Postoperative pain in children: Developmental and family influences on spontaneous coping strategies.

Examined children's and parents' reactions to postoperative pain, including stress appraisal and cognitive-behavioral coping processes from a developmental perspective. 30 younger children (aged 7–9 yrs) and 30 older children (aged 10–16 yrs) and their parents provided interview and psychometric data about pain and coping on the day following surgery. Observational data also was provided by nurses. All children described a variety of self-control strategies found to be helpful in managing postoperative pain. Older children were more likely to report using cognitive coping strategies, yet they reported lower overall self-efficacy. Coping strategy use, perceived self-efficacy, and frequency of catastrophizing thoughts were significantly predictive of children's pain, affective distress, and physical recovery. Parental anxiety was positively related to child anxiety, and inversely related to child self-efficacy and frequency of cognitive coping. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with a breast cancer diagnosis: A prospective study.

Employing the stress and coping theory of R. S. Lazarus and S. Folkman (1984), this study followed 117 women age 40+ regarding personality, cognitive appraisal, coping, and mood variables before breast biopsy, after diagnosis, and, for those who had cancer, after surgery. Upon biopsy, 36 received a cancer diagnosis, and 81 received a benign diagnosis. The 2 groups did not differ on appraisals, coping, or affect before diagnosis. With prebiopsy affect controlled, cancer patients reported more negative affect postbiopsy than did benign patients. Postsurgery, cancer patients expressed less vigor and more fatigue than benign patients, but the groups did not differ on other negative emotions. Prebiopsy, psychosocial predictors accounted for 54% and 29% of the variance in negative and positive emotion, respectively. Prebiopsy variables also predicted postbiopsy and postsurgery mood; cognitive coping was a particularly important predictor of high distress and low vigor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking screening and management in primary care practices

This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. Ratings of pain during the mammogram were collected using a 6-point pain/discomfort scale, a 100-mm Visual Analog Scale, the adjective checklist of the McGill Pain Questionnaire, and the Brief Pain Inventory. Up to 93% of the women reported the mammogram examination was painful. On average, women rated the mammography pain in the low to moderate range. Considerable variability in pain ratings was found, however, with some women reporting severe pain and others reporting little or no pain. Correlational analyses were conducted to examine how coping efficacy (CSQ ratings of ability to decrease pain and ability to control pain) and coping strategies (CSQ pain coping strategy subscales) related to variations in pain report. There was a pattern for ratings of ability to decrease pain to be related to lower ratings of current mammography pain. Women who rated their ability to decrease pain as high reported lower average levels of mammography pain, lower ratings on the mammography pain/discomfort scale, and were much more likely to report having had lower levels of pain during their last mammogram. These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.     

Distortion of Palmaz-Schatz stent geometry following side-branch balloon dilation through the stent in a rabbit model

In this prospective study, we have compared women undergoing laparoscopic cholecystectomy, laparoscopic gynaecological surgery and laparoscopic minor gynaecological procedures (diagnostic, tubal, ligation) (n = 10 in each group) to determine if lower abdominal laparoscopy results in less postoperative pulmonary dysfunction than upper abdominal laparoscopy. Pulmonary testing was performed before operation, and 3 and 6 h after operation, on the first and second days after surgery. After operation, a significant reduction in forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow rate occurred after laparoscopic cholecystectomy at each time. There were no significant changes after minor gynaecologic laparoscopy, whereas laparoscopic gynaecological surgery resulted in minor pulmonary dysfunction on the day of surgery only. We conclude that postoperative pulmonary function was less impaired after gynaecological laparoscopy than after laparoscopic cholecystectomy. This study suggests that the site of surgery is an important determinant of lung dysfunction after laparoscopy.     

Emotion regulation as a mediator of associations between mother–child attachment and peer relationships in middle childhood.

Although a link between attachment and peer relationships has been established, the mechanisms that account for this link have not been identified. The 1st goal of this study was to test emotion regulation as a mediator of this link in middle childhood. The 2nd goal was to examine how different aspects of emotion regulation relate to peer competence. Fifth graders completed self-report and semiprojective measures to index mother–child attachment, mothers reported on children's emotionality and coping strategies, and teachers reported on children's peer competence. Constructive coping was related to both attachment and peer competence, and mediated the association between attachment and peer competence, suggesting that emotion regulation is one of the mechanisms accounting for attachment-peer links. Constructive coping was more strongly associated with peer competence for children high on negative emotionality than for children low on negative emotionality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping as a mediator of emotion.

There is widespread conviction among health care professionals that coping affects emotion. Yet theory and research have traditionally emphasized the effects of emotion on coping. The present research addresses this imbalance by evaluating the extent to which coping mediated emotions during stressful encounters in two Caucasian, community-residing samples. Subjects' recently experienced stressful encounters, the ways they coped with the demands of those encounters, and the emotions they experienced during two stages of those encounters were assessed repeatedly. The extent to which eight forms of coping mediated each of four sets of emotions was evaluated with a series of hierarchical regression analyses (of residuals). Coping was associated with changes in all four sets of emotions, with some forms of coping associated with increases in positive emotions and other forms associated with increases in negative emotions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of extensive oral surgery and hemorrhage on coagulation and fibrinolysis

The changes in coagulation and fibrinolytic activity in 22 patients with oral cancer undergoing extensive surgical procedures were studied. The patients were divided into two groups: group I patients suffered blood loss of less than 2,000 mL and group II patients had blood loss of more than 2,000 mL. The platelet count decreased significantly during surgery, at the end of surgery and on the 1st postoperative day in both groups. Fibrinogen was decreased during and at the end of surgery in both groups, but increased significantly on the 3rd postoperative day and reached about two times the preoperative levels on the 7th postoperative day. Fibrin degradation products increased significantly after surgery and reached the maximum value on the 1st postoperative day in both groups. Plasmin inhibitor complex and plasminogen increased significantly on the 3rd and 7th postoperative days. There was no clear evidence regarding the influence of blood loss on coagulation and fibrinolytic factors except for platelets. It was concluded that coagulation and fibrinolysis are enhanced between the 3rd and 7th postoperative days.     

The Relations of Parental Expressivity and Support to Children's Coping With Daily Stress.

The relations of parents' emotional expressivity, mothers' support, and children's daily stress to children's constructive coping were examined in a sample of ninety-four 7- to 12-year-old children. For 2 weeks, children, together with their mothers, completed daily diaries of their stressful events. Mothers and fathers reported on their expression of positive, negative submissive, and negative dominant emotion. Although fathers' expressivity was not related to children's constructive coping, mothers' expression of negative emotion, particularly negative dominant emotion, was negatively related to children's constructive coping. Children's stress was negatively related to their constructive coping, and this relation was stronger for children exposed to low levels of parents' positive emotion and mothers' expression of negative submissive emotion. Children's constructive coping was positively related to mothers' supportive strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress appraisal in women with spinal cord injury: Supplementary findings through mixed methods.

A study was conducted to examine how women with spinal cord injury (SCI) perceive the stressors they encounter, and how cognitive appraisal is associated with coping and life satisfaction. Fifty women with SCI were interviewed regarding their experience with stress and coping. The interviews were then coded using a framework based on stress and coping theory (transactional model). The systematic application of quantitative methods to the coded interview data allowed for statistical analyses, which demonstrated that the context in which the women spoke about their experiences with various stressors was associated with coping strategies, time since injury, and life satisfaction. Although stress and coping are commonly seen as interacting constructs that influence quality of life outcomes, current findings suggest that appraisal of stressors in the context of loss (more common among women more recently injured) may have a direct impact on life satisfaction apart from any coping strategies put into effect. Interventions designed to facilitate coping with loss and enhance problem-solving skills, along with education about available resources, may foster a sense of empowerment after SCI and ultimately change how stressors are perceived and managed in order to dampen their negative impact on life satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Care of stroke patients by relatives--social support and coping strategies

OBJECTIVE: To assess the coping ability and the social support of relatives looking after patients who have had a stroke. Of special interest was to ascertain how coping behaviour and social support differed between short-term (caring period of 3-6 months) and long-term (caring period longer than 2 years) carers. Differences in social networking between relatives and a control group (no caring tasks) were also assessed. SUBJECTS AND METHODS: A questionnaire based on the well-established "Berne coping forms" and another on social support were filled in by 20 relatives (18 women, two men; mean age 50.6 years) after a short-term caring period of up to 6 months and 20 relatives after a caring period longer than 2 years (14 women, six men; mean age 64.9 years) and a control group (27 women, 10 men; mean age 57.8 years). RESULTS: Among the total group of relatives the coping strategies (listed by order of importance) were: "passive cooperation", "acceptance", and "lending a hand". The short- and long-term carers showed no significant differences in these strategies. However, there were significant deficits in social support between the relatives and the controls as to practical support (P < 0.05), social integration (P < 0.01), social support received (P < 0.01), social burden (P < 0.01) and the caring persons (P < 0.05). There was no difference regarding social support between the short- and long-term carers. CONCLUSIONS: The results confirm the importance of social support for relatives who look after stroke patients. Every form of psychosocial help should be given at the time the patient is discharged to home care. This would require day clinics and short-term places in nursing homes.     

The emerging field of emotion regulation: An integrative review.

The emerging field of emotion regulation studies how individuals influence which emotions they have, when they have them, and how they experience and express them. This review takes an evolutionary perspective and characterizes emotion in terms of response tendencies. Emotion regulation is defined and distinguished from coping, mood regulation, defense, and affect regulation. In the increasingly specialized discipline of psychology, the field of emotion regulation cuts across traditional boundaries and provides common ground. According to a process model of emotion regulation, emotion may be regulated at five points in the emotion generative process: (a) selection of the situation, (b) modification of the situation, (c) deployment of attention, (d) change of cognitions, and (e) modulation of responses. The field of emotion regulation promises new insights into age-old questions about how people manage their emotions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in coping styles and implications for depressed mood.

Based on a sample of young adults in Miami-Dade County, Florida, this paper examined the extent to which there were sex differences in 3 coping style types: problem focused, emotion focused, and avoidance focused (Endler & Parker, 1990). Further examined were the extent to which sex differences in coping styles could be explained by sex differences in chronic strain; the extent to which sex differences in depressed mood could be explained by sex differences in coping style; and whether the effects of different coping style types on depressed mood varied by sex. Results suggested somewhat complex relationships among sex, coping, chronic strain, and depression. No sex differences in the use of problem-focused coping were observed when statistical controls for socioeconomic status were applied; however, women more often used avoidance-focused techniques. Although female respondents more often used emotion-oriented strategies compared to male respondents, such use did not prove to be fundamentally harmful for women. In fact, the effects of using emotion-focused strategies, such as the expression of feelings, reduced depressed mood for women, but not for men. Implications for practice and policy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of antibiotic prophylaxis on patients undergoing total abdominal hysterectomy. II. Alterations of microbial flora

Preoperative cultures of the endocervix were taken on 93 women who subsequently underwent total abdominal hysterectomy and received a 5 day course of either prophylactic cephalosporins or placebo. Postoperative cultures of the vaginal apex were taken on 86 of these women 5 days after surgery, i.e. 1 day after the cessation of study medication. Comparisons of the preoperative and postoperative flora in both the active drug and placebo groups as well as comparisons between the postoperative flora of the drug group and that of the placebo group were made. Postoperative alterations of bacterial flora occurred whether or not the patient received prophylactic antibiotics.     

Depression history and coping with chronic pain: A daily process analysis.

This study examined how a previous episode of depression is related to daily pain and reactions to pain among individuals with fibromyalgia, a chronic pain syndrome. Seventy-one women with fibromyalgia (including 30 who were previously depressed) rated their pain and mood 3 times daily for 30 days. Each night, participants rated the extent to which they responded to pain by catastrophizing, how much control they had over that day's pain, their ways of coping with pain that day, and the effectiveness of their coping efforts. Multivariate multilevel regression models revealed that after controlling for neuroticism and current depressive symptoms, formerly depressed and never-depressed individuals differed in how they coped with increased pain and in how they appraised the efficacy of their coping efforts. Formerly depressed participants who also reported more current depressive symptoms showed a greater decline in pleasant mood on more painful days than did formerly depressed participants who were experiencing fewer current depressive symptoms. These findings illustrate how a history of depression can be captured in the dynamics of daily life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blue notes: Coping by music listening predicts neuroticism changes in adolescence.

It is important to understand distinctive developmental specificities of coping in adolescence and how these can relate to personality development. Adolescents can actively use music listening as a coping resource to maintain emotional stability and this is likely to influence their personality development. The aim of this study was to examine if interactions between 3 styles of coping by music listening (emotion oriented, problem oriented, and avoidance/disengagement oriented) could predict changes in adolescent neuroticism. This 2-wave longitudinal study followed 336 adolescent girls and boys over a 6-month period. In adolescents combining high neuroticism (baseline) and low avoidance-oriented coping, problem-oriented coping predicted lower neuroticism. In adolescents combining high neuroticism (baseline) with high avoidance-oriented coping, problem-oriented coping predicted higher neuroticism. In adolescent girls presenting high avoidance-oriented coping, emotion-oriented coping predicted higher neuroticism. Overall, avoidance/disengagement coping by music listening may represent a short-term risk/precipitating factor of increasing neuroticism in adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion regulation, coping, and psychological symptoms.

The question of whether emotion control and coping are separate independent concepts or overlapping constructs was explored with a sample of 422 university students using the Emotional Control Questionnaire and the Coping Inventory for Stressful Situations. In addition, the relationship between emotion control, coping, and psychological symptoms was explored using the Brief Symptom Inventory. Evidence was found for both independence and overlap between emotion control and coping. Emotion focused coping was a strong predictor of psychopathology. Rehearsal and benign control were associated with the set of psychological symptoms. Aggression control was related to hostility and interpersonal sensitivity. Coping-emotion control combinations and gender differences were also examined in terms of the psychological symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Silver linings and candles in the dark: Differences among positive coping strategies in predicting subjective well-being.

Ideal coping strategies enhance positive aspects of well-being as well as reduce distress. Although researchers have identified several "positive coping" strategies, it is unclear which are most strongly associated with well-being or whether all strategies are equally appropriate for all kinds of stressors. Participants completed well-being measures, and described the most negative event of the day and their emotion regulation strategies for the next 7 days. Dispositional use of positive emotion-inducing coping strategies was most strongly associated with positive aspects of well-being. Use of positive coping did not decrease with increased objective stress during the week, and use of particular strategies was partly predicted by the types of stressors that were reported. Implications for theories of positive coping are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catharsis: an investigation of its meaning and nature

Nurses commonly use catharsis and cathartic techniques as part of their clinical practice to enable clients and themselves to release emotion, to feel better and to facilitate coping. However, the literature does not provide clinical nursing evidence for its use. The main purpose of the investigation is to examine the beliefs about and understanding of catharsis which two groups of nurses hold: one group of nurse teachers and one group of nursing students. One hundred and forty-two respondents completed self-administered questionnaires asking about their understanding of and beliefs about catharsis as being beneficial, social, negative or psychotherapeutic in nature. The possible relationship of their answers to age, sex, philosophical orientation and qualifications was deemed to be important. The results suggest nurses understand that catharsis is related to emotion and has a psychotherapeutic purpose. However, there appear to be gaps in their understanding. Nurses also seem to believe that the release and expression of emotions is more acceptable for women than for men. There is also evidence that the more experienced nurses think differently from less experienced nurses, placing more emphasis on behaviour rather than emotion as they grow older. The problems associated with catharsis are discussed along with the implications for research and practice.     

Relationship between coping styles and perceptual asymmetry.

This study examined the relationship between coping styles and hemispheric asymmetry, on the basis of prior evidence of reduced posterior right hemisphere (RH) activity in depression, and the relationship between ruminative coping and depression. Two samples of undergraduates (N=170) completed chimeric faces tasks and 2 measures of coping styles, the self-report Responses Styles Questionnaire and a behavioral choice task. In women but not in men, self-reported rumination was associated with a decreased RH bias on the emotion-based chimeric task. In both genders, choosing to engage in an emotional task was associated with increased RH involvement. Results indicate that although brooding and dwelling on the negative may be associated with decreased RH involvement, openness to emotion may be associated with increased RH involvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping and Anxiety in Women Recalled for Additional Diagnostic Procedures Following an Abnormal Screening Mammogram.

This study characterized women's concurrent and subsequent levels of emotional distress associated with a questionable mammogram screening and relationships between women's coping and psychosocial adjustment. State anxiety was assessed in 98 women 1 day after receiving a mammogram screening (Time 1), after notification of a questionable screening result that necessitated additional testing (Time 2), and after being informed of their breast-cancer-free status (Time 3). Key findings include (a) women reported a significant increase in anxiety following notification of the need to return for follow-up testing; (b) significant and positive associations were found between anxiety and behavioral approach, behavioral avoidance, cognitive approach, and cognitive avoidance coping in cross-sectional analyses; and (c) cognitive avoidance coping was a strong predictor of final levels of state anxiety in women. Findings suggest that cognitive avoidance coping plays an important role in reducing anxiety in women recalled to clarify an initially ambiguous screening procedure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)