Measuring Patient Coping

Abstract

When faced with a threatening event an individual will utilize various strategies in an attempt to cope with it and lessen its emotional impact. Most people find hospitalization a very threatening experience and although many patients cope effectively with this experience, some do not. For the individual who has difficulty coping, both the course of his illness and the subsequent quality of his life may be adversely affected (Mechanic, 1977). Identifying patients who are having difficulty coping should, therefore, be a concern of the nurse. If a nurse could measure the extent to which patients were coping she would be able to identify those patients who were having difficulty coping and, thus, in particular need of her attention. There is, however, no generally accepted, valid way to measure patient coping. Without such a measure nurses are unable to identify, with any certainty, which patients are having difficulty coping. The present study was, therefore, undertaken to assess whether one particular method of measuring patient coping provides a valid measure. Coping has been defined in different ways by different authors. It has been defined by Lazarus and his associates as the efforts, both action-oriented and intrapsychic, which an individual makes to manage environmental and internal demands which tax or exceed his resources (Lazarus & Launier, 1978). Although different problems require different solutions Lazarus and Launier (1978) identify four modes or forms of coping. These are direct action such as fight or flight; information seeking; intrapsychic in which attention deployment, defensive thought processes or wish-fulfilling fantasies are used to neutralize the threat or achieve the desired goal; and inhibition of action which involves refraining from actions which are impulsive or which might be dangerous or embarrassing. Lazarus (1968, 1974) makes no distinction between the merits of the various coping responses. Any of the coping modes may be used by the individual either to alter a stressful person-environment relationship or to control his emotional response to the situation (Lazarus & Launier, 1978).