1 Preserving a reasonable emotional balance. This involves compensating for the
negative emotions aroused by illness with sufficient positive ones.
2 Preserving a satisfactory self-image and maintaining a sense of competence
and mastery. This involves dealing with changes in appearance following illness
(e.g. disfigurement) and adapting to a reliance on technology (e.g. pacemaker).
3 Sustaining relationships with family and friends. This involves maintaining social
support networks even when communication can become problematic due to changes
in location and mobility.
4 Preparing for an uncertain future. Illness can often result in loss (e.g. of sight,
lifestyle, mobility, life). This task involves coming to terms with such losses and
redefining the future.
Process 3: Coping skills Following both appraisal and the use of adaptive tasks,
Moos and Schaefer described a series of coping skills that are accessed to deal with the
crisis of physical illness. These coping skills can be categorized into three forms: (1)
appraisal-focused coping; (2) problem-focused coping; and (3) emotion-focused coping
(see Table 3.2).
Appraisal-focused coping involves attempts to understand the illness and represents a
search for meaning. Three sets of appraisal-focused coping skills have been defined:
1 Logical analysis and mental preparation, involving turning an apparently
unmanageable event into a series of manageable ones.
2 Cognitive redefinition, involving accepting the reality of the situation and redefining
it in a positive and acceptable way.
3 Cognitive avoidance and denial, involving minimizing the seriousness of the illness.
Appraisal-focused
Logical analysis and mental preparation
Cognitive redefinition
Cognitive avoidance or denial
Problem-focused
Seeking information and support
Taking problem-solving action
Identifying rewards
Emotion-focused
Affective regulation
Emotional discharge
Resigned acceptance
Table 3.2 Coping skills
ILLNESS COGNITIONS 65