Coping strategies, pain, and disability in patients with hemophilia and related disorders

Objective. To analyze the use of various coping strategies in homogeneous g roups of patients with hemophilia and von Willebrand's disease and to inves tigate the relationship between the state of the disease, the use of coping strategies, and management of the disease. Methods. The coping strategies measured by the Coping Strategies Questionna ire were analyzed in 3 homogeneous groups of 224 patients. Psychosocial wel l-being (PWB) measured by the Rand 36-item Health Survey 1.0 was used as an indicator of management of the disease. The pain factor consisted of the f ollowing variables: pain intensity, use of analgesics, Functional Disabilit y Index, and physical activity level. Results. The groups of patients differed significantly only in the use of t he catastrophizing strategy (CAT). In all pain groups, distraction was the most commonly used coping strategy. A significant interaction effect of pai n factor and age on PWB (P = 0.04) was found. The mediating function of the CAT strategy was confirmed by the series of regression analyses. Conclusion. The coping strategy profile in hemophilia was found to be simil ar to those in other chronic pain states. The use of the strategies does no t depend on the severity of the disease. We confirmed the role of age and t he use of the CAT strategy as, respectively, moderator and mediator in the pattern of relationships between the clinical state of the disease and psyc hosocial well-being.