When and how do hospital nurses cope with daily stressors? A multilevel study

Abstract

Background During their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses. Objectives To identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses. Design This study uses descriptive, correlational, two-level design with repeated measures. Settings Wards of two University hospitals. Participants A random cohort of 113 nurses was studied. Methods An ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships. Results Different momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task. Conclusions The choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping.

The COVID-19 pandemic – A focus on nurse managers’ mental health, coping behaviours and organisational commitment

“…Despite some Nurse Managers’ using maladaptive strategies as a way to cope with the uncertainty of the pandemic, our study also found that Nurse Managers who had worked longer as a nurse and hence more experience as a nurse, adopted adaptive coping strategies. Adaptive coping strategies have been demonstrated to be more influential on stress management than maladaptive coping strategies ( Holton et al, 2016 ), reducing negative emotions ( Huang et al, 2020 ), improving performance and job satisfaction ( Martinez-Zaragoza et al, 2020 ). Indeed, it is important to note that adaptive coping strategies were used by Nurse Managers with more experience.…”

“…In an address to nurses in the United Kingdom when the pandemic was declared, the Chief Nursing Officer for England stated that nurses needed to “set aside [our] fears to show our outstanding leadership skills” ( NHS England, 2020 ). This was a challenge for mid-level Nurse Managers, who experienced high levels of stress and anxiety due to an imbalance between effort and reward received ( Martinez-Zaragoza et al, 2020 ). The psychological and social factors heightened during COVID-19 ( Zheng et al, 2020 ) that impacted mid-level Nurse Managers can lead to a number of mental and physical disorders ( Alkhawaldeh et al, 2020 ).…”

“…The psychological and social factors heightened during COVID-19 ( Zheng et al, 2020 ) that impacted mid-level Nurse Managers can lead to a number of mental and physical disorders ( Alkhawaldeh et al, 2020 ). In addition, a disparity between effort and reward leads to sick leave, an intention to quit, turnover, work-home struggles, emotional fatigue, depression, anxiety and burnout ( Martinez-Zaragoza et al, 2020 ; Alkhawaldeh et al, 2020 ; Labrague & de los Santos, 2020b ). This impact on Nurse Managers needs attention, particularly since WHO (2020) have identified that COVID-19 is likely to have ongoing effects on mental health beyond the short term.…”

“…This, along with family pressures due to COVID 19 such as home schooling, could have had an even greater psychological impact on Nurse Managers. All these demands and factors could contribute to Nurse Managers having a perceived lack of control over their workload at the height of the COVID-19 pandemic, and thereby being at a higher risk of psychological difficulties ( Martinez-Zaragoza et al, 2020 ).…”

“You Need to Get Over the Difficulties and Stand Up Again”—A Qualitative Inquiry into Young Nurses’ Coping with Lateral Violence from the Feminist Perspective

“…The problem-focused strategy of making extra efforts can enhance the young nurses’ self-efficacy in performing their new roles. This strategy is widely reported by other studies [ 7 , 23 , 24 ], reflecting nurse professionals’ pragmatic nature.…”