This study examined the relationship among chronic disease, coping strategy patterns, and health-related quality of life (HRQOL) among children and adolescents. The cohort included 273 Israeli children and adolescents aged 8-18 years diagnosed with asthma, diabetes mellitus, or celiac disease. All completed the Coping with a Disease Questionnaire (CODI) and the DISABKIDS Chronic Generic Measure (DCGM-37). The outcome measures were as follows: association of the use of effective and non-effective coping strategies with type of disease; predictive value of coping patterns for health-related quality of life; a European sample was used for comparison. On k means cluster analysis, three strategy patterns (two "effective" and one "non-effective") were associated with health-related quality of life and disease specifics. Disease predicted coping patterns, but it had a weak direct relationship to health-related quality of life. Coping patterns were the strongest predictor of health-related quality of life. These results are similar to the European DISABKIDS study, indicating cross-cultural parallels.
Conclusions: The findings highlight the power of the concept of coping patterns as opposed to coping strategies to explain HRQOL of children and adolescents with chronic disease. Both types of disease (categorical approach) and coping patterns (non-categorical approach) are relevant to predicting HRQOL. What is Known: • The literature on coping has widely documented the existence of individual (unique) coping strategies. • Coping strategies are considered "useful" or "non-useful," based on whether they increase or decrease negative outcomes caused by certain stressors, such as chronic illness. What is New: • Our findings suggest that youngsters can use "non-useful" strategies to reduce stress caused by chronic illness, while still maintaining higher quality of life, as long as they also apply certain "useful" strategies. • The use of certain combinations of coping strategies, rather than single strategies, is more important to our understanding of how coping affects HRQOL of children with chronic disease.
Keywords: Adolescents; Children; Chronic illness; Coping; Quality of life.