The coping flexibility questionnaire: development and initial validation in patients with chronic rheumatic diseases

Abstract

Coping flexibility may be beneficial for the adjustment in the context of a progressive and unpredictable course of chronic rheumatic diseases. The aim of this study was to develop and initially validate a self-report measure that assesses coping flexibility. Study participants were 147 outpatients with chronic rheumatic diseases (73% women, mean age 59 (range 20–79) years). Principal axis factoring analysis with oblique rotation was applied and internal consistency was determined. To investigate the initial validity of the coping flexibility questionnaire (COFLEX), hypothesised correlations with psychological and physical adjustment outcomes, pain, and coping strategies were examined. Factor analysis yielded a two-factor model of coping flexibility with acceptable internal consistency: versatility, the capability of switching between assimilative and accommodative coping strategies according to personal goals and situational demands (α = .88) and reflective coping, the capability of generating and considering coping options, and appraising the suitability of a coping strategy in a given situation (α = .70). Versatility was correlated with adaptive ways of coping and psychological adjustment, but not with physical adjustment and pain. Reflective coping was correlated with both adaptive and maladaptive ways of coping, but it was not correlated with adjustment outcomes. In conclusion, the current study suggests acceptable internal consistency of the COFLEX. Preliminary evidence of the validity of the versatility dimension is indicated, while the validity of reflective coping could not be firmly established. The associations of versatility with favourable adjustment to the disease warrant future confirmatory and validity research in larger samples of patients with chronic rheumatic diseases.

Appendix: The coping flexibility questionnaire (COFLEX)

Explanation

People may be faced with changes in their lives: difficult or stressful situations and wishes or goals which cannot be realised as they would prefer. How people cope with these changes differs from one individual to the other. Below you will find statements of how individuals cope with these changes and deal with difficulties. Please indicate to which extent these statements apply to you by ticking the first answer that comes to mind.

When confronted with an important problem

		Seldom or never	Sometimes	Often	Almost always
1.	I can easily change my approach if necessary	□	□	□	□
2.	I think of different options when a solution is not successful	□	□	□	□
3.	I immediately change my approach if a certain approach fails	□	□	□	□
4.	I adjust my strategy as soon as I notice that my approach fails	□	□	□	□
5.	I think about the effort it will to take to achieve a certain goal	□	□	□	□
6.	I have enough strategies to deal with the problem	□	□	□	□
7.	I am flexible in my approach towards a problem	□	□	□	□
8.	I question myself what is really important to me	□	□	□	□
9.	I have enough different options to quickly solve a problem	□	□	□	□
10.	I usually take some time to think about what I am going to do	□	□	□	□
11.	I question myself whether my approach to the problem is the best solution	□	□	□	□
12.	I find it is a challenge to adapt to changing circumstances	□	□	□	□
13.	I easily think of a different approach that suits the changing situation	□	□	□	□

1. Scoring of COFLEX dimensions: Versatility = sum score of items 1, 2, 3, 4, 6, 7, 9, 12 and 13. Missing item scores are replaced with the mean of the other items; when more than two items are missing, the versatility score is invalid. Reflective coping = sum score of items 5, 8, 10 and 11. A single missing item score is replaced with the mean of the other items; when more than 1 item is missing, the reflective coping score is invalid