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Coping styles associated with depression, health anxiety and health-related quality of life in pulmonary hypertension: cross-sectional analysis

Rawlings, Gregg Harry, Thompson, Andrew R. ORCID:, Armstrong, Iain, Novakova, Barbora and Beail, Nigel 2022. Coping styles associated with depression, health anxiety and health-related quality of life in pulmonary hypertension: cross-sectional analysis. BMJ Open 12 (8) , e062564. 10.1136/bmjopen-2022-062564

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Objectives Pulmonary hypertension (PH) is a life-shortening disease associated with early mortality and high morbidity. With advancements in medical treatment, people are living longer with the disease, and research is now needed to explore variables that help to enhance patient-reported outcomes. This study investigated the coping strategies of individuals with PH and examined the relationship between coping, depression, health anxiety and health-related quality of life (HRQoL). Design A cross-sectional survey design was used. Participants Participants (n=121) were recruited from membership of Pulmonary Hypertension Association (PHA) UK. Outcome measures Participants completed a series of questionnaires assessing depression (Patient Health Questionnaire-9), health anxiety (Short Health Anxiety Inventory), HRQoL (emPHasis-10) and coping (Brief COPE). A principal component analysis was used to identify participants’ coping profile. A series of correlational, linear and moderated multiple regression analyses were performed to examine the relationship between coping and health-related outcomes. Results Overall, 43% participants met criteria for potential clinical depression. Depression and health anxiety were strongly associated with HRQoL, explaining 37% and 30% of variance respectively (p<0.001). A principal component analysis identified a four-component model of coping. Dimensions were named based on construct items: ‘cognitive and affirmation coping’ (seven items), ‘passive coping’ (four items), ‘external coping’ (seven items) and ‘substance use coping’ (two items). Cognitive and affirmation and external coping moderated the relationship between depression and HRQoL, with high use of these coping strategies reducing the impact of depression on HRQoL. External coping also moderated the effect of health anxiety on HRQoL. Conclusions The results uniquely highlight the importance of coping styles and psychological distress in predicting HRQoL in PH. Our findings indicate the importance to assess for psychological distress in this population and suggest the need to offer psychological interventions that take into account coping resources and strategies.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Additional Information: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license
Publisher: BMJ Publishing Group
ISSN: 2044-6055
Date of First Compliant Deposit: 16 August 2022
Date of Acceptance: 31 July 2022
Last Modified: 06 May 2023 17:07

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