Coping with stress and illness

Research evidence suggests that coping may intervene in the relationship between stress and illness. This research has important implications in the medical context, in that it necessitates a focus on the patient, rather than just the underlying illness and suggests that psychological interventions may be as important as medical interventions for attaining optimal health outcomes. The coping concept is also central to the biopsychosocial model of illness, in which it is recognised that health may be affected not only by biological factors (eg. a virus, genetic predisposition), but also by psychological factors (eg. personality and coping style) and social factors (eg. the social resources available to aid coping). However, researchers have also noted that the concept of coping is lacking in conceptual clarity and in the availability of adequate methods of measurement. This thesis therefore aimed to address these limitations and to assess the effectiveness of a coping-based intervention for improving physical and psychological well-being in a sample of patients with a chronic illness. Five studies are presented. The first four are aimed at developing a valid method of coping assessment. Study I (N=51) examines descriptions of real-life coping episodes, in order to consider the types of phenomena that ‘belong’ to the coping concept. Study II (N=132) translates these descriptions into items for a situation-response scale, and examines interrelationships between coping responses. Relationships between coping scores, psychological and social variables are examined in Study III (N=102), and relationships between coping scores and biological variables explored in Study IV (N=21). The final study (N=68) represents a practical application of the coping measure developed in studies 1-4 using a patient population. Relationships between dispositional coping style and the strategies used on a daily basis to cope with the on-going effects of a chronic illness are examined. The implications of dispositional and daily coping for health outcomes in this group of patients are also investigated and a coping-based intervention applied. The theoretical and practical implications of this research are discussed.