title: Avoidant coping with health problems is related to poorer quality of life among lung transplant candidates.
abstract: BACKGROUND
  Lung transplant candidates face numerous health-related stressors. Although previous work has described the range of coping strategies candidates may use, whether those strategies are related to quality of life in physical functioning, emotional, and social domains has rarely been examined.
  
  
  METHODS
  Adult lung transplant candidates (N = 128) participated in semistructured interviews that included questions regarding global and domain-specific quality of life and a multidimensional assessment of coping with health-related problems. Demographic characteristics, health status, and other psychosocial variables were also assessed, and their effects were examined and controlled in multivariate analyses of the coping-quality-of-life relationship.
  
  
  RESULTS
  Respondents were most likely to use active, acceptance, and support-seeking strategies to cope with health problems. Self-blame or avoidance were rarely used. Although used least often, avoidant coping was the most strongly and consistently related to quality of life. With demographic and psychosocial variables controlled, higher avoidant coping remained associated with significantly poorer global quality of life, bodily pain, difficulty with daily work or activities as a function of emotional problems, and depressive symptomatology. Avoidant coping accentuated the association of poor health status and lower quality of life. Among respondents with lower health status, using more avoidant coping was associated with greater difficulty functioning in daily activities as a result of emotional problems. Those with higher health status had less difficulty functioning in daily activities as a result of emotional problems.
  
  
  CONCLUSIONS
  Transplant team members are encouraged to be aware of and help patients refrain from using avoidant coping strategies.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, Pa, USA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Myaskovsky
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: Galen E
authors.initials: GE
authors.lastname: Switzer
authors.forename: Martica
authors.initials: M
authors.lastname: Hall
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kormos
authors.forename: Jean M
authors.initials: JM
authors.lastname: Goycoolea
authors.forename: Andrea F
authors.initials: AF
authors.lastname: DiMartini
authors.forename: Jan D
authors.initials: JD
authors.lastname: Manzetti
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: McCurry
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D001362:Avoidance Learning; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology / Q000523:psychology; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D011340:Problem Solving; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires