Coping predicts depression and disability in heart transplant candidates

Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7205, USA.
Journal of Psychosomatic Research (Impact Factor: 2.74). 11/2005; 59(4):215-22. DOI: 10.1016/j.jpsychores.2005.06.055
Source: PubMed


The aim of this study was to describe the coping strategies used by cardiac patients who are pursuing heart transplant and to determine which coping strategies are related to depression and self-reported disability.
This is a cross-sectional design with 50 cardiac patients (74% male) who were inpatients being evaluated for heart transplant at a large medical center. Coping styles were measured using the COPE Inventory (Carver CS, Scheier MF, Weintraub, JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989;56:267-83). Depression was assessed with the Structured Interview Guide for the Hamilton Depression Rating Scale (HAM-SIGH-D; Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56-62), and disability was assessed using the Sickness Impact Profile (SIP; Bergner M, Bobbitt R, Carter W, Gilson B. The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981;19:787-805).
Patients reported using a variety of adaptive coping strategies, but depression and disability were only significantly correlated with maladaptive coping strategies. Multiple regressions demonstrated that denial had the strongest association with depression, and focusing on and venting emotions had the strongest association with disability.
Maladaptive coping styles, such as denial and focusing and venting of emotions, can serve as markers of emotional distress and disability that may identify patients who may benefit from psychologic and psychiatric interventions.

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    • "Denial was correlated with depression and suicidal ideation but, contrary to our hypothesis, was not a predictor of depression or suicidal ideation. The use of denial as a coping strategy has been associated with depression (Burker et al., 2005; Kortte et al., 2003; Panayiotou & Papageorgious, 2007) and suicidal ideation (Apter et al., 1997). However, only Apter and colleagues focused on adolescents and it is possible that the use of denial as a coping strategy may have different outcomes for adolescents and adults. "
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    ABSTRACT: The coping strategies used by adolescents to deal with stress may have implications for the development of depression and suicidal ideation. This study examined coping categories and specific coping behaviors used by adolescents to assess the relation of coping to depression and suicidal ideation. In hierarchical regression models, the specific coping behaviors of behavioral disengagement and self-blame were predictive of higher levels of depression; depression and using emotional support were predictive of suicidal ideation. Results suggest that specific behaviors within the broad coping categories of emotion-focused coping (e.g., self-blame) and avoidant coping (e.g., behavioral disengagement) account for these categories' associations with depression and suicidal ideation. Specific problem-focused coping strategies did not independently predict lower levels of depression or suicidal ideation. It may be beneficial for interventions to focus on eliminating maladaptive coping behaviors in addition to introducing or enhancing positive coping behaviors.
    Journal of Adolescence 11/2010; 34(5):1077-85. DOI:10.1016/j.adolescence.2010.10.004 · 2.05 Impact Factor
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    • "ansplantationer ur ett omvårdnadsperspektiv har inte genomförts i lika stor utsträckning ( Cupples , m . fl . , 2006 ) . Ur ett omvårdnadsperspektiv har forskning fokuserats på livskvalitet ( Fusar - Poli m . fl . , 2005 ) , depression ( Burker , Evon , Marroquin Losielle , Finkel & Mill , 2005 ; Fusar - Poli m . fl . , 2005 ) , copingstrategier ( Burker m . fl . , 2005 ) och postoperativ träning hos patienter som genomgår en hjärttransplantation ( Braith & Edwards , 2003 ) ."

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    • "This finding supports the belief that denial is one of the passive coping strategies, while acceptance, instrumental support and emotional support are active coping strategies. Denial is used in 'an attempt to reject the reality of the stressful event' [41]. However, instrumental or emotional support consists of 'seeking assistance, information, or advice' to solve a stressful issue on the basis of appropriately assessing reality. "
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    ABSTRACT: This study provided essential information, about Turkish patients with type I and type II diabetes, concerning: levels of anxiety, coping strategies used, and relationships that exist among anxiety, coping strategies, sociodemographic and medical characteristics. A sample comprising 161 Turkish adults with both types of diabetes participated in the study. The trait anxiety scale, the brief COPE, sociodemographic and medical questionnaire were administered to patients with diabetes. The mean age was 49.01 (SD = 9.74), with a range from 20 to 60 years. The majority of the participants were female (60.9%) and type II diabetes (75.8%). 79% of the participants experienced anxiety. A clear majority of the participants reported to integrate their diabetes. Acceptance, religion, planning, positive reframing, instrumental support, emotional support, self-distraction and venting were the most frequently used coping strategies. The most frequently used problem-focused and the emotion-focused coping strategies were found to be similar in both type I and type II diabetes. However, participants with type II diabetes had relatively higher scores on the problem-focused strategies than those with type I. Participants with type I diabetes used humour, venting and self-blame more than those with type II diabetes. Other findings indicated that only a small minority responded to diabetes-related problems by denial, behavioural disengagement and substance use. Significant correlations were found among anxiety, coping strategies and sociodemographic characteristics of the participants. Moreover, Self-blame was found to be correlated significantly with both the problem-focused and emotion-focused coping strategies. Self-blame was also significantly correlated with both instrumental support and emotional support indicated that higher self-blame caused more frequent use of instrumental and emotional support by patients with diabetes. The findings of this study indicate that care for patients with diabetes should address their physical, psychological, social and economic wellbeing and the findings point to the importance of taking individual coping strategies into account when evaluating the impact of diabetes on psychosocial wellbeing. Because of the mean of anxiety were not in normal range, for this study, health professionals need to pay attention to patient's psychological state. This is especially true for patients who are likely to use self-blame and behavioural disengagement as a coping strategy. Through psychosocial interventions, professionals need to assist patients in establishing positive self evaluations. Delineation of coping strategies might be useful for identifying patients in need of particular counselling and support.
    Health and Quality of Life Outcomes 11/2008; 6(1):79. DOI:10.1186/1477-7525-6-79 · 2.12 Impact Factor
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