Avoidant coping as a predictor of mortality in veterans with end-stage renal disease

Health Psychol. 2009 May;28(3):330-7. doi: 10.1037/a0013583.

Abstract

Objective: The aim of this study was to examine the role of active and avoidant coping strategies in predicting mortality in 61 veterans with end-stage renal disease.

Design: Participants completed a self-report measure of coping strategies (The COPE; Carver, Scheier, & Weintraub, 1989) and were interviewed as part of a structured assessment to determine their appropriateness for renal transplant. On average, participants were then followed for 9 years via medical record review to determine mortality status.

Main outcome measures: Mortality, as predicted by factor scores on active and avoidant coping factors estimated via confirmatory factor analysis of select COPE subscales.

Results: A Cox regression revealed that a unit change in avoidant coping was associated with a 114% increase in odds of mortality, even after controlling for variance attributable to demographic variables. There was also a statistical trend indicating that this association might be mediated by poor attendance at medical appointments. Active coping did not predict mortality.

Conclusion: Results demonstrate the importance of assessing coping style in this population; clinical implications of these findings and possible mechanisms of this effect are discussed.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Avoidance Learning*
  • Defense Mechanisms*
  • Diabetic Nephropathies / mortality
  • Diabetic Nephropathies / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension, Renal / mortality
  • Hypertension, Renal / psychology
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / psychology*
  • Kidney Transplantation / psychology
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Compliance / psychology
  • Peritoneal Dialysis, Continuous Ambulatory / psychology
  • Personality Inventory / statistics & numerical data
  • Psychometrics
  • Renal Dialysis / psychology
  • Risk Factors
  • Statistics as Topic
  • Survival Analysis
  • Veterans / psychology*