Ways of coping and survival in Cystic Fibrosis: a 20-year longitudinal study

Background: The relationship between ways of coping and health outcomes has been a focus of interest for decades. There is increasing recognition that positive psychological functioning can influence health outcomes beneficially. This work investigated the role of coping in predicting survival in CF.Methods: A longitudinal observational cohort study with a 20-year follow-up period was undertaken. At entry to the study, demographic and clinical variables were recorded, and ways of coping were as-sessed using the Cystic Fibrosis Coping Scale which measures four distinct ways of coping: optimism, hopefulness, distraction and avoidance. Survival outcome was measured as time in days from the date of recruitment to exit from the study, where exit was either death, loss to follow-up or the end of the follow-up period.Results: Survival time was modelled using Cox's proportional hazards model. At baseline, 116 peo-ple with CF were recruited. By the census date, 54 people had died (14 men had died during 248,565 person-days of observation and 40 women had died during 358,372 person-days of observation). Opti-mism was the only way of coping that showed any beneficial effect on survival (RR = 0.984, p = 0.040) after adjustments for age, gender, ppFEV1 and the three other coping variables measured at baseline.Conclusion: This work suggests that optimistic coping serves as a prognostic measure of survival in CF beyond key clinical and demographic variables. Ways of coping are modifiable, providing a target for clinical intervention; to improve quality of life and clinical outcomes and potentially increase longevity.(c) 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.