Coping Efficacy as a Moderator of Disease Severity and Health-Related Quality of Life in Adolescents with Cystic Fibrosis

Adolescents with cystic fibrosis (CF) face unique stressors that require effective coping strategies. Although research suggests that coping may be an important moderator of adjustment to stress, previous studies have utilized generic coping measures that are not specific to the disease or context. Using the Role-Play Inventory of Situations and Coping Strategies (RISCS), a context-specific coping measure for adolescents with CF, the current study examined whether coping efficacy moderated the relationship between disease-related stress and health-related quality of life. Additionally, this study investigated the impact of two family-based behavioral interventions on adolescents’ coping skills: Behavioral Family Systems Therapy (BFST) and the Family Education Program (FEP). Although no direct effects of coping on HRQOL at baseline were found, resulted showed that effective coping buffered the negative effects of disease severity and stressor frequency on HRQOL in several domains. In addition, some evidence indicated that at the most severe end of the severity continuum, there may be thresholds at which effective coping strategies no longer exert their beneficial effects. Longitudinal models revealed that improvements in coping skills were associated with positive changes in HRQOL in different domains, depending upon treatment group. These findings highlighted the utility of using context-specific, sensitive coping measures when examining the moderating effects of coping, and the importance of identifying adolescents with poor coping skills and providing tailored interventions.