Stress, cognitive appraisal, coping, and event free survival in patients with heart failure

Peer Teasing and Restrained Eating among Chinese College Students: The Chain Mediating Role of Negative Coping Styles and Negative Physical Self

This study aimed to determine whether negative coping styles and negative physical self sequentially mediate the relationship between peer teasing and restrained eating among Chinese university students. In total, 1127 participants (66.9% women, average age = 18.43 years; age range, 14-26 years) completed the Perception of Teasing Scale, Coping Style Questionnaire, Negative Physical Self Scale, and the Chinese version of the Restraint Scale. The mediational analysis showed that, after controlling for age, sex, and body mass index (BMI), peer teasing was related to restrained eating behaviors through (a) the mediating effect of negative coping styles, (b) the mediating effect of negative physical self, and (c) the chain-mediating effect of negative coping styles and negative physical self. This study showed for the first time that negative coping styles and negative physical self may chain mediate the association between peer teasing and restrained eating. It also provides suggestions for clinical practices as to strategies for controlling restrained eating.

Does covid-19 pandemic tell us something about time and space to meet our being, belonging and becoming needs?

BACKGROUND

People's perceptions of events like a pandemic are shaped by individual experiences within their socio-cultural context. Attributing negative or positive meanings to an experience may influence the sense of Being, Belonging and Becoming.

AIM AND OBJECTIVES

To investigate the impact of the isolation/social distancing measures on people's sense of Being, Belonging, Becoming and overall sense of Occupational Wholeness compared to the time before the Covid-19 Pandemic as it is perceived by an Iranian population.

METHODS

The Model of Occupational Wholeness used to inform the theoretical basis of this study and development of the survey questions. An internet-based survey using a convenient and snowball sampling method was conducted. A self-administered questionnaire was published using a software named Porsline. A sample of 1624 members of the general population in Iran (67% response rate) completed the questionnaire within the first four weeks of the isolation/social distancing period starting on 18 March 2020. The Data was analysed by the SPSS 22.

RESULTS

The participants showed a more positive perceived level of Being and Belonging as well as an overall sense of Occupational Wholeness, and no difference in the perceived sense of Becoming during the isolation/social distancing period compared to the time before the Covid 19 pandemic.

CONCLUSIONS

The findings show that the isolation/social distancing measures were perceived by participants as an opportunity to meet some of their Being, and Belonging needs that contribute to an overall sense of OccupationalWholeness.This highlights the role that Occupational science and Occupational therapy may have in helping people in situations when they need to rethink and replan for what they Do and the way they attribute meaning to their experiences.

Estimating the causal effects of work-related and non-work-related stressors on perceived stress level: A fixed effects approach using population-based panel data

OBJECTIVES

Prolonged or excessive stress can have a negative impact on health and well-being, and stress therefore constitutes a major public health issue. A central question is what are the main sources of stress in contemporary societies? This study examines the effects of work-related and non-work-related stressors and perceived social support on perceived stress within a causal framework.

METHODS

Panel data were drawn from two waves (2013 and 2017) of the population-based health survey "How are you?" conducted in the Central Denmark Region. The analytical sample comprised 9,194 subjects who had responded to both surveys. Work-related and non-work-related stressors included major life events, chronic stressors, daily hassles and lack of social support. Perceived stress was measured with the 10-item Perceived Stress Scale (PSS). Data were analysed using fixed effects regression in a fully balanced design.

RESULTS

The largest effects on PSS were seen in own disease, work situation and lack of social support. Other stressors affecting the perceived stress level were financial circumstances, relationship with partner, relationship with family and friends, and disease among close relatives. Most variables had a symmetrical effect on PSS.

CONCLUSIONS

The results point to the need for comprehensive policies to promote mental health that span life domains and include both the individual and the group as well as organizational and societal levels. The study indicates that there are multiple potential entry points for stress prevention and stress management. However, it also shows that disease, work situation and social support weigh heavily in the overall picture. This points to the healthcare system and workplace as key institutional venues for action.

Coping styles as predictors for quality of life and prognosis in patients at risk for or with a diagnosis of heart failure: Results from the observational DIAST-CHF study

OBJECTIVE

Patients with heart failure often experience impaired health-related quality of life (HRQOL) and have an increased risk of cardiovascular and cerebrovascular events. The aim of this study was to investigate the predictive role of different coping styles on outcome.

METHODS

This longitudinal study included 1536 participants who either had cardiovascular risk factors or were diagnosed with heart failure. Follow-ups took place one, two, five and ten years after recruitment. Coping and HRQOL were investigated using self-assessment questionnaires (Freiburg Questionnaire for Coping with Illness, Short Form-36 Health Survey). Somatic outcome was quantified by incidence of major adverse cardiac and cerebrovascular events (MACCE) and 6-min-walking-distance.

RESULTS

Pearson correlation and multiple linear regression analysis showed significant associations between the coping styles used at the first three time points and HRQOL after five years. After adjusting for baseline HRQOL, minimization and wishful thinking predicted worse mental HRQOL (β = -0.106; p = 0.006), while depressive coping predicted worse mental (β = -0.197; p < 0.001) and physical HRQOL (β = -0.085; p = 0.03; n = 613). Active problem-oriented coping could not significantly predict HRQOL. Only minimization and wishful thinking was significantly associated with an increased 10-year-risk for MACCE (hazard ratio = 1.06; 95% confidence interval: 1.01-1.11; p = 0.02; n = 1444) and reduction in 6-min-walking-distance at 5 years (β = -0.119; p = 0.004; n = 817) in adjusted analyses.

CONCLUSIONS

Depressive coping and minimization and wishful thinking were associated with worse quality of life in patients at risk for or with diagnosed heart failure. Minimization and wishful thinking also predicted worse somatic outcome. Therefore, patients using those coping styles might benefit from early psychosocial interventions.

Cognitive Appraisal, Dispositional Coping, and Posttraumatic Growth among Patient-Caregiver Dyads Undergoing Hemodialysis

The present study aims to investigate the mediating effect of dispositional coping on the relationship between cognitive appraisal (which includes areas of threat, challenge, harm/loss, and benign/irrelevant appraisals) and posttraumatic growth (PTG) among patient-caregiver dyads undergoing hemodialysis. In total, 237 dyads of patients undergoing hemodialysis and their family caregivers were recruited from a tertiary hospital in Tianjin, China. Dyadic data were analyzed using the Actor-Partner Interdependence Mediation Model (APIMeM). The final APIMeM model examining dyadic effects of challenge appraisal and dispositional coping on PTG demonstrated an excellent model fit. The challenge appraisal of family caregivers was directly associated with the PTG of patients undergoing hemodialysis. Dispositional coping mediated the pathways between challenge appraisal and PTG for both patients undergoing hemodialysis and family caregivers. By exploring the cognitive appraisal and dispositional coping of patient-caregiver dyads undergoing hemodialysis may help both partners foster PTG.

Health Risk Factors among Doctors, Psychologists and Nurses of Pakistan during COVID-19 Pandemic

The present study aimed to find out differences in health risk factors of COVID-19 among doctors, nurses and psychologists by determining the relationship of cognitive appraisal, coping styles, stress and fear among health professionals. Cross-sectional research design was used. Sample comprised of 3 groups; doctors, nurses and psychologists (n = 145 in each group) working in tertiary care hospitals. Stress appraisal measure, Brief COPE inventory, Perceived stress scale and Fear contracting COVID-19 questionnaire were used to assess cognitive appraisal, coping, stress and fear respectively. Results showed that nurses had high uncontrollable, stressfulness and primary appraisal, used more avoidant emotional and problem focused coping, were more stressed and fearful as compared to doctors and psychologists. Psychologists had a high appraisal of control-self and control-others as compared to doctors and nurses and were more fearful than doctors. Doctors and psychologists used more coping of humor as compared to nurses. Moreover, primary appraisal and avoidant emotional coping positively predicted stress whereas control-self appraisal negatively predicted stress among health professionals. Uncontrollable and stressfulness appraisal positively correlated with fear. This study will direct the administrative authorities to take effective measures to improve psychological wellbeing and to deal with fear and stress of health professionals.

OUP accepted manuscript

AIMS

To identify and provide clarity on factors that influence coping and the type of coping strategies used by patients with heart failure (HF) to improve health-related quality of life (HRQoL).

METHODS AND RESULTS

The Arksey and O'Malley template framed this scoping review guided by the stress and coping model. Five databases were explored: PubMed, Web of Science, Cochrane, CINAHL, and PsycINFO. Keywords included HF, quality of life, coping, and influencing factors. Eligibility criteria involved patients with HF, reported on coping strategies and HRQoL, and published in English. Thirty-five studies were included (4 randomized controlled trials, 27 cross-sectional, and 4 qualitative/mixed methods). Active emotional coping (e.g. acceptance) and problem-focused (e.g. seeking social support) coping strategies were linked to better HRQoL, while avoidant emotional coping (e.g. denial) was linked to worse HRQoL. In the presence of the stressor of HF severity, key factors that influenced the types of the coping strategy included sex, age, social support, income, education, spiritual beliefs, and illness duration. However, the evidence on the effectiveness of the type of coping on HRQoL remains inadequate due to the majority of studies being cross-sectional.

CONCLUSION

Problem-focused and active emotional coping strategies are associated with improved HRQoL. However, their effect is inconclusive due to the lack of experimental studies. Additional predictive studies will enhance the understanding of coping among HF patients.

Cognitive appraisal, Coping, Stress and Fear Contracting Covid-19 in Working People in Pakistan

The present study aimed to examine the relationship and prediction of cognitive appraisal and coping with Stress and Fear contracting COVID-19 among the working population of Pakistan. Cross-sectional research design was employed. The data was collected from 980 participants of almost 39 different professions using the purposive sampling technique. Stress Appraisal Measure (Peacock et al., in Stress Med 6:227-236, 1990, http://www.drpaulwong.com/wp-content/uploads/2018/03/Stress-Appraisal-Measure-SAM-Peacock-Wong-1990-Paper.pdf). Brief COPE Inventory (Caver, in Int J Behav Med 4:92-100, 1997), and Perceived Stress Scale (Cohen et al., in J Health Soc Behav 24:385-396, 1983) were used to measure cognitive appraisal, coping, and stress, respectively. Fear was measured by using Fear contracting COVID-19 questionnaire (Ali et al., in J Pakistan Soc Int Med 2(2):140-144, 2021). Age, education, and previously attended stress management training were significantly positively correlated with stress and fear. Females were more stressed and fearful than males. Average time spent on social media was significantly positively correlated with stress. Participants, who were employed, had family members of the older age group above 50 years and had family members with the history of biological diseases were more fearful. Results of hierarchical multiple regression analyses showed that threat, centrality, stressfulness appraisal, and avoidant emotional coping significantly positively predicted stress, whereas control-self appraisal and active emotional coping significantly negatively predicted stress. Moreover, threat, challenge, centrality, stressfulness appraisal, and problem-focused coping significantly positively predicted fear contracting COVID-19, whereas control-self appraisal and active emotional coping significantly negatively predicted fear contracting COVID-19 after controlling for covariates. This study will address the administrative authorities and government institutions to provide first-aid mental health services for emergencies, epidemics, or pandemics in the future.

Impact of COVID-19 on Heart Failure Self-Care: A Qualitative Study

BACKGROUND

Difficulties in coping with and self-managing heart failure (HF) are well known. The COVID-19 pandemic may further complicate self-care practices associated with HF.

OBJECTIVE

The aim of this study was to understand COVID-19's impact on HF self-care, as well as related coping adaptations that may blunt the impact of COVID-19 on HF health outcomes.

METHODS

A qualitative study using phone interviews, guided by the framework of vulnerability analysis for sustainability, was used to explore HF self-care among older adults in central Texas during the late spring of 2020. Qualitative data were analyzed using directed content analysis.

RESULTS

Seventeen older adults with HF participated (mean [SD] age, 68 [9.1] years; 62% female, 68% White, 40% below poverty line, 35% from rural areas). Overall, the COVID-19 pandemic had an adverse impact on the HF self-care behavior of physical activity. Themes of social isolation, financial concerns, and disruptions in access to medications and food indicated exposure, and rural residence and source of income increased sensitivity, whereas adaptations by healthcare system, health-promoting activities, socializing via technology, and spiritual connections increased resilience to the COVID-19 pandemic.

CONCLUSIONS

The study's findings have implications for identifying vulnerabilities in sustaining HF self-care by older adults and empowering older adults with coping strategies to improve overall satisfaction with care and quality of life.

Personal Tools and Psychosocial Resources of Resilient Gender-Based Violence Women

Gender-based violence is considered a serious social and public health problem. Overcoming this situation implies a process that results in the favorable biopsychosocial rehabilitation of the resilience of women. The objective of this study was to analyze the tools, resources and personal and psychosocial mechanisms used by women survivors of gender-based violence. The design was an interpretative phenomenology. It was carried out with 22 women who have overcome gender-based violence. Data were collected through personal interviews and narration. The results were grouped into four themes: “Process of violence”, “Social resources for coping and overcoming GBV”, “Personal tools for coping and overcoming GBV” and “Feelings identified, from the abuse stage to the survival stage”. Several studies concluded that overcoming abuse is influenced by the women’s social network, and it can be the action of these people determining their survival to gender violence. Despite the recognized usefulness of these available resources, it would be desirable to strengthen them in order to be able to drive more women toward survival, assuming a strengthening of coping and overcoming, without forgetting the importance of other support mechanisms, such as their family and group therapies.

The Influence of Social Support and Ability Perception on Coping Strategies for Competitive Stress in Soccer Players: The Mediating Role of Cognitive Assessment

Objectives: To explore the effect of social support and ability perception on stress coping strategies for competitive stress, and to reveal the mediating effects of primary and secondary evaluation, so as to further improve the theoretical model of stress coping in soccer players.

Methods: A total of 331 male athletes from 22 teams in the Chengdu Middle School Campus Football League were taken as survey samples, and surveys were conducted on their stress experience, social support, ability perception, cognitive assessment, and coping strategies for competition stress. SPSS 21.0 and AMOS 21.0 statistical analysis software were used. Descriptive statistics, correlation analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were used to process the obtained data.

Results: (1) Positive primary assessment acted as a full mediator in the relationship between social support and secondary assessments, and negative primary assessment acted as a partial mediator in the relationship between competence perception and secondary assessments; (2) Secondary assessment played a partial mediating role between positive primary assessment and positive coping strategies, and a full mediating role between negative primary assessment and positive coping strategies; (3) Secondary assessments played the mediator neither between social support and a coping strategy for stress nor competence perception and a coping strategy for stress; (4) Positive primary assessment, positive negative assessment, and secondary assessment all had significant positive benefits for positive coping. Still, the impact of positive primary assessment on positive coping was significantly better than negative primary assessment and secondary assessment.

Conclusion: The coping strategy for the competitive stress model proposed by this study has a very good fit for the causal model. It can be used to explain the observed data from soccer players in middle schools. The primary and secondary assessments play different roles in the model. The combination of problem focuses and emotional focus on the positive stress coping strategy is suitable in the field of competitive sports. Still, the relevant research results need to be further explored and verified in the future.

Transitional Shock of Multi-Nationality Newly Graduate Nurses in Kuwait

Introduction

The transitional period of newly graduate nurses became more stressful, different coping mechanisms are essential. Therefore, effective coping with transition-related stress and anxiety is important for the life and professional of those nurses.

Objectives

To examine the transitional shock through assessing the occupational stress and coping mechanism of multi-nationality newly graduate nurses in Kuwait.

Methods

A descriptive correlational design was used to identify the occupational stress of the newly graduate nurses (NGNs) and their coping mechanisms during the transitional period to their professional life. All the NGNs were recruited. The total number of participants was 152 nurses.

Results

Highly significant correlations on almost all stress domains with p-values P < 0.01. We found that "Death and dying" was ranked as the highest stressor with a mean score of 6.20, followed by "uncertainty concerning treatment" with a mean score of 5.59, and in the "Inadequate preparation" was the least stressor with a mean score of 1.64.

Conclusion

"Religious coping" was the highest-ranked coping mechanism. In conclusion, NGNs have to adjust quickly to the new practical atmosphere encountered in the health care settings by using the proper coping mechanisms techniques.

The Relationship Between Uncertainty in Illness and Quality of Life in Patients With Heart Failure: Multiple Mediating Effects of Perceived Stress and Coping Strategies

BACKGROUND

Previous investigators have demonstrated that uncertainty in illness is associated with quality of life (QoL) in patients with chronic illness. However, little is known about the mechanism underlying the relationship in patients with heart failure.

OBJECTIVE

The aim of this study was to examine the multiple mediating effects of perceived stress and coping strategies on the relationship between uncertainty in illness and QoL in patients with heart failure.

METHODS

We conducted a cross-sectional study in 302 patients with heart failure recruited at a general hospital in China from October 2016 to September 2017. Uncertainty in illness, perceived stress, coping strategies, and QoL were assessed using self-reported questionnaires. The multiple mediation model was tested using the PROCESS macro for SPSS.

RESULTS

Of the 302 patients, 51.7% had poor physical QoL and 45.7% had poor mental QoL (physical component summary or mental component summary score of <50 points). Uncertainty in illness had a significantly negative indirect effect on mental QoL through perceived stress and acceptance-resignation (indirect effect, -0.02; 95% confidence interval, -0.04 to -0.01). Uncertainty in illness also had a significantly negative indirect effect on mental QoL via perceived stress only (indirect effect, -0.18; 95% confidence interval, -0.26 to -0.09).

CONCLUSIONS

Poor QoL is prevalent in patients with heart failure. Perceived stress and acceptance-resignation are important mediating factors between uncertainty in illness and mental QoL in patients with heart failure. Interventions aimed at reducing perceived stress and acceptance-resignation coping may be beneficial for improving mental QoL in patients with heart failure.

Effects of Depression on Heart Failure Self-Care

BACKGROUND

Depression has been identified as a barrier to effective heart failure self-care, but recent studies suggest that the relationship between depression and self-care is more complex than was previously believed. This study was designed to clarify the relationship between depression and self-care in hospitalized patients with HF.

METHODS AND RESULTS

During hospitalization with a confirmed clinical diagnosis of HF, 400 patients completed a structured interview to diagnose Diagnostic and Statistical Manual, 5th edition (DSM-5) depressive disorders, the Patient Health Questionnaire (PHQ-9) depression questionnaire, the Self-Care of Heart Failure Index (SCHFI), and several psychosocial questionnaires. Multivariable models were fitted to each SCHFI scale; separate models were run with DSM-5 disorders and PHQ-9 depression scores. Higher PHQ-9 depression scores were independently associated with lower (worse) scores on the SCHFI Maintenance (P < .05), Management (P < .01), and Confidence (P < .01) scales. No independent associations with DSM-5 depressive disorders were detected. Measures of perceived stress, anxiety, and low perceived social support were also significantly associated with poor HF self-care.

CONCLUSIONS

Patients with a combination of psychosocial problems, including symptoms of depression, stress, anxiety, and inadequate social support, may be more likely than other patients to display difficulties with HF self-care that can increase their risk for hospitalization. Research is needed on "broad-spectrum" psychosocial interventions for patients with HF self-care deficits.

Perceived Stress, Subjective, and Objective Symptoms of Disturbed Sleep in Men and Women with Stable Heart Failure

Objective/Background: Sleep disturbance is prevalent among patients with heart failure (HF) and is associated with increased morbidity and mortality. Stress also affects health and quality of life among patients with cardiovascular disease and likely plays a prominent role in HF. However, little is known about the associations between stress and sleep among HF patients.Participants: One hundred fifty-three stable New York Heart Association (NYHA) Classification I-IV HF patients with at least low symptoms of insomnia (M_age:63.0 ± 12.8, 42% Women).Methods: We examined baseline stress, sleep disturbance, and sleep-related characteristics from a randomized controlled trial of cognitive behavioral therapy for insomnia, including the Perceived Stress Scale, Insomnia Severity Index, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Sleep Disturbance Questionnaire, Dysfunctional Beliefs about Sleep Scale, PROMIS Cognitive Ability, SF-36 Mental Health, and wrist actigraphy. We used Pearson correlations and general linear models to assess stress-sleep associations, including the potential moderating effects of sex and symptom severity (NYHA).Results: There were moderate-to-large correlations between stress and self-reported sleep disturbance, dysfunctional beliefs about sleep, cognitive ability, and mental health (p's < 0.01). High stress was associated with more objectively-measured (i.e., actigraph-assessed) awakenings and sleep fragmentation among women than men (β = - 0.04, p < 0.01; β = - 0.71, p = 0.04). Relationships between stress and objectively-measured sleep did not vary by symptom severity.Conclusions: Perceived stress is related to sleep disturbance among HF patients, and effects may be sex-dependent. Subsequent research should determine the temporal links between sleep and stress, and optimal opportunities for intervention among HF patients.

Impact of type D personality on major adverse cardiac events in patients undergoing percutaneous coronary intervention: The mediating role of cognitive appraisal and coping style

OBJECTIVE

Individuals with type D personality are characterized by maladaptive cognitive appraisal and coping styles, but it remains unclear whether cognitive appraisal and coping style mediate the interaction between type D personality and major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). This gap was investigated in this study.

METHODS

A prospective study was conducted on a cohort of 392 individuals after undergoing PCI. All participants completed questionnaires meant to collect information about type D personality, cognitive appraisal, coping styles and demographic characteristics. They were then prospectively followed for up to 1 year for occurrence of MACE after PCI. Path analyses were performed to assess mediating effects of cognitive appraisal and coping styles.

RESULTS

The path analysis revealed that type D personality and negative affectivity (NA) had a direct positive effect on MACE (odds ratio [OR] = 1.056, 95% confidence interval [CI] = 1.023, 1.089，p = .031; OR = 1.118, 95% CI = 1.031, 1.205, p = .001), but indirect effects on MACE through negative appraisal, positive appraisal and acceptance-resignation coping (P < .001). MACE was not significantly associated with social inhibition (SI), the interaction of NA and SI (both p > .05).

CONCLUSIONS

This study revealed that type D personality and NA dimension increased the likelihood of developing MACE after PCI. Cognitive appraisal and coping styles mediated the association between type D personality and MACE. These findings may provide factors that lead to poor prognosis of patients with type D personality undergoing in PCI.

The Role of Cognitive Appraisal in Quality of Life Over Time in Patients With Cancer

OBJECTIVES

To better understand how personal factors, contextual factors, and cognitive appraisals predict quality of life.

SAMPLE & SETTING

81 patients with a new diagnosis of cancer were recruited from two oncologists' offices in the midwestern United States.

METHODS & VARIABLES

A longitudinal design was used to collect data at three time points.

RESULTS

Individuals identified a variety of primary appraisals at the same time and more consistently identified their cancer as a challenge rather than a harm/loss or a threat. The greatest variation in appraisals and quality of life occurred about six months after diagnosis. Hierarchical regression analyses demonstrated that age and primary and secondary appraisals explained a significant amount of variance in quality of life at all three time points.

IMPLICATIONS FOR NURSING

Interventions to improve quality of life for individuals newly diagnosed with cancer are needed and may be more helpful if they target cognitive appraisals. Nurses should assess what matters to the individual; it is important to evaluate how each person appraises a cancer diagnosis so providers can support coping and adjustment from diagnosis through individual treatment trajectories.

Cognitive Reappraisal and the Association Between Perceived Stress and Anxiety Symptoms in COVID-19 Isolated People

The purpose of this study is to examine how the emotion regulation strategy, cognitive reappraisal, affects the association between perceived stress and anxiety symptoms in COVID-19 isolated people. Data for this cross-sectional study come from a community-based online survey of COVID-19 isolated people (N = 328), who are not infected with the 2019-nCoV virus. We applied correlation and moderating effect for data analysis and found that cognitive reappraisal negatively moderated the relationship between perceived stress and anxiety symptoms. These results give us a new perspective on understanding the relationship between anxiety symptoms and perceived stress by clarifying the protective function of cognitive reappraisal. It buffers the induced negative emotion when COVID-19 isolated people perceive overpressure, and thus instigates future research into targeted clinical interventions, which aim to cultivate cognitive reappraisal skills for those isolated people in the face of stressful events or crisis events.