Coping with What, When, Where, How - and So What?

Abstract

Concepts such as coping and adaptation are key elements in our nursing work - particularly since our goal is to work with people to improve their health. We face constantly the challenge of understanding people's behaviour and finding ways to help them as they live with illness situations and/or seek to improve their health. Richard Lazarus (1993) introduced a fundamental change in how we define coping and in how we should pursue coping research. He conceives coping behaviour as a process that changes over the course of a situation. Coping behaviour is dependent on the meaning of the event, the context, and the goals of the person in the situation. I believe that nurses find a "good fit" in the Lazarus emphasis on the process of coping. Our values and experience are consistent with his lack of a priori judgement about what is "appropriate" or "effective" coping. The fundamental questions in research about stress, coping, and adaptation are "coping with what?", "when?", "in what context?", "how?", and "with what outcome?". Nurse researchers must also ask questions about which nursing approaches are effective in helping people to cope in ways that enable them to achieve health. Nurses have had a significant focus on coping and adaptation research for nearly two decades. The concepts of stressful situations, coping behaviours, influencing factors, coping outcomes, and the relationships among them are complex. Their investigation demands conceptual clarity and sophisticated research methods. Jalowiec (1993) and Rice (1993) conducted extensive reviews of nurses' research on stress and coping. They reached the following conclusions: most research has been descriptive and correlational in design; research questions commonly lack specificity in relation to the stressful event; studies often do not make links between the coping behaviours examined and the outcomes of those behaviours. They reported that most studies were based on Lazarus and Folkman's (1984) theoretical perspective of stress and coping, but very few were designed in ways consistent with that framework