Browsing School of Nursing by Subject "Adaptation, Psychological"
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The relationships among coping strategies and depression and anxiety in adult bone marrow and peripheral blood stem cell transplantation patientsBone Marrow Transplantation (BMT) and Peripheral Blood Stem Cell Transplantation (PBST) are rapidly becoming standard treatment alternatives for a variety of malignant and hematological diseases. BMT/PBSTs are associated with a multitude of both physical and psychological stresses. As a consequence of these multiple stresses, the coping capabilities of patients become depleted, resulting in a myriad of stress-induced behavioral and psychological responses including depression and anxiety. The purpose of this study was twofold to examine the relationship between coping strategies and depression and anxiety, and to investigate the prevalence and severity of depression and anxiety in BMT/PBST patients. Lazarus and Folkman's (1984) transactional theory of stress and coping provided the conceptual framework for this study. A cross-sectional, descriptive, correlational research design was used. A convenience sample of 50 adult hospitalized BMT/PBST patients was recruited from a cancer center's BMT unit. The measures used in the study were the Ways of Coping-Cancer (WOC-CA) and the Hospital Depression and Anxiety Scale (HADS). Multivariate statistics were used to analyze the data. The results indicated the following: (1) the majority of patients appraised this procedure and its associated hospitalization recovery period as stressful to extremely stressful; (2) a significant number of patients experienced moderate to severe levels of depression and anxiety; (3) more frequent use of distancing coping predicted higher levels of depression; (4) distancing coping, higher levels of stress appraisal, and less than a college education predicted higher levels of anxiety; and (5) various person and situation factors were associated with use of specific coping strategies. Implications for nursing practice included three areas: reduction of stress associated with undergoing a BMT/PBST, evaluation of depression and anxiety, and interventions to decrease depression and anxiety. Recommendations for future research included: further psychometric testing of the WOC-CA, methodological issues, and future advancement of knowledge regarding the relationship between coping and psychological outcomes in hospitalized BMT/PBST patients.
War and non-war stressors, family resources, coping and family adaptation among Lebanese familiesThe Lebanese war (1975-1991) represented a continuing source of difficulty and disruption for the people of Beirut. The negative impact on individuals mental health has been documented, but little is known about its impact on families. The study was undertaken to describe the objective stressors, perceived stress, coping and resources of families living in Beirut during the Lebanese war and to test a model based on McCubbin's double Abcx theory predicting the relationships of these variables to family adaptation. The study was a secondary analysis of cross-sectional data collected in Beirut in 1987. The cluster sample consisted of 438 families chosen at random. Independent variables included objective stressors and perceived stress. The mediating variables were family resources and coping strategies. The dependent variables were health and interactional indicators of the outcome family adaptation: physical and psychological health, depression, and interpersonal and marital relationships. Families reported a medium to low number of objective war and non-war events stressors but a more severe perceived stress and moderate level of physical and psychological symptoms, depression, a problematic pattern in their interpersonal relationships, and good quality of marital relations. Findings provided support for the theoretical framework. Multiple regression analyses revealed that perceived stress, rather than the objective occurrence of events that predicted family adaptation. However, the more objective events experienced, the greater their perception as stressful, which led, in turn, to less positive family adaptation. Family resources particularly social support, directly and positively impacted family adaptation, and was also associated with increased use of cognitive coping. Cognitive coping did not predict either health or interactional outcomes; however behavioral coping predicted poor family adaptation. Discriminant analysis indicated a high degree of consistency in the prediction and classification of high/low perceived stress groups. Families in the low perceived stress groups had a more positive adaptation than those in the high perceived stress groups. The findings provide a beginning theoretical model which, upon further testing, can serve as a basis for practice by nurses and other health professionals when working with traumatized families.