Coping with rheumatoid arthritis. How can specialist nurses influence it and promote better outcomes?

• ? Psychological stressors are said to be an important influence on the outcome of chronic illnesses such as rheumatoid arthritis (Engel, 1977).
• ? Helping patients to cope with stressors is identified as a central concept in the delivery of nursing care (Khan et al., 1994). It is thus reasonable to suggest that rheumatology nurses may be key players in the process of coping with rheumatoid arthritis.
• ? But in order for rheumatology nurses to be effective players in this process, they need to discourage coping behaviour(s) linked to poor outcomes, and/or promote an overall behaviour pattern linked to a better outcome. Literature showing the link between different coping behaviours and outcome is examined, and cognitive restructuring is emphasized as one method nurses could use.
• ? Having identified coping behaviour which is optimal in terms of future outcome, further study of different forms of coping-based educational intervention is suggested, to reveal how such patterns of behaviour can be taught by nurses in the most effective way

     

Matching pain coping strategies to the individual: A prospective validation of the Cognitive Coping Strategy Inventory

The validity of the Cognitive Coping Strategy Inventory (CCSI; Butler et al., 1989) was tested in a prospective fashion. Subjects were randomly assigned to one of three conditions. Some were matched to a strategy for which they received a high CCSI score, some were mismatched to a strategy for which they received a low CCSI score, and some were given a choice of strategies. Those subjects using a matched strategy obtained better threshold and tolerance times on the cold pressor than subjects who used a mismatched strategy. Despite clear differences in exposure to the cold pressor these conditions did not differ from each other in self-reported levels of pain. It was concluded that the CCSI appears to be a valid and useful tool for selecting a coping strategy to help particular individuals manage acute pain. Though the CCSI is relatively easy to administer and score, the comparative costs and benefits of using it must be weighed against the somewhat more efficient approach of simply offering the subject a choice of treatments. Subjects given a choice of strategies performed as well as subjects matched to a strategy on the basis of CCSI scores.     

Coping with Domestic Violence: Control Attributions,Dysphoria, and Hopelessness

We investigated the influence of control judgments and coping style on emotional reactions to domestic violence utilizing the framework of hopelessness theory. We assessed abuse severity, control attributions, coping, dysphoric symptoms, and hopelessness in 70 battered women recruited from 12 domestic violence agencies. Respondents reported dysphoria but not hopelessness. Increased reports of dysphoria were associated with higher levels of self-blame and avoidance coping and lower levels of problem-focused coping. Increased problem-focused coping was associated with decreased hopelessness. Perceived control over current abuse was not related to dysphoria. High expectations for control over future events were associated with decreased dysphoria. We discuss our results in terms of their application to attributional accounts of emotional reactions to battering.     

An Assessment of Gender Differences in the Perception of Benefit Resulting from the Loss of a Child

The current study focused on a sample of adults (N = 67) experiencing bereavement following the loss of a child. The Post Traumatic Growth Inventory (PTGI) was used to assess whether bereaved parents were able to perceive benefit from their trauma, and whether there were gender differences in perception of benefit. The impact of the following variables on the PTGI was also assessed: the nature and length of time since the loss, and the age and marital status of the bereaved. The results indicated that bereaved parents do perceive benefit from their loss. However, there was poor evidence to suggest perception of benefit along gender lines. Results also indicated a potential relation between greater perception of benefit and those bereaved through illness, and more perception of benefit for the longer the time elapsed since the bereavement. Lastly, there was a tendency for younger individuals and married respondents to obtain higher scores on the PTGI.     

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目的探讨父母养育方式对子女人格特质的影响。方法2004-04四川大学华西临床医学院采用“父母养育方式评价量表(EMBU)”和“艾森克个性问卷(EPQ)”对成都市区586名高一学生进行问卷调查,并采用SPSS10·0软件分析人格特质与父母养育方式之间的关系。结果在EMBU中,父亲的教养方式存在性别差异,而母亲的教养方式无性别差异;在EPQ中,P,N,L3个维度得分有性别差异,E维度得分无性别差异;相关及回归分析显示父母养育方式中母亲的惩罚、严厉(m4)对子女精神质(P),掩饰或纯朴性(L)两维度的影响更显著,母亲的过分干涉、过度保护(m2)对子女内外向(E)维度影响更为显著;父亲的惩罚、严厉(f2),母亲的过分干涉、过度保护(m2)对子女神经质或情绪的稳定性(N)维度的影响更显著。结论父亲对子女的养育方式存在性别差异;男、女生的人格特质有差别;父母养育方式对子女人格特质有影响。表明培养子女健全人格需父母采取个体化、正性的养育方式。     

Predictors of quality of life in newly diagnosed melanoma and breast cancer patients.

BACKGROUND: Quality of life (QoL) is a multidimensional construct, and several psychosocial and medical factors can predict a patient's QoL. We investigated the impact of factors in the psychological stress processes on QoL 3 months after diagnosis of melanoma or breast cancer. PATIENTS AND METHODS: In consecutive melanoma and breast cancer patients with localized disease, cancer-specific social support, coping with cancer, personality trait anger expression, non-cancer stress, sociodemographic variables, cancer and treatment variables, and QoL (evaluated as self-reported psychological and physical symptoms, self-perceived QoL, and depression) were assessed with validated quantitative questionnaires. The associations between QoL and the other factors were investigated with multivariate methods. RESULTS: Only a few factors differed between melanoma and breast cancer, in terms of treatment modalities and gender. The amount of received social support was higher among breast cancer patients. The predicting power of psychological stress factors on all the QoL measures was strong, but differed between the treatment groups (surgery only versus adjuvant treatment). Psychosocial factors were the strongest predictors of QoL, not cancer type or treatment. Behavioral Escape-Avoidance coping was associated with worse QoL. However, non-cancer life stresses showed the strongest QoL-decreasing influence. QoL-enhancing factors, including social support, were seen clearly only within the breast cancer patients receiving adjuvant treatment. CONCLUSIONS: QoL of newly diagnosed cancer patients is highly associated with psychosocial factors. Non-cancer life stresses seem to be very important in the QoL of newly diagnosed cancer patients. Adjuvant treatment may comprise supportive psychosocial factors that enhance QoL in cancer.     

How nurses cope with patient death: A systematic review and qualitative meta‐synthesis

Aims and objectives

To review literature on nurses’ coping strategies with patient death.

Background

Dealing with the loss of a patient was viewed as one of the most demanding and challenging encounters in clinical practice. Those nurses who are not competent in coping with patient death may be inadequate in supporting dying patients and their family members, and minimise the quality of end‐of‐life care. To get a broader understanding of how nurses cope with patient death and to develop meaningful and effective interventions, a systematic review which would help underpin the multidimensional approaches is needed.

Design

A systematic review.

Methods

Exhaustive searching in ten databases: CINAHL Plus, EMBASE, MEDLINE, AMED, PsycINFO, ProQuest Health & Medical Complete, ProQuest Dissertations & Theses Global, Google Scholar, EThOS and CareSearch. Meta‐aggregation was used to synthesise the findings of the included studies.

Results

This systematic review aggregated ten categories from the sixteen qualitative studies included, and then two synthesised findings were derived: intrinsic resources and extrinsic resources. The intrinsic resources consisted of setting boundaries, reflection, crying, death beliefs, life and work experience, and daily routines and activity. The extrinsic resources were comprised of talking and being heard, spiritual practices, education and programmes, and debriefing.

Conclusion

This systematic review synthesised the findings about what resources nurses use when coping with patient death and made recommendations on future directions. Areas which could be developed to improve deficiencies that nurses had when faced with the losses of their patients were identified. Nurses need more support resources, which better assist them in coping with patient death.

Relevance to clinical practice

The results of this systematic review could provide evidence for nurses’ coping strategies when dealing with patient death, and the recommendations could be employed by nurses to cope with the losses of patients.     

Stress and Coping Styles are Associated with Severe Fatigue in Medical Students

Fatigue is a common complaint among medical students and researchers consider it to be related to poor academic outcomes. The authors' goal in the present study was to determine whether stress and coping strategies were associated with fatigue in medical students. The study group consisted of 73 second-year healthy students attending the Osaka City University Graduate School of Medicine. Participants completed a questionnaire about fatigue (Japanese version of Chalder Fatigue Scale), stress, stress coping (Japanese version of the Coping Inventory for Stressful Situations), overwork, and nocturnal sleeping hours. On univariate and multivariate logistic regression analyses adjusted for age and gender, stress was positively associated with fatigue. In addition, after adjustment for age, gender, and emotion- and task-oriented stress coping activities, avoidance-oriented stress coping activity was associated with fatigue. The results suggest that stress and the coping style are correlated with fatigue in medical students.     

宗教心理应对对癌症病人的身心影响及相关因素研究进展

介绍了国外癌症病人宗教心理应对的历史发展、相关因素及宗教心理应对对癌症病人的影响、国内癌症病人宗教心理应对现状,以期对我国宗教信仰病人护理及临床宗教护理发展有所启示。