• Karla T Washington and Christopher R Rakes.
• Department of Family & Community Medicine, University of Missouri, Columbia, Missouri, USA. Electronic address: washingtonkar@health.missouri.edu.
• J Pain Symptom Manage. 2015 Dec 1;50(6):867-73.

ContextHospice family caregivers must often cope with significant stressors. Research into the ways caregivers attempt to cope with these stressors has been challenged by pronounced difficulties conceptualizing, measuring, and categorizing caregiver coping.ObjectivesThe purpose of this study was to begin addressing these challenges by determining the structure of coping among hospice family caregivers.MethodsHospice family caregivers (n = 223) residing in the midsouthern U.S. completed the Ways of Coping Questionnaire as part of a cross-sectional survey. To examine the validity of various coping response factor structures, researchers conducted multiple confirmatory factor analyses.ResultsAlthough individual coping behaviors were able to be sorted into broader "ways of coping" (i.e., first-order factors), data did not support the further grouping of ways of coping into more general "families of coping" (i.e., second-order factors). Folkman and Lazarus's proposed structure of coping, which comprises eight first-order factors or subscales, better fit the data than the tested alternatives.ConclusionDespite its broad appeal, grouping ways of coping responses into families of coping based on the presupposed nature of the responses (e.g., positive or negative) lacked empirical support for this sample of hospice family caregivers, which suggests that relying on families of coping may oversimplify complex responses from caregivers. Rather than trying to characterize coping responses into broader families, hospice support for caregiver coping strategies may be more effective when based on individualized assessments of each caregiver's ways of coping and the consequences of those coping responses on their quality of life.Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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