Highlights
- •Optimistic coping is an independent predictor of survival in CF.
- •Illustrative survival curves suggest that women with low optimistic coping have the poorest outcomes.
- •Women employed more distraction coping than men, but this had no bearing on survival.
- •Ways of coping are modifiable, providing a target for clinical intervention.
Abstract
Background: The relationship between ways of coping and health outcomes has been a
focus of interest for decades. There is increasing recognition that positive psychological
functioning can influence health outcomes beneficially. This work investigated the
role of coping in predicting survival in CF.
Methods: A longitudinal observational cohort study with a 20-year follow-up period
was undertaken. At entry to the study, demographic and clinical variables were recorded,
and ways of coping were assessed using the Cystic Fibrosis Coping Scale which measures
four distinct ways of coping: optimism, hopefulness, distraction and avoidance. Survival
outcome was measured as time in days from the date of recruitment to exit from the
study, where exit was either death, loss to follow-up or the end of the follow-up
period.
Results: Survival time was modelled using Cox's proportional hazards model. At baseline,
116 people with CF were recruited. By the census date, 54 people had died (14 men
had died during 248,565 person-days of observation and 40 women had died during 358,372
person-days of observation). Optimism was the only way of coping that showed any beneficial
effect on survival (RR=0.984, p=0.040) after adjustments for age, gender, ppFEV1 and the three other coping variables measured at baseline.
Conclusion: This work suggests that optimistic coping serves as a prognostic measure
of survival in CF beyond key clinical and demographic variables. Ways of coping are
modifiable, providing a target for clinical intervention; to improve quality of life
and clinical outcomes and potentially increase longevity.
Keywords
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Article info
Publication history
Published online: April 20, 2022
Accepted:
April 11,
2022
Received in revised form:
March 14,
2022
Received:
January 7,
2022
Identification
Copyright
© 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
