2.2.4. Brief-COPE Scale

The Italian HCWs' coping strategies were evaluated using the Brief-COPE [66]; it is the short version of the original COPE (Coping Orientation to Problems Experienced) inventory [65]. We adapted the original Brief-COPE scale into the Italian language using a forward and backward translation process to guarantee correspondence between Italian and English original versions. The Brief-COPE consists of 14 faced-scales (each of them composed of 2 items), which represent 14 different coping strategies [66,67] that can be grouped into two overarching coping styles: approach coping (active coping, planning, positive reframing, acceptance, seeking emotional support, seeking instrumental support) and avoidant coping (self-distraction, denial, venting, substance use, behavioral disengagement, self-blame). Humor and religion are excluded from these styles, since, according to [90], they are both adaptive and problematic components. Some authors (e.g., [63]) distinguish the 14 faced-scales into three composite subscales: problem-focused (active coping, seeking instrumental support, planning), emotion-focused (acceptance, seeking emotional support, humor, positive reframing, religion), and dysfunctional (behavioral disengagement, denial, self-blame, self-distraction, substance use, venting). The 28 items, that are measured with scores ranging from 0 (I haven't been doing this at all) to 3 (I've been doing this a lot), can be "converted to a dispositional 'coping style' format [ ... ] or a situational concurrent format, by changing verb forms [ ... ]. They can assume a retrospective, situational format [ ... ], a concurrent situational format [ ... ], or even a dispositional format" [66] (pp. 95–98). Since we wanted to measure the Italian healthcare professionals' situational and retrospective coping strategies, i.e., related to a specific circumstance (the COVID-19 pandemic), we presented the items in the past tense.

In order to assess the goodness of fit indexes of the factor structure of the Italian version of the Brief-COPE scale, we performed a Confirmatory Factor Analysis (CFA). The CFA outcomes supported the hypothesized structure: all standardized factor loadings resulted statistically significant (with values between 0.430 and 0.989), and the goodness of fit indexes acceptable (CFI = 0.927; TLI = 0.919; RMSEA = 0.078; SRMR = 0.089).

Cronbach alpha for the Brief-COPE was 0.82, and McDonald's omega was 0.82. Specifically, following the distinction between problem-focused, emotion-focused, and dysfunctional strategies, we obtained that alpha and omega for problem-focused strategies were 0.76 and 0.77, respectively, while for emotion-focused strategies 0.71 and 0.77, respectively. Alpha and omega for dysfunctional strategies were 0.77 and 0.79, respectively.
