The Relationship between Anxiety and Coping Strategies in Family Caregivers of Patients with Trauma

Coping and anxiety symptoms in family carers of dependent older people: Mediation and moderation effects of subjective caregiver burden

INTRODUCTION

Coping responses influence anxiety symptoms experienced by informal carers. However, only a few studies have investigated the longitudinal association between coping responses and anxiety symptoms in family carers. We also currently have limited knowledge on the mediating or moderating influence of subjective caregiver burden on this relationship over time. The aim of the present study was to investigate the longitudinal relationship between coping and anxiety symptoms in family carers of dependent older people, and examine the mediating or moderating role of subjective caregiver burden over time.

DESIGN

Prospective longitudinal study.

METHODS

We recruited and enrolled participants from a probability sample of 132 family carers of older dependent relatives. We measured coping strategies, anxiety symptoms, subjective caregiver burden, and several covariates (sex and intensity of care) at baseline and at 1-year follow-up. We used generalized estimating equations with multiple imputations to examine associations over time.

RESULTS

Considering both direct and indirect effects through subjective burden, anxiety symptoms were positively associated with proactive coping (B = 0.13), planning (B = 0.15), self-distraction (B = 0.24), denial (B = 1.15), venting (B = 0.94) and self-blame (B = 0.90), and negatively associated with positive reframing (B = -0.83) and acceptance (B = -0.75). Subjective caregiver burden moderated the relationship between anxiety symptoms and planning, and the use of denial as a form of coping.

CONCLUSIONS

Our results show that subjective caregiver burden is an important moderator and mediator of the longitudinal association between coping responses and anxiety symptoms in carers.

CLINICAL RELEVANCE

Proactive coping and planning when subjective burden is low, self-distraction, denial, venting, and self-blame significantly increase levels of anxiety and caregiver burden in carers over time. Acceptance and positive reframing however as coping responses are associated with lower levels of anxiety and caregiver burden long-term. Our findings highlight the need for a multi-dimensional approach in future caregiving interventions.

The challenges of nursing care for patients with lumbar discectomy: A qualitative study

AIM

Patients with lumbar disc surgery experience many different problems during their hospital stay. Nurses also face different challenges in providing care to them. Nonetheless, no study has yet specifically addressed these challenges to the best of our knowledge. This study aimed at exploring the challenges of nursing care for patients with lumbar discectomy.

DESIGN

This qualitative study was conducted in 2022 using content analysis.

METHODS

Eight nurses, three patients with lumbar discectomy, and one physician were purposively selected from the neurosurgery wards of the hospitals affiliated to Golestan University of Medical Sciences, Gorgan, Iran. Semi-structured interviews were conducted for data analysis and the content analysis method recommended by Elo and Kyngas was used for data analysis. The main phases of this method are open coding, grouping, categorization, and abstraction. The MAXQDA 10 software was employed to facilitate data management. Data collection continued to reach data saturation.

RESULTS

The challenges of nursing care for patients with lumbar discectomy were categorized into eleven subcategories and three main categories, namely dominant routine-based practice in the healthcare system, futile attempt for team-based care, and shortages as a major barrier to quality care. There are different personal, professional, financial, structural, and organizational challenges in nursing care for patients with lumbar discectomy which can negatively affect postoperative patient recovery.

Anxiety and Coping Stress Strategies in Researchers During COVID-19 Pandemic

The current COVID-19 pandemic has affected the whole world, leading to changes in one's personal and working life. Researchers have undergone extensive changes in their roles, mainly in the area of health care, with research into the virus now the priority.

Aim

To assess the anxiety, depression, stress, fears, and coping strategies of Portuguese researchers during the COVID-19 pandemic.

Participants and Methods

A total of 243 researchers, with an average age of 37.9 ± 9.6, participated in an online questionnaire. The study was performed between 1 June 2021 and 11 August 2021. The questionnaire included depression, anxiety, and stress (DASS-21), fear of COVID-19 scale (FCV-19S), and coping inventory for stressful situations (CISS).

Results

The findings suggest being female and younger seem to be related to more significant fears. Singles and younger researchers showed higher values of stress, depression, and anxiety. Research areas, such as medical and health sciences, presented higher levels in the DASS-21 depression and stress scale (p < 0.05). Also, the results showed a moderate or moderate strong significant positive linear relationship between the scales (p < 0.001): DASS-21 stress, DASS-21 anxiety, and DASS-21 depression (r > 0.70); CISS-21 emotional-oriented with DASS-21 stress (r = 0.683), DASS-21 depression (r = 0.622), and DASS-21 anxiety (r = 0.557); and emotional fear and cognitive fear (r = 0.652).

Conclusion

The findings of this study support the growing concern for the psychological well-being of researchers and the need for intervention with more extensive and diverse studies.

Coping as a Mediator of the Relationship between Stress and Anxiety in Caregivers of Patients with Acute Stroke

According to Lazarus and Folkman's theory, stress and coping affect an individual's anxiety, which is an adaptive outcome. This study examined the mediation effects of stress-coping strategies on the relationship between stress and anxiety in caregivers of patients with acute stroke. A cross-sectional descriptive design was used to analyze a total of 131 caregivers caring for patients with acute stroke at a university hospital. The Caregivers Stress Scale, Ways of Coping Questionnaire, and Korean Beck Anxiety Inventory were used to quantify the participants' responses. Our results revealed that emotion-focused coping (β = .56, p < .001) partially mediated the relationship between stress and anxiety (Z = 3.30, p < .001), suggesting its ability to exacerbate anxiety in the short term by acting as a mediator between stress and anxiety. Developing appropriate coping strategies for caregivers of patients with acute stroke is therefore critical for reducing their anxiety.

Culture Related Factors May Shape Coping During Pandemics

This study aimed to examine how anxiety related to different styles of coping during the COVID-19 pandemic and how these relationships were moderated by the cultural orientations of individualism/collectivism and a person’s sense of meaning in life. A sample of 849 participants from Georgia completed an online survey during the final stage of lockdown. To measure the main variables, we used the State Anxiety Inventory, the Horizontal and Vertical Individualism and Collectivism Scale, the Meaning of Life Questionnaire, the COVID-19 Worry Scale, and the Ways of Coping Scale tailored to COVID-19 pandemic. The latter measured rational coping via the subscales of information accessing/processing and action-planning coping, and affective coping – via the subscales of passive-submissive and avoidant coping. Results suggested that anxiety positively predicted both affective coping styles and negatively predicted the action-planning coping style, while COVID-19 worry predicted all coping styles; presence of meaning in life positively predicted both rational coping styles and negatively predicted the avoidant coping style, while search for meaning positively predicted all coping styles; individualism negatively predicted the passive-submissive style and positively predicted the action-planning style, whereas collectivism predicted all coping styles; furthermore, individualism and collectivism moderated the link between anxiety and the passive-submissive coping style, presence of meaning in life moderated the link between anxiety and avoidant coping style, while search for meaning in life moderated the link between anxiety and the action-planning coping style. Overall, the findings enrich the cultural transactional theory of stress and coping, and generate insights for the culture-sensitive approach to the meaning in life. The results were conceptualized vis-a-vis Georgia’s intermediate position between clear-cut individualism and clear-cut collectivism.

Financial Awards and Their Effect on Football Players' Anxiety and Coping Skills

OBJECTIVE

Financial awards can be an important factor affecting athletes' mental preparation and various skills to manage stress. Since such a link has not yet been studied, the study has been designed to evaluate the moderation effect of financial awards in relation to football players' anxiety and coping skills.

METHODS

The study consists of 110 male football players aged 18-32 years old (mean ± SD: 23.98 ± 3.01 years) who were divided into two groups: financial awarded (n = 48) and financial unawarded for sports performance (n = 62). The anxiety of football players was measured by the Sport Anxiety Scale SAS-2. Coping strategies to manage stress were assessed by the Athletic Coping Skills Inventory ACSI-28. The effect of financial awards in relation to football players' anxiety and coping skills was evaluated by the mediators' model using the PROCESS software (Hayes, 2018).

RESULTS

The results suggest that financial awards are important factors that influence football players' anxiety and coping skills. The financial awards increase the motivation of football players to better prepare for sports performance, which has been proven, through better setting of performance goals and more careful mental preparation. Financially awarded football players seem to respect the coach and follow his instructions to a greater extent than unawarded football players, which may be due to the financial benefits and the commitment they have confirmed by signing to the football club. In another aspect, the financial awards are likely to increase the cognitive trait of the anxiety of football players. It seems that financial players are more concerned about the failure of the match, which increases their anxiety, especially since it is a cognitive part and affects their sports performance.

CONCLUSION

For this reason, we encourage sports organizations to focus more on the mental preparation of football players. It is important to provide football players the opportunity to graduate from short- or long-term mental training conducted by a trained sports psychologist not only at the time of the athlete's failure but also as a preventive measure against increasing cognitive anxiety. We recommend sports organizations to train coaches in the field of mental training, preferably through annual short training sessions with a sports psychologist, to influence the development of desirable athletes' coping skills.

Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients

BACKGROUND

Irritable bowel syndrome (IBS) is a common digestive system disease with a high incidence rate and is common in women. The cause of IBS remains unclear. Some studies have shown that mental and psychological diseases are independent risk factors for IBS. At present, the treatment of IBS is mainly symptomatic treatment. Clinically, doctors also use cognitive behavioral therapy to improve patients' cognitive ability to diseases and clinical symptoms. In recent years, exercise therapy has attracted more and more attention from scholars. Improving the symptoms of IBS patients through psychosomatic treatment strategy may be a good treatment method.

AIM

To explore the effects of an intervention of cognitive behavioral therapy combined with exercise (CBT+E) on the cognitive bias and coping styles of patients with diarrhea-predominant irritable bowel syndrome (IBS-D); and to provide a theoretical reference for the management of IBS.

METHODS

Sixty IBS-D patients and thirty healthy subjects were selected. The 60 IBS-D patients were randomly divided into experimental and control groups. The experimental group was treated with the CBT+E intervention, while the control group was treated with conventional drugs without any additional intervention. The cognitive bias and coping styles of the participants were evaluated at baseline and after 6 wk, 12 wk and 24 wk using the Automatic Thoughts Questionnaire (ATQ), Dysfunctional Attitudes Scale (DAS) and Pain Coping Style Questionnaire (CSQ) instruments, and the intervention effect was analyzed using SPSS 17.0 statistical software.

RESULTS

At baseline, the scores on the various scales showed that all subjects had cognitive bias and adverse coping styles. The IBS Symptom Severity Scale (IBS-SSS) scores, ATQ total scores, DAS scores and CSQ scores of the two groups were not significantly different (P > 0.05). Compared with baseline, after 6 wk of the CBT+E intervention, there were significant differences in the ATQ scores, the dependence and total scores on the DAS, and the catastrophization, distraction and prayer scores on the CSQ (P < 0.05). After 12 wk, there were significant differences in the scores for perfectionism on the DAS and in the scores for reinterpretation, neglect and pain behavior on the CSQ in the experimental group (P < 0.05). After 24 wk, there were significant differences in the vulnerability, dependence, perfectionism, and total scores on the DAS and in the catastrophization, distraction and prayer scores on the CSQ in the experimental group (P < 0.01). The IBS-SSS scores were negatively correlated with the ATQ and DAS total scores (P < 0.05) but were positively correlated with the CSQ total score (P < 0.05).

CONCLUSION

Intervention consisting of CBT+E can correct the cognitive bias of IBS-D patients and eliminate their adverse coping conditions. CBT+E should be promoted for IBS and psychosomatic diseases.

The Associations among Psychological Distress, Coping Style, and Health Habits in Japanese Nursing Students: A Cross-Sectional Study

Background: Nursing students in many countries have been reported to experience high levels of stress and psychological distress. Health habits could potentially mediate the association between coping styles and psychological status. The purpose of this study was to evaluate the mediation effect of health habits in the relationship between stress coping styles and psychological distress in Japanese nursing students. Methods: A total of 181 nursing students completed anonymous self-reported questionnaires comprised of the General Health Questionnaire-12 (GHQ-12), the Brief Coping Orientation questionnaire, and an additional questionnaire on health behavior. A mediation analysis using path analysis with bootstrapping was used for data analysis. Results: Multivariate linear regression analysis showed that psychological distress was significantly and positively associated with “Avoidance coping” (β = 0.39, p < 0.001), and was negatively associated with “Active coping” (β = −0.30, p < 0.001), “exercise habit” (β = −0.25, p = 0.001), and “sleeping” (β = −0.24, p = 0.002). In the path model, “Active coping” and “Avoidance coping” had significant or marginally significant associations with “exercise habits” (active: β = 0.19, p = 0.008, avoidance: β = −0.12, p = 0.088), and psychological distress (active: β = −0.25, p < 0.001, avoidance: β = 0.363, p < 0.001). However, these coping style variables did not have a significant association with “sleep”. In general, the size of the correlations was below 0.4. Conclusions: Exercise habits mediated the relationship between coping styles and psychological distress to a greater extent than sleep. The present study suggests the possibility that complex interactions between health habits and coping styles may influence the psychological status of nursing students.