Avoidant coping as a predictor of mortality in veterans with end-stage renal disease

The aim of this study was to examine the role of active and avoidant coping strategies in predicting mortality in 61 veterans with end-stage renal disease.

Participants completed a self-report measure of coping strategies (The COPE; Carver, Scheier, & Weintraub, 1989) and were interviewed as part of a structured assessment to determine their appropriateness for renal transplant. On average, participants were then followed for 9 years via medical record review to determine mortality status.

Mortality, as predicted by factor scores on active and avoidant coping factors estimated via confirmatory factor analysis of select COPE subscales.

A Cox regression revealed that a unit change in avoidant coping was associated with a 114% increase in odds of mortality, even after controlling for variance attributable to demographic variables. There was also a statistical trend indicating that this association might be mediated by poor attendance at medical appointments. Active coping did not predict mortality.

Results demonstrate the importance of assessing coping style in this population; clinical implications of these findings and possible mechanisms of this effect are discussed.