DIMENSIONS underlying the Brief COPE in surgical patients: psychometric construct validation of new scales

Abstract

Background: The Brief COPE is a 28-item measure of coping used widely in health research, including studies in surgical settings. However, its psychometric properties have not been validated with a sample of surgical patients and scores have been interpreted with a general model proposed by the original author. Evaluation of the Brief COPE's factor structure was conducted to present psychometrically robust scales that inform use in the surgical setting. Methods: Brief COPE data from 606 patients awaiting surgery were analysed using a priori models from previous research and confirmatory factor analysis. These models failed to converge due to empirical under-identification. Exploratory factor analysis (EFA) with principal axis extraction and parallel analysis was used to identify alternative psychometric models, which were interpreted alongside theory to identify a suitable measurement model for further research. Findings: EFA identified a psychometrically robust measurement model for Brief COPE responses, with seven factors and no cross-loadings or items that loaded below .32. Interpretation of loadings identified the latent variables as Approach coping (8 items), Avoidant coping (8 items), Use of social support (4 items), Humour (2 items), Substance-use (2 items), Religion (2 items) and Self-distraction (2 items). All scales also demonstrated high internal reliabilities. Discussion: A psychometrically valid method of aggregating Brief COPE responses into scales is presented to inform research on coping in surgical patients. The proposed model is discussed alongside psychological theories of coping, and the measurement model is compared with those validated in other samples, such as adults with minor traumatic brain injury.