Coping

Question 1

What is coping ?

Answer 1

The process by which people manage the perceived discrepancy between demands of the situation and the resources of the person they appraise in a stressful situation.

Question 2

What is coping linked to ?

Answer 2

Health status

Question 3

Significance of coping

Answer 3

Failure to cope may have significant health consequences.

Important to understand how people cope with stress and illness.

Question 4

‘Stress-coping’ paradigm

Answer 4

LAZARUS 1980
Emphasises cognitive appraisal:

• Primary appraisal: danger
• Secondary appraisal: coping

Question 5

Primary appraisal

Answer 5

A person determines whether a stimulus is dangerous or not.

If not dangerous, may be benign, irrelevant or +ve.

Question 6

Describe the relationship between coping and secondary appraisal

Answer 6

Coping relates to secondary appraisal

Coping decreases the effects of stressors

Not necessarily associated with good outcomes

Question 7

Cognitive and Behavioural transactions

Answer 7

Coping may change over time: it is dynamic

Many different coping styles, strategies

Individual/situational differences

Question 8

Should coping be considered a ‘trait’ or ‘state’

Answer 8

Trait: focus on style

State: focus on a Process/Strategy

Question 9

Trait

Answer 9

Personality
Style
Consistency

Question 10

State

Answer 10

Response to time and situation
Process or strategy
Different ways of coping

Question 11

State the types of coping

Answer 11

Problem focused
Emotion focused

Question 12

Function of coping

Answer 12

Alter the problem

OR

Regulate the emotional response to the problem

Question 13

Problem focused

Answer 13

Reduce demands of the situation OR expand resources to deal with it.

Question 14

Emotion focused

Answer 14

Control emotional response to the situation

Question 15

When is problem focused coping used ?

Answer 15

Used when people believe their resources or demands of the situation are changeable.

Question 16

Give examples of problem-focused coping

Answer 16

Change form a high to low stress job

Change from an unhealthy to healthy diet

Question 17

When is emotion focused coping used ?

Answer 17

Used when people feel that they can do nothing to change the situation.

Question 18

Give examples of emotion-focused coping

Answer 18

Using alcohol or drugs
Seek emotional support from friends
Use distraction

Question 19

Stress in medical students (relation to coping)

Answer 19

Levels of stress are high in medical students
Stress can lead to burnout
A variety of coping strategies are used (+ve / -ve)

Question 20

Burnout

Answer 20

Emotional exhaustion
Cynicism

Question 21

State a coping strategy of medical students
(negative)

Answer 21

Alcohol - Stress
(emotion-focused coping)

21% of students reported drinking due to stress

Question 22

What are some reasons for differences in coping styles ?

Answer 22

Gender ?
Social class

Question 23

Gender - causing differences in coping styles

Answer 23

Women use more emotion focused coping

Men use more problem focused coping

Question 24

Social class - causing differences in coping styles

Answer 24

High income, high education > problem focused

Disadvantaged individuals:
> stress
less control
ineffective coping

Question 25

Coping mechanism for disadvantaged individuals

Answer 25

Increased stress Decreased control over events Ineffective coping

Question 26

State some problem-focused coping strategies

Answer 26

Planning Active coping Seeking social support Positive reappraisal

Question 27

State some emotion-focused coping strategies

Answer 27

Distancing Escape-avoidance Denial Distraction Substance use Self-control Accepting responsibility

Question 28

State some coping strategies which are both problem and emotion focused

Answer 28

Seeking social support Positive re-appraisal

Question 29

Examples of ways people cope with illness

Answer 29

Normalising Denial Resignation Accommodation

Question 30

Normalising

Answer 30

Interpret symptom as normal experience i.e. neutralising the threat

Question 31

Denial

Answer 31

Denies existence of symptom

Question 32

Resignation

Answer 32

Become consumed by illness

Question 33

Accommodation

Answer 33

Acknowledges, deals with problem

Question 34

State some coping resources EXAM Q

Answer 34

Money Health Sense of control Personality Beliefs and attitudes Become informed Exercise Social support

Question 35

How is coping assessed ?

Answer 35

Questionnaires, Rating Scales - Ways of coping checklist - COPE

Question 36

What is COPE ?

Answer 36

COPE inventory is a widely used scale for assessment of coping. Carver et al., 1989

Question 37

What does the COPE scale measure ?

Answer 37

What individuals do and feel when they experience stressful events. Measures situational / dispositional coping The values of responses reflect coping style/strategy.

Question 38

Describe the COPE scale

Answer 38

Coping strategies / responses incorporated into 13 scales : e.g. - Active coping - Seeking instrumental social support - Seeking emotional social support - Positive reinterpretation

Question 39

Example of seeking instrumental support

Answer 39

'I try to get advice from someone about what to do' 'I ask people who have had similar experiences what they did'

Question 40

Example of seeking emotional social support

Answer 40

'I discuss my feelings with someone' 'I try to get emotional support from friends or relatives'

Question 41

State the COPE rating types

Answer 41

I usually: 1. Don't do this at all 2. Do this a little bit 3. Do this a medium amount 4. Do this a lot

Question 42

Does coping moderate the association between stress and health ? Post-op example

Answer 42

Decreased anxiety Decreased hospital stay Increased recovery Decreased medication

Question 43

Monitors

Answer 43

Seek information -high information

Question 44

Blunters

Answer 44

Avoidance -low information

Question 45

Key points regarding information and coping

Answer 45

Preparing the patient - Dr-patient discussion - Pamphlet - Video - Family involvement

Question 46

State some information which could be provided for stressful medical procedures e.g. surgery

Answer 46

Procedural information Sensation information Behavioural information

Question 47

RCT study : information and coping

Answer 47

Family-centered preparation for surgery improves peri-operative outcomes in children.

Question 48

Social Support and Coping

Answer 48

Networks Types Quantity Quality / satisfaction

Question 49

Social Support definition

Answer 49

The perceived comfort, caring, esteem or health a person receives from other people/groups.

Question 50

Main types of social support EXAM TYPE Q

Answer 50

Emotional / Esteem Informational Tangible (lend money, give time) Companionship

Question 51

How does social support influence health ?

Answer 51

Buffering effect Direct effect

Question 52

Buffering effect

Answer 52

Protects individuals against negative effects on health - stressor is strong - enhances resources, enables re-appraisal, distraction

Question 53

Direct effect

Answer 53

Beneficial to health and well-being - Regardless of degree of stress - e.g. belonging, self-esteem - e.g. positive outlook, increased resistance to infection, healthier lifestyle

Question 54

When is social support not beneficial ?

Answer 54

When not perceived as supportive Reduces self-esteem Type of social support may not match needs Encourages damaging lifestyle: - poor role model - not engaging in healthy behaviours - overprotective

Question 55

Implications of coping

Answer 55

How patients cope with their symptoms/illness can markedly affect health outcomes.