- •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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Cystic Fibrosis
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- CFTR genotype as a predictor of prognosis in cystic fibrosis.Chest. 2006; 130: 1441-1447https://doi.org/10.1378/chest.130.5.1441
- Predictive 5-year survivorship model of cystic fibrosis.Am J Epidemiol. 2001; 153: 345-352
- Validation of a predictive survival model in Italian patients with cystic fibrosis.J Cyst Fibros. 2012; 11: 24-29
- Clinical Characteristics and Predictors of Reduced Survival for Adult-diagnosed Cystic Fibrosis. Analysis of the Canadian CF Registry.Ann Am Thorac Soc. 2018; 15: 1177-1185https://doi.org/10.1513/AnnalsATS.201801-037OC
- A contemporary survival analysis of individuals with cystic fibrosis: a cohort study.European Respiratory Journal. 2015; 45: 670-679https://doi.org/10.1183/09031936.00119714
- Predictors of mortality in adults with cystic fibrosis.Pediatric Pulmonology. 2007; 42: 525-532
- Association between initial disease presentation, lung disease outcomes, and survival in patients with cystic fibrosis.Am J Epidemiol. 2004; 159: 537-546
- Impact of Burkholderia dolosa on lung function and survival in cystic fibrosis.American Journal of Respiratory and Critical Care Medicine. 2006; 173: 421-425
- Cystic fibrosis mortality and survival in the UK: 1947–2003.European Respiratory Journal. 2007; 29: 522-526https://doi.org/10.1183/09031936.00099506
- Early diagnosis from new born screening maximises survival in severe cystic fibrosis.ERJ Open Research. 2018; 4: 00109-02017https://doi.org/10.1183/23120541.00109-201
- Socioeconomic status and health outcomes: cystic fibrosis as a model.Expert Review of Respiratory Medicine. 2016; 10: 967-977https://doi.org/10.1080/17476348.2016.1196140
- Association between socioeconomic status, sex, and age at death from cystic fibrosis in England and Wales (1959 to 2008): cross sectional study.BMJ. 2011; 343: d4662https://doi.org/10.1136/bmj.d4662
- How Socioeconomic Status Affects Patient Perceptions of Health Care: A Qualitative Study.Prim Care Community Health. 2017; 8: 169-175https://doi.org/10.1177/2150131917697439
- Decreased survival in cystic fibrosis patients with a positive screen for depression.J Cyst Fibros. 2021; 20: 120-126https://doi.org/10.1016/j.jcf.2020.07.020
- Can health-related quality of life predict survival in adults with cystic fibrosis.Am J Resp Crit Care Med. 2009; 179: 54-58https://doi.org/10.1164/rccm.200802-220OC
- Disposition optimism and all-cause and cardiovascular mortality in a prospective cohort of elderly Dutch men and women.Archives of General Psychiatry. 2004; 61: 1126-1135
- Optimism, cynical hostility, and incident coronary heart disease and mortality in the Wo7men's Health Initiative.Circulation. 2009; 120: 656-662
- Prediction of all-cause mortality by the Minnesota Multiphasic Personality Inventory Optimism-Pessimism Scale scores: Study of a college sample during a 40-year follow-up period.Mayo Clinic Proceedings. 2006; 81: 1541-1544
- Optimism and Cause-Specific Mortality: A Prospective Cohort Study.Am J Epidemiol. 2017; 185: 21-29https://doi.org/10.1093/aje/kww182
- The Veterans Administration longitudinal study of healthy aging.The Gerontologist. 1966; 6: 179-184
- Optimism is associated with exceptional longevity in 2 epidemiologic cohorts of men and women.PNAS. 2019; 116: 18357-18362https://doi.org/10.1073/pnas.1900712116
- Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis.JAMA Netw Open. 2019 Sep 4; 2e1912200https://doi.org/10.1001/jamanetworkopen.2019.12200
- Breathing easy: A prospective study of optimism and pulmonary function in the normative aging study.Annals of Behavioral Medicine. 2002; 24: 345-353https://doi.org/10.1207/S15324796ABM2404_11
- Chan. Happy People Live Longer: Subjective Well-Being Contributes to Health and Longevity.Applied Psychology: Health and Well-Being. 2011; 3: 1-43
- Optimism and Hope in Chronic Disease: A Systematic Review.Front. Psychol. 2017; 7: 2022https://doi.org/10.3389/fpsyg.2016.02022
- Dispositional optimism and coping: a meta-analytic review.Pers Soc Psychol Rev. 2006; 10: 235-251https://doi.org/10.1207/s15327957pspr1003_3
- Psychological resilience and intolerance of uncertainty in coping with cystic fibrosis.J Cyst Fibros. 2016; 15: 689-695https://doi.org/10.1016/j.jcf.2015.11.011
- Coping with cystic fibrosis.J R Soc Med. 2003; 96: 42-50
- Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries.Thorax. 2014; 69: 1090-1097https://doi.org/10.1136/thoraxjnl-2014-205983
- Ways of coping with cystic fibrosis: implications for treatment adherence.Disabil Rehabil. 2001; 23: 315-324
- Health-related quality of life in adults with cystic fibrosis: the role of coping.Journal of Psychosomatic Research. 2008; 64: 149-157https://doi.org/10.1016/j.jpsychores.2007.08.017
- Can psychological interventions increase optimism? A meta-analysis.The Journal of Positive Psychology. 2017; 12: 594-604
- Guidance for industry. Patient-reported outcome measures: Use in medical product development to support labeling claims.Draft guidance. February 2006;
- Personal and contextual determinants of coping strategies.J Pers Soc Psychol. 1987; 52: 946-955
- Coping resources and processes: current concepts and measures.(editors)in: Goldberger L. Breznitz S. Handbook of stress: theoretical and clinical aspects. 2nd ed. Free Press, New York1993: 234-257
- Regression models and life tables (with discussion).J R Statist Soc B. 1972; 34: 187-220
- Gender and survival in cystic fibrosis.Curr Opin Pulm Med. 2013; 19: 692-697https://doi.org/10.1097/MCP.0b013e328365af49
- Is optimism associated with healthier cardiovascular-related behavior? meta-analyses of 3 health behaviors.Circ Res. 2018; 122: 1119-1134https://doi.org/10.1161/CIRCRESAHA.117.310828
Hingle M.D., Wertheim B.C., Tindle H.A., et al. Optimism and diet quality in the Women's Health Ini tiative. J Acad Nutr Diet. 2014;114(7):1036-1045. doi:10.1016/j.jand.2013.12.018
- Optimism predicts sustained vigorous physical activity in postmenopausal women.Prev Med Rep. 2017; 8: 286-293https://doi.org/10.1016/j.pmedr.2017.10.008
- The Mediating Role of Appraisal and Coping in the Relationship between Optimism-Pessimism and Quality of Life.Psychooncology. 2005; 14: 718-727https://doi.org/10.1002/pon.896
- The role of optimism in social network development, coping, and psychological adjustment during a life transition.Journal of Personality and Social Psychology. 2002; 82: 102-111https://doi.org/10.1037/0022-3518.104.22.168
- Optimism, Pessimism, and Psychological Well-Being.Optimism and Pessimism: Implications for Theory, Research, and Practice. 2001; 1: 189-216https://doi.org/10.1037/10385-009
- Optimism/Pessimism and Its Relationship with Locus of Control Among Children and Adolescents.Mathews J Psychiatry Ment Health. 2018; 3: 017
- Health locus of control predicts survival after lung transplant.J Health Psychol. 2005; 10 (PMID: 16033791): 695-704https://doi.org/10.1177/1359105305055326
- Optimism, positive affectivity, and salivary cortisol.British Journal of Health Psychology. 2005; 10 (http://dx.doi.org/10.1348/135): 467-484
- Associations of trait optimism with diurnal neuroendocrine activity, cortisol responses to mental stress, and subjective stress measures in healthy men and women.Psychosom Med. 2011; 73: 672-678https://doi.org/10.1097/PSY.0b013e31822f9cd7
- Neuroendocrine and inflammatory factors associated with positive affect in healthy men and women: The Whitehall II study.American Journal of Epidemiology. 2008; 167: 96-102
- Positive affect and markers of inflammation: discrete positive emotions predict lower levels of inflammatory cytokines.Emotion. 2015; 15: 129-133https://doi.org/10.1037/emo0000033
- Optimism in relation to inflammation and endothelial dysfunction in older men: the VA Normative Aging Study.Psychosom Med. 2011; 73: 664-671https://doi.org/10.1097/PSY.0b013e3182312497
- Dispositional optimism and physical health: a long look back, a quick look forward.Am. Psychol. 2018; 73: 1082-1094https://doi.org/10.1037/amp0000384
- Can psychological interventions increase optimism? A meta-analysis.J. Posit. Psychol. 2017; 12: 594-604https://doi.org/10.1080/17439760.2016.1221122
- Long-term Outcomes of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Systematic Review and Meta-analysis.JAMA Psychiatry. 2020; 77: 265-273https://doi.org/10.1001/jamapsychiatry.2019.3986
- A review of the efficacy and effectiveness of cognitive-behaviour therapy and short-term psychodynamic therapy in the treatment of major depression: implications for mental health social work practice.Australian Social Work. 2014; 67: 197-213
- Promoting Resilience in Stress Management: A Pilot Study of a Novel Resilience-Promoting Intervention for Adolescents and Young Adults With Serious Illness.J Pediatr Psychol. 2015; 40: 992-999https://doi.org/10.1093/jpepsy/jsv004
- Resilience in adolescents and young adults with cystic fibrosis: A pilot feasibility study of the promoting resilience in stress management intervention.Pediatr Pulmonol. 2020; 55: 638-645https://doi.org/10.1002/ppul.24574
Published online: April 20, 2022
Accepted: April 11, 2022
Received in revised form: March 14, 2022
Received: January 7, 2022
© 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.