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  1. Home
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Browsing by Subject "coping"

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    Abuse-Related Post-Traumatic Stress, Coping, and Tobacco Use in Pregnancy
    (2011-07-01) Lopez, William D.; Konrath, Sara H.; Seng, Julia S.
    Objective: To examine the relationship between trauma history, posttraumatic stress disorder (PTSD), coping, and smoking in a diverse sample of pregnant women, some of whom are active smokers. Design: Secondary analysis from a prospective study on PTSD and pregnancy outcomes. Setting: Maternity clinics at three health systems in the midwestern United States. Participants: Women age 18 or older (1,547) interviewed at gestational age fewer than 28 weeks. Methods: Participants were classified at nonsmokers, quitters (stopped smoking during pregnancy), and pregnancy smokers. Demographic, trauma, and pregnancy factors, substance use, and use of tobacco to cope were compared across groups. Logistic regression assessed the influence of these factors on being a smoker versus a nonsmoker and a quitter versus a pregnancy smoker. Results: Smokers differed from nonsmokers on all demographic risk factors (being African American, being pregnant as a teen, having lower income and less education, and living in high-crime areas), had higher rates of current and lifetime PTSD, and were more likely to report abuse as their worst trauma. Pregnancy smokers had lower levels of education, were more likely to classify their worst trauma as “extremely troubling,” and were more likely to exhibit PTSD hyperarousal symptoms. In regression models, smoking “to cope with emotions and problems” doubled the odds of continuing to smoke while pregnant even after accounting for several relevant risk factors. Conclusion: Smoking behavior in pregnancy may be influenced by the need to cope with abuse-related PTSD symptoms. Clinicians should consider using trauma-informed interventions when working with tobacco-using pregnant women.
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    Clinical and Psychological Correlates of Two Domains of Hopelessness in Schizophrenia
    (2008-12) Lysaker, Paul H.; Salyers, Michelle P.; Tsai, Jack; Spurrier, Linda Yorkman; Davis, Louanne W.
    Hopelessness is a widely observed barrier to recovery from schizophrenia spectrum disorders. Yet little is known about how clinical, social, and psychological factors independently affect hope. Additionally, the relationships that exist between these factors and different kinds of hope are unclear. To explore both issues, we correlated two aspects of hope, expectations of the future and agency, with stigma, clinical symptoms, anxiety, and coping preferences in 143 persons with a schizophrenia spectrum disorder. Multiple regressions revealed that hope for the future was predicted by lesser alienation, lesser preference for ignoring stressors, and lesser emotional discomfort and negative symptoms, accounting for 43% of the variance. A greater sense of agency was linked to lesser endorsement of mental illness stereotypes, fewer negative symptoms, lesser social phobia, and lesser preference for ignoring stressors, accounting for 44% of the variance. Implications for research and interventions are discussed.
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    Cognitive Appraisals, Coping and Depressive Symptoms in Breast Cancer Patients
    (2012-12) Bigatti, Silvia M.; Steiner, Jennifer L; Miller, Kathy D.
    Depression in breast cancer patients and survivors is related to negative disease outcomes and worse quality of life. Factors that explain this depression can serve as targets of intervention. This study, guided by the Transactional Theory of Stress, examined the relationship between cognitive appraisals, coping strategies and depressive symptoms in a group of women with mostly advanced-stage breast cancer (N = 65), who scored mostly within the normal range for depressive symptoms. Path analysis was used to determine the relationships among variables, measured with the Cognitive Appraisals of Illness Scale, the Ways of Coping Questionnaire and the Center for Epidemiological Studies Depression Scale. The results of the path analysis showed that higher appraisals of harm/loss and greater use of escape–avoidance coping predicted higher depressive symptoms. These findings enhance the prediction of depression among breast cancer patients and suggest the need to examine cognitive appraisals when attempting to understand depressive symptoms.
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    Facilitators and Barriers to Illness Management and Recovery Implementation
    (Office of the Vice Chancellor for Research, 2013-04-05) White, Dominique A.; McGuire, Alan B.; Salyers, Michelle P.
    Illness Management and Recovery (IMR) is an evidence-based program designed to help people with severe mental illness better manage their illness and achieve personally meaningful goals. IMR has shown improved outcomes including better coping and reduced psychiatric symptoms. There have been some difficulties implementing IMR, even within programs that have received IMR training. The purpose of the current study was to examine the differences between facilitators and barriers for implementing IMR as perceived by providers of IMR and non-providers of IMR in order to identify potential targets for implementation strategies. A national online survey was conducted with VA Medical Centers (VAMCs), resulting in 151 responses representing 107 VAMCs nationwide. Survey respondents included local recovery coordinators (LRCs) and staff referred by the LRC for being knowledgeable regarding IMR. The current analyses focused on two open-ended questions pertaining to facilitators and barriers to implementation. The authors independently developed codes through an iterative process to categorize responses. We then established overall consensus on codes and applied those codes to each open-ended response. Chi-square tests were performed on each category to determine differences between provider and non-provider perceived facilitators and barriers. Differences in identified facilitators and barriers were discovered between the providers and non-providers respondents. Overall barriers and facilitators to implementation are described. Identifying facilitators and barriers that differ between providers and non-providers can provide insight into areas that may impact implementation. By understanding these differences we can provide carefully targeted interventions to increase implementation, for example, gaining support from individuals who do not directly provide IMR, could reinforce the experiences of direct service providers.
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    Is Cyberloafing More Complex than we Originally Thought? Cyberloafing as a Coping Response to Workplace Aggression Exposure
    (Elsevier, 2019) Andel, Stephanie A.; Kessler, Stacey R.; Pindek, Shani; Kleinman, Gary; Spector, Paul E.; Psychology, School of Science
    Employees spend approximately 2 h per day engaging in cyberloafing (i.e., using the internet at work for nonwork purposes) behaviors, costing organizations almost $85 billion dollars per year. As a result, cyberloafing is often considered a counterproductive type of withdrawal behavior. However, recent research suggests that cyberloafing may have some unexpected positive workplace outcomes. Therefore, we argue that the role of workplace cyberloafing is more complex than previously assumed and posit that cyberloafing may provide employees with a way to cope with workplace stress such as exposure to workplace aggression. To examine this proposition, we used a heterogeneous sample of 258 employees to test whether cyberloafing buffers the detrimental effects of workplace aggression exposure on two outcome variables: employees’ turnover intentions and job satisfaction. Overall, results supported the notion that employees use cyberloafing as a workplace coping mechanism, which runs counter to the majority of research that conceptualizes cyberloafing as a counterproductive workplace behavior. These findings suggest that managers may consider allowing some degree of cyberloafing so that employees can better cope with work stress. Moreover, managers should directly target stressful workplace conditions (e.g., aggression) that serve as the impetus for cyberloafing behaviors.
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    Social (societal) support
    (2014-01-21) Konrath, Sara H.
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    Social Comparisons, Social Support, and Self-Perceptions in Group Exercise for People With Parkinson's Disease
    (Taylor & Francis, 2017) Sheehy, Tammy L.; McDonough, Meghan H.; Zauber, S. Elizabeth; Department of Neurology, School of Medicine
    People with Parkinson's disease (PD) may experience declining function and limited interaction with others with PD. Group exercise provides opportunities for physical accomplishment and social support, as well as potential social challenges. We used interpretative phenomenological analysis to examine experiences of social comparison, social support, and self-perceptions of 20 people with PD in group exercise. Participants experienced (a) reticence evolving to inspiration, (b) anxiety relief through camaraderie and breaking taboos, and (c) maintaining athletic identity through participating and helping others. Practical implications include facilitating a safe space and support to alleviate anxiety and sustain participation.
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    Spiritual and Religious Coping of Medical Decision Makers for Hospitalized Older Adult Patients
    (Liebert, 2019-04) Maiko, Saneta M.; Ivy, Steven; Watson, Beth Newton; Montz, Kianna; Torke, Alexia M.; Medicine, School of Medicine
    Background: Critically ill adult patients who face medical decisions often delegate others to make important decisions. Those who are authorized to make such decisions are typically family members, friends, or legally authorized representatives, often referred to as surrogates. Making medical decisions on behalf of others produces emotional distress. Spirituality and/or religion provide significant assistance to cope with this distress. We designed this study to assess the role of surrogates' spirituality and religion (S/R) coping resources during and after making medical decisions on behalf of critically ill patients. The study's aim was to understand the role that S/R resources play in coping with the lived experiences and challenges of being a surrogate. Methods: Semistructured interviews were conducted with 46 surrogates by trained interviewers. These were audio-recorded and transcribed by research staff. Three investigators conducted a thematic analysis of the transcribed interviews. The codes from inter-rater findings were analyzed, and comparisons were made to ensure consistency. Results: The majority (67%) of surrogates endorsed belief in God and a personal practice of religion. Five themes emerged in this study. Personal prayer was demonstrated as the most important coping resource among surrogates who were religious. Trusting in God to be in charge or to provide guidance was also commonly expressed. Supportive relationships from family, friends, and coworkers emerged as a coping resource for all surrogates. Religious and nonreligious surrogates endorsed coping strategies such as painting, coloring, silent reflection, music, recreation, and reading. Some surrogates also shared personal experiences that were transformative as they cared for their ill patients. Conclusion: We conclude that surrogates use several S/R and other resources to cope with stress when making decisions for critically ill adult patients. The coping resources identified in this study may guide professional chaplains and other care providers to design a patient-based and outcome-oriented intervention to reduce surrogate stress, improve communication, increase patient and surrogate satisfaction, and increase surrogate integration in patient care. We recommend ensuring that surrogates have S/R resources actively engaged in making medical decisions. Chaplains should be involved before, during, and after medical decision making to assess and address surrogate stress. An interventional research-design project to assess the effect of spiritual care on surrogate coping before, during, and after medical decision making is also recommended.
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    Spiritual Experiences of Adults with Advanced Cancer in Outpatient Clinical Settings
    (Elsevier, 2019) Maiko, Saneta; Johns, Shelley A.; Helft, Paul R.; Slaven, James E.; Cottingham, Ann H.; Torke, Alexia M.; Medicine, School of Medicine
    Context Adults who have advanced cancer experience distress, and many use religion and spirituality to cope. Research on the spiritual experiences of advanced cancer patients will help guide the provision of high-quality spiritual care. Objectives To qualitatively describe advanced cancer patients’ spiritual experiences of illness. Methods We conducted semi-structured qualitative interviews at a single cancer center with 21 patients with stage IV solid malignancies who had a prognosis of less than 12 months, as estimated by each patient’s medical oncologist. Five investigators conducted a thematic analysis of the transcribed interviews. Results We found 31 patients who were eligible for enrollment, and 21 (67.7%) participated in interviews to thematic saturation. Using a thematic-analysis approach, five major themes emerged. Relationships with family and friends was the most important theme among all 21 patients irrespective of their religious or spiritual identity. Relationship with God and faith community was frequently identified by those who considered themselves spiritually religious. Cancer often led to reflection about the meaning of life and the nature of existential suffering Patients addressed the extent to which identity was changed or maintained through the cancer experience, and some expressed acceptance as a way of coping with illness. Conclusions Spiritual care for dying cancer patients should always include the exploration of relationships with family and friends, as well as God and faith community for some patients. Relationships with family, friends, and God can be a source of strength for many. Making meaning, addressing identity concerns, supporting acceptance as a resource for coping with illness, and acknowledging existential suffering will often arise for these patients.
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    Stress and Coping in Nurse Managers: A Qualitative Description
    (2009-03-18T18:50:58Z) Shirey, Maria R.; McDaniel, Anna M.; Doebbeling, Bradley N.; Ebright, Patricia R.; Fisher, Mary L.
    Objective: This study provided a qualitative description of stress and coping as perceived by today's nurse manager incumbents. Background: The healthcare work environment as a source of overwork and stress has been implicated in today's nursing shortage. Nurse managers play a pivotal role in creating work environments for staff nurses, but little is known about the nature of nurse manager work. Methods: This qualitative descriptive study determined what situations contribute to nurse manager stress, what coping strategies they utilize, what health outcomes they report, and what decision-making processes they follow to address stressful situations in their roles. A purposive sample of 21 nurse managers employed at three U.S. acute care hospitals participated in the study. Participants completed a demographic questionnaire and a 14-question interview incorporating components of the Critical Decision Method. Content analysis was completed and themes identified. Results: Difficult situations reported included feeling pressure to perform, interpersonal conflicts associated with organizational communication deficits, and issues of human resources and staffing. Nurse managers utilized a combination of emotion-focused and problem-focused coping strategies. When comparing novice nurse managers (3 years or less in role) with experienced nurse managers (greater than 3 years in role), the novices used predominantly emotion-focused coping strategies, a narrow repertoire of self-care strategies, and experienced negative psychological, physiological, and functional outcomes related to their coping efforts. Experienced nurse managers working as co-managers demonstrated mostly problem-focused coping strategies, a broad repertoire of self-care strategies, and reported no negative health outcomes. The study produced a cognitive model in the form of 10 questions that guide nurse manager decision-making related to stressful situations. The study generated four themes amenable to intervention. Conclusions: Performance expectations for nurse managers in acute care hospitals have increased since the 1990's making the role requirements unrealistic. Rising expectations increase nurse manager stress perceptions, making coping more difficult, and potentially harming nurse manager and work environment well-being. Findings from this study suggest that to address stress, coping, and complexity in the nurse manager role requires a combination of strategies that address individual factors as well as organizational culture, supportive structures, and systems that facilitate the role.
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