title: Caregiver coping, mental health and child problem behaviours in cystic fibrosis: a cross-sectional study.
abstract: BACKGROUND
  In children with cystic fibrosis (CF) sleep, eating/mealtime, physiotherapy adherence and internalising problems are common. Caregivers also often report elevated depression, anxiety and stress symptoms.
  
  
  OBJECTIVE
  To identify, through principal components analysis (PCA), coping strategies used by Australian caregivers of children with CF and to assess the relationship between the derived coping components, caregiver mental health symptoms and child treatment related and non-treatment related problem behaviours.
  
  
  METHODS
  One hundred and two caregivers of children aged 3 to 8 years from three CF clinic sites in Australia, completed self-report questionnaires about their coping and mental health and reported on their child's sleep, eating/mealtime, treatment adherence and internalising and externalising behaviours.
  
  
  RESULTS
  Two caregiver coping components were derived from the PCA: labelled 'proactive' and 'avoidant' coping. 'Avoidant' coping correlated moderately with caregiver depression (0.52), anxiety (0.57) and stress (0.55). For each unit increase in caregiver use of avoidant coping strategies, the odds of frequent child eating/mealtime behaviour problems increased by 1.3 (adjusted 95 % CI 1.0 to 1.6, p = .03) as did the odds of children experiencing borderline/clinical internalising behaviour problems (adjusted 95 % CI 1.1 to 1.7, p = .01). Proactive coping strategies were not associated with reduced odds of any child problem behaviours.
  
  
  CONCLUSIONS
  Avoidant coping strategies correlated with caregiver mental health and child problem behaviours. Intervening with caregiver coping may be a way to improve both caregiver mental health and child problem behaviours in pre-school and early school age children with CF.
authors: Health Professions Education & Educational Research (HealthPEER), Behavioural Medicine Unit, Monash University, Clayton, Victoria, Australia, 3800, jane.sheehan@mcri.edu.au.
authors: Jane
authors: J
authors: Sheehan
authors: Harriet
authors: H
authors: Hiscock
authors: John
authors: J
authors: Massie
authors: Adam
authors: A
authors: Jaffe
authors: Margaret
authors: M
authors: Hay
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000523:psychology; D001315:Australia; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000451:nursing / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals / Q000523:psychology; D001523:Mental Disorders / Q000523:psychology; D008603:Mental Health; D025341:Principal Component Analysis / Q000379:methods; D011795:Surveys and Questionnaires