Level of Stress and Coping Strategies Adopted by Care Givers of Patients Admitted in Critical Care Units
Anumol KK1, Ms. Anupama Das Antony1, Binju Thomas1, Chinju Mathew1, Deepthi Mathew1, DhanyaBabu1 and Syed Imran2*
1Nursing student, Yenepoya University, India
2Department of Mental Health Nursing, Yenepoya University, India
Submission: December 28, 2018; Published: January 30, 2019
*Corresponding author: Syed Imran, Nursing student, Yenepoya University, Mangalore, Karnataka, India
How to cite this article: Anumol K, Ms. Anupama D A, Binju T, Chinju M, Deepthi M, DhanyaBabu, et al. Level of Stress and Coping Strategies Adopted by Care Givers of Patients Admitted in Critical Care Units. JOJ Nurse Health Care. 2019; 10(002 3): 555787. DOI: 10.19080/JOJNHC.2019.10.555787.
Abstract
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: To determine the level of stress among care givers of patient admitted in critical care units. a) To determine the level of coping strategies adopted by the caregivers of patient admitted in critical care units. b) To find the relationship between the level of stress and coping strategies adopted by the care givers of patients admitted in critical care units. c) To find the association between level of stress and selected demographic variables. d) To find the association between level of coping strategies and selected demographic variables. 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. 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. Result: The study results revealed that majority of the caregivers (39%) 0 were in the age group 31-40 years. Among them 52%were males and 48% were Muslims. Majorities (45%) of the caregivers were living in semi urban area and 50% of them belonged to nuclear family. Majority (43%) of the caregivers having only primary school education. Most of the (32%) caregivers were private employees. Majority (47%) of the family had monthly income between 5001-10000. Majority (31%) of the caregivers were siblings of the patient. Most of the (85%) of caregivers were staying with the patient for 1-10 days. Majority of them (30%) had moderate level of stress, 22% had mild and severe level of stress, 17% had normal level of stress and 9% had extremely severe level of stress. Majority of the caregivers (52%) had average coping. The study also revealed that stress score and coping score were dependent of selected demographic variables Conclusion: The findings of the study reveals that 30% of caregivers had moderate level of stress and 22% had mild stress. Stress score and coping score were not dependent on selected demographic variables.
Keywords: Stress; Coping; Caregiver; Patient; Critical conditions
Introduction
Stress is a part of our lives. We live with it; deal with it, and above all worry about it. It is a state produced by a change in the environment that is perceived as challenging, threatening or damaging to once dynamic balance or equilibrium [1,2]. Coping strategies refers to the specific efforts, both behavioral and psychological that people employ to master, tolerate, reduce, or minimize stressful events. Coping consists of the cognitive and behavioral efforts are made to manage an anxious situation [3,4]. 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. Family members are the most important physical and emotional 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.
Result and Discussion
(Table 1) Section 1: Description of subjects according to the level of stress
This section deals with the analysis and interpretation of data with regard to the stress Level of caregivers of patient admitted in critical care units obtained through the stress rating scale. (Table 2) shows that only 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.
N=100. Max score-52, minimum score-0
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 (Table 3) and diagram. (Table 3) shows that only 3% caregivers have well coping and 52% have average coping and 45% have poor coping.
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 [11-15].
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 [16-20]. 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. b) Majority of care givers (52%) included in this study are males and 48% are females. c) Highest percentages of caregivers (48%) belongs to Muslim, 32% care givers are belonging to Hindu religion, 18% are belongs to Christian religion, only 2% of caregivers are belongs to other religion. d) Majority of caregivers (45%) are staying in semi-urban area, 38% of caregivers staying in rural and 17% are staying in urban area. e) Most of the caregivers (50%) are from nuclear family, 42% caregivers are belonging to joint family and 8% from extended family. f) Majority of caregivers (43%) are having primary school education, 27% of have high school education, 17% of caregivers had no formal education and only 13% of them have college education. g) Majority of caregivers (32%) are private employee, 25%of them are doing business,17% are coolie worker,14% of them are other workers and 12% are Government employees. h) Majority of caregivers (47%) have income between 5001 – 10000, 27% of them have income between 10001 – 20000, 12% of them have income between less than 5000 ,11% have income between 15001 – 20000,3% of care givers have income more than 20001. i) Most of the caregivers (31%) are siblings of the patient,27% of caregivers are son or daughters,17% of caregivers are parents,15% of caregivers are husband or wife and only 10% of caregivers are include in the others category. j) 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.
Acknowledgments
The authors express sincere thanks to the faculty of Yenepoya Nursing College Mangalore and the study participants for their whole-hearted support.
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