Estrategias de afrontamiento

  • 文章类型: Journal Article
    背景:妊娠丢失(PL)是常见的,然而,很少检查与心理健康受损风险增加相关的公共卫生问题,尤其是抑郁症。目标:先前的研究表明,无子女与PL后的抑郁症有关。第一批研究还表明损失类型的关联,多重损失,关系质量,以及怀孕后抑郁的应对策略。然而,结果不一致,少数现有研究显示方法学缺陷。因此,我们期望没有活孩子的女性抑郁得分更高,我们探索性地研究了损失类型之间的关联,损失的数量,关系质量,以及患有PL的女性抑郁评分的应对策略。方法:在联机设置中,在过去的12个月中,n=172例流产(n=137)或死产(n=35)的妇女完成了患者健康问卷(PHQ-D),简短-COPE,和Partnerschaftsfragebogen(PFB),衡量关系质量的德国问卷。结果:在多元层次回归分析中,死产,β=0.15,p=.035,存在活着的孩子,β=-0.17,p=0.022,自责/情绪回避,β=0.34,p<.001,是抑郁评分的预测因子。然而,抑郁症状和其他应对策略之间没有关联,关系质量,多重损失。结论:特别是对于没有活孩子的妇女,患有死胎,或者受到自责/情感回避的影响,卫生保健提供者应监测抑郁症状的存在。我们的结果表明,PL后需要特定的工具来衡量应对方式和关系质量,因为PFB和Brief-COPE的标准项目似乎不适合此设置。
    与流产相比,死产与更高的产妇抑郁评分相关。有活着孩子的女性在怀孕后比没有孩子的女性表现出更低的抑郁评分。自责和情绪回避与怀孕失败后更高的母亲抑郁评分相关。
    Background: Pregnancy loss (PL) is a common, yet rarely examined public health issue associated with an increased risk of impaired mental health, particularly depression.Objective: Previous research shows childlessness to be a correlate of depression after PL. First studies also indicate associations of the type of loss, multiple losses, relationship quality, and coping strategies with depression after the loss of a pregnancy. However, results are inconsistent and the few existing studies show methodological deficits. Therefore, we expect higher depression scores for women without living children, and we exploratively examine the associations between the type of loss, the number of losses, relationship quality, and coping strategies with depression scores for women who suffered a PL.Method: In an online setting, N = 172 women with miscarriage (n = 137) or stillbirth (n = 35) throughout the last 12 months completed the Patient Health Questionnaire (PHQ-D), Brief-COPE, and Partnerschaftsfragebogen (PFB), a German questionnaire measuring relationship quality.Results: In a multiple hierarchical regression analysis, stillbirth, β = 0.15, p = .035, presence of living children, β = -0.17, p = .022, and self-blame/emotional avoidance, β = 0.34, p < .001, are predictors of depression scores. However, there was no association between depression symptoms and other coping strategies, relationship quality, and multiple losses.Conclusions: Especially with regard to women who have no living children, have suffered a stillbirth, or are affected by self-blame/emotional avoidance, health care providers should monitor the presence of depressive symptoms. Our results indicate the need for specific instruments measuring coping style and relationship quality after PL, since the standard items of the PFB and the Brief-COPE seem inappropriate for this setting.
    Stillbirth is associated with higher maternal depression scores than miscarriage.Women with living children show lower depression scores after pregnancy loss than childless women.Self-blame and emotional avoidance are associated with higher maternal depression scores after pregnancy loss.
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  • 文章类型: Journal Article
    应激源相关疾病对个人和组织来说都是一个日益严重的问题。这项研究的目的是分析护士管理者用来面对危机的策略。对文献进行了系统的回顾,进行了定性研究.使用基于框架的综合分析数据,并将其归纳为多个领域。使用JBIQARI清单评估质量。10项研究符合纳入标准。数据收集是基于访谈,其次是问卷调查和焦点小组。良好的沟通,组织承诺和情感支持是主要领域。机构应支持护士经理应对压力,并提出适应建议。
    Stressor-related disorders are a growing issue for both the individual and the organizations. The aim of the study was to analyze the strategies used by nurse managers to face crises. A systematic review of the literature, including qualitative studies was performed. Data were analyzed using framework-based synthesis and summarized into domains. Quality was evaluated using the JBI QARI Checklist. 10 studies met the inclusion criteria. Data collection was based on interviews, followed by questionnaires and focus groups. Good communication, organizational commitment and emotional support were the principal domains. Institutions should support nurse managers to cope with stress and make suggestions for adaptations.
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  • 文章类型: Journal Article
    OBJECTIVE: Little is known about the role of coping in relation to suicidal risk in adolescents with Adjustment Disorder (AD). The present study aimed to assess the relation between suicidal ideation and intention and coping strategies in a clinical sample of adolescents with AD, paying special attention to gender differences.
    METHODS: Self-reported questionnaires about suicidal ideation and intention and coping strategies were administered to 108 adolescents with an AD diagnosis.
    RESULTS: Compared with the normative population, adolescents with an AD diagnosis made more use of Acceptance-Resignation (an avoidance-type coping strategy) and less use of Positive Reappraisal (an approach-type coping strategy). Nevertheless, gender introduced some peculiarities. A relationship was observed between the use of certain coping strategies and suicidal ideation and intention, but with notable differences depending on gender: significant and high correlations were found between these two variables in AD boys, both in the total approach score (r=.53, p<.01) and in the total avoidant score (r=.60, p<.01), with coping strategies explaining 41% of suicidal ideation and intention; in girls, in contrast, the only significant relationship was with an avoidant strategy, Emotional Discharge (r=.25, p<.05), although it had low explanatory power.
    CONCLUSIONS: Coping strategies must be taken into consideration when assessing and treating adolescents with AD at risk of suicide, especially in the case of boys. The absence of association between coping strategies and suicidal risk in girls is discussed, and some therapeutic proposals are presented.
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  • 文章类型: Journal Article
    Violence against health workers is a highly prevalent phenomenon with serious psychological and labour consequences among professionals. This paper aims, first, to find out the main studies undertaken to date to describe and analyse the phenomenon, as well as to present different initiatives and protocols of action carried out. The second objective is to offer a procedure of action both to prevent aggression and to intervene in the event of receiving an aggression at work. After a bibliographic search in PubMed, Scopus and SciELO databases, the impact of the aggressions suffered by health professionals, the contexts in which aggressions are more frequent, their main consequences and different strategies and protocols conducted in Spain are reviewed. Given that rigorous reviews supporting such procedures are lacking in scientific journals, different action guidelines for professionals to prevent and to deal with hostile behaviour based on available evidence are developed and proposed. Finally, an easily consultable and applicable action procedure for health workers attacked in the workplace is presented.
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  • 文章类型: Journal Article
    BACKGROUND: Bariatric surgery is considered a more effective means of achieving weight loss than non-surgical options in morbid obesity. Rates of failure or relapse range from 20 to 30%. The study aims to analyse the influence of psychological variables (self-esteem, social support, coping strategies and personality) in the maintenance of weight loss after bariatric surgery.
    METHODS: A cohort study was conducted involving 64 patients undergoing bariatric surgery for 24 months. At the end of the follow-up period, patients were divided into 2sub-cohorts classified as successes or failures. Success or favorable development was considered when the value of percent excess weight loss was 50 or higher.
    RESULTS: No statistically significant differences were observed between the 2groups in any variable studied. All patients had high self-esteem (87,3 those who failed and 88,1 those who are successful) and social support (90,2 and 90,9). Patients who succeed presented higher scores for cognitive restructuring (57,1) and were more introverted (47,1), while those who failed scored more highly in desiderative thinking (65,7) and were more prone to aggression (50,7) and neuroticism (51,7).
    CONCLUSIONS: High self-esteem and social support does not guarantee successful treatment. The groups differed in how they coped with obesity but the data obtained do not justify the weight evolution. In the absence of psychopathology, personality trait variability between patients is insufficient to predict the results.
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  • 文章类型: Journal Article
    OBJECTIVE: This study aims to measure the economic costs of maternal complication and to understand household coping strategies for financing maternal healthcare cost.
    METHODS: A household survey of the 706 women with maternal complication, of whom 483 had normal delivery, was conducted to collect data at 6 weeks and 6 months post-partum. Data were collected on socio-economic information of the household, expenditure during delivery and post-partum, coping strategies adopted by households and other related information.
    RESULTS: Despite the high cost of health care associated with maternal complications, the majority of families were capable of protecting consumption on non-health items. Around one-third of households spent more than 20% of their annual household expenditure on maternal health care. Almost 50% were able to avoid catastrophic spending because of the coping strategies that they relied on. In general, households appeared resilient to short-term economic consequences of maternal health shocks, due to the availability of informal credit, donations from relatives and selling assets. While richer households fund a greater portion of the cost of maternal health care from income and savings, the poorer households with severe maternal complication resorted to borrowing from local moneylenders at high interest, which may leave them vulnerable to financial difficulties.
    CONCLUSIONS: Financial protection, especially for the poor, may benefit households against economic consequences of maternal complication.
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