Farmers' stress and coping in a time of drought.

INTRODUCTION: Farmers as a group have unique attitudes, sources of stress and a heightened risk of suicide. In the context of a prolonged drought and associated stress and increased risk of mental-health problems, this study provides an insight into the levels of psychological distress experienced by different demographic groups within the Australian farming community. The study also addresses a significant gap in the literature by exploring ways in which this unique cohort copes and may better cope, with the inevitable challenges of life 'on the land'. METHODS: A sample of 309 drought-affected South Australian farmers and their spouses (M=51.81, SD=11.69) completed questionnaires containing measures of psychological distress (Kessler Psychological Distress Scale) and coping (situational version of the COPE) in response to a recent stressor. RESULTS: There was no significant difference detected between the levels of distress reported by men and women. Younger farmers (25-54 years) were experiencing significantly higher levels of distress than those in the 55-64 age group but not those aged 65-74 years. The most commonly employed coping strategies were planning, acceptance and active coping and least used were alcohol/drug use, denial, behavioural disengagement and religion. Gender, age-group and the type of stressor (ie farm related, non-farm related, combination) were found to affect farmers' choice of some coping strategies. A multiple regression analysis suggested that behavioural disengagement (&#946;=.28, p < .05), suppression of competing activities (&#946;= .20, p < .05), venting (&#946;= .18, p < .05), alcohol/drug use (&#946;= .18, p < .05), and mental disengagement (&#946;=.12, p < .05) all significantly and positively predicted distress in this population, collectively accounting for 34.6% of the variance. CONCLUSION: This study offers a rare examination of farmers' psychological distress and coping in a time of drought. The results demonstrate that in this unique context it is erroneous to assume the universality of models of coping that have been validated in other samples. The results provide for the development of tailored interventions to help farmers cope more effectively during future times of drought.

Determinants of adherence in adults with cystic fibrosis.

Cystic fibrosis (CF) is now as much a disease of adults as of children and adolescents. An important focus of recent research has been the impact of the complex, expensive, and time consuming routine of self-care and medical treatment that is required by adults with CF to maintain health. A growing concern for medical and allied health teams is the issue of patient adherence to prescribed health management plans. A summary of the particular medical and treatment context of CF is followed by a review of adherence measurement issues and the determinants of adherence to treatment regimens in people with CF, primarily adults. Evidence for factors which influence adherence decisions of people with CF is examined. The medical and psychological aspects of this complex problem have not been adequately addressed because of difficulties with definition and measurement. Only a small proportion of the variance in adherence has been accounted for in the literature. New measurement technologies and new theoretical directions offer promise for a better understanding of this complex and important issue and may result in more effective intervention strategies to improve adherence.