Nurses coping with daily stressors

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.