Adapting and avoiding coping strategies for women with ovarian cancer during the COVID-19 pandemic

Background: The COVID-19 pandemic has resulted in unprecedented challenges for people living with cancer, impacting not only physical health but psychological well-being. The psychological response affects the individual as well as the community and can persist long after the outbreak. We aim to assess coping strategies employed by women with ovarian cancer during the COVID-19 pandemic.Methods: Women with a current or prior diagnosis of ovarian cancer completed an online survey which included a query about coping strategies during the COVID-19 pandemic. The survey was distributed from March 30th through April 13, 2020 through survivor networks and social media.Results: Six hundred and three women visited the survey website during the study period and 555 (92.0%) completed the survey. Four hundred and eight (73.5%) provided information on coping strategies utilized during COVID-19. Among those who responded, the median age was 58 years (range 20–85) and 150 participants (40.8%) were undergoing active cancer treatment. Commonly utilized adaptive coping strategies included emotional support (159, 39.0%), self care (148, 36.3%), hobbies (139, 34.1%), planning (87, 21.3%), positive reframing (54, 13.2%), religion (50, 12.3%) and instrumental support (38, 9.3%). Many participants also relied on avoidance coping strategies including self distraction (111, 27.2%) and substance use (19, 4.7%).Conclusions: Most ovarian cancer survivors are using adaptive, problem-focused coping strategies during the COVID-19 pandemic, however many are practicing avoidance strategies as well. As coping mechanisms profoundly impact quality of life, oncology providers must assist patients in identifying coping strategies that optimize physical and psychological well-being.     

Coping of diseases in old age--partnership as a resource

Somatic as well as mental health of the elderly are to a high extent determined by the quality of their marriage, the reciprocity of social support, and the available socio-economic resources. The coping behavior does not change very much in the course ofa person's life. If he or she has sufficient skills and resources, the elderly person will engage in problem-focused coping. If demands are appraised as outside of the person's control, secondary control strategies aiming at a reappraisal are more frequently applied. A crucial coping resource in old age is the availability of social support that is experienced as adequate and useful by the recipient. The spouse and members and close family members are the most important sources of social support for the elderly.     

Stressful events and coping with infertility: factors determining pregnancy outcome among IVF couples in Jamaica

Objective: The goal of this study was to investigate infertility-coping patterns and pregnancy outcome among IVF participants who face stressful life events in addition to their infertility. Background: Many studies on stress and IVF-assisted pregnancy focus specifically on infertility-related stress without considering the role of other stressful events. Additionally, these studies seldom include the mediating influence of coping patterns. Methods: In a retrospective study, we reviewed the clinical records of 430 men and women who attended the sole fertility centre in Jamaica over a 10-year period. Using cross-sectional analyses, we examined exposure to past significant losses (death, intimate relationship, income) and current stressors (health, work, financial, personal relationships), as well as different coping patterns that emerged (problem-focused, emotion-focused, congruence between partner) with pregnancy outcome. Results: Univariate analyses and logistic regression revealed that participants exposed to multiple stressors were not at increased risk for a negative pregnancy outcome, but women who used problem-focused strategies to cope with their infertility were more likely to become pregnant than those who used emotion-focused strategies. Regardless of coping strategies, however, age was the only independent predictor of pregnancy outcome. Conclusions: Determinants of pregnancy outcome are identified, and the experience of general stress for IVF couples is discussed within the context of a developing country. Areas of future research are highlighted along with implications for psychosocial interventions.     

Parents' coping in the neonatal intensive care unit: a theoretical framework

The conceptual framework that has been widely used to study the coping strategies of parents of preterm infants in neonatal intensive care units (NICU) has been the transactional model of stress and coping proposed by Lazarus and colleagues. This model supports the cognitive system as the key factor in stress transactions. The cognitive system produces an interpretation of events that leads to making sense of numerous sensations and perceptions from both external and social sources as well as from the internal physiological environment. The individual cognitive system appraises stimuli in two ways: primary appraisal and secondary appraisal. Another factor that may influence the individual's coping effort is gender difference. Mothers and fathers of preterm infants have been found to use different coping strategies to deal with the preterm birth. Other factors such as personality traits and the perceived and actual availability of social support may also influence the parents' coping effort. Implications for clinical practice by the NICU interdisciplinary team are considered.     

Depressive and posttraumatic symptoms among women seeking protection orders against intimate partners: relations to coping strategies and perceived responses to abuse disclosure

This investigation examined the relationship of abuse-specific coping strategies and perceived responses to abuse disclosure to symptoms of depression and posttraumatic stress among 131 women seeking a protection order against an intimate partner. Disengagement, denial, and self-blame coping strategies, as well as blaming of the participant by others, were associated with greater depressive and posttraumatic symptoms. None of the strategies of coping or responses to abuse disclosure were negatively related to depressive or posttraumatic stress symptoms. Findings suggest that mental health providers may find it useful to address these negative styles of coping while public education campaigns should target victim blaming.     

Intimate partner violence and suicidality in low-income African American women: a multimethod assessment of coping factors

This study used quantitative and qualitative methods to examine psychological factors that influence links between intimate partner violence (IPV) and suicidality in a sample of low-income African American women. Quantitative results demonstrated greater general coping, more efficacious behavioral strategies in response to IPV, more effective use of resources, greater use of social support, and less substance use among women who did not attempt suicide compared with those who did. Qualitative findings showed that suicide attempters showed less adaptive coping strategies aimed at accommodating the abuser, whereas non-attempters were more focused on strategies that supported leaving the relationship and/or avoiding further harm.     

Frequency and perceived effectiveness of strategies to survive abuse employed by battered Mexican-origin women

This study documented the frequency and perceived effectiveness of battered Mexican-origin women's usage of formal and informal help and personal strategies to survive abuse. Semistructured interviews were conducted with 75 battered Mexican-origin women. Consistent with survivor theory, results indicated that participants sought help multiple times from several formal and informal help sources; some (i.e., shelter, family) were perceived more effective than others (i.e., lawyer, in-laws). Participants engaged in various personal strategies to survive abuse; some (i.e., using faith/religion) were rated more effective than others (i.e., placating the batterer). Responses to open-ended questions suggest why specific help sources and strategies were/were not effective and provide socioculturally specific suggestions for improving services. This study illuminates battered Mexican-origin women's strengths and barriers that impede their survival efforts. Contributions include focusing on a subset of battered Latinas and documenting the frequency and perceived effectiveness of a wide array of help sources and strategies.     

Adapting the revised prenatal coping inventory (NuPCI) for use in a Spanish population

Objective: To adapt the Revised Prenatal Coping Inventory (NuPCI) for the evaluation of prenatal stress coping strategies utilised by Spanish women.

Methods: A cross-sectional study was performed to evaluate the psychometric properties of NuPCI adapted for a Spanish population. Two hundred and sixty one puerperium women completed the NuPCI at the time of discharge after childbirth. Instrument construct validity was evaluated using subscale item correlations. Internal consistency was assessed using Cronbach’s α test.

Results: Items from each subscale (Preparation, Avoidance and Spiritual – Positive Coping) were significantly correlated with the global result (p?α?>?0.7). The most frequently used coping strategy was Preparation and the least used was Avoidance. Utilisation of the coping strategies with Preparation decreased with increasing parity (p?=?.002) and greater prenatal stress was associated with increased use of the Avoidance coping strategy (p?Conclusions: The NuPCI adapted for Spanish women demonstrates good psychometric properties for evaluating the three types of prenatal stress coping strategies: Preparation, Avoidance and Spiritual – Positive Coping. Results were similar to those presented by the instrument in its English language version.     

Types, patterns, and predictors of coping with stress during pregnancy: examination of the Revised Prenatal Coping Inventory in a diverse sample

The present study investigated coping in early, mid-, and late pregnancy in 321 ethnically and socioeconomically diverse women of varying medical risk. The goal was to determine how women cope with stress across pregnancy and to explore the association of coping with maternal characteristics, stress perceptions, disposition, and social support. Factor analysis of the Revised Prenatal Coping Inventory revealed three distinct types of coping: Planning-Preparation, Avoidance, and Spiritual-Positive Coping. Spiritual coping was used most frequently during pregnancy; avoidant coping was used least often. As hypothesized, use of spiritual coping and avoidance differed across pregnancy. Planning was used more consistently across time. Multivariate regression analyses revealed that the strongest predictors of planning were high optimism and pregnancy-specific distress. Avoidance was most strongly predicted by high state anxiety and pregnancy-specific distress. Greater religiosity and optimism were the strongest predictors of spiritual coping. These results add to a body of evidence that women use distinctive and varied strategies to manage stress prenatally. They also suggest that coping is responsive to changing demands across pregnancy and reflective of women's characteristics, perceptions, and social situations.     

Communicating social support online: a new classification dichotomy for exploring coping in interaction concerning infertility

Objective: This study explores how social support is utilised in the context of an online infertility support group. Background: Social support is often studied to decipher how those with health concerns cope through communication and interaction. Method: Online socially supportive messages (N = 200) were examined using a hybrid approach (i.e. deductive and inductive) to thematic analysis. Results: Analysis developed a dichotomy of social support (i.e. normative and transformative themes). This dichotomy creates a new theoretical framework for evaluating social support with implications for cognitive coping strategy. The normative and emotional themes were the most frequently represented in the studied context demonstrating overall network-level positivity. Messages did not demonstrate tangible support. Conclusion: Expected characteristics of emotional and informational support were demonstrated, but the forum included no tangible support. The support messages also possessed latent characteristics that should be further studied to understand implications for forum participant coping.     

Preliminary evaluation of a coping strategy enhancement method of preparation for labour

OBJECTIVES: To compare the use and effects of enhanced pre-existing coping strategies with the use and effects of coping strategies usually taught in National Health Service (NHS) antenatal education on women's experience of pain and emotions during labour. DESIGN: A between-group comparison of women who chose to attend NHS antenatal education where courses of preparation were randomly assigned to include either a new method of coping strategy enhancement (CSE) or standard taught coping strategies. SETTING: Two large maternity units in one city in the North of England. PARTICIPANTS: 20 women participated in antenatal classes incorporating the CSE method and 21 women participated in antenatal classes incorporating the standard approach to developing coping strategies for labour. FINDINGS: Women who attended CSE classes used enhanced coping strategies for a larger proportion of their labour than women who attended standard classes who used taught coping strategies. Birth companions were more involved in women's use of enhanced than taught strategies. Self-efficacy for use of coping strategies and subsequent experiences of pain and emotions during labour were equivalent between groups. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: An approach based on enhancing pre-existing coping strategies was associated with greater coping strategy use and involvement from the birth companion, and provided benefits to women's overall experience of labour at least equivalent to that associated with standard preparation. Further research should explore this novel approach in larger groups, and for women who may choose not to attend group antenatal preparation.     

Coping and violence exposure as predictors of psychological functioning in domestic violence survivors

This study examines the differential effects of adult and childhood physical and psychological abuse, abuse-specific coping, and psychological adjustment in battered women seeking emergency shelter. Multivariate regression analyses confirmed the devastating impact of psychological abuse (childhood and concurrent) on battered women's adjustment. The results corroborated prior research suggesting a cumulative vulnerability to psychological victimization in a substantial proportion of residents. Unexpectedly, frequency of physical violence was unrelated to women's distress. The study argues that modes of coping traditionally considered adaptive (e.g., engaged, proactive) may be unsafe for battered women and children. The multifaceted nature of survivors' coping choices is discussed.     

The range of coping strategies women use to manage pain and anxiety prior to and during first experience of labour

OBJECTIVES: To investigate whether nulliparous women, during pregnancy, can identify their own pre-existing coping strategies for managing pain and anxiety and whether the range of coping strategies used in Labour by women who do not attend antenatal classes can be described. DESIGN: Qualitative semi-structured interviews. SETTING: Two large maternity units in a city in the North of England. PARTICIPANTS: Twenty-three nulliparous women were interviewed during their third trimester of pregnancy (prior to any antenatal class attendance) regarding strategies used to cope with previous experiences of pain and anxiety. A separate sample of 20 women, who had not attended any form of antenatal education, were interviewed within 72h of their first experience of labour regarding the coping strategies used to manage pain and anxiety during labour. FINDINGS: Template Analysis was used to code data from transcribed interviews. The findings indicate that as women approach their first experience of labour they can identify coping strategies that they have employed to manage pain and anxiety in their past. Equally women who have not attended antenatal classes use a wide range of strategies in labour. The range of identified coping strategies is described and comprises thoughts and behaviours with positive and negative consequences. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It is possible to help nulliparous women to identify, in pregnancy, a range of strategies that they have previously employed to manage pain and anxiety. This range reflects the coping strategies that women may potentially use in labour to manage pain and anxiety. Women may benefit from assistance in pregnancy to develop strategies for labour that are based on knowledge of their own coping repertoire, which includes enhancing positive strategies and finding alternatives to negative strategies.     

Exploring the Relationships Between Child Maltreatment and Risk Factors for Pregnancy Complications

ObjectiveThis study explored the pathways underlying the relationships between child maltreatment (CM) subtypes (i.e., physical, sexual, and emotional abuse and neglect) and factors associated with a heightened risk of pregnancy complications by examining post-traumatic stress disorder (PTSD) symptoms as a potential mediator.MethodsA sample of 98 pregnant parents between the ages of 18 and 29 years was recruited through social media and community organizations throughout Canada. Participants completed a series of surveys on their exposure to CM, PTSD symptoms, and pregnancy experiences on a secure online platform. Following data cleaning procedures, 85 participants were included in this study.ResultsFour separate mediation analyses were conducted with child neglect, physical abuse, sexual abuse, and emotional abuse as factors associated with a heightened risk of pregnancy complications (i.e., a congregate score of limited prenatal care, weight gain concerns, smoking, second-hand smoke, alcohol consumption, substance use, and insufficient food intake during pregnancy). Each CM subtype was associated with increased PTSD symptoms, which were in turn associated with the presence of more factors known for increasing the risk of pregnancy complications. Neglect, physical abuse, sexual abuse, and emotional abuse were all indirectly associated with the presence of more factors associated with a heightened risk of pregnancy complications through their association with PTSD symptoms.ConclusionsFindings from this study could encourage prenatal care providers to screen for CM history and PTSD symptoms. Furthermore, mental health treatment early in the prenatal period may improve pregnant parents’ health and lower their risk of pregnancy complications.     

Psychological aspects of high risk pregnancy in hospitalized women -- toward the change of the existing model of care

OBJECTIVES: The aim of this study was to explore the psychological situation of hospitalized women with high risk pregnancy, i.e. 1) the level and sources of anxiety, 2) coping strategies and 3) the needs regarding the model of care at OB/GYN department. DESIGN, MATERIALS AND METHODS: 116 subjects participated in the study. The experimental group consisted of 65 pregnant women with high risk of preterm delivery and after repeated perinatal loss, hospitalized at complicated pregnancy dept. The controls were 51 women with low risk pregnancy. The following methods were used: State-Trait Anxiety Inventory (STAI) by Spielberger, Ways of Coping Questionnaire by Folkman and Lazarus and a specially designed questionnaire on women's needs, sources of anxiety and social support. RESULTS: The results clearly show that the level of anxiety is significantly higher in experimental group. There are also differences in coping strategies used in the two groups under study. CONCLUSIONS: The conclusion is that a new model of care is needed for hospitalized high risk pregnancy patients in order to reduce the level of their anxiety, support effective coping strategies as well as help them in working through psychic conflicts relating to reproductive health.     

Surviving the storm: the role of social support and religious coping in sexual assault recovery of African American women

African American women are at high risk for sexual assault. In addition, many African American women endorse the use of social support and religiosity to cope with trauma. The current study investigates the relationship between these two coping strategies and posttrauma symptoms in a sample of 413 African American female sexual assault survivors using confirmatory factor analysis and structural equation modeling. Findings indicated that survivors with greater social support were less likely to endorse the symptoms of depression and PTSD. Conversely, increased use of religious coping was related to greater endorsement of depression and PTSD symptoms. Counseling and research implications are explored.     

The embryologist as counsellor during assisted reproduction procedures

This study aimed to establish whether patients who receive support counselling by the embryologist as counsellor during assisted reproduction procedures would be better equipped with efficient coping mechanisms than patients who were not counselled. Sixty patients were randomly assigned to either the support counselling or the control groups. Questionnaires, measuring pre- and post-treatment levels of anxiety, depression and ways of coping, were presented to both groups. The support counselling group received emotional support and counselling from the embryologist. The control group were treated routinely, received no counselling or emotional support and were asked to phone the gynaecologist daily concerning embryo development. Despite reliable internal consistency, the hypothesis was not accepted due to non-significant differences between the groups. However, t-tests indicated a changed pattern of behaviour within the support counselling group, who experienced a statistically significant (P < 0.017) reduction in anxiety levels after the counselling intervention, as well as increased use of problem-focused coping strategies, such as instrumental action, in dealing with the demands of the treatment programme.     

Violence against pregnant women: prevalence and characteristics. A population-based study in Nicaragua

Objective   This study aims to estimate the prevalence and characteristics of partner abuse during pregnancy as well as to investigate associated social factors in León, Nicaragua.
Design   Cross-sectional community-based study.
Setting   All pregnant women from 50 randomly selected geographical clusters out of 208 in the municipality of León, Nicaragua.
Sample   A total of 478 pregnant women were included; only one woman refused to participate.
Method   The domestic violence questionnaire from the WHO-co-ordinated Multi-Country Study on Women's Health and Life Events was used with each participant being interviewed twice during pregnancy.
Main outcome measures   Prevalence and characteristics of partner violence during pregnancy.
Results   The prevalence of emotional, physical and sexual abuse during pregnancy was 32.4%, 13.4% and 6.7%, respectively. Seventeen percent reported experience of all three forms of violence. Two-thirds of the victims reported repeated abuse. Half of the abused women had experienced punches and kicks directed towards the abdomen and 93% had been injured. Most women had not sought health care in relation to the abuse, but those who did were usually hospitalised. Factors such as women's age below 20 years, poor access to social resources and high levels of emotional distress were independently associated with violence during pregnancy.
Conclusion   Violence against pregnant women in Nicaragua is common and often repeated. Although these women have poor access to social resources and high levels of emotional distress, they are rarely assisted by the health services. Innovative strategies are needed to provide support and counselling.     

Assessing stress and coping in pregnancy and postpartum

This paper evaluates questionnaire measures of stress and coping for use with pregnant and postpartum women. For each area of measurement the main issues or problems are delineated, appropriate measures are described and the validity and reliability of the measures are discussed, as well as the problems and benefits of using each measure with pregnant or postpartum women. Finally, norms are provided for female and obstetric samples, where available. The following constructs are examined: stress, demands of the infant, social support, coping and repressive coping style. A version of the Hassles and Uplifts Scale that was shortened for use with postpartum women is appended. It is hoped that this paper will provide a valuable resource for future research into stress and coping in pregnant and postpartum women.     

SEQUELAE OF ABUSE: Health Effects of Childhood Sexual Abuse,Domestic Battering,and Rape

Violence against women is endemic in the United States. One third to one half of all women will experience one or more types of abuse in their lifetime, most often at the hands of a family member or an intimate or formerly intimate partner. One in 12 women is battered during pregnancy. Abuse survivors are disproportionately frequent users of health care services because of acute and chronic physical, somatic, emotional, and behavioral sequelae of abuse. Health care practitioners are often the first contact abuse survivors have with a potentially helping professional. It is, therefore, essential that health care providers learn to identify and to intervene appropriately with survivors of abuse. This article reviews and compares the health effects of three of the most common types of violence against women: childhood sexual abuse, domestic battering, and rape. Sequelae are divided into six categories: physical/medical, somatic, emotional/psychological, social/interpersonal, behavioral/sexual, and pregnancy-related effects. The health effects discussed in this article include research findings, as well as effects noted in clinical practice. Recommendations are made for routine screening of all women for past and current abuse, as well as for intervention strategies.