Coping In Nursing Research: Coping has emerged as a prolific subject in nursing research, encompassing thousands of studies that explore various dimensions of coping with chronic illnesses, acute conditions, treatment-related stress, and the responses of families dealing with illness. This extensive body of work is particularly focused on populations facing chronic diseases, with cancer and cardiovascular diseases being the most commonly investigated.
Coping plays a crucial role in influencing health outcomes, as it affects how individuals respond to stressors associated with illness and treatment. Understanding coping mechanisms can lead to better nursing interventions that enhance patient well-being and recovery.
Exceptions in Coping in Nursing Research
Despite the broad application of coping concepts in nursing research, the definitions and frameworks predominantly draw from the work of psychologists Lazarus and Folkman (1984). They define coping as “constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person” (p. 141). This definition emphasizes that coping is a dynamic process that requires effort and is not inherently positive or negative.
In nursing research, coping is typically viewed as part of a larger process that includes a stressor, appraisal, available resources, coping strategies, and eventual outcomes. Stress is defined as a relationship between the individual and their environment that the individual perceives as taxing their resources and jeopardizing their well-being (Lazarus & Folkman, 1984). Understanding how patients perceive and respond to stressors is critical in developing effective nursing care plans.
Nursing Research Portrays
Nursing research often conceptualizes coping as a multifaceted process that includes stressors categorized as internal or external events, conditions, or cues that can elicit significant physiological, psychological, social, or spiritual reactions (Werner, Frost, & Orth, 2000). Stressors can be normative, occurring as part of typical life transitions, or catastrophic, resulting in profound changes to one’s health or lifestyle.
Problem-Focused and Emotion-Focused Coping
Lazarus and Folkman (1984) distinguish between two primary coping strategies: problem-focused and emotion-focused coping. Problem-focused coping involves managing or altering the stressor itself, while emotion-focused coping aims to regulate emotional responses to the stressor. Understanding these coping strategies is vital for nurses, as different strategies may be more effective depending on the situation.
Coping Theories
Several coping theories have been tested within nursing research. One such theory is Scott, Oberst, and Dropkin’s Stress-Coping Model, which incorporates anxiety into the coping process. The Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1996) is frequently used in nursing studies examining family coping strategies. These theories provide a framework for understanding the complex interactions between stress, coping, and health outcomes.
Coping Resources
Coping resources can be categorized into social, psychological, spiritual, and material resources, such as finances and education. One of the most frequently studied social resources is social support. Underwood (2000) states that social support functions through various mechanisms, including direct assistance, emotional buffering, and providing information or advice.
Research indicates that perceived availability of support often correlates more strongly with coping effectiveness than actual support received. Context plays a crucial role; the types and sources of support needed may vary depending on the patient’s situation. Instruments such as Norbeck’s Social Support Questionnaire and Weinert’s Personal Resource Questionnaire are commonly used to assess social support in nursing research.
Hardiness in Psychological Resources
Hardiness is another psychological resource extensively studied in nursing coping research. Defined as a combination of commitment, challenge, and control, hardiness has been linked to positive health outcomes. Ford-Gilboe and Cohen (2000) argue that hardiness helps individuals and families cope with stress more effectively, contributing to better overall adaptation during health crises.
Coping Resources Gaining Nursing Research
Other coping resources gaining traction in nursing research include hope, control, sense of coherence, and self-efficacy. Antonovsky’s sense of coherence framework posits that individuals who perceive their experiences as comprehensible, manageable, and meaningful are more likely to cope effectively (Antonovsky, 1998).
Coping strategies are often distinguished from coping styles, where coping style refers to typical responses across different situations, and coping strategies indicate specific behaviors enacted in response to stress. Nurse researchers tend to focus more on coping strategies, as these can vary depending on the phase of illness and specific stressors encountered.
Specific Findings in Nursing Coping Research
A wealth of findings has emerged from nursing coping research. Generally, problem-focused coping is associated with positive health outcomes, while emotion-focused strategies, though sometimes linked to negative outcomes, can be beneficial in certain contexts where little can be done to alter the stressor.
Generalizations from Research
- Optimism plays a crucial role in facilitating constructive actions and maintaining a sense of control over circumstances.
- Social support has a significant positive impact on health outcomes, functioning through various mechanisms, such as emotional bolstering and practical assistance.
- Spiritual coping strategies, such as prayer or religious practices, are also associated with improved health outcomes.
- Control and a sense of agency are correlated with positive outcomes; individuals who feel they can exert influence over their situations tend to fare better.
- Coping strategies are dynamic and change throughout the stages of illness, highlighting the need for tailored interventions.
Research Design and Methodology
Most nursing coping studies utilize descriptive and correlational research designs, with qualitative methodologies also gaining prominence. Longitudinal studies are increasingly common, providing deeper insights into the coping process over time. While self-report instruments are often employed, interviews are becoming a popular method for gathering rich, qualitative data.
Exemplary programs of research on coping in nursing include the works of Grey, Hagedoorn, Hinds, Hoskins, Jaloweic, McCubbin, Nail, Northouse, and Ryan-Wenger. These researchers have contributed significantly to understanding coping mechanisms in various nursing contexts, spanning pediatric to geriatric populations.
Conclusion
Coping remains a vital area of investigation in nursing research, with significant implications for patient care and outcomes. Understanding the coping processes of individuals and families facing health challenges enables nurses to develop effective interventions that address not only physical needs but also emotional and psychological well-being.
As healthcare continues to evolve, the integration of coping strategies into nursing practice will be essential for improving patient outcomes and enhancing the overall quality of care. By acknowledging the multifaceted nature of coping and the resources available to patients, nurses can foster resilience and support patients in navigating the complexities of illness and treatment.