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Coping Flexibility and Health-Related Quality of Life Among Older Adults: The Compensatory Effect of Co-rumination.

ABSTRACT: Background: Coping flexibility, defined as a wide range of coping strategies, may be a promising construct in determining coping effectiveness, especially in conjunction with a person-centered approach. However, no studies have focused on these issues. The study aimed to identify the distinct, multidimensional patterns of strategies for coping with chronic health conditions and their association with changes in physical and psychological health-related quality of life (HRQoL) among older adults over a one month period. Methods: Coping strategies (brooding, reflection, co-rumination, and positive reappraisal) and HRQoL psychological and physical domains were assessed twice (at the baseline and one month later) among 210 older adults (age 76.12 ± 9.09 years, 66% women). Findings: The parallel process analysis demonstrated the sample heterogeneity regarding coping. In multidimensional latent class growth analysis (MLCGA), four coping classes of overall strategies were identified: consistently low (46%), medium and decreasing (18%), medium and increasing (20%), and consistently high (16%). The last two can be considered the coping flexibility. Participants in the medium and increasing subgroup reported enhancement in HRQoL psychological domain, whereas members of the consistently high subgroup indicated its decrease. The favorable effects were related to an increase in co-rumination. Discussion: The findings shed light on the longitudinal patterns of coping in older adults, showing that coping flexibility is more adaptive when it relies on modifying coping efforts rather than coping complexity. Co-rumination played a key role, compensated by the effect of maladaptive strategies.

SUBMITTER: Kroemeke A

PROVIDER: S-EPMC6351461 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Coping Flexibility and Health-Related Quality of Life Among Older Adults: The Compensatory Effect of Co-rumination.

Kroemeke Aleksandra A

Frontiers in psychology 20190123

<b>Background:</b> Coping flexibility, defined as a wide range of coping strategies, may be a promising construct in determining coping effectiveness, especially in conjunction with a person-centered approach. However, no studies have focused on these issues. The study aimed to identify the distinct, multidimensional patterns of strategies for coping with chronic health conditions and their association with changes in physical and psychological health-related quality of life (HRQoL) among older ...[more]

PMID: 30728797

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Project description:BackgroundLiving with a chronic disease, such as primary antibody deficiency, will often have consequences for quality of life. Previous quality-of-life studies in primary antibody deficiency patients have been limited to different treatment methods. We wanted to study how adults with primary antibody deficiencies manage their conditions and to identify factors that are conducive to coping, good quality of life and hope.MethodsQuestionnaires were sent to all patients > or =20 years of age with primary antibody deficiencies who were served by Rikshospitalet University Hospital. The questionnaires consisted of several standardized scales: Ferrans and Powers Quality of Life Index (QLI), Short Form-36 (SF-36), Jalowiec Coping Scale (JCS), Nowotny Hope Scale (NHS), and one scale we devised with questions about resources and pressures in the past. Of a total of 91, 55 patients (aged 23-76 years) answered the questionnaires. The questionnaire study were supplemented with selected interviews of ten extreme cases, five with low and five with high quality of life scores.ResultsAmong the 55 patients, low quality of life scores were related to unemployment, infections in more than four organs, more than two additional diseases, or more than two specific occurrences of stress in the last 2-3 months. Persons with selective IgA deficiency had significantly higher QLI scores than those with other antibody deficiencies. An optimistic coping style was most frequent used, and hope values were moderately high. Based on the interviews, the patients could be divided into three groups: 1) low QLI scores, low hope values, and reduced coping, 2) low QLI scores, moderate hope values, and good coping, and 3) high QLI scores, moderate to strong hope values, and good coping. Coping was related to the patients' sense of closeness and competence.ConclusionLow quality of life scores in adults with primary antibody deficiencies were linked to unemployment and disease-related strains. Closeness and competence were preconditions for coping, quality of life and hope. The results are valuable in planning care for this patient group.

Project description:BackgroundObesity impairs cognition and health-related quality of life (HRQOL) in older adults; however, the appropriate treatment of obese older adults remains controversial.ObjectiveThe objective was to determine the independent and combined effects of weight loss and exercise on cognition, mood, and HRQOL in obese older adults.DesignOne hundred seven frail, obese older adults were randomly assigned to a control, weight-management (diet), exercise, or weight-management-plus-exercise (diet-exercise) group for 1 y. In this secondary analysis, main outcomes were Modified Mini-Mental State Examination (3MS) and total Impact of Weight on Quality of Life-Lite (IWQOL) scores. Other outcomes included Word Fluency Test, Trail Making Test Parts A and B, and Geriatric Depression Scale (GDS) scores.ResultsScores on the 3MS improved more in the diet (mean ± SE: 1.7 ± 0.4), exercise (2.8 ± 0.4), and diet-exercise (2.9 ± 0.4) groups than in the control group (0.1 ± 0.4) (between-group P = 0.0001-0.04); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. Scores on the Word Fluency Test improved more in the exercise (4.1 ± 0.8) and diet-exercise (4.2 ± 0.7) groups than in the control group (-0.8 ± 0.8; both P = 0.001). For the Trail Making Test Part A, scores in the diet-exercise group (-11.8 ± 1.9) improved more than in the control group (-0.8 ± 1.9) (P = 0.001); a similar finding was observed for the Trail Making Test Part B. Scores on the IWQOL improved more in the diet (7.6 ± 1.6), exercise (10.1 ± 1.6), and diet-exercise (14.0 ± 1.4) groups than in the control group (0.3 ± 1.6) (P = 0.0001-0.03); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. In the diet-exercise group, peak oxygen consumption and strength changes were independent predictors of 3MS changes; weight and strength changes were independent predictors of IWQOL changes. GDS scores did not change.ConclusionsWeight loss and exercise each improve cognition and HRQOL, but their combination may provide benefits similar to exercise alone. These findings could inform practice guidelines with regard to optimal treatment strategies for obese older adults. This trial was registered atclinicaltrials.govas NCT00146107.

Dataset Information

Coping Flexibility and Health-Related Quality of Life Among Older Adults: The Compensatory Effect of Co-rumination.

Publications

Coping Flexibility and Health-Related Quality of Life Among Older Adults: The Compensatory Effect of Co-rumination.

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