Identifying patients' stress coping behavior key to treatment outcomes

Austrian researchers found that learning about a patient's stress coping strategies could help physicians with proper diagnosis and treatment of some medical conditions.

The study, published in the Journal of Periodontology (JOP), found that patients with defensive coping skills are more likely to refuse all responsibility and down play their conditions in comparison with others. Thus, making it difficult for physicians to determine the severity of the medical condition and inhibiting their ability to counsel patients on possible prevention methods.

"Should these results be confirmed, they would constitute an important means of enhancing the patient's compliance during medical examinations and treatment," said Gernot Wimmer, DMD, study author and lector at the Karl Franzens University of Graz in Austria. "In such cases, care should be taken to ensure that patients receive information in such a way that it does not cause them to become defensive, and that proper access to the disease is established."

He continued, "Either consciously or unconsciously, individuals use coping measures as a response to stress, in order to reduce its intensity or to overcome stress altogether. Thus, the individual's concept of stress coping appears to be particularly an important determinant of the general tenor on his/her health."

The study looked at coping behavior in 89 men and women with periodontitis, an inflammatory gum infection at its most aggressive and destructive form, and 63 healthy persons. All study participants underwent a periodontal examination and took one of the most comprehensive stress questionnaires in German-speaking countries to determine their coping behavior. Results showed that those with periodontal disease were less likely to use active coping strategies, such as situation control, than those in the control group. They were also more likely to cope with stress situations by means of averting blame.

"This Investigation further demonstrates a correlation between emotional and psychosocial stress factors and medical treatment success," said Gordon Douglass, DDS, and president of the American Academy of Periodontology. "It is important that both patients and their therapists understand ways to improve their stress coping ability."

In terms of differentiating the various stressors, earlier reports indicate that work-related issues are coped with in a rather problem-oriented fashion, whereas disease-related situations are handled emotionally. Concerning family issues, no specific style is given preference; both patterns are used to an equal extent.

Problem-oriented coping is practiced in those situations that are considered changeable. For example, previous research in the JOP found that people with financial worries were at a higher risk of periodontal disease. However, authors recommended problem-based coping behaviors, such as taking charge and tackling the situation head first, to reduce the stress-associated risk. Emotional coping is more common in situations that have to be accepted and in which the individual feels helpless.

You can obtain a referral to a periodontist and a free brochure on what you should know about periodontal diseases by calling 800-FLOSS-EM or visiting the AAP's Web site at www.perio.org .