping play a role in the prognosis of cardiac patients. This two-wave longitudinal study aims to analyze the ability of adaptive and maladaptive coping to predict the emotional well-being of cardiac patients after controlling for their functional physical capacity. Emotional well-being (positive and negative affect), coping strategies, and functional physical capacity were evaluated both at Time 1 (n = 253) and at Time 2 (n = 186), 8 weeks later. At Time 1, positive affect was positively predicted by adaptive coping and negatively predicted by maladaptive coping, while the opposite pattern was found when negative affect was considered. At Time 2, after controlling for sociodemographic variables and for negative affect and functional physical capacity at T1, negative affect was negatively predicted by adaptive coping and positively predicted by maladaptive coping. In addition, positive affect was only predicted by adaptive coping after controlling for functional physical capacity and positive affect at Time 1. Relationships between coping and emotional well-being remain after controlling for the functional physical capacity of cardiac patients, which has a big impact on their emotional state. Finally, it is suggested that specific modules to improve coping and emotional state of cardiac patients should be included in Cardiac Rehabilitation Programs.

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.

The influence of workplace stress and coping on depressive symptoms among registered nurses in Bangladesh

Background

Nurses report high levels of workplace stress, which has been linked to an increased risk for experiencing depressive symptoms. Nurses' workplace stress is also linked to increased absenteeism and decreased job satisfaction.

Objectives

The objectives of this study were to examine: (1) the incidence of depressive symptoms among hospital-based registered nurses in Bangladesh; (2) common sources of workplace stress and their relationships to individual characteristics and depressive symptom scores; and (3) the potential mediating roles of coping strategies in the relationship between workplace stress and depressive symptoms.

Methods

A cross-sectional study design involved three hundred and fifty-two registered nurses. Data were collected using a demographic questionnaire and three standardized tools measuring sources of nurses' workplace stress, coping strategies, and depressive symptoms.

Results

More than half of the participants scored ≥ 16 on the CES-D, which was associated with a major depression episode. Total NSS scores had a small but significant influence on scores on the depression scale. Coping strategies had no mediated effect on the relationship between workplace stress and scores on the depression scale. Low-reliability coefficients for subscales of two of the standardized tools highlight the challenge for researchers in developing countries to address contextual differences that may influence the meanings attached to individual items.

Conclusion

Findings suggest that the mental health of registered nurses in Bangladesh requires immediate attention in part by attending to workplace stressors. Further research should focus on a deeper understanding of Bangladeshi registered nurses' work experiences and the unique contribution that workplace stressors have on their physical and mental health.

How Days Between Tests Impacts Alternate Forms Reliability in Computerized Adaptive Tests

An essential question when computing test-retest and alternate forms reliability coefficients is how many days there should be between tests. This article uses data from reading and math computerized adaptive tests to explore how the number of days between tests impacts alternate forms reliability coefficients. Results suggest that the highest alternate forms reliability coefficients were obtained when the second test was administered at least 2 to 3 weeks after the first test. Even though reliability coefficients after this amount of time were often similar, results suggested a potential tradeoff in waiting longer to retest as student ability tended to grow with time. These findings indicate that if keeping student ability similar is a concern that the best time to retest is shortly after 3 weeks have passed since the first test. Additional analyses suggested that alternate forms reliability coefficients were lower when tests were shorter and that narrowing the first test ability distribution of examinees also impacted estimates. Results did not appear to be largely impacted by differences in first test average ability, student demographics, or whether the student took the test under standard or extended time. It is suggested that for math and reading tests, like the ones analyzed in this article, the optimal retest interval would be shortly after 3 weeks have passed since the first test.

Psychometric evaluation of the pregnancy-related anxiety scale: Acceptance of pregnancy, avoidance, and worry about self subscales

BACKGROUND

Increasingly pregnancy-related anxiety is acknowledged as a distinct anxiety type, characterised by specific fears/worries. The Pregnancy-related Anxiety Scale (PrAS) screens for this distinct anxiety and refinements to the scale have prompted further validity examination. This study aims to: replicate findings that distinguished pregnancy-related anxiety from general anxiety/depression using the PrAS; confirm the PrAS's factor structure, and examine the validity of the PrAS subscales: Acceptance of Pregnancy, Avoidance and Worry About Self.

METHODS

Pregnant women (N = 608) were recruited online and completed the PrAS, Pregnancy Acceptance Questionnaire, Ways of Coping Questionnaire, Cambridge Worry Scale, Parenting Sense of Competence Scale, State Trait Anxiety Inventory and the Edinburgh Depression Scale.

RESULTS

Multiple regression analysis confirmed general anxiety/depression contributed little to the PrAS's variance, supporting the scale's validity and distinctiveness of pregnancy-related anxiety. Structural equation modelling confirmed the PrAS's factor structure, and the three PrAS subscales generally correlated more highly with convergent measures than the discriminant measures.

LIMITATIONS

Limitations included the cross-sectional design of the study and the use of some convergent/discriminant measures that lacked validity evidence for prenatal use.

CONCLUSIONS

This study provides evidence of the distinctiveness of pregnancy-related anxiety from state/trait anxiety and depression and also adds to the psychometric properties of the PrAS. The PrAS is a useful screening scale that can be used for antenatal screening potentially reducing the risk of adverse outcomes associated with pregnancy-related anxiety. The PrAS is also a useful research tool providing a more comprehensive assessment of pregnancy-related anxiety.

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.

Outcomes of a Randomized Trial of a Cognitive Behavioral Enhancement to Address Maternal Distress in Home Visited Mothers

Objectives To assess the effectiveness of a 6-week, cognitive behavioral therapy (CBT) group-based enhancement to home visiting to address stress and prevent depression as compared with home visiting as usual in low income mothers of young children. Methods We conducted a randomized controlled trial with 95 low-income mothers of young children to assess the effectiveness of a 6-week, cognitive behavioral group-based enhancement to Healthy Families America and Parents as Teachers home visiting (HV/CBT = 49) to address stress and prevent depression as compared with home visiting as usual (HV = 46). Booster sessions for the HV/CBT group were offered at 3 and 6 months. Participants completed measures of coping, stress and depression at three points: baseline prior to randomization, post-intervention, and 6 months post-intervention. Parent child interaction was also measured at 6 months. Results Intent-to-treat analyses found improved coping and reduced stress and depression post-intervention. While impacts on these outcomes were attenuated at 6 months, positive impacts were observed for selected aspects of mothers’ interactions with their children. Maternal characteristics at baseline were associated with participation in the intervention and with post-intervention and 6-month outcomes. Mothers with lower levels of stress and those with fewer children were more likely to attend intervention sessions. Mothers with lower levels of stress had more favorable post intervention outcomes. Conclusions CBT group-based enhancement to home visiting improved maternal coping, reduced stress and depression immediately post intervention but not at 6 months, suggesting more work is needed to sustain positive gains in low-income mothers of young children.

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.

Obsessive-compulsive disorder in children and adolescents: parental understanding, accommodation, coping and distress

Parental accommodation of pediatric OCD is common and is associated with negative affect in parents. Qualitative accounts of caring for a child with OCD are limited and no studies have assessed differences between mothers and fathers in accommodation, coping and distress. The current study used a mixed methods approach to understand parental accommodation, negative affect and coping. Forty-one mothers and 29 fathers of 43 children with OCD were asked to write narratives about their understanding and management of OCD and to complete measures of accommodation, coping, and distress. Symptom accommodation was high with almost half of the parents watching the child complete rituals or waiting for the child on a daily basis. Analysis of parental narratives indicated a distressing struggle between engaging in and resisting accommodation in order to manage their own and their child's anger and distress. T-tests and correlation analysis indicated that accommodation did not differ significantly between mothers and fathers but was more strongly associated with negative affect in mothers. Analyses indicated that mothers reported using all types of coping strategy more often than fathers, particularly escape-avoidance, taking responsibility and using social support. Escape-avoidance coping was positively correlated with accommodation and negative affect in both mothers and fathers. Interventions that target parental constructions of OCD and their behavioural and emotional responses to it may assist in reducing the occurrence of accommodation, avoidant coping and parental distress.