Coping competence and health outcomes in post-COVID: A prospective study on the role of adaptive strategies in symptom management... 2025 Koller et al

Andy

Andy

Retired committee member
Full title: Coping competence and health outcomes in post-COVID: A prospective study on the role of adaptive strategies in symptom management and physical and mental health

Highlights
  • Women show greater competence in spiritual/religious coping, coping skills, and healthy lifestyle than men.
  • High-educated patients demonstrate greater competence in coping skills, information-seeking, and leading a healthy lifestyle.
  • High coping competence is a protective factor for symptoms of fatigue and depression.
  • High information-seeking is a risk factor for symptoms of post-exertional malaise.
Abstract

Background
Post-acute sequelae of COVID-19 (PASC), characterized by persistent symptoms like fatigue, cognitive impairments, and mental health problems, requires effective coping strategies for symptom management, yet their impact on health outcomes in PASC patients remains unclear. This study examines differences in coping strategies across subgroups, changes over time, and their relationship with PASC symptoms and physical and mental health.

Methods
In a prospective study, conducted at the Post-COVID Center of the University Hospital of Erlangen, patients were assessed at baseline (T0) and follow-up (T1; M = 4.46 months, SD = 2.27). Coping strategies were measured using the Patient Competence Questionnaire-2 (PCQ-2), including coping competence, religious/spiritual coping, healthy lifestyle, information-seeking, and adaptability. PASC symptom severity (PCS score), fatigue (FSS), post-exertional malaise (DSQ-PEM), and depressive symptoms (PHQ-9) were also assessed.

Results
Among 339 participants (age: M = 45.51 years, SD = 11.96; 70.2 % women) coping competence improved significantly over time, while no notable changes were observed in the other factors and overall patient competence. Women scored higher than men in religious/spiritual coping, coping competence, and healthy lifestyle (all p < .001). Higher education levels were associated with higher scores in coping competence, information-seeking, and healthy lifestyle (p = .028, p = .014 and p = .012, respectively). Higher coping competence at T0 significantly predicted fewer symptoms of fatigue and depression (p = .021 and p < .001, respectively) at T1, whereas higher adaptability at T0 was associated with more severe fatigue, PEM, and depression at T1 (p < .001, p = .001 and p = .020, respectively).

Conclusion
Strengthening coping competence may improve symptom management and severity in PASC patients, highlighting the need for targeted interventions.

Open access
 
Andy said:
Highlights
  • Women show greater competence in spiritual/religious coping, coping skills, and healthy lifestyle than men.
  • High-educated patients demonstrate greater competence in coping skills, information-seeking, and leading a healthy lifestyle.
  • High coping competence is a protective factor for symptoms of fatigue and depression.
  • High information-seeking is a risk factor for symptoms of post-exertional malaise.
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These deductions, presumbably entirely based on unsuitable questionnaires seem to me to reflect more about the questionnaires used than the realities of life with a disabling illness.

For example, someone highly educated may also have more resources and the sort of job that allows for sick leave and adjustments than someone who does manual work, and may have more resources to enable them to live healthily. And men and women may have different ways of coping which are reflected in questionnaires as better or worse, but are actually just different. This outcome statement seems pretty judgemental to me.

The last two are upside down. They should read:
Those with less fatigue and depression are more able to cope.
Those who experience PEM have lives more radically disrupted, and get less help and understanding from doctors, so are forced to research their illness themselves.
 
544 patients completed the questionnaire at T0 (response rate = 94.6 %). 419 were invited to the follow-up survey (T1) at least three months after the initial presentation, with 339 (80.9 %) responding.
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38 % dropout, which they try to fram as 19 % dropout.
 
Line breaks added.
5. Conclusion
The findings of this study have significant implications for the management of PASC.

The gender and educational differences in coping competence suggest that interventions should be individualized, with additional support for men and individuals with lower education to foster effective coping strategies.

Notably, better coping competence was found to predict not only better mental health (e.g. depressive symptoms) but also less severe physical symptoms in PASC like fatigue.

This highlights coping competence as a crucial factor in the treatment of PASC, underscoring the need to address coping strategies to mitigate both mental health and physical symptom burdens.

Additionally, further research is needed to understand the mechanisms underlying the paradoxical effects of adaptability and information-seeking, ensuring these behaviors can be used effectively to support recovery.
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Correlation != Causation, and we have no way of knowing the direction.

These are really basic concepts, and it’s worrying that the authors seemingly do not understand them. How their analysis got past peer review and the editor is beyond me.
 
Seeking information allows people to recognize and name what they're experiencing. That's how it becomes a "risk factor".
 
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Aside from being very judgmental to the point of being snobby, this seems to be the health care equivalent of industry propaganda about how "only you can save the planet, by recycling and taking shorter showers". Nevermind that most things sent to recycling aren't ever recycled.

There are so many confounders that make this all irrelevant. It's about as relevant as physical reactions to a car crash in a huge pile-up. Some people got crushed to death, I guess they chose the wrong physical reaction, while others merely got a bruise, they clearly did it right. "So, just, uh, choose the right thing, choose to not get crushed to death or injured. I'm so glad I helped."

And of course ye olde reversal of causation with information-seeking. Good grief even children are able to get stuff like this right.
The findings of this study have significant implications for the management of PASC.
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They, uh, do not. Don't kid yourself, this is barely worth lighting a fire with its printout.
Hoopoe said:
Seeking information allows people to recognize and name what they're experiencing. That's how it it becomes a "risk factor".
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In most cases, especially seeking beyond the garbage heap of misinformation that comes out of health care about LC, seeking beyond it is the only way to get accurate information for the vast majority of people. There is simply no other way, and either they find that what they got told is a bunch of BS, or, if accurate, that they don't know anything more than what a half-page summary can give, and that, no, there is no help or support out there.
 
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