Estresse e Enfrentamento das Dificuldades em Universitários da Área da Saúde / Stress and Coping with Difficulties in Health University Students / Estrés y Enfrentamiento de Dificultades por Universitarios del Sector Salud

Resumo: Este estudo pretende identificar a percepção de estudantes de uma mesma instituição de ensino superior da área da saúde sobre dificuldades acadêmicas e não acadêmicas, estratégias de coping e identificar a presença de estresse. Foi um estudo transversal utilizando abordagens quantitativa e qualitativa, desenvolvido por meio de questionário estruturado e inventários psicométricos validados ( COPE Breve; inventário de sintomas de estresse ISLL ). Adicionalmente, foram realizadas entrevistas para ampliar a compreensão dos resultados dos instrumentos quantitativos. Na etapa quantitativa, participaram 162 estudantes dos cursos de graduação em Fisioterapia, Fonoaudiologia, Medicina, Nutrição e Terapia Ocupacional. Destes, 60 participaram de entrevista qualitativa. Os dados foram submetidos à análise estatística univariada e análise multivariada por regressão logística. Os estudantes relataram encontrar grande número de dificuldades e utilizar variadas estratégias de coping . A análise estatística univariada demonstrou que não houve diferenças importantes entre cursos e etapas quanto ao número de dificuldades e estratégias utilizadas. A presença de estresse foi identificada em proporções entre 45% e 100% dos estudantes, conforme o curso e a etapa considerada, sem diferenças significativas entre eles. A análise multivariada identificou cinco variáveis independentes como determinantes de estresse: sexo feminino, renda familiar, número de dificuldades acadêmicas/não acadêmicas e número de estratégias de coping voltadas à "emoção" presentes. Esta análise também mostrou que o estresse patológico está relacionado a somente uma variável: o número de dificuldades não acadêmicas. Estes achados reforçam a necessidade de manter ações institucionais de assistência social e apoio psicológico, favorecendo assim um planejamento efetivo de medidas de promoção da saúde mental dos estudantes.

Abstract: This study aimed to find undergraduate students' perceptions about academic and non-academic difficulties and coping strategies and determining the occurrence of stress among them. This was a cross-sectional study using quantitative and qualitative approaches to evaluate students from different health professions in a single institution. Physical therapy, speech therapy, medicine, nutrition, and occupational therapy program students (N=162) answered a structured questionnaire and two validated psychometric inventories (COPE Brief scale and the ISS stress symptoms inventory). Additionally, 60 students underwent a semi-structured interview to better understand the results from the quantitative instruments. Quantitative data underwent univariate analysis to test differences between proportions and stepwise multiple regression analysis to identify the independent determinants of stress. Students reported a large number of academic and non-academic difficulties and a variety of coping strategies. Univariate statistical analysis showed no significant differences between courses and stages regarding the number of difficulties and coping strategies. A large proportion of students showed stress, ranging from 45% to 100%, depending on the course and stage, with no significant differences between them. Multivariate statistical analysis found five independent variables as stress determinants: female gender, low family income, number of academic and non-academic difficulties, and number of emotion-focused coping strategies. This analysis also showed that pathological stress is related to only one variable: the number of non-academic difficulties. These findings reinforce the importance of maintaining institutional actions for student social assistance and psychological support. Results also provide meaningful data for adequately planning more effective measures to promote students' mental health.

Resumen: Este estudio pretende identificar la percepción de los estudiantes del sector salud sobre las dificultades académicas y no académicas, las estrategias de coping y la presencia de estrés. Este estudio transversal, con enfoque cuantitativo y cualitativo, utilizó cuestionarios estructurados e inventarios psicométricos validados (escala Brief COPE; inventario de sintomatología de estrés ISE ); además de entrevistas para ampliar la comprensión de los resultados de los instrumentos cuantitativos. En la etapa cuantitativa participaron 162 estudiantes de los cursos de grado en Fisioterapia, Fonoaudiología, Medicina, Nutrición y Terapia Ocupacional. De estos, 60 participaron en la entrevista cualitativa. Los resultados se sometieron a análisis estadístico univaria nte, para distinguir los grupos y asociaciones entre variables, y a análisis multivariado por regresión logística para identificar variables independientes que determinan el estrés. Los estudiantes reportaron enfrentar muchas dificultades académicas y no académicas, y utilizaban diferentes estrategias de coping. El análisis estadístico univariante no obtuvo diferencias significativas entre cursos y etapas respecto al número de dificultades y estrategias utilizadas. Un 45% y 100% de los estudiantes experimentaron estrés según el curso y la etapa considerada, sin diferencias significativas entre ellos. Se encontraron cinco variables independientes como factores de estrés: sexo femenino, renta familiar, número de dificultades académicas/no académicas y número de estrategias de coping orientadas a la "emoción". El estrés patológico estuvo relacionado solo a la variable número de dificultades no académicas. Se necesita mantener acciones institucionales de asistencia social y apoyo psicológico para favorecer una planificación efectiva de medidas de promoción de salud mental de los estudiantes.

Vítimas indiretas dos homicídios: impactos; apoio recebido e estratégias de superação / Indirect homicide victims: impacts, support received, and coping strategies

Resumo O Brasil tem apresentado elevado percentual de homicídio e mortes por intervenção legal. Este artigo faz parte de um estudo qualitativo de casos múltiplos sobre vítimas indiretas que perderam parentes por homicídio devido à ação de agentes de segurança e de policiais no Rio de Janeiro. Os dados provêm de quatro entrevistas individuais com familiares de pessoas mortas por policiais e três familiares de policiais vítimas de homicídio, que foram submetidos à análise temática. Os depoimentos revelaram os impactos da perda do familiar na saúde das vítimas indiretas, como o intenso sofrimento mental e a repercussão negativa em ocupações humanas, como trabalho, lazer, sono e cuidado em saúde. Ante a experiência traumática, o apoio das instituições é limitado, ao passo que grupos ativistas e entidades ligadas aos direitos humanos são relatados, pelos entrevistados, como de grande ajuda na elaboração da dor da perda, sobretudo no grupo dos que perderam seus entes pela ação policial. O estudo indica a necessidade de pesquisas sobre as lacunas entre os equipamentos e políticas públicas e as necessidades das vítimas indiretas.

Abstract Brazil has recorded a high percentage of homicides and deaths due to legal intervention. This article is part of a qualitative multiple case study about indirect victims who lost relatives to homicide perpetraded by security agents and police officers in Rio de Janeiro. Data were collected in four individual interviews with family members of people killed by police officers and three family members of police officers who were victims of homicide, and then subjected to thematic analysis. The testimonies revealed the major impacts of the loss of a family member on the indirect victim's health, such as intense mental suffering and the negative impacts on human occupations such as work, leisure, health care, and sleep. Institutional support is limited in the face of the traumatic experience, whereas activist groups and entities tied to human rights advocacy are of great help in overcoming the pain of loss, especially for those who have lost their family members to the police. Further research is needed about the gaps between public facilities and policies and the needs of indirect victims.

Burnout, estrategias afrontamiento y satisfacción laboral en enfermeros / Burnout, coping strategies and job satisfaction in nurses

Resumen Objetivo: Determinar la relación que existe entre burnout, estrategias de afrontamiento y satisfacción laboral en enfermeros del área asistencial COVID en Lima Este. Materiales y Método: Estudio de diseño cuantitativo, correlacional y descriptivo, se contó con la participación de 300 enfermeros peruanos que laboraron en los servicios COVID-19 de alto riesgo durante la emergencia sanitaria. Resultados: Se determinó con la prueba Rho de Spearman, para el Síndrome de Burnout (SB) y estrategias de afrontamiento un resultado de 0.223 (p<0.01), que es una relación positiva, directa y altamente significativa, mientras que, la relación entre el SB y la satisfacción laboral es de -0.627 (p<0.01), que es una relación negativa, inversa y altamente significativa, y finalmente la relación entre estrategias de afrontamiento y satisfacción laboral, el resultado fue de 0.368 (p<0.01), lo que indica una relación positiva, directa y altamente significativa. Conclusiones: Existe una relación lineal significativa (ANOVA F=120.353, p=0.000) entre la satisfacción laboral como variable criterio; y el SB y las estrategias de afrontamiento como variables predictoras.

Abstract Objective: To determine the relationship between burnout, coping strategies, and job satisfaction among nurses working in the COVID care area in East Lima. Materials and Methods: A quantitative, descriptive, and correlational study was conducted with the participation of 300 Peruvian nurses who worked in high-risk COVID-19 services during the health emergency. Results: Spearman's Rho test showed a result of 0.223 (p<0.01) for the burnout syndrome and coping strategies, indicating a positive, direct, and highly significant relationship. The relationship between the burnout syndrome and job satisfaction was -0.627 (p<0.01), indicating a negative, inverse, and highly significant relationship. Finally, the relationship between coping strategies and job satisfaction had a result of 0.368 (p<0.01), indicating a positive, direct, and highly significant relationship. Regarding the prediction of the variables, the coefficient of determination (adjusted R2) was analyzed, obtaining a result of 0.444, indicating that 44.4% of the variability in job satisfaction is explained by the variables of burnout syndrome and coping strategies. Conclusions: There is a significant (ANOVA F=120.353, p=0.000) linear relationship between job satisfaction as the criterion variable, and burnout syndrome and coping strategies as predictor variables.

Estrategias de afrontamiento centradas en las emociones de enfermeros de un hospital de Corrientes en el año 2022 / Coping strategies focused on emotions in nurses from a hospital in Corrientes in the year 2022

Introducción: el personal de enfermería enfrenta a diario jornadas extendidas de trabajo, tiene muchos pacientes a su cargo, dificultades en las relaciones interpersonales, que podrían desencadenar en estrés, para lo cual el individuo desarrolla un proceso de adaptación o desequilibrio y es por esta razón la importancia de contar con estrategias para afrontar las situaciones. Objetivos: el objetivo de este estudio fue analizar las estrategias de afrontamiento ante situaciones de estrés utilizadas por los profesionales de enfermería de un Hospital Público de la ciudad de Corrientes capital, así como su asociación con variables socio demográficas. Metodología: estudio de tipo cuantitativo, descriptivo, transversal y observacional. La población incluyó enfermeros de un hospital público de la ciudad de Corrientes en el período 2022. Se consideró como criterios de inclusión personal de enfermería que cumpla funciones asistenciales y su tiempo de labor fuera de 1 año o más; como criterios de exclusión, personal que tuviera dos o más puestos de trabajo y de criterios de eliminación aquellos enfermeros que no se encuentren presentes al momento de la encuesta. El cálculo del tamaño muestral se realizó a través del método probabilístico aleatorio simple resultando de éste 120 profesionales de enfermería. Para la recolección de datos, se aplicó una encuesta adaptada del cuestionario Ways of Coping Questionnaire de Lazarus y Folkman. Resultados: se evidenció que la estrategia de afrontamiento más utilizada por los enfermeros fue la reinterpretación positiva. Conclusión: a través de este estudio se logró reconocer las estrategias de afrontamiento que el personal de enfermería utilizó al momento de enfrentar situaciones o experiencias estresantes[AU]

Introduction: nursing staff face extended work days daily, have many patients under their care, difficulties in interpersonal relationships, which could trigger stress, for which the individual develops a process of adaptation or imbalance and it is for this reason the importance of having strategies to deal with situations. Objectives: the objective of this study was to analyze coping strategies in stressful situations used by nursing professionals from a Public Hospital in the capital city of Corrientes, as well as their association with sociodemographic variables. Methodology: quantitative, descriptive, cross-sectional and observational study. The population included nurses from a public hospital in the city of Corrientes in the period 2022. Inclusion criteria were considered nursing personnel who perform care functions and their time of work was 1 year or more; as exclusion criteria, personnel who had two or more jobs and as elimination criteria those nurses who were not present at the time of the survey. The calculation of the sample size was carried out through the simple random probabilistic method, resulting in 120 nursing professionals. For data collection, a survey adapted from the Ways of Coping Questionnaire by Lazarus and Folkman was applied. Results: it was evidenced that the coping strategy most used by nurses was positive reinterpretation. Conclusion: through this study, it was possible to recognize the coping strategies that the nursing staff used when facing stressful situations or experiences[AU]

Introdução: a equipe de enfermagem enfrenta diariamente jorna-das de trabalho extensas, tem muitos pacientes sob seus cuidados, dificuldades no relacionamento interpessoal, podendo desenca-dear estresse, para o qual o indivíduo desenvolve um processo de adaptação ou desequilíbrio e por isso a importância de se ter estra-tégias para lidar com as situações. Objetivos: o objetivo deste estudo foi analisar as estratégias de enfrentamento em situações estressan-tes utilizadas por profissionais de enfermagem de um Hospital Pú-blico da capital Corrientes, bem como sua associação com variáveis sociodemográficas. Metodologia: estudo quantitativo, descritivo, transversal e observacional. A população incluiu enfermeiros de um hospital público da cidade de Corrientes no período de 2022. Os critérios de inclusão foram considerados pessoal de enfermagem que desempenha funções assistenciais e seu tempo de trabalho foi de 1 ano ou mais; como critérios de exclusão, pessoal que exercesse dois ou mais vínculos empregatícios e como critérios de eliminação os enfermeiros que não estivessem presentes no momento da pes-quisa. O cálculo do tamanho da amostra foi realizado pelo método probabilístico aleatório simples, resultando em 120 profissionais de enfermagem. Para a coleta de dados, foi aplicado um questionário adaptado do Questionário de Modos de Enfrentamento de Lazarus e Folkman. Resultados: evidenciou-se que a estratégia de enfrenta-mento mais utilizada pelos enfermeiros foi a reinterpretação posi-tiva. Conclusão: Por meio deste estudo, foi possível reconhecer as estratégias de enfrentamento que a equipe de enfermagem utiliza diante de situações ou experiências estressantes[AU]

Insomnia, Related Problems and Coping Strategies Among Primigravida and Multigravida Mothers

Background: Insomnia is a typical complaint during pregnancy. Hormonal alterations, physiological changes during early pregnancy, and the enlargement of the foetus during late pregnancy contribute to disrupted sleep. Nursing interventions to identify sleep deficits and promote sleep are required at all stages of the maternity cycle. Methods: Insomnia, related problems and coping strategies were assessed using a structured Questionnaire of purposive sample of 50 Primigravida and 50 Multigravida Mothers attending OBG unit at HSK hospital and research centre, Bagalkot, Karnataka. Data were analyzed using descriptive and inferential statistics. Results: The result depicts that the majority of primigravida mothers (92%) experienced moderate and 8% experienced severe insomnia, 94% moderate, 4% mild and 2% experienced severe insomnia-related problems, 84% followed average, 12% good and 4% followed poor coping strategies, whereas, majority of Multigravida mothers (90%) experienced mild and 10% experienced moderate insomnia, 82% moderate and 18% experienced mild degree insomnia related problems, 92% followed average, 6% good and 2% followed poor coping strategies. There is a significant difference between primigravida mothers' insomnia, related problems and coping strategies and that of multigravida mothers. There was an irrelevant association found between insomnia scores of Primigravida and Multigravida mothers with socio-demographic variables. Conclusion: The overall study findings depicted that the mean percentage scores of insomnia of primigravida mothers (49.33%) was comparatively higher than the mean percentage scores of multigravida mothers (16.33%). Hence it was concluded that primigravida mothers has experienced more insomnia than compared to multigravida mothers.

Comparative Study to Assess Stress and Coping Strategies among Working and Non-Working Women of Selected Areas of Bagalkot

Background: As a woman, she is a wonderful invention by God, and she has a complex personality with pleasantness, morality, adjusting, and tolerance in their life. Stress affects our physical, physiological, and mental health, so to manage Stress in daily life, an individual may learn to cope with that by using coping strategies. Methods: In the present study, a nonexperimental design was adopted at different organizations and homes in the Bagalkot, Vidyagiri, and Navanagar areas of Bagalkot. A convenient technique was used. A sample consists of 100 with 50 working and 50 non-working women. Cohen's perceived stress scale collected data to check the Stress and the Brief COPE scale to check the level of coping. Result: Mean and SD of Stress among working women were 20.66�2, and S.E.M was 0.45. The mean and SD of Stress among non-working women was 19.76�43, S.E.M was 0.34, and 't'-value (1.571) at a 5% significance level. The Mean and SD of coping among working women were 63.3�43 and S.E.M was 1.19. The mean and SD of coping among non-working women was 61.58�98, S.E.M was 0.84, 憈� value (1.186) at a 5% l.o.s. Conclusion: The study's overall findings show that there is higher perceived Stress in working women compared to non-working women, and coping is higher in working women than non-working women.

Estrés, estrategias de afrontamiento y consumo de alimentos no saludables durante la pandemia de COVID-19 en estudiantes universitarios

Los estudiantes universitarios suelen presentar una dieta poco saludable por estar expuestos, entre otros factores, a situaciones estresantes que se han visto exacerbadas por la pandemia del COVID-19. Para enfrentar el estrés se pueden utilizar diferentes estrategias, sin embargo, se desconoce si los estudiantes universitarios han utilizado dichas estrategias y/o cambiado sus hábitos alimentarios como mecanismo para manejar el estrés durante la pandemia. Este estudio evaluó si el estrés generado durante la pandemia de COVID-19 impactó en los hábitos alimentarios de los estudiantes universitarios y en las estrategias de afrontamiento para enfrentar el estrés. La muestra fue no probabilística y estuvo compuesta por 236 estudiantes universitarios de dos instituciones universitarias chilenas. Se aplicó una encuesta en línea que evaluó consumo de alimentos no saludables, estrés, estrategias de afrontamiento, e información sociodemográfica. Los datos se analizaron mediante regresión binomial negativa. El análisis reveló un aumento en el consumo de alimentos poco saludables, especialmente en estudiantes con altos niveles de estrés. Las estrategias utilizadas se agruparon en 'evitación emocional' y 'mantenerse ocupado'. Se evidenció que los estudiantes más jóvenes preferían las estrategias de evitación emocional y había una fuerte asociación entre las estrategias de "mantenerse ocupado" con un menor consumo de alimentos poco saludables. Estos resultados respaldan el desarrollo de estrategias para el manejo del estrés y de esta forma evitar el consumo excesivo de alimentos poco saludables durante períodos estresantes como la pandemia de COVID-19.

College students often have an unhealthy diet due to exposure to, among other factors, stressful situations that have been exacerbated by the COVID-19 pandemic. Different strategies can be used to cope with stress; however, it is unknown whether university students have used such strategies and/or changed their dietary habits as a mechanism to manage stress during the pandemic. This study assessed whether the stress generated during the COVID-19 pandemic impacted college students' eating habits and coping strategies to deal with stress. The sample was non-probabilistic and was composed of 236 university students from two Chilean university institutions. An online survey was administered that assessed unhealthy food consumption, stress, coping strategies, and sociodemographic information. Data were analyzed using negative binomial regression. The analysis revealed an increase in the consumption of unhealthy foods, especially in students with high levels of stress. The strategies used were grouped into 'emotional avoidance' and 'keeping busy'. It was evident that younger students preferred emotional avoidance strategies and there was a strong association between 'keeping busy' strategies with lower consumption of unhealthy foods. These results support the development of stress management strategies to avoid excessive consumption of unhealthy foods during stressful periods such as the COVID-19 pandemic.

Perceived academic stress in Mexican medical students. The role of sex emotional distress, burnout, academic-social support, current abuse experiences, and coping strategies / Percepción del estrés académico en estudiantes de medicina mexicanos. El papel del sexo, distrés emocional, burnout, apoyo académico-social, experiencias actual es de abuso y estrategias de afrontamiento

Abstract Introduction Academic stress is a common problem among medical students that has a negative physiological, social, and learning impact. Perceived academic stress indicates how stressed a student is about academic issues over a given period of time and the ability to handle that stress. Objective To determine the prevalence of PAS and evaluate possible risk factors, focusing on sex differences, burnout, emotional distress, academic-social support, and coping strategies. Method A cross-sectional, retrospective, and comparative study was conducted through an online survey with medical students (MS) willing to participate anonymously. Results All students reported PAS and the majority to a moderate-severe degree. Comparing the presence of abuse within the academic environment between men and women, we found differences in the frequency of reporting emotional abuse and sexual. Also, we found differences in perceived academic social support from teachers and family members. Multiple logistic regression analysis showed sex and current sexual abuse inside school had the strongest association with PAS in MS, followed by a family history of depression and perceived less academic social support from family. Discussion and conclusion Timely identification of individuals at-risk will be critical to establish preventive strategies to limit the impact of PAS in MS, stress management programs, training coping skills, and offer prompt therapeutic alternatives when needed.

Resumen Introducción El estrés académico es un problema común entre los estudiantes de medicina que tiene un impacto negativo a nivel fisiológico, social y de aprendizaje. El estrés académico percibido (PAS) indica lo estresado que está un estudiante por cuestiones académicas durante un periodo de tiempo determinado y la capacidad para manejar ese estrés. Objetivo Determinar la prevalencia del PAS y evaluar los posibles factores de riesgo, centrándose en las diferencias por sexo, burnout, el malestar emocional, el apoyo académico-social y las estrategias de afrontamiento. Método Se realizó un estudio transversal, retrospectivo y comparativo a través de una encuesta en línea con estudiantes de medicina dispuestos a participar de forma anónima. Resultados Todos los estudiantes reportaron PAS y la mayoría en un grado moderado-severo. Comparando la presencia de maltrato dentro del ámbito académico entre hombres y mujeres, encontramos diferencias en la frecuencia de denuncia de maltrato emocional y sexual. Asimismo, encontramos diferencias en el apoyo social académico percibido por parte de docentes y familiares. El análisis de regresión logística múltiple mostró que el sexo y el abuso sexual actual dentro de la escuela tenían la asociación más fuerte con PAS, seguidos por antecedentes familiares de depresión y menos apoyo social académico percibido por parte de la familia. Discusión y conclusión La identificación oportuna de las personas en riesgo será fundamental para establecer estrategias preventivas para limitar el impacto de PAS, programas de manejo del estrés, capacitación en habilidades de afrontamiento y ofrecer alternativas terapéuticas rápidas cuando sea necesario.

Afrontamiento al estrés académico en la carrera de Estomatología

Introducción: el estrés académico es un proceso sistémico, adaptativo y esencialmente psicológico; es la manera de reaccionar de una persona frente a ciertos estímulos. El del artículo es evaluar el estrés académico en estudiantes de primer y segundo años de la carrera Estomatología. Método: investigación analítica de corte pedagógico en la Facultad de Estomatología de Camagüey. El universo estuvo constituido por los 42 estudiantes matriculados en primer y segundo año de la carrera; a los que se les aplicó el inventario SISCO de Estrés Académico, diseñado para establecer los niveles de estrés en estudiantes universitarios. Los datos fueron procesados mediante estadística descriptiva e inferencial. Resultados: Predominó el nivel moderado de estrés en ambos grupos, con el 70 y 72,7 % en primer y segundo año respectivamente. Los estresores que más influyeron fueron las evaluaciones de los profesores y el tiempo limitado para realizar el trabajo que solicitan con puntuaciones por encima de 10 en primer año y 9 en segundo. Predominaron las reacciones psicológicas y físicas en segundo año y la estrategia de afrontamiento predominante fue la elaboración de un plan y ejecución de sus tareas con puntuación de 9 en segundo año y 11,4 en primero (p=0,006). Discusión: el ingreso a la universidad y los cambios que suscita, la adopción gradual de responsabilidades y la percepción individual además de los efectos de la pandemia se consideran factores que influyen en el estrés manifestado por los estudiantes; situación que afrontan fundamentalmente mediante la elaboración de un plan y la ejecución de sus tareas.

Introduction: Academic stress is a systemic, adaptive and essentially psychological process; it is the way people react to certain stimuli. Aim: to assess the academic stress in first and second year students of Dentistry. Method: analytic research with pedagogical kind, conducted in Camaguey Faculty of Dentistry involving the 42 students of first and second year of the program. SISCO tool of academic stress was applied since it allows to establish the levels of stress in university students. Data were processed through both descriptive and analytic statistics. Results: Moderate levels of stress were predominant in both years with 70% and 72,7 % in first and second respectively. The most influent stressors were the evaluations and the limited time for accomplishment of assigned tasks with figures above 10 in first year and 9 in second one. Psychological and physical reactions were predominant in second year students, and the most used strategy to face up to stress was elaboration of a plan and carry out its tasks which exhibited figures of 9 in second year and 11,4 in first year (p=0,006). Discussion: university admission and changes associated combined, the gradual responsibilities assumed and individual perception together with the impact of the pandemics are the main factors contributing to the stress exhibited by students; issue faced by elaborating a plan and develop its tasks as it is the preferred strategy.

Autorregulação afetiva: aspectos cognitivos e emocionais na experiência com o câncer / Affective self-regulation: cognitive and emotional aspects in the experience with cancer

Foi analisado se a autorregulação afetiva de mulheres com câncer de mama interfere no enfrentamento do câncer e na busca pela cura. Para tanto, participaram 40 mulheres com câncer de mama de uma instituição de saúde especializada em prevenção, diagnóstico e tratamento do câncer. Os instrumentos utilizados foram Escala de Resiliência, Escala de Coping Religioso/Espiritual Abreviada e Escala de Modos de Enfrentamento de Problemas. Os resultados apontaram que há relação positiva significante entre autorregulação afetiva e melhores modos de enfrentamento, ou seja, quanto maior for o nível de resiliência e espiritualidade de um indivíduo, melhor será o seu modo de enfrentamento em situações adversas e estressoras. Conclui-se que a autorregulação afetiva pode interferir no bem-estar físico, mental e social de mulheres com câncer de mama em quimioterapia, bem como em suas estratégias de modos de enfrentamento dos problemas.

It was analyzed whether the affective self-regulation of women with breast cancer interferes in coping with cancer and in seeking a cure. For this, 40 women with breast cancer from a health institution specialized in prevention, diagnosis, and treatment of cancer participated in the study. The instruments used were the Resilience Scale, the Brief Spiritual/Religious Coping Scale, and the Ways of Coping Checklist. The results pointed out that there is a significant positive relationship between affective self-regulation and better ways of coping, that is, the higher the level of resilience and spirituality of an individual, the better his/her way of coping in adverse and stressful situations. It is concluded that affective self-regulation can interfere in the physical, mental, and social well-being of women with breast cancer undergoing chemotherapy, as well as in their strategies for coping with problems.

Stress and strategies in coping stress among the medical students of a south Indian city

Background: Stress is a personal experience brought on by complex interactions between a person and their environment, so it cannot be avoided. It typically happens when a person’s situational demand exceeds their available resources. Additionally, it has been noted that excessive stress can hurt self-esteem, academic performance, and both personal and professional development. This study sought to determine the stress level, different stressors, and coping mechanisms used by undergraduate medical students. Materials and Methods: A cross-sectional study was done among first to final-year medical undergraduate students between January and June 2022 at a tertiary care institution in South India. 450 students enrolled in the first year to last year were included in the study through the purposeful sampling method. The medical Student Stressor Questionnaire was used to assess the stress levels among the study participants. The coping strategies were considered using a brief coping orientation to problems experienced (COPE) inventory. Cluster analysis used the K-means method. Results: A total of 278 out of the 450 students completed the questionnaire and returned it, yielding an overall response rate of61.78%. Of which 175 (62.95%) women respondents made up the majority of the study participants. The mean age of the participants was 20.15 ± 2.8 years. 45.32% ( n = 126) of the study participants belonged to the first year of their study, whereas 23.02% ( n = 64) belonged to the second year of their research. Academic stress was the primary stressor. The predominant coping strategies used were problem-focused and emotion-focused coping with stress. Conclusion: A variety of stress management techniques should be offered to help the students in better handling of the demanding professional course.

Psychometric properties of the Stress Coping Scale Brief-COPE 28 in a Peruvian population / Propiedades psicométricas de la Escala de Afrontamiento al Estrés Brief-COPE 28 en una población peruana

Background: The highly stressful events we are currently experiencing require great cognitive and emotional effort and affect the mental health of the population. In this sense, coping with stress provides evidence of how people use their resources to cope with or avoid stressful events, which requires validated and reliable instruments to measure accurately. Objective: To determine the psychometric properties of reliability and validity of the BRIEF COPE 28, Spanish version. Method: The design used was instrumental; 530 people participated, 60% men and 40% women, between 18 and 60 years old, from different regions of Peru, selected by non-probability convenience sampling. Results: It is evident that the alpha coefficient of coping styles ranges from α ordinal = 0.74 to 0.82; while in strategies it was between α ordinal = 0.59 to 0.90. In terms of internal structure, the four-factor model obtained a good fit SB-χ²/gl=1.836; CFI=0.92; TLI=0.90, SRMS=0.09 and RMSEA=0.10. A good fit was found with the ten coping strategies model SB-χ²/gl=1.902; CFI=0.96; TLI=0.95, SRMS=0.056, RMSEA=0.069. Conclusion: COPE 28 has good internal consistency; and the model with the four coping styles is inconclusive, while the model with ten strategies has adequate goodness of fit.

Introducción: Los acontecimientos altamente estresantes que vivimos actualmente demandan gran esfuerzo cognitivo y emocional y afectan la salud mental de la población; en este sentido el afrontamiento al estrés proporciona evidencia de cómo las personas recurren a sus recursos para afrontar o evadir los eventos estresantes, lo cual necesita de instrumentos validados y confiables para medirlo con precisión. Objetivo: Determinar las propiedades psicométricas de confiabilidad y validez del BRIEF COPE 28, versión española. Método: El diseño usado fue instrumental; participaron 530 personas, 60% varones y 40% mujeres, entre 18 y 60 años, de distintas regiones del Perú, seleccionadas con el muestreo no probabilístico por conveniencia. Resultados: Se evidencia que el coeficiente alfa de los estilos de afrontamiento oscila entre α ordinal=0.74 a 0.82; mientras que en las estrategias fue entre α ordinal=0.59 a 0.90. En cuanto a la estructura interna, el modelo de cuatro factores obtuvo buen ajuste de bondad SB-χ²/gl=1.836; CFI=0.92; TLI=0.90, SRMS=0.09 y RMSEA=0.10. Asimismo, se encontró buen ajuste con el modelo de 10 estrategias de afrontamiento SB-χ²/gl=1.902; CFI=0.96; TLI=0.95, SRMS=0.056, RMSEA=0.069. Conclusión: El COPE 28 tiene buena consistencia interna; y que el modelo con los cuatro estilos de afrontamiento no es concluyente; mientras el modelo con 10 estrategias tiene adecuado ajuste de bondad.

Nurses’ Attitudes Towards Ambiguity in Communication with Patients and Families, Emotional Coping Strategies and Attitudes Towards End-Of-Life Care in General Wards

Purpose: We clarified the relationship between attitudes towards ambiguity in nurses’ communication with patients and families, emotional coping strategies and attitudes towards end-of-life care among nurses in general wards. Methods: Requests for participation in a survey were sent to nurses working in general wards with 3 or more years of work experience. The survey was in the form of an online self-administered questionnaire. Results: The responses of the 239 nurses who answered the survey were subject to analysis. Among nurses’ attitudes towards ambiguity, the highest scores were for “control of ambiguity” followed by “enjoyment of ambiguity.” Among emotional coping strategies, the highest scores were for “regulating both patients’ and one’s own emotions.” “Positive attitudes toward caring for dying persons” was most significantly associated with “enjoyment of ambiguity.” “Recognition of caring for the pivot dying persons and his families” was most significantly associated with “regulating both patients’ and one’s own emotions.” Conclusion: The results suggest that nurses working in general wards may need to foster attitudes towards “enjoyment of ambiguity” in communication with patients and families, and also coping abilities “regulating both patients’ and one’s own emotions”, so that they can enhance the attitude toward end-of-life care.

Coping with the economic burden of non-communicable diseases among hypertensive and diabetic patients in private and public health facilities in Ado-Ekiti, Nigeria

Objective: To assess and compare how private and public health facilities patients cope with the economic burden of non-communicable diseases. Design: Comparative cross-sectional study. Setting: Thirty-nine private and eleven public health facilities in Ado-Ekiti, Nigeria Participants: Three hundred and forty-eight (Private:173; Public:175) patients with hypertension or diabetes, or both were recruited. Main Outcome Measures: Specific coping methods and numbers of coping strategies used by participants, as well as the perceived ability of participants to cope with the economic burden of non-communicable diseases. Results: Majority of participants paid through out-of-pocket (OOP) than through health insurance(HI) (Private:OOP:90.2% HI:9.8%; Public:OOP:94.3% HI:5.7%; p=0.152). More participants in private used instalment payments(p<0.001). However, other coping strategies showed no significant difference in both groups(p>0.05). Delayed treatment (Private:102; Public:95) was the most used strategy in both arms, and the number of strategies used by the participants showed no significant difference(p=0.061). Lower levels of education, out-of-pocket payment, increasing number of clinic visits, and hospital admission were associated with the use of higher numbers of coping strategies in both groups while being female and retired/unemployed were associated with the private arm. Conclusion: Although most patients in both groups pay out-of-pocket and use detrimental coping strategies, more patients in private arm use instalment payment, a non-detrimental method. Healthcare providers, especially public providers, should adopt policies encouraging patients to use non-detrimental coping strategies to meet their healthcare expenditures.

Psychological well-being, stressors, coping strategies and support of undergraduate healthcare students amid COVID-19

Background: Students function better academically when psychologically well. The COVID-19 pandemic proved a new challenge to the mental wellness of undergraduate healthcare students. Students were not only faced with academic changes but also had to complete clinical practice in healthcare facilities amid the COVID-19 pandemic. Aim: This study investigated the psychological well-being, stressors, coping strategies and support of undergraduate healthcare students amid COVID-19. Setting: A South African university's faculty of health sciences. Methods: A survey design through a cross-sectional descriptive approach was used to collect data from the population of 1529 undergraduate healthcare students. One hundred and ninety-six (n = 196) students responded to the online survey. Results: Participants reported a variety of stressors influencing their psychological well-being. Participants chose mostly adaptive coping strategies to deal with stressors. They gave feedback on the support they received from the faculty and institution. Most of the participants indicated they prefer weekly online communication from the higher education institution. Conclusion: The COVID-19 pandemic influenced the psychological well-being of undergraduate healthcare students. The psychological well-being of these students is a collective responsibility between students and higher education institutions to enable academic success and positive patient outcomes. Contribution: This study found that undergraduate healthcare students had academic, psychological, financial and other stressors during the COVID-19 pandemic. Higher education institutions, especially those involved in training undergraduate healthcare professionals, in collaboration with students, need to provide students with targeted continued support and training to use healthy coping behaviours to manage various stressors.

Food Insecurity and Coping Strategies amongst Undergraduate Students during the COVID-19 pandemic in Malaysia

@#Introduction: Undergraduate students are at a high risk for food insecurity and knowledge on relevant coping strategies is the key issue in dealing with food insecurity. Therefore, this study is aimed at determining the food insecurity status, coping strategies, and the factors associated with food insecurity and coping strategies during the COVID-19 pandemic. Methods: This cross-sectional study involved 383 undergraduate students from health-related courses at the International Islamic University Malaysia Kuantan campus. The participants were selected by convenience sampling. The instrument used for data collection was a self-administered questionnaire consisting of three parts: socio-demographic background, food insecurity, and coping strategies. The data were analysed as descriptive and inferential analyses, such as Chi-Square, Mann-Whitney, and Kruskal-Wallis. Results: It was found that 21.41% of the participants reported experiencing food insecurity. There were significant associations between parents’ income (p<0.001), financial status (p<0.001), academic performance (p = 0.04) and working part-time (p = 0.01) with food insecurity. It was also discovered that there were significant associations between working part-time (p<0.001), faculty of study (p<0.001), academic year (p<0.001), financial status (p<0.001), academic cumulative grade point average (CGPA) (p<0.001) and monthly expenses (p = 0.01) with Malaysian Coping Strategies Instruments (MCSI) score. A significant association between food insecurity and MCSI score (p<0.001) was also found in this study. Conclusion: The prevalence of food insecurity was consistent with previous studies, which is considered high in Malaysia. The findings could assist university authorities to identify the characteristics of the students that are related to food insecurity.

Trauma and Coping in Battling the COVID-19 Pandemic Among Malaysian Healthcare Workers

@#Introduction: Prolonged COVID-19 pandemic with high morbidity and mortality may cause traumatic events to Healthcare Workers (HCW), resulting in Post-Traumatic Stress Disorder (PTSD) symptoms. Hence, this study aims to determine the prevalence of PTSD symptoms and its association with coping strategies among HCW in managing COVID-19 pandemic at Klang Valley Public Hospitals in Malaysia. Methods: A cross-sectional study with total of 424 eligible respondents were recruited through stratified random sampling. Data was collected from 6th May until 6th June 2021 using a self-administered online questionnaire adopted from MPCL-5 and Brief COPE instruments. IBM Statistical Package for Social Sciences Version 26 was used to analyse data. Result: 25% of the respondents demonstrated PTSD symptoms. Respondents who are single (aOR=3.319, 95% CI: 1.912, 5.762, p-value <0.001) and had history of positive COVID-19 (aOR= 2.563, 95% CI:1.058, 6.209, p-value=0.037) were more likely to experience PTSD symptoms. Frequently coping with self-blaming (aOR= 7.804, 95% CI: 3.467, 17.568, p-value < 0.001), behavioural disengagement (aOR= 7.262, 95% CI: 1.973, 26.723, p-value =0.003), humour (aOR= 5.303, 95% CI: 1.754, 16.039, p-value =0.003), venting emotion (aOR= 3.287, 95% CI: 1.521, 7.105, p-value =0.002) and less planning (aOR= 2.006, 95% CI:1.154, 3.487 p-value =0.014) are significant predictors for PTSD symptoms. Conclusion: One in four HCW managing COVID-19 in Klang Valley public hospitals experienced PTSD symptoms. Therefore, urgent interventional program targeting HCW who are single with history of positive COVID-19 is beneficial to prevent PTSD. Maladaptive coping strategies like self-blaming, venting emotion, humour and behavioural disengagement should be replaced with more adaptive coping strategies like planning, self-compassion, self-care and self-reflection.

Coping styles of Filipino hypertensive patients seen at the family and community medicine outpatient clinic of Region 1 Medical Center: A cross-sectional study

Introduction@#Hypertension is still prevalent globally, especially in low- and middle-income countries such as the Philippines. Despite its great burden, its psychosocial aspect including the coping strategies is still understudied. Upon literature search, there seems to be no local studies available, hence this study aimed to explore the coping strategies used by Filipino hypertensive patients.@*Objective@#This study aimed to identify the coping styles utilized by Filipino hypertensive patients seen in Region 1 Medical Center Family and Community Medicine Out-Patient Clinic (R1MC FCM OPC).@*Methods@#This is a cross-sectional descriptive study with a descriptive-cross-sectional research design. Purposive sampling was used to select 280 hypertensive patients from the R1MC FCM OPC between April 1, 2021 and April 1, 2022 to answer a modified version of the Filipino Coping Strategies Scale (FCSS). The following statistical tests were utilized: frequency count and percentages for qualitative data; mean, median and standard deviation for continuous variables. All analyses were performed using SPSS version 26.@*Results@#The study enrolled 280 respondents who met the eligibility criteria. The majority were 51 to 60 years old (27.14%, mean age 51.23 ± 13.12), female (60%), and high school graduates (41.79%). Furthermore, most were unemployed (63.57%) and belonging to the low-income class (75%). Among the coping strategies, the highest scores were the problem-solving domain, religiosity and relaxation/recreation domains (Mdn=3). The lowest were in emotional release and substance use domains (Mdn=1). @*Conclusion@#The coping strategies of Filipino hypertensive patients seen at R1MC FCM OPC were problem-oriented domain, religiosity and relaxation/recreation; emotional release and substance use was the least used. Further research into the psychosocial aspects of hypertension using FCSS should be conducted in other institutions or locations.

Mediating role of family function between coping strategies and emotional behavior in children with chronic superficial gastritis / 四川精神卫生

BackgroundChronic superficial gastritis （CSG） is a common clinical disease in children. The emotional behavior of CSG children is susceptible due to them suffering from such disease at young age. ObjectiveTo explore the impact of coping strategies on emotional behavior and the effect of family function in children with CSG， and to provide references for clinical intervention in CSG children with emotional behavior problems. MethodsA total of 177 children with CSG admitted to Anhui Children's Hospital from June 2019 to January 2023 were selected as the research subjects. Investigation on family function， emotional and behavioral problems and coping strategies of children was conducted by employing the Family APGAR index （APGAR）， the Strengths and Difficulties Questionnaire （SDQ） and Coping Strategies Questionnaire （CSQ）. The structural equation model was used to test the mediating effect of family function between coping strategies and emotional behaviors. ResultsThe APGAR score was negatively correlated with both SDQ score and negative coping strategies score （r=-0.507， -0.551， P<0.01）， but was positively correlated with positive coping strategy score （r=0.579， P<0.01）. The positive coping strategy score was negatively correlated with SDQ score （r=-0.539， P<0.01）， while the negative coping strategy score was positively correlated with SDQ score （r=0.543， P<0.01）. The result showed that family function played a partial mediating role between positive coping strategies and emotional behavior ［indirect effect was -0.133 （95% CI： -0.256~-0.079， P<0.01）， accounting for 29.40% of the total effect］. The same mediating effect happened between negative coping strategies and emotional behavior ［indirect effect was 0.093 （95% CI： 0.198~0.045， P<0.01）， accounting for 28.50% of the total effect］. ConclusionCoping strategies of CSG children can affect emotional behavior directly and indirectly with family function playing a partial intermediary effect.

Advances of Immunotherapy Resistance and Coping Strategies in Non-small Cell Lung Cancer / 中国肺癌杂志

Immunotherapy has significantly improved clinical outcomes of non-small cell lung cancer (NSCLC), however, along with the popularization of immunotherapy, immune resistance has become an unavoidable problem. Immunotherapy can induce extensive cellular and molecular alterations in the tumor microenvironment. Considering the mechanisms of immune resistance are not yet fully understood and the efficacy of standard chemotherapy regimens is limited, more effective coping strategies based on resistance mechanisms are urgently needed. In this review, we intend to summarize the known mechanisms of immune resistance and feasible strategies, so as to provide a foundation for clinicians to develop more individualized and precise regimens and finally improve patients' prognosis.
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