Background & Aims

Coping is a relevant construct in psychology for the study of adaptation processes to highly stressful events. The way people cope with stress can be a significant predictor of the impact on their short- and long-term mental and physical health. In children, coping requires a developmental perspective adapted to their ability to respond to stress. Preschool age would be the stage where coping processes begin to develop, but research with this population is small and limited. In this context, the Revised Children’s Coping Scale (CCS-R; Kiernan et al., 2017) is presented as a guiding tool in the study of preschool coping strategies. The CCS has shown evidence of validity and reliability in coping with situations in everyday life, however, no adaptations have been made to health stress situations. The objective of the present study was to evaluate and adapt the CCS-R to a sample of preschoolers who face experiences of pain due to illness or invasive medical procedures.

Methods

A comprehensive theoretical and empirical literature review was conducted about CCS-R. A translation of the instrument from English to Spanish was carried out independently by 2 bilingual experts, and a back-translator by a third professional. The translated version was reviewed by a committee of experts to evaluate linguistic and conceptual equivalence. In this process, 2 daily child stress and 2 health-related stress situations were established: high control (Do something he/she dislike and coping with pain of a fall injury) and low control (Say goodbye to a caregiver and coping painful medical procedure). A multicenter pilot test was carried out in 4 Chilean PEDs, with a sample of 100 caregivers. Cognitive interviews were conducted with 50% of sample. Questions of comprehension, interpretation, evocation, opinion and evaluation allowed iterative cultural adjustments. Confirmatory and exploratory factor analyzes were performed to examine the factor structure of the CCS-R.

Results

The sample had 51% girls. 90% of caregivers were women, with educational backgrounds: high school (55%), technical (20%), and university (24%). Socioeconomic status included 45% vulnerable, 34% lower-middle, and 21% upper-middle class. Factor analysis revealed distinct structures for high/low control and everyday/health situations. Saying goodbye to a caregiver aligned with the original structure (CFI = 0.94, TLI = 0.93, RMSEA = 0.04, SRMR = 0.09), unlike situations where a child resists (CFI = 0.83, TLI = 0.79, RMSEA = 0.06, SRMR = 0.10). Analysis identified 10 CCS-R items effective in everyday but not health events (CFI = 0.94, TLI = 0.93, RMSEA = 0.04, SRMR = 0.09). The adaptation showed favorable results, (CFI = 0.94, TLI = 0.93, RMSEA = 0.04, SRMR = 0.09, suggesting a 3-factor structure but with items distributed differently than the original version. Based In the cognitive interviews, 7 new items were added, making a total of 32 items for the adapted version.

Conclusions

This study addresses the relevant psychological construct of coping in preschool children facing health-related stress, an understudied area. The adapted CCS-R showed promising results for assessing specific coping strategies for health events. The results revealed differentiated structures of coping strategies depending on the stressful situation, suggesting a context-dependent property. Factor analyses supported the 3-factor structure, which could be grouped into positive-collaborative, negative-avoidant, and negative-emotional coping styles. The diverse demographic sample, which considers gender, education, and socioeconomic status, enhances the generalizability of the study. The adapted CCS-R, provides a valuable tool to understand and support coping with health-related stress in preschoolers, in addition to equipping health professionals and caregivers to identify and modulate coping strategies, promoting an effective adaptation to health demands.

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Presenting Author

Sofía Hidalgo Vilche

Poster Authors

Sofía Hidalgo Vilche

BS

Universidad de Chile. Psychology Student, Universidad de Chile

Lead Author

Mariela Bustamante

PhD

Universidad de Chile. Master in Health Psychology and Doctoral Candidate in Psychology Pontificia Universidad Católica de Chile

Lead Author

Valeska Tapia

Universidad de Chile

Lead Author

Gabriela Ruiz

BNSc

Universidad de Chile. Medical Student, Universidad de Chile

Lead Author

Scarlett Caroca

BNSc

Universidad de Chile. Bachelor in Medicine, Universidad de Chile

Lead Author

Topics

  • Pain in Special Populations: Infants/Children