Racial/Ethnic Differences in Stress, Coping, and Distress Among Mothers With a Child in the ICU

2021 ◽  
Vol 30 (4) ◽  
pp. 275-284
Author(s):  
Mary E. Ernst ◽  
Jessica Roberts Williams ◽  
Brian E. McCabe
Keyword(s):  
Ethnic Differences ◽  
Stress And Coping ◽  
Self Report ◽  
Stressful Event ◽  
Coping Behaviors ◽  
Icu Admission ◽  
Coping Process ◽  
Race Ethnicity ◽  
And Coping ◽  
Racial Ethnic

Background Having a child in the intensive care unit (ICU) is a stressful event that can cause negative mental health outcomes for parents, but little is known about the experience of parental stress among members of racial/ethnic minority groups. Objective To examine the stress and coping process in a racially/ethnically diverse sample of mothers of a child who was acutely admitted to an ICU. Methods Participants (N = 103) completed a cross-sectional self-report survey; 86.4% completed it within a week of their child’s ICU admission. Analysis of variance was used to examine racial/ethnic differences in perceived ICU-related stressors, coping behaviors, and distress level. Linear regression was used to examine the moderating effects of race/ethnicity on the relationships between stressors, coping behaviors, and distress. Results Mothers across racial group experienced similar stressors during the acute phase of their child’s ICU admission. African American mothers reported greater overall use of coping behaviors, particularly avoidance coping, and experienced higher levels of distress than did Hispanic or non-Hispanic White mothers. Hispanic mothers experienced the least distress. The interaction of race/ethnicity and emotion-focused coping moderated the stress and coping process. Conclusions Racial and ethnic diversity in sampling should be a priority in future studies of the stress and coping process of mothers with a child in an ICU. Critical care nurses should minimize known stressors for these mothers and encourage and support their preferred coping behaviors, recognizing that these may differ across racial/ethnic groups.

The Coping Scales From the German Stress and Coping Questionnaire for Children and Adolescents

2020 ◽  
Vol 36 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Heike Eschenbeck ◽  
Uwe Heim-Dreger ◽  
Denise Kerkhoff ◽  
Carl-Walter Kohlmann ◽  
Arnold Lohaus ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Children And Adolescents ◽  
Internal Consistency ◽  
Stress And Coping ◽  
Self Report ◽  
Partial Metric ◽  
Confirmatory Factor Analyses ◽  
Language Version ◽  
English Speaking ◽  
And Coping

Abstract. The coping scales from the Stress and Coping Questionnaire for Children and Adolescents (SSKJ 3–8; Lohaus, Eschenbeck, Kohlmann, & Klein-Heßling, 2018 ) are subscales of a theoretically based and empirically validated self-report instrument for assessing, originally in the German language, the five strategies of seeking social support, problem solving, avoidant coping, palliative emotion regulation, and anger-related emotion regulation. The present study examined factorial structure, measurement invariance, and internal consistency across five different language versions: English, French, Russian, Spanish, and Ukrainian. The original German version was compared to each language version separately. Participants were 5,271 children and adolescents recruited from primary and secondary schools from Germany ( n = 3,177), France ( n = 329), Russia ( n = 378), the Dominican Republic ( n = 243), Ukraine ( n = 437), and several English-speaking countries such as Australia, Great Britain, Ireland, and the USA (English-speaking sample: n = 707). For the five different language versions of the SSKJ 3–8 coping questionnaire, confirmatory factor analyses showed configural as well as metric and partial scalar invariance (French) or partial metric invariance (English, Russian, Spanish, Ukrainian). Internal consistency coefficients of the coping scales were also acceptable to good. Significance of the results was discussed with special emphasis on cross-cultural research on individual differences in coping.

Applying the Health Belief Model to Characterize Racial/Ethnic Differences in Digital Conversations Related to Depression Pre– and Mid–COVID-19 (Preprint)

2021 ◽  
Author(s):  
Ruby Castilla-Puentes ◽  
Jacqueline Pesa ◽  
Caroline Brethenoux ◽  
Patrick Furey ◽  
Liliana Gil Valletta ◽  
...  
Keyword(s):  
Health Belief Model ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Health Belief ◽  
Depression Symptoms ◽  
Seeking Help ◽  
Key Drivers ◽  
Race Ethnicity ◽  
Belief Model ◽  
Racial Ethnic

BACKGROUND The prevalence of depression symptoms in the United States is >3 times higher mid–COVID-19 versus pre-pandemic. Racial/ethnic differences in mindsets around depression and the potential impact of the COVID-19 pandemic are not well characterized. OBJECTIVE To describe attitudes, mindsets, key drivers, and barriers related to depression pre– and mid–COVID-19 by race/ethnicity using digital conversations about depression mapped to health belief model (HBM) concepts. METHODS Advanced search, data extraction, and AI-powered tools were used to harvest, mine, and structure open-source digital conversations of US adults who engaged in conversations about depression pre– (February 1, 2019-February 29, 2020) and mid–COVID-19 pandemic (March 1, 2020-November 1, 2020) across the internet. Natural language processing, text analytics, and social data mining were used to categorize conversations that included a self-identifier into racial/ethnic groups. Conversations were mapped to HBM concepts (ie, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy). Results are descriptive in nature. RESULTS Of 2.9 and 1.3 million relevant digital conversations pre– and mid–COVID-19, race/ethnicity was determined among 1.8 million (62%) and 979,000 (75%) conversations pre– and mid–COVID-19, respectively. Pre–COVID-19, 1.3 million conversations about depression occurred among non-Hispanic Whites (NHW), 227,200 among Black Americans (BA), 189,200 among Hispanics, and 86,800 among Asian Americans (AS). Mid–COVID-19, 736,100 conversations about depression occurred among NHW, 131,800 among BA, 78,300 among Hispanics, and 32,800 among AS. Conversations among all racial/ethnic groups had a negative tone, which increased pre– to mid–COVID-19; finding support from others was seen as a benefit among most groups. Hispanics had the highest rate of any racial/ethnic group of conversations showing an avoidant mindset toward their depression. Conversations related to external barriers to seeking treatment (eg, stigma, lack of support, and lack of resources) were generally more prevalent among Hispanics, BA, and AS than among NHW. Being able to benefit others and building a support system were key drivers to seeking help or treatment for all racial/ethnic groups. CONCLUSIONS Applying concepts of the HBM to data on digital conversation about depression allowed organization of the most frequent themes by race/ethnicity. Individuals of all groups came online to discuss their depression. There were considerable racial/ethnic differences in drivers and barriers to seeking help and treatment for depression pre– and mid–COVID-19. Generally, COVID-19 has made conversations about depression more negative, and with frequent discussions of barriers to seeking care. These data highlight opportunities for culturally competent and targeted approaches to address areas amenable to change that might impact the ability of people to ask for or receive mental health help, such as the constructs that comprise the HBM.

Abstract P352: Racial/Ethnic Differences in Cardiovascular Disease Outcomes among Patients with Hypertension or Type 2 Diabetes

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jia Pu ◽  
Sukyung Chung ◽  
Beinan Zhao ◽  
Vani Nimbal ◽  
Elsie J Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Asian Indian ◽  
Ethnic Differences ◽  
Elevated Risk ◽  
Stroke Incidence ◽  
Men And Women ◽  
Hazard Ratios ◽  
Race Ethnicity ◽  
Racial Ethnic

Background: This study assesses racial/ethnic differences in CVD outcomes among patients with hypertension (HTN) or type 2 diabetes (T2DM) across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese), Mexican, non-Hispanic black (NHB), and non-Hispanic White (NHW) in a large, mixed payer ambulatory care setting in northern California. Study Design: We estimated the rate of CVD incidence among adult patients with HTN (N=171,864) or T2DM (N=10,570), or both (N=36,589) using electronic health records between 2000-2013. Average follow-up was 4.5 years. CVD, including CHD (410-414), PVD (415, 440.2, 440.3, 443.9, 451, 453), and stroke (430-434), was defined by ICD-9 codes; HTN and T2DM were defined by ICD-9 codes, medication history, or two or more elevated blood pressure measures/abnormal glucose lab test results. Cox proportional hazard models were used to estimate hazard ratios for CHD, PVD, and stroke across race/ethnicity. Results: Among these patients, 10.5% developed CVD by the end of year 2013 (5.4% CHD, 3.4%PVD, 3.6% stroke). There was a gender difference in the risk of incident CHD. Among males, the age-adjusted hazard ratios for CHD were significantly higher for Asian Indians (HR: 1.3, 95% CI: 1.2-1.5) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.8, CI: 0.6-0.9) compared to NHWs. Among females, the age-adjusted hazard ratios for CHD were significantly higher for Mexican (HR: 1.3, CI: 1.1-1.5) and NHBs (HR: 1.7, CI: 1.4-2.0) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.5, CI: 0.4-0.7). NHB men and women also had significantly higher age-adjusted hazard ratios for PVD (men: HR: 1.5, CI: 1.2-1.9; women: HR: 1.6, CI: 1.3-1.9) and stroke (men: HR: 1.3, CI: 1.1-1.7; women: HR: 1.3, CI: 1.1-1.6) compared to NHWs. The age-adjusted hazard ratios for PVD and stroke were lower or equivalent to NHWs for all Asian subgroups and Mexican men and women. Patients with both HTN and T2DM were at elevated risk to develop CVD compared to patients with only one of the two conditions, regardless of their race/ethnicity. Conclusions: Compared to previous studies, we found less racial/ethnic variation in CVD outcomes, in particular stroke, among patients with HTN or T2DM. Our finding suggests the higher stroke incidence rates in several races/ethnicities are likely to be explained by the higher prevalence of HTN and T2DM among these groups. However, Asian Indian men and NHB and Mexican women with HTN or T2DM were at elevated risk for CHD compared to NHWs. Since the majority of patients in the study cohort had health insurance, further studies are needed to better understand the reasons for the observed racial/ethnic differences beyond disparities in access to health care. Special attention needs to be paid to patients with multiple conditions.

scholarly journals Racial/Ethnic Disparities in Cancer-Associated Thrombosis: A Population-Based Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 53-55
Author(s):  
Tatini Datta ◽  
Ann M Brunson ◽  
Anjlee Mahajan ◽  
Theresa Keegan ◽  
Ted Wun
Keyword(s):  
Racial Differences ◽  
Ethnic Differences ◽  
Brain Cancer ◽  
Lower Risk ◽  
Prediction Models ◽  
Population Based ◽  
Risk Prediction Models ◽  
Cancer Types ◽  
Race Ethnicity ◽  
Racial Ethnic

Introduction Risk factors for cancer-associated venous thromboembolism (CAT) include tumor type, stage at diagnosis, age, and patient comorbidities. In the general population, race/ethnicity has been identified as a risk factor for venous thromboembolism (VTE), with an increased risk of VTE in African Americans (AA) and a lower risk in Asians/Pacific Islanders (API) and Hispanics compared to non-Hispanic Whites (NHW) after adjustment for confounders such as demographic characteristics and patient comorbidities. However, the impact of race/ethnicity on the incidence of CAT has not been as well-studied. Methods We performed an observational cohort study using data from the California Cancer Registry linked to the California Patient Discharge Dataset and Emergency Department Utilization database. We identified a cohort of patients of all ages with first primary diagnosis of the 13 most common cancers in California between 2005-2014, including breast, prostate, lung, colorectal, bladder, uterine, kidney, pancreatic, stomach, ovarian, and brain cancer, Non-Hodgkin lymphoma, and multiple myeloma, and followed them for a diagnosis of VTE using specific ICD-9-CM codes. The 12-month cumulative incidences of VTE [pulmonary embolism (PE) alone, PE + lower extremity deep venous thrombosis (LE DVT), proximal LE DVT alone, and isolated distal DVT (iDDVT)] were determined by race/ethnicity, adjusted for the competing risk of death. Multivariable Cox proportional hazards regression models were performed to determine the effect of race/ethnicity on the risk of CAT adjusted for age, sex, cancer stage, type of initial therapy (surgery, chemotherapy, radiation therapy), neighborhood socioeconomic status, insurance type, and comorbidities. Patients with VTE prior to cancer diagnosis were excluded. Results A total of 736,292 cancer patients were included in the analysis cohort, of which 38,431 (5.2%) developed CAT within 12 months of diagnosis. When comparing the overall cancer cohort to those that developed VTE, AA (7.2 vs 10.5%) and NHW (61.9 vs 64.3%) appear to be over-represented, and API (11.6 vs 7.6%) under-represented in VTE cohort (Figure 1). The greatest disparities in incidence by race/ethnicity were seen in PE. AA had the highest and API had the lowest 12-month cumulative incidences for all cancer types except for brain cancer (Figure 2). These racial/ethnic differences were also seen among cumulative incidences of proximal LE DVT. For iDDVT, AA again had the highest cumulative incidence compared to the other racial groups among all cancer types except for myeloma. Racial differences were not as prominent when examining cumulative incidence of all VTE (PE+DVT). In adjusted multivariable models of overall CAT, compared to NHW, AA had the highest risk of CAT across all cancer types except for brain cancer and myeloma. API had significantly lower risk of CAT than NHW for all cancer types. When examining PE only in multivariable models, AA had significantly higher risk of PE compared to NHW in all cancer types except for kidney, stomach, brain cancer, and myeloma (Hazard Ratio (HR) ranging from 1.36 to 2.09). API had significantly lower risk of PE in all cancer types except uterine, kidney, and ovarian cancer (HR ranging from 0.45 to 0.87). Hispanics had lower risk of PE than NHW in breast, prostate, colorectal, bladder, pancreatic cancer, and myeloma (HR ranging from 0.64 to 0.87). [Figure 3] Conclusion In this large, diverse, population-based cohort of cancer patients, race/ethnicity was associated with risk of CAT even after adjusting for cancer stage, type of treatment, sociodemographic factors, and comorbidities. Overall, AA had a significantly higher incidence and API had a significantly lower incidence of CAT than NHW. These racial/ethnic differences were especially prominent when examining PE only, and PE appears to be the main driver for the racial differences observed in overall rates of CAT. Current risk prediction models for CAT do not include race/ethnicity as a parameter. Future studies might examine if incorporation of race/ethnicity into risk prediction models for CAT may improve their predictive value, as this may have important implications for thromboprophylaxis in this high-risk population. Disclosures Wun: Glycomimetics, Inc.: Consultancy.

Abstract P228: Do Cardiometabolic Risk Profiles Differ Across Race-Ethnicity? An Analysis of the Most Active U.S. Adults in the 2003-2006 NHANES

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
William Boyer ◽  
Michael R Richardson ◽  
James R Churilla ◽  
Lindsay Toth ◽  
Eugene Fitzhugh ◽  
...  
Keyword(s):  
Sex Education ◽  
Ethnic Differences ◽  
Mexican American ◽  
Cardiometabolic Risk ◽  
Total Activity ◽  
Self Report ◽  
Fasting Insulin ◽  
Physiological Factors ◽  
Beneficial Effects ◽  
Race Ethnicity

Introduction: Previous studies have revealed a significant, inverse dose-response relationship between total activity counts/day (TAC/d) and several cardiometabolic risk factors (CMRF). An ongoing line of research is the examination of the contributions of behavioral, environmental, and physiological factors to CMRF differences across race-ethnicity. However, it is unknown if these differences exist among the most physically active adults. Hypothesis: Among the most active U.S. adults, we hypothesize that CMRF measures will differ across race-ethnic groups. Methods: Study sample (n=1,059) included adult (20-79 years of age) participants from the 2003-2006 NHANES who wore an ActiGraph model 7164 accelerometer on the right hip. The top quartile of accelerometer-derived age- and gender-specific TAC/d was used as a cutpoint to define the “most active”. All participants were without T2D (fasting glucose <126 mg/dL, no medication, no self-reported diagnosis) and without CVD (self-report). CMRF included HOMA-IR, fasting insulin and glucose, systolic (SBP) and diastolic blood pressure (DBP), HDL, LDL, triglycerides, BMI, waist circumference (WC) and C-reactive protein (CRP). Multiple linear regression was used to examine CMRF differences between non-Hispanic white (NHW), non-Hispanic black (NHB) and Mexican American (MA) participants. Regression models were adjusted for age, sex, education, smoking, wear time, BMI (except BMI and WC models), objectively-measure MVPA (≥760 counts/min) and race-ethnicity. Results: No significant differences were found in mean TAC/d across race-ethnicity. When compared to NHW, NHB had significantly higher HOMA-IR, fasting insulin, SBP, WC, and BMI. Compared to NHW, MA had significantly higher HOMA-IR, fasting insulin, triglycerides, WC and BMI. When comparing NHB to MA, MA had significantly higher triglycerides and HDL and significantly lower SBP. Conclusions: It has been proposed that the race-ethnic differences in PA participation could be contributing to disparities in elevated CMRF, but even among U.S. adults in the 75th percentile for total activity volume (i.e. TAC/d), race-ethnic differences in CMRF still exist. It is probable that other social, environmental, and genetic factors are responsible for moderating the beneficial effects PA has on CMRF specifically among NHB and MA adults.

scholarly journals Racial and Ethnic Differences in Presentation and Outcomes for Patients Hospitalized with COVID-19: Findings from the American Heart Association's COVID-19 Cardiovascular Disease Registry

Circulation ◽  
2020 ◽  
Author(s):  
Fatima Rodriguez ◽  
Nicole Solomon ◽  
James A. de Lemos ◽  
Sandeep R. Das ◽  
David A. Morrow ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ethnic Differences ◽  
American Heart ◽  
Disease Registry ◽  
Asian Patients ◽  
Black Patients ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Background: The COVID-19 pandemic has exposed longstanding racial/ethnic inequities in health risks and outcomes in the U.S.. We sought to identify racial/ethnic differences in presentation and outcomes for patients hospitalized with COVID-19. Methods: The American Heart Association COVID-19 Cardiovascular Disease Registry is a retrospective observational registry capturing consecutive patients hospitalized with COVID-19. We present data on the first 7,868 patients by race/ethnicity treated at 88 hospitals across the US between 01/17/2020 and 7/22/2020. The primary outcome was in-hospital mortality; secondary outcomes included major adverse cardiovascular events (MACE: death, myocardial infarction, stroke, heart failure) and COVID-19 cardiorespiratory ordinal severity score (worst to best: death, cardiac arrest, mechanical ventilation with mechanical circulatory support, mechanical ventilation with vasopressors/inotrope support, mechanical ventilation without hemodynamic support, and hospitalization without any of the above). Multivariable logistic regression analyses were performed to assess the relationship between race/ethnicity and each outcome adjusting for differences in sociodemographic, clinical, and presentation features, and accounting for clustering by hospital. Results: Among 7,868 patients hospitalized with COVID-19, 33.0% were Hispanic, 25.5% were non-Hispanic Black, 6.3% were Asian, and 35.2% were non-Hispanic White. Hispanic and Black patients were younger than non-Hispanic White and Asian patients and were more likely to be uninsured. Black patients had the highest prevalence of obesity, hypertension, and diabetes. Black patients also had the highest rates of mechanical ventilation (23.2%) and renal replacement therapy (6.6%) but the lowest rates of remdesivir use (6.1%). Overall mortality was 18.4% with 53% of all deaths occurring in Black and Hispanic patients. The adjusted odds ratios (ORs) for mortality were 0.93 (95% confidence interval [CI] 0.76-1.14) for Black patients, 0.90 (95% CI 0.73-1.11) for Hispanic patients, and 1.31 (95% CI 0.96-1.80) for Asian patients compared with non-Hispanic White patients. The median OR across hospitals was 1.99 (95% CI 1.74-2.48). Results were similar for MACE. Asian patients had the highest COVID-19 cardiorespiratory severity at presentation (adjusted OR 1.48, 95% CI 1.16-1.90). Conclusions: Although in-hospital mortality and MACE did not differ by race/ethnicity after adjustment, Black and Hispanic patients bore a greater burden of mortality and morbidity due to their disproportionate representation among COVID-19 hospitalizations.

Temperament and coping: Advantages of an individual differences perspective

2003 ◽  
Vol 15 (4) ◽  
pp. 1049-1066 ◽  
Author(s):  
DOUGLAS DERRYBERRY ◽  
MARJORIE A. REED ◽  
CAROLYN PILKENTON–TAYLOR
Keyword(s):  
Individual Differences ◽  
Coping Skills ◽  
Coping Mechanisms ◽  
Self Control ◽  
Stressful Event ◽  
Coping Process ◽  
Children's Coping ◽  
And Coping ◽  
Cortical Functions

This paper examines the advantages that arise from an individual differences approach to children's coping and vulnerabilities. It suggests that the basic motivational and attentional systems involved in temperament constitute relatively primitive coping mechanisms. With development, these primitive coping skills are aided by representational and other cortical functions, allowing the coping process to begin before a stressful event and thereby increasing the child's capacity to plan an effective coping option and to enhance self-control. Such an emphasis on motivational and attentional differences allows us to take advantage of children's diverse personalities as “experiments of nature” and to better understand the temperamental patterns that contribute to adaptive and maladaptive outcomes.

Meaning in the Context of Stress and Coping

1997 ◽  
Vol 1 (2) ◽  
pp. 115-144 ◽  
Author(s):  
Crystal L. Park ◽  
Susan Folkman
Keyword(s):  
Stressful Life Events ◽  
Meaning Making ◽  
Critical Role ◽  
Empirical Work ◽  
Stress And Coping ◽  
Future Research ◽  
Extended Model ◽  
Critical Dimensions ◽  
Coping Process ◽  
And Coping

Although theoretical and empirical work on topics related to meaning and meaning making proliferate, careful evaluation and integration of this area have not been carried out. Toward this end, this article has 3 goals: (a) to elaborate the critical dimensions of meaning as it relates to stressful life events and conditions, (b) to extend the transactional model of stress and coping to include these dimensions, and (c) to provide a framework for understanding current research and directions for future research within this extended model. First, the authors present a framework for understanding diverse conceptual and operational definitions of meaning by distinguishing 2 levels of meaning, termed global meaning and situationalmeaning. Second, the authors use this framework to review and synthesize the literature on the functions of meaning in the coping process and propose a definition of meaningmaking that highlights the critical role of reappraisal. The authors specify the roles of attributions throughout the coping process and discuss implications for future research.

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