The association of coping strategies on emergency room visits in patients with acute asthma

Introduction. Asthma in the United States (U.S.) shows an increase in incidence, ER visits and mortality (Moorman, Rudd, Johnson, King, Minor, Bailey, et al., 2007). Since research shows that ineffective coping styles produce exacerbations and emergency room visits, identifying both positive and negative coping strategies could decrease asthma morbidity (Chen, 2008).;Purpose of the study. The purpose of this study was to investigate the relationship between coping strategies and emergency room visits in adult patients with asthma.;Methodology. The research design utilized an exploratory cross-sectional survey with a convenience sample of asthmatic patients consecutively visiting the emergency room to study the relationship of a patient's coping strategies to number of visits to the emergency room in the past year. Asthmatics with severe acuity of disease display symptoms throughout the day requiring treatment at multiple times per day. Patients, aged 19 to 67 years with physician-diagnosed asthma, completed four sub-scales (active coping, behavioral disengagement, social support and restraint) of the Coping Orientations to Problems Experienced (COPE) survey. Generalized linear regression was used to analyze the data and formulate a model to predict emergency room visits.;Results. Forty-five patients completed the study. The hypothesis that coping did not affect ER use (controlling for important confounding variables) was rejected. Coping strategies that appear to reduce ER use in people with asthma were active coping and social support. Coping strategies that appear to increase ER use include behavioral disengagement and restraint. Severity and insurance demonstrated significant affects in the model. Sex, race and smoking status were not associated with the number of ER visits in this sample, but did contribute to a better fitting model. Coping strategies showed no association with age, insurance, severity, sex, race or smoking status.;Conclusion. The Null Hypothesis, "Controlling for the confounding variables such as sex, race, severity of illness and insurance coverage, coping strategies of adult asthmatics will have no association with their emergency room visits," was rejected as all four coping variables showed association with the emergency room visits. Educating patients with asthma about coping strategies may help decrease the high use of emergency room.