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The adolescents in thls study described the use of dlstanclng, or the purposeful use of dlstracting thoughts to cope wlth the unpleasant emotions aroused by stressful events dunng

Coping strategies of hospitalized adolescents.

Children's health care : journal of the Association for the Care of Children's Health, no. 3 (2010): 163-169

Cited by: 8|Views6
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Abstract

This study identified how adolescents cope with hospitalization for surgery and the congruency between anticipated and actual coping strategies. Preoperative emotional state was examined in relation to the type of reported coping strategies. Fifty-nine adolescents were interviewed before and after surgery. Six coping strategies were ident...More

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Introduction
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  • The number of these lnvestlgatlons 1s I ~ m ~ t eads, IS the generaltzabllrty of the findlngs Because most Investlgators have used smngle-subject case study des~gnsto gather observat~onaldata, the theoretrcal perspectrve used to select behav~orsfor observatron and to rnterpret these behavrors has Influenced the results
Highlights
  • Taylor & Francis makes every effort to ensure the accuracy of all the information contained in the publications on our platform
  • This study identifiedhow adolescentscope with hospltalt7~tionfor surgery and the congruency between anttcipated and actual coping strateges Preoperative emottonal state was examined in relat~onto the type of reported coping strategtes F~ftv-nineadolescents were intervie~edbefore and after surgery Six coplng strategies were identified there was no statisttcally stgnificant relationship between anttctpated and actual strateges, the htghest proportion of adolescents in the study (23 of 59) both anticipated and reported the use of strateges to regulate the emotional distress aroused by stressful encounters dunng hospttali7ation No statistically significant relattonship extsted between preoperative emotional state and reported coping strategws
  • Content val~d~twyas establlshed by havzng four experts In the area of stress and coplng revlew the lntervlew schedules T h e lntervlews were des~gnedto obtaln a maxmum amount of data on the nature and meanlng of thls expenence for the adolescent (Swanson & Chen~tz, 1982) Internal validlty of the Instrument was establlshed by asking multrple questlons about coplng strateges and prov~dlngoverlapping frames of reference to the respondent In an attempt to offset the problems of omlsslon of relevant data from underreportlng or failure of recall (Cannel, Marqu~s&, Laurent, 1977, Dean & Whyte, 1958)
  • W ~ t h~nstttuttonalapproval to conduct the study, I collected data over a 9-month per~od Dally telephone contact was made wlth the unlt secretaries o r nurslng staff of the SIX hosp~tals used for data coHect~onTelephone contact was used to determlne whether el~grbleadolescents were scheduled for admlssron to the hosp~tal that evenlng for surgery the following day T h e author, the sole lnvestlgator, approached the potentla1 subject and h ~ os r her parent on the evenlng of admlss~onto the hosp~talT h e subjects were told that the purpose of the study was to learn what it is llke to be a teenager In the hosp~taland what things teenagers do to cope with thls experience The subjectswere told that the investigator would be conductlng an Interview nrth them that evenlng and agaln in a telephone interview about 2 weeks after them return home Convenience and adolescents' preference for use of telephones were the reasons for conductlng the follow-up Interview via telephone
  • The type of strategymost frequently mentroned by the adolescent in h ~ os r her preoperative Interview was consrdered the anticipated coping strategy The type of strategy most frequently mentioned in the postoperative interview was considered the reported strategy Those adolescents who anticipated or reported emotion-focused and problem-focused coping wlth equal frequency were categorized as mixed (Table 2) To establish the relatronship between the antrclpated strategy and reported strategy, a crosstabulation of the strategy most frequently mentioned by each adolescent In the pre- and postoperatlve Interviews was completed there was not a significant relatronshlp between anticipated and reported strategy (x2[2,N = 591
  • The adolescents in thls study described the use of dlstanclng, or the purposeful use of dlstracting thoughts to cope wlth the unpleasant emotions aroused by stressful events dunng
Methods
  • Two sem~structuredtntervlew schedules were developed to determlne what adolescents cons ~ d e rstressful during hosp~tal~zat~aonnd how they cope w ~ t hthese stressors The questlons included were derlved from the Emot~onInterview, Stress and Coplng Project (Lazarus & Cohen, 1977), the Ways of Coplng Checklist (Folkman, 1982, Folkman & Lazarus, 1980), Adolescents Coplng w ~ t hHospltallzat~on(Savedra & Cnttenden, 1982), and the author's review of the literature Preoperative emot~onal state was measured by asking adolescents durlng the tnlt~alntervlew to select the word that best described how they were feeling at the tlme about the impendrng surgery P r ~ oresearch by Folkman and Lazarus (1983) and Mllkte~n (1983) gu~dedselect~onof a serles of adjectives representing the follow~ngappraisal categories threat, challenge, harm, and benefit.
Conclusion
  • SIXcoplng strategles were anticipated and/or reported by the adolescents In this study dlstancmg, Inaction, self-control,seeklng soclal s u p port, actlve coping, and situational control.
  • The adolescents in thls study described the use of dlstanclng, or the purposeful use of dlstracting thoughts to cope wlth the unpleasant emotions aroused by stressful events dunng Wb. CHC, SUYlMER 10b9, Ya 18, NO.
  • COPING STRATEGIES USED BY ADOLESCENTS Scrdccgy Theme of Stnrcgy.
  • Inactton Self-control Seektng soctal support Probiet11-focused coptng Acttve coptng
Tables
  • Table1: COPING STRATEGIES USED BY ADOLESCENTS
Download tables as Excel
Funding
  • = 0 24, p = 0 62), the largest percentage of adolescentsboth antlclpated and reported using emot~on-focusedstrategies (Table 2) Distancing (46%, N = 27) and seeklng emotional support (68%N, = 40),particularly from mothers(54%), were the two most frequently antlclpated and/ or reported emot~on-focusedcoplng strategles
  • Most of the adolescents reported thew preoperatlve emotional state to be one of threat (60%)and almost all of others reported it to be of challenge (27%) A cross-tabulat~onof emotlonal state before surgery and reported coping strategy was performed Low cell frequencies prevented further statlstrcal testing
Study subjects and analysis
adolescents: 61
. Sample

A convenlence sample of female and male adolescents between the ages of 12and 17 years was studted Only subjects adm~ttedfor a scheduled surgcal procedure requlnng an overn~ght stay the evenlng before surgery were Included In the study Subjects were recru~tedfrom SIX hospitals

Of 61 adolescents approached for partmpatton, 2 refused Thlrty males and 29 females w ~ t ha mean age of 13 8 years (SD = 57) partlc~patedSeventy-SIXpercent were caucaslan, 10% black, 10% hlspanlc, 1% Aslan, and 3% other Th~rty-fiveof the subjects had a pnor expenence w ~ t hhosp~tallzat~o(nrange, 0 to 10, M = 2) F~fty-fourpercent were hospltallzed for orthoped~csurgery, 13% for ear, nose, and throat, and the rema~nderfor plast~creconstructive, neurolog~c,urologrc, cardlac, o r general surgery Instruments

Two sem~structuredtntervlew schedules were developed to determlne what adolescents cons ~ d e rstressful during hosp~tal~zat~aonnd how they cope w ~ t hthese stressors The questlons included were derlved from the Emot~onInterview, Stress and Coplng Project (Lazarus & Cohen, 1977), the Ways of Coplng Checklist (Folkman, 1982, Folkman & Lazarus, 1980), Adolescents Coplng w ~ t hHospltallzat~on(Savedra & Cnttenden, 1982), and the author's review of the literature Preoperative emot~onal state was measured by asking adolescents durlng the tnlt~alntervlew to select the word that best described how they were feeling at the tlme about the impendrng surgery P r ~ oresearch by Folkman and Lazarus (1983) and Mllkte~n (1983) gu~dedselect~onof a serles of adjectives representing the follow~ngappraisal categories threat, challenge, harm, and benefit

The vanable of antrclpated coplng strategy was measured by asklng adolescents durlng the preoperatlve lntervlew to ~dentrfywhat they thought they would d o to manage the stressors of hospltallzatlon T h e vanable of reported c o p mg strategies was measured by responses to questlons dunng the postoperative lntervlew about how the adolescents actually managed the most drficult events durlng hosp~tallzatlon

T h e preoperatlve lntervlew g u ~ d esurveyed the adolescents' experlence w~thprlor hospitallzatron (e g , "What d o you remember about prevlous hospttal~zatlons?"),experlence at the announcement of hospltal~zat~o(ne g , 'Make a checkmark by the words that best descrlbe how you felt when you were first told that you needed to come to the hosp~tal"),and experlence In the lmmedlate preoperatlve perlod (e g , "What d o you thlnk will be the worst part about belng In the hosp~tal'") In addlt~ont,he adolescent was lnterv~ewedby telephone after the hosp~tal~zat~Ionnorder to survey the adolescent's experlence wlth posthospttal~zat~o(en g , "Was belng In the hosprtal better o r worse than you expected?") (A complete ltstlng of all the questlons used In the lntervlew g u ~ d eIS available from the author )

Content val~d~twyas establlshed by havzng four experts In the area of stress and coplng revlew the lntervlew schedules T h e lntervlews were des~gnedto obtaln a maxmum amount of data on the nature and meanlng of thls expenence for the adolescent (Swanson & Chen~tz, 1982) Internal validlty of the Instrument was establlshed by asking multrple questlons about coplng strateges and prov~dlngoverlapping frames of reference to the respondent In an attempt to offset the problems of omlsslon of relevant data from underreportlng or failure of recall (Cannel, Marqu~s&, Laurent, 1977, Dean & Whyte, 1958)A convenlence sample of female and male adolescents between the ages of 12and 17 years was studted Only subjects adm~ttedfor a scheduled surgcal procedure requlnng an overn~ght stay the evenlng before surgery were Included In the study Subjects were recru~tedfrom SIX hospitals
. Of 61 adolescents approached for partmpatton, 2 refused Thlrty males and 29 females w ~ t ha mean age of 13 8 years (SD = 57) partlc~patedSeventy-SIXpercent were caucaslan, 10% black, 10% hlspanlc, 1% Aslan, and 3% other Th~rty-fiveof the subjects had a pnor expenence w ~ t hhosp~tallzat~o(nrange, 0 to 10, M = 2) F~fty-fourpercent were hospltallzed for orthoped~csurgery, 13% for ear, nose, and throat, and the rema~nderfor plast~creconstructive, neurolog~c,urologrc, cardlac, o r general surgery

adolescents: 61
Sample

A convenlence sample of female and male adolescents between the ages of 12and 17 years was studted Only subjects adm~ttedfor a scheduled surgcal procedure requlnng an overn~ght stay the evenlng before surgery were Included In the study Subjects were recru~tedfrom SIX hospitals

Of 61 adolescents approached for partmpatton, 2 refused Thlrty males and 29 females w ~ t ha mean age of 13 8 years (SD = 57) partlc~patedSeventy-SIXpercent were caucaslan, 10% black, 10% hlspanlc, 1% Aslan, and 3% other Th~rty-fiveof the subjects had a pnor expenence w ~ t hhosp~tallzat~o(nrange, 0 to 10, M = 2) F~fty-fourpercent were hospltallzed for orthoped~csurgery, 13% for ear, nose, and throat, and the rema~nderfor plast~creconstructive, neurolog~c,urologrc, cardlac, o r general surgery Instruments

Two sem~structuredtntervlew schedules were developed to determlne what adolescents cons ~ d e rstressful during hosp~tal~zat~aonnd how they cope w ~ t hthese stressors The questlons included were derlved from the Emot~onInterview, Stress and Coplng Project (Lazarus & Cohen, 1977), the Ways of Coplng Checklist (Folkman, 1982, Folkman & Lazarus, 1980), Adolescents Coplng w ~ t hHospltallzat~on(Savedra & Cnttenden, 1982), and the author's review of the literature Preoperative emot~onal state was measured by asking adolescents durlng the tnlt~alntervlew to select the word that best described how they were feeling at the tlme about the impendrng surgery P r ~ oresearch by Folkman and Lazarus (1983) and Mllkte~n (1983) gu~dedselect~onof a serles of adjectives representing the follow~ngappraisal categories threat, challenge, harm, and benefit

The vanable of antrclpated coplng strategy was measured by asklng adolescents durlng the preoperatlve lntervlew to ~dentrfywhat they thought they would d o to manage the stressors of hospltallzatlon T h e vanable of reported c o p mg strategies was measured by responses to questlons dunng the postoperative lntervlew about how the adolescents actually managed the most drficult events durlng hosp~tallzatlon

T h e preoperatlve lntervlew g u ~ d esurveyed the adolescents' experlence w~thprlor hospitallzatron (e g , "What d o you remember about prevlous hospttal~zatlons?"),experlence at the announcement of hospltal~zat~o(ne g , 'Make a checkmark by the words that best descrlbe how you felt when you were first told that you needed to come to the hosp~tal"),and experlence In the lmmedlate preoperatlve perlod (e g , "What d o you thlnk will be the worst part about belng In the hosp~tal'") In addlt~ont,he adolescent was lnterv~ewedby telephone after the hosp~tal~zat~Ionnorder to survey the adolescent's experlence wlth posthospttal~zat~o(en g , "Was belng In the hosprtal better o r worse than you expected?") (A complete ltstlng of all the questlons used In the lntervlew g u ~ d eIS available from the author )

Content val~d~twyas establlshed by havzng four experts In the area of stress and coplng revlew the lntervlew schedules T h e lntervlews were des~gnedto obtaln a maxmum amount of data on the nature and meanlng of thls expenence for the adolescent (Swanson & Chen~tz, 1982) Internal validlty of the Instrument was establlshed by asking multrple questlons about coplng strateges and prov~dlngoverlapping frames of reference to the respondent In an attempt to offset the problems of omlsslon of relevant data from underreportlng or failure of recall (Cannel, Marqu~s&, Laurent, 1977, Dean & Whyte, 1958)A convenlence sample of female and male adolescents between the ages of 12and 17 years was studted Only subjects adm~ttedfor a scheduled surgcal procedure requlnng an overn~ght stay the evenlng before surgery were Included In the study Subjects were recru~tedfrom SIX hospitals. Of 61 adolescents approached for partmpatton, 2 refused Thlrty males and 29 females w ~ t ha mean age of 13 8 years (SD = 57) partlc~patedSeventy-SIXpercent were caucaslan, 10% black, 10% hlspanlc, 1% Aslan, and 3% other Th~rty-fiveof the subjects had a pnor expenence w ~ t hhosp~tallzat~o(nrange, 0 to 10, M = 2) F~fty-fourpercent were hospltallzed for orthoped~csurgery, 13% for ear, nose, and throat, and the rema~nderfor plast~creconstructive, neurolog~c,urologrc, cardlac, o r general surgery. Two sem~structuredtntervlew schedules were developed to determlne what adolescents cons ~ d e rstressful during hosp~tal~zat~aonnd how they cope w ~ t hthese stressors The questlons included were derlved from the Emot~onInterview, Stress and Coplng Project (Lazarus & Cohen, 1977), the Ways of Coplng Checklist (Folkman, 1982, Folkman & Lazarus, 1980), Adolescents Coplng w ~ t hHospltallzat~on(Savedra & Cnttenden, 1982), and the author's review of the literature Preoperative emot~onal state was measured by asking adolescents durlng the tnlt~alntervlew to select the word that best described how they were feeling at the tlme about the impendrng surgery P r ~ oresearch by Folkman and Lazarus (1983) and Mllkte~n (1983) gu~dedselect~onof a serles of adjectives representing the follow~ngappraisal categories threat, challenge, harm, and benefit

adolescents: 61
A convenlence sample of female and male adolescents between the ages of 12and 17 years was studted Only subjects adm~ttedfor a scheduled surgcal procedure requlnng an overn~ght stay the evenlng before surgery were Included In the study Subjects were recru~tedfrom SIX hospitals. Of 61 adolescents approached for partmpatton, 2 refused Thlrty males and 29 females w ~ t ha mean age of 13 8 years (SD = 57) partlc~patedSeventy-SIXpercent were caucaslan, 10% black, 10% hlspanlc, 1% Aslan, and 3% other Th~rty-fiveof the subjects had a pnor expenence w ~ t hhosp~tallzat~o(nrange, 0 to 10, M = 2) F~fty-fourpercent were hospltallzed for orthoped~csurgery, 13% for ear, nose, and throat, and the rema~nderfor plast~creconstructive, neurolog~c,urologrc, cardlac, o r general surgery. Two sem~structuredtntervlew schedules were developed to determlne what adolescents cons ~ d e rstressful during hosp~tal~zat~aonnd how they cope w ~ t hthese stressors The questlons included were derlved from the Emot~onInterview, Stress and Coplng Project (Lazarus & Cohen, 1977), the Ways of Coplng Checklist (Folkman, 1982, Folkman & Lazarus, 1980), Adolescents Coplng w ~ t hHospltallzat~on(Savedra & Cnttenden, 1982), and the author's review of the literature Preoperative emot~onal state was measured by asking adolescents durlng the tnlt~alntervlew to select the word that best described how they were feeling at the tlme about the impendrng surgery P r ~ oresearch by Folkman and Lazarus (1983) and Mllkte~n (1983) gu~dedselect~onof a serles of adjectives representing the follow~ngappraisal categories threat, challenge, harm, and benefit

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