Situational aspects are more important in shaping proactive coping behaviour than individual characteristics: A vignette study among adults preparing for ageing

It seems likely that proactive coping is an important mechanism for dealing successfully with threats to personal goals, yet little empirical research has been conducted in relation to this concept. The aim of the present study is to examine to what extent proactive coping is influenced by situation-specific features as well as by personal characteristics. Three vignettes, each representing a potential decline in an important resource (health, social relationships and finance), were presented to 123 adults between 50 and 70 years old. Multilevel analyses show that proactive coping is highly variable within persons and that three situational factors (type of stressor, appraised threat and appraised control) affected the employment of proactive coping strategies. Future temporal orientation was identified as a significant, positive predictor of proactive coping, but none of the other personal factors were found to be relevant.     

Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management

This study examines the effectiveness of a brief self-management intervention to support patients recently diagnosed with type-2 diabetes to achieve sustained improvements in their self-care behaviours. Based on proactive coping, the intervention emphasizes the crucial role of anticipation and planning in maintaining self-care behaviours. In a randomised controlled trial among recent screen-detected patients, participants who received the intervention were compared with usual-care controls, examining changes in proximal outcomes (intentions, self-efficacy and proactive coping), self-care behaviour (diet, physical activity and medication) and weight over time (0, 3 and 12 months). Subsequently, the contribution of proactive coping in predicting maintenance of behavioural change was analysed using stepwise hierarchical regression analyses, controlling for baseline self-care behaviour, patient characteristics, and intentions and self-efficacy as measured after the course. The intervention was effective in improving proximal outcomes and behaviour with regard to diet and physical activity, resulting in significant weight loss at 12 months. Furthermore, proactive coping was a better predictor of long-term self-management than either intentions or self-efficacy. Proactive coping thus offers new insights into behavioural maintenance theory and can be used to develop effective self-management interventions.     

Adaptive Tasks in Multiple Sclerosis: Development of an Instrument to Identify the Focus of Patients' Coping Efforts

Objective : Adaptive tasks, referring to the subjective evaluation of disease-related stressors in relation to personal concerns, have been neglected in the extensive literature on coping with chronic disease. In this study, the development of an instrument for measuring adaptive tasks is described: the Questionnaire Adaptive Tasks in Multiple Sclerosis (QuAT-MS). Method : The QuAT-MS is based on a bottom-up categorization of patients' statements on the losses, threats, and challenges brought about by their disease, and employs 10 scales to measure the importance attached to particular disease-related stressors. Validity and reliability of this bottom-up categorization were established in a sample of MS patients ( N = 259) by examining their associations with related concepts relevant in adaptation to disease, such as coping (CISS), coping resources (LOT, self-efficacy), and quality of life (SIP). We also investigated whether patients' backgrounds and disease characteristics were related to adaptive tasks. Results : Adaptive tasks are more closely related with concepts relevant for adaptation (coping and coping resources) than with physical functioning (SIP) and disease-related characteristics (illness duration). Adaptive tasks are also associated with gender and level of education. Conclusion : It is concluded that adaptive tasks can be distinguished from related concepts like coping and quality of life. Furthermore, the QuAT-MS offers a reliable and patient-centred instrument for measuring the tasks which MS patients identify in their adaptation process.     

Development of E-Info Geneca: A Website Providing Computer-Tailored Information and Question Prompt Prior to Breast Cancer Genetic Counseling

This article describes the stepwise development of the website ‘E-info gene^ca’. The website provides counselees in breast cancer genetic counseling with computer-tailored information and a question prompt prior to their first consultation. Counselees generally do not know what to expect from genetic counseling and they tend to have a passive role, receiving large amounts of relatively standard information. Using the “intervention mapping approach,” we developed E-info gene^ca aiming to enhance counselees’ realistic expectations and participation during genetic counseling. The information on this website is tailored to counselees’ individual situation (e.g., the counselee’s age and cancer history). The website covers the topics of the genetic counseling process, breast cancer risk, meaning of being a carrier of a cancer gene mutation, emotional consequences and hereditary breast cancer. Finally, a question prompt encourages counselees to prepare questions for their genetic counseling visit.     

Coping and physical health outcomes: an overview

The aim of the present study was to investigate longitudinally the sensitivity of optimistic beliefs (positive outcome expectancies, efficacy expectancies, and optimistic bias) to disease-related stress (measured by disease duration, depressive symptoms, physical symptoms, physical impairment, and life-events) in Type 1 diabetes (n = 90) and multiple sclerosis (n = 90). First, we examined whether chronically ill patients were less optimistic than a healthy control group (n = 60), which showed that patients reported lower levels of optimistic bias but similar levels of the two other optimistic beliefs. Next, we analyzed the stability of the three types of optimistic beliefs across time (one year) for both disease groups, which demonstrated that optimistic bias in MS patients decreased. Finally, the impact of disease-related stressors on optimistic beliefs during a one-year period was determined, showing that all three optimistic beliefs decreased when patients reported depressive symptoms. Together, these findings show that positive outcome expectancies and efficacy expectancies were unaffected by being ill and fairly stable unless patients reported depressive symptoms while optimistic bias appeared to decrease as a result of being ill. Results are discussed in terms of the role of control and depression in optimistic bias.     

Cancer Genetic Counseling: Communication and Counselees’ Post-Visit Satisfaction,Cognitions, Anxiety,and Needs Fulfillment

Little is known about the relation between communication during cancer genetic counseling and outcome. We assessed associations between counselor-counselee communication and counselee satisfaction, cognitions, anxiety, and fulfillment of major needs, corrected for pre-visit levels as appropriate. In total 171 consecutive new counselees, mainly referred for breast or colon cancer, received pre- and post-visit questionnaires assessing needs/fulfillment, knowledge, perceived control (PPC), anxiety (STAI), and satisfaction. Initial visits were videotaped and counselor eye gaze was recorded. Verbal communication was rated by Roter Interaction Analysis System (RIAS). Asking more medical questions was associated with lower satisfaction levels. Receiving more medical information was related to higher correct knowledge scores, higher reported fulfillment of some needs, and unrelated to perceptions of control. Receiving more psychosocial information and longer counselor eye gaze were related to higher anxiety scores. Longer visits were related to higher correct knowledge scores. Providing medical information appears the most powerful communication aspect to increase counselee satisfaction and address needs. More research is needed on how to address adequately (emotional) needs and increase feelings of control.     

Knowledge and Attitudes Towards Genetic Testing: A Two Year Follow-Up Study in Patients with Asthma,Diabetes Mellitus and Cardiovascular Disease

Adequate knowledge and personal attitudes towards DNA-testing are major determinants of optimal utilization of genetic testing. This study aims to (1) assess the genetic knowledge and attitude towards genetic testing of patients with asthma, diabetes mellitus type II and cardiovascular diseases, (2) determine whether their knowledge or attitude changed since 2002, and (3) investigate the predictive role of knowledge on attitude. Data were collected within the Panel of Patients with Chronic Diseases in 2002 and 2004, resulting in 398 data-pairs. Results show that factual knowledge mainly relates to associations between genes and diseases, less is known on associations between genes, chromosomes, cells and body. The perceived knowledge on DNA-testing has not increased since 2002. The attitude towards genetic testing also appeared to be rather consistent. Less perceived medical genetic knowledge and more perceived social genetic knowledge were found predictive for a more reserved attitude towards genetic testing. In conclusion, advanced developments in the field of genetics are not accompanied by increased knowledge of patients with common multi-factorial diseases. The finding that more perceived social genetic knowledge results in more reluctance can be considered an indicator for the necessity of social debates on genetic testing.     

The characteristics of a potential goal threat predict attention and information-seeking in middle-aged and older adults

The present experiment examined to what extent features of a potential goal threat and personal characteristics affect attention and information-seeking in 124 adults aged 50–70. We manipulated two characteristics of a potential decline in future health: the amount of control people have over preventing the threat (no-control versus control) and the amount of time left before the threat will occur (short-term versus long-term). As expected, a shorter period of time left resulted in more attention being paid to threat signals and also in more information being sought. Control did not influence attention, but did have an effect on information-seeking behavior. More control resulted in more time that was taken to seek information about the potential health threat and possible ways to prevent it. Aging anxiety was a predictor of attention, and age and education predictors of information-seeking. None of the other personal factors were found to be relevant.     

A one year study of coping,social support and quality of life in parkinson's disease

Abstract

The role of coping and social support in the quality of life for Parkinson's Disease (PD) patients is not well understood. Most studies are cross-sectional and concentrate on depression as an outcome measure. The aim of the present study was to explore the role of coping and social support in quality of life for patients with PD. Self-report measures were completed by 105 sufferers of PD; 75 completed the same questionnaire a year later. Patients had the most problems with social function, followed by problems with mobility control and psychological autonomy and communication. After controlling for age, gender and illness duration, the number of PD symptoms predicted mobility control, social functioning and psychological function. Passive coping explained additional variance in most functional domains with more passive coping being related to increased problems. The quality of life was highly stable over the course of the year. Active coping was related to superior psychological functioning one year later. In fact, this was the only coping and social support variable related to functioning after one year, when controlling for previous functions. The results are discussed in terms of the importance of symptom management in PD.