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GENERAL CONSIDERATIONS

Understanding the coping strategies of critical care patients and their families or primary care providers is vital in helping facilitate the use of effective and healthy ways to cope with their illnesses and their consequences. The suddenness of onset of acute life threatening illness, unavailability of family and social support, feelings of aloneness, and uncertainty about the illness and its implications for the patient’s ability to cope with demands of personal life and maintaining family and social relationship are the stressors that critical care patients and their families/primary care givers experience. The current COVID-19 pandemic and its consequences (e.g., lock down, isolation, feelings of uncertainty, fear of getting infected, and loss or decrease of financial and social resources) magnify and increase the stressors of hospitalization. How are the patients and their families coping? Coping is best defined as problem-solving behaviors and thoughts intended to manage both external and internal stressors and to help bring about resolution and relief.1,2 It is a process of appraisal, self-instruction and correction, performance, and self-rehearsal as well as guidance and help from outside sources.1 Cultural and religious practices need to be considered and understood for individuals’ coping strategies. There are four major categories of coping,2 which include:

  1. Emotion-focused: aims to decrease negative emotions associated with the stressors like fear, anger, anxiety, and depression. Ask patients what aspects of their illnesses and their treatment that they are most worried or afraid about and understanding where their emotions are coming from.

  2. Problem-focused: addresses the main problem causing the distress (e.g., COVID-19 pandemic and its consequences).

  3. Meaning-focused: uses cognitive strategies “to derive and manage the meaning of the situation.” Religious and cultural practices play a role in their type of coping.

  4. Social coping support: seeking from family and medical community emotional and instrumental support. Open communication is important in their type of coping.

Preliminary data on coping strategies gathered from interviews of patients and their families, physicians, primary care providers, and other health care providers as well as from data of existing literature on coping strategies are included and arranged here from A to Z. Each person has developed their own coping strategies and what works for them may not work for other people. Effective copers are usually optimistic, practical, flexible, resourceful, and composed when facing difficult situations to avoid impairment of judgment. Bad copers or ineffective copers are usually rigid and inflexible with very high self-expectation and with excess denial and extreme rationalization and failed to focus on important problems. Negative or maladaptive coping strategies include abuse of alcohol and drugs, overspending or too much “retail therapy,” overeating, oversleeping, self and family neglect with failure to follow up with medical appointments with poor compliance, intimate partner abuse/violence, and indiscriminate, unprotected sex and other reckless and self-destructive behaviors. Effective coping strategies mitigate acute and chronic stress, which is the body’s respond to stressors from different situations and events. The ...

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