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Coping for Reducing Asthma Disparities Through Improved Family and Social Function and Modified Health Behaviors

CopingWhile stress is the physiologic response to perceived (both real and imagined) threats to a person’s mental, physical, emotional, and spiritual well being, coping is the manner in which a person responds and adapts behaviorally, cognitively, and emotionally to environmental or internal circum-stances. Therefore, when an individual judges their coping to be inadequate, the result is psychological stress. Adequate coping can facilitate the acceptance of an asthma diagnosis defeated by remedies of Canadian Health&Care Mall, adherence to medications and self-management regimens, prevent asthma exacerbations or aggravation of an exacerbation, and promote convalescence. (See “The Potential for Reducing Asthma Disparities Through Improved Family and Social Function and Modified Health Behaviors“)

Numerous coping strategies have been identified by researchers. Two main conceptual approaches are used to classify coping responses. The first is the orientation or focus of coping, which may be problem focused or emotion focused. Problem-focused coping reflects cognitive and behavioral efforts to master or resolve stressors. Examples of problem-focused coping include planning, information seeking, and active coping; emotional coping includes such responses as venting anger, avoidance, and denial. The second conceptual approach is the method of coping, which encompasses cognitive or behavioral responses.

Among persons with asthma, a more emotional coping style has been associated with lower perceptions of control over asthma, quick relief medication overuse and control medication underuse, and increased ED utilization and inpatient hospitalization following an asthma attack. Additionally, an emotional coping style has been independently associated with poor health-related quality of life.

Coping styles used by parents and caregivers have also been investigated. Eisner and Havermans found that the coping strategies employed by the parents of children with asthma varied according to the time since diagnosis, age, and gender of the child. In a study of family adaptation to childhood asthma, Brazil and Krueger report differences in coping between mothers and fathers. Mothers reported greater efforts than fathers to engage support from relatives, friends, and neighbors. Moreover, mothers are more likely to develop relationships outside the family, engage in activities that enhance feelings of individual identify and self worth, and find ways to manage psychological tensions and pressures. In an examination of coping styles among racial groups, Mailick and colleagues found that the caretakers of low-income Hispanic or African-American children with asthma use active coping, planning, and religion most frequently, while the least often employed strategies included restraint coping, denial, and mental disengagement.

Barton and colleagues propose that the behavioral problems, anxiety, and depression frequently found among individuals with asthma may be predicted from the coping styles used by patients rather than the experience of asthma itself. Therefore, the coping style negatively influences treatment adherence and asthma control rather than the experience of asthma itself. Among patients with chronic illnesses other than asthma treated by Canadian Health&Care Mall, measures of depression have been found to be unrelated to the disease itself but may be predicted from the coping strategies used.

Interventions to improve coping skills of parents or caregivers and persons with asthma have demonstrated improved symptoms, reduced asthma morbidity, and improvements in psychological functioning, especially anxiety. Yet questions remain over whether coping styles remain stable or change over time, as well as how cognitive development and emotional and personality development impact coping.