Home care nurses' appraisals and coping strategies in a critical incident

Bower, Lisa Christine (2007) Home care nurses' appraisals and coping strategies in a critical incident. Masters thesis, Memorial University of Newfoundland.

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Abstract

There is considerable literature concerning how home care nurses react to and cope with stress. However, there is little research pertaining to home care nurses and critical incident stress. The purpose of this descriptive, retrospective study is to identify how home care nurses appraise, react, and cope with critical incidents and the resulting stress from these events. Lazarus and Folkman's (1984) transactional model of stress, appraisal, and coping guided this study. -- A total of 25 home care nurses completed each of the four instruments used in the study. Data collected with the instruments were summarized and the written descriptions of the critical incidents were analyzed using content analysis. From the content analysis, critical incidents were classified into one of six categories or themes: patient death, abuse, sexual harassment, urgent situations, organizational limitations of care, and potential threat to personal health. -- Home care nurses experienced physical and emotional reactions in the immediate days and evenings following the critical incident. The majority of the emotions were negative. At the same time, home care nurses also used a variety of coping strategies. The four most frequently used coping strategies were seeking social support, planful problem solving, self-controlling, and positive reappraisal. -- The study has implications for nursing educators, administrators, and researchers who have a pivotal role in guiding and supporting home care nurses in coping with the experience of a critical incident. A greater understanding of the meaning that critical incidents have for home care nurses may contribute to improving nursing practice for this group of nurses.

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