Level of Stress and Coping Strategies Adopted by Care Givers of Patients Admitted in Critical Care Units

Background: Stress is a part of our lives. We live with it; deal with it, and above all worry about it. Coping strategies refers to the specific efforts, both behavioral and psychological that people employ to master, tolerate, reduce, or minimize stressful events. A care giver is the person belonging to the patient’s informal support systems who takes care and who commits most of his or her time to that task without receiving any economical revenge. Objectives:

care providers to the patient in critical care units [5,6]. Admission in critical care unit generates a stressful situation for both the patient and family members. Patients with terminal or acute illness are requiring intensive and immediate care.
The ICU provides treatment for adults and children with conditions, such as disturbed consciousness or coma, acute respiratory failure or acute exacerbation of chronic respiratory failure, shock, acute drug intoxication, serious metabolic disorder (e.g. hepatic or renal dysfunction, diabetic ketoacidosis or environmental disorder), multiple trauma, post resuscitation encephalopathy and severe sepsis [7]. Intensive care admission can be a stressful event for the families of critically ill patients [8].

Materials and Methods
A descriptive study design was adopted in order to assess the level of stress and coping strategies adopted by caregivers of patients admitted in critical care units in a selected hospital at Mangalore. The tool used for the study was DASS-21 stress scale and Brief COPE scale. The content validity of the tool was established in consultation with seven experts in the field of Mental Health Nursing, Psychiatric Medicine, Psychology, Medical surgical Nursing, Child Health Nursing, Community Health Nursing, obstetrics and Gynecology [9]. Reliability of the tool was tested by Crohnbach's'alpha method. The sampling technique adopted was non-probability convenient sampling. The sample size was 100. Pilot study was conducted to find out the feasibility of the study. Data collected from the samples were analyzed using descriptive and inferential statistics. (Table 1) Section 1: Description of subjects according to the level of stress.  Extremely severe 34+ 9 9% N=100. Max score-52, minimum score-0.

Result and Discussion
Section 2: Description of subject according to their level of coping.
The section deals with the analysis and interpretation of data with regards to the level of coping of caregivers of patients admitted in critical care units obtained through the brief coping scale. Data is presented in the form of (

Discussion
This chapter presents the major findings of the study and discusses them in relation to similar studies conducted by the researchers. The study intends to assess the level of stress and coping strategies adopted by caregivers of patients admitted in critical care units in a selected Hospital at Mangalore [10]. The findings of the study have been discussed with reference to objectives and hypothesis along with findings of other studies. The findings of the study are discussed under the following headings.

Description of level of stress and coping strategies adopted by caregivers of patients admitted in critical care units
Description of level of stress among caregivers of patients admitted in critical care units. In the present study result revealed that most of the caregivers (39%) belongs to the age group of 31-40 years. Majority of care givers (52%) are males. Most of the caregivers 48% belongs to Muslim religion highest percentage of the caregivers (45%) staying in semi urban area majority of the care givers (50%) are from nuclear family, most of the caregivers (32%) are private employee, most of the caregivers (47%) have monthly income between 5001-10000, highest percentage (31%) of caregivers are siblings of the patients, majority of the caregivers (85%) are staying with the patient since 1-10 days. The study showed that 9% of caregivers have extremely severe stress and 22% of caregivers have severe stress and 30% of caregivers have moderate stress and 22% caregivers have mild stress and remaining 17% have no stress. Majority of the caregivers (52%) have average coping and (45%) have poor coping and only (3%) caregivers have well coping [11][12][13][14][15].
Similar findings were also found in a descriptive study was conducted in Dharwad to assess the level of stress and coping mechanism among family members of clients admitted in critical care unit. The study revealed that a majority of 54 (90%) members were moderately stressed and 1 (1.66%) were mild stress and 5 (8.3%) severely stressed [16][17][18][19][20]. The way of coping experienced by family members were 50 (83.3%) were able to cope some extent, 0 (00%) were able to cope effectively and 10 (16.6%) were not able to cope.

Association between level of stress and selected demographic variables
The present study findings show that there is no significant association between stress scores and selected demographic variables.

Association between levels of coping with selected demographic variables
The present study findings show that there is no significant association between coping scores and selected demographic variables.

Conclusion
This chapter includes the major findings of the study, nursing implications, limitations, suggestions and recommendations. The following conclusions are drawn on the bases of findings of the study. a) Majority of caregivers (67%) in this study are in the age group of 20 -40 years and 33% are in the age group of 41-60 years. Majority of caregivers (85%) are staying with the patient since 1 -10 days,12% of care givers are 11 -20 days, and only 3% of caregivers are staying with the patient for one month.