Work stress and proactive coping strategies in hospital nurses during the first wave of COVID-19 pandemic

Relevance. The article presents the results of published studies’ review and the empirical study, targeted to estimate job stressors and proactive coping strategies in nurses during COVID-19 pandemic. The research urgency is connected with the necessity to evaluate psychological availability of nurses to be resistant to high work strain and risk of SARS-CoV-2 contamination.

Objectives. The research aim: to compare stress level, job stressors evaluation and proactive coping strategies in nurses with high and low chronic states.

Methods. Diagnostic set included: Chronic stress and fatigue inventories by A.B. Leonova; Job stress survey by Ch. Spielberger; Professional burnout inventory by N.E. Vodopyaynova; Proactive coping inventory by E. Greenglass; checklist “Means states’ optimization” by A.S. Kuznetsova.

Sample. Hospital nurses (n = 306; age 43,2±10,9; service 20,7±11,5). 

Results. Revealed job stressors are typical for nurses: inadequate salary, insufficient time for breaks, excessive paperwork and increased responsibility. Strong differences in job stressors evaluation are found between nurses of risk group (with high level of chronic states) and nurses with no chronic states (well-to-do group): in risk group, perceived job stress is significantly higher. Proactive coping strategies are quite high. Regression analysis did not reveal coping strategies as stress predictors. Three months after well-to-do nurses still perceived no high job stress, while in risk group perceived job stress increased.

Conclusions.Under pressure of unmanageable pandemic strain, self-evaluation of proactive coping possibilities in risk group and well-to-do group significantly diverged. Most likely perceived stressors are connected with the inability to manage work strain and to minimize the impact of its negative effects.

References

Abdullaeva М.М.(2020) Psychological Support of Hospice Medical Staff Work. European Psychiatry,63 (S1), 182.

Abraham L.J., Thom O., Greenslade J.H., Wallis M., Johnston A.N.B., Carlström E., Mills D., Crilly J. (2008) Morale, Stress and Coping Strategies of Staff Working in the Emergency Department: A Comparison of Two Different-sized Departments. Emergency Medicine Australasia, 30, 375–381.

Antokhin E.Yu., Budza V.G., Baidavletova E.T., Druz' V.F., Chalaya E.B., Bomov P.O. (2010) Coping behavior in nurses of psychiatric and somatic hospitals. Nauchno-meditsinskii vestnik Tsentral'nogo Chernozem'ya (Scientific Medical Bulletin of Central Cernozem Region), 39–1, 5–14. (in Russ.).

Aspinwall L.G. (2012). Future-Oriented Thinking, Proactive Coping, and the Management of Potential Threats to Health and Well-Being. In S. Folkman (Ed.). The Oxford handbook of stress, health, and coping (pp. 334–368). Oxford: Oxford University Press.

Bamonti P., Conti E., Cavanagh C., Gerolimatos L., Gregg J., Goulet C., Pifer M., Edelstein B. (2019) Coping, Cognitive Emotion Regulation, and Burnout in Long-Term Care Nursing Staff: A Preliminary Study. Journal of Applied Gerontology, 38 (1), 92–111.

Barabanshchikova V.V. (2019) Employees’ professional deformations in dynamic organizational environment. Vestnik Moskovskogo universiteta. Seriya 14: Psikhologiya (Moscow University Psychology Bulletin), 1, 91–107. (in Russ.).

Belinskaya E.P., Vecherin A.V., Agadullina E.R. (2018) Proactive coping inventory: adaptation to a non-clinical sample and the predictive capability. Klinicheskaya i spetsial'naya Psikhologiya (Clinical Psychology and Special Education), 7 (3), 192–211. (in Russ.).

Bochaver K.A., Danilov A.B., Nartova-Bochaver S.K., Kvitchastyi A.V., Gavrilova O.Ya., Zyazina N.A. (2019) Future of salutogenic approach to prevention of burnout syndrome in Russian physicians. Klinicheskaya i spetsial'naya Psikhologiya (Clinical Psychology and Special Education), 8 (1), 58–77. (in Russ.).

BrownP., AlaszewskiA., PilgrimD., CalnanM.(2011) The Quality of Interaction between Managers and Clinicians: a Question of Trust.Public Money & Management,31 (1),43–50.

Butenko T.V. (2010) Burnout syndrome and work motivation in nurses. Molodoi uchenyi (Young Scientist), 11 (22), 157–161. (in Russ.).

Cai H., Tu B., Ma J., Chen L., Fu L., Jiang Y., Zhuang Q. (2020) Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan between January and March 2020 during the Outbreak of Coronavirus Disease 2019 (COVID‑19) in Hubei, China. Medical Science Monitor, 26. (Retrieved form: https://pubmed.ncbi.nlm.nih.gov/32291383/(Review date: 04.02.2020). DOI: 10.12659/MSM.924171

Chang Y., Chan H.-J. (2015) Optimism and Proactive Coping in Relation to Burnout among Nurses. Journal of Nursing Management, 23 (3), 401–408.

Chang K.-H., Gotcher D.F., Chan M.-Y. (2006) Does Social Capital Matter when Medical Professionals Encounter the SARS Crisis in a Hospital Setting. Health Care Management Review, 31 (1), 26–33.

Cruz J.P., Cabrera D.N.C., Hufana O.D., Alquwez N., Almazan J. (2018) Optimism, Proactive Coping and Quality of Life among Nurses: A Cross-sectional Study. Journal of Clinical Nursing, 27 (9–10), 2098–2108.

Dorokhina A.A. (2018) Role of social-hygienic factors in the development of burnout syndrome in nurses. Prikladnye informatsionnye aspekty meditsiny (Applied Informational Aspects of Medicine), 21 (3), 160–163. (in Russ.).

Evdokimov V.I., Roldugin G.N., Khmelinina N.V. (2009) Assessment of influence of proactive coping behavior on professional burning-out in nurses. Vestnik psikhoterapii (Bulletin of Psychotherapy), 31, 100–111. (in Russ.).

Evdakov V.A., Allenov A.M., Artem'eva G.B., L'vova D.P., Alekhin S.G., Gushchin M.V. (2020) Improvement of municipal outpatient activity on the basis of lean technologies. Nauka molodykh (Eruditio Juvenium) (Science of the Young), 8 (4), 502–510. (in Russ.).

Fathi А., Simamora R.H. (2019) Investigating Nurses’ Coping Strategies in their Workplace as an Indicator of Quality of Nurses’ Life in Indonesia: A Preliminary Study. IOP Conf. Series:Earth and Environmental science, 248, 1–5.

Greenglass E.R. (2002) Proactive Coping and Quality of Life Management. In E. Frydenberg (Ed.). Beyond Coping: Meeting Goals, Visions, and Challenges(pp. 37–62). London: Oxford University Press.

Greenglass E.R., Fiskenbaum L. (2009) Proactive Coping, Positive Affect, and Well-Being: Testing for Mediation Using Path Analysis. European Psychologist, 14 (1), 29–39.

Hewison A., Gale N., Yeats R., Shapiro J. (2013) An Evaluation of Staff Engagement programmes in four National Health Service Acute Trusts. Journal of health organization and management, 27 (1), 85–105.

Huang L., Lei W., Xu F., Liu,H., Yu L. (2020) Emotional Responses and Coping Strategies in Nurses and Nursing Students during Covid-19 Outbreak: A Comparative Study. Public Library of Science, 15 (8). Retrieved form: https://pubmed.ncbi.nlm.nih.gov/32764825/(Review date: 04.02.2020). DOI: 10.1371/journal.pone.0237303

Johnston D., Bell C., Jones M., Farquharson B., Allan J., Schofield P., Ricketts I., Jonston M. (2016) Stressors, Appraisal of Stressors, Experienced Stress and Cardiac Response: A Real-time, Real-life Investigation of Work Stress in Nurses. Annals of Behavioral Medicine, 50 (2), 187–197.

Khazova S.A. (2015) Personal resources of adults. Voprosy Psikhologii (Questions of Psychology),5, 28–37. (in Russ.).

Kryukova T.L., Ekimchik O.A., Opekina T.P., Shipova N.S. (2020) Stress and coping in a self-isolated family during covid-19 pandemic. Sotsial'naya psikhologiya i obshchestvo (Social Psychology and Society), 11 (4), 120–134. (in Russ.).

Kuznetsova A.S., Titova M.A. (2016) Efficient self-regulation of human functional states in tensed work conditions as differentiative competence. Organizatsionnaya psikhologiya i psikhologiya truda (Organizational and Work Psychology), 1 (1), 87–113. (Retrieved from: http://work-org-psychology.ru/cntnt/bloks/dop-menu/arhiv-vipuskov/n2016/tom-1-1/effektivnaya-samoreg... (Review date: 04.02.2020).(in Russ.).

Kuznetsova A.S., Titova M.A., Zlokazova T.A. (2019) Psychological functional state self-regulation and professional success. Vestnik Moskovskogo universiteta. Seriya 14: Psikhologiya (Moscow University Psychology Bulletin), 1, 51–68 (in Russ.).

Laranjeira C. (2011) The Effects of Perceived Stress and Ways of Coping in a Sample of Portuguese Health Workers. Journal of Clinical Nursing, 21 (11–12), 1755–1762.

Lee S.M., Kang W.S., Cho A.R., Kim T., Park J.K. (2018) Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Comprehensive psychiatry, 87, 123–127. (Retrieved form: https://www.sciencedirect.com/science/article/pii/S0010440X18301664?via%3Dihub (Review date: 04.02.2020). DOI: 10.1016/j.comppsych.2018.10.003

Lee-Baggley, D., DeLongis A., Voorhoeave P., Greenglass E. (2004) Coping with the Threat of Severe Acute Respiratory Syndrome: Role of Threat Appraisals and Coping Responses in Health Behaviors. Asian Journal of Social Psychology, 7, 9–23. (Retrieved form: https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1467-839X.2004.00131.x(Review date: 04.02.2020). DOI: 10.1111/j.1467-839X.2004.00131.x

Leonova A.B. (2007) Towards Strategic Stress Management in the Workplace: Stress in Medical Doctors’ Professions. In P. Richter, J.M. Peiro, W. Schaufeli (Eds.). Psychosocial Resources in Health Care System (pp. 97–109). Munchen: Rainer Hampp Verlag.

Leonova A.B., Blinnikova I.V., Kapitsa M.S. (2019) Cognitive tasks performance in emotional tension increasing. Vestnik Moskovskogo universiteta. Seriya 14: Psikhologiya (Moscow University Psychology Bulletin), 1, 69–90. (in Russ.).

Leonova A.B., Zlokazova T.A., Kachina A.A., Kuznetsova A.S. (2013) The Determinants of the Development of Professional Distortions in Medical Personnel, Teachers and Psychologists, Working in an Industrial Disaster Zone. Psychology in Russia: State of the Art, 6 (3), 132–149.

Levanov V.M., Perevezentsev E.A., Garin L.Yu. (2018) Medical institution management based on the key performance indicators. Meditsinskii al'manakh (Medical Almanac), 5 (56), 12–16. (in Russ.).

Liu Z., An Yu., Wu K. (2020) China’s Mental Health Interventions during the COVID-19 Outbreak. Psychology in Russia: State of the Art, 13 (4), 183–190.

Lu D., Sun N., Hong S., Fan Y., Kong F., Li Q. (2015) Occupational Stress and Coping Strategies among Emergency Department Nurses of China. Archives of Psychiatric Nursing, 29 (4), 208–212.

Marjanovic Z., Greenglass E.R., Coffey S. (2007) The Relevance of Psychosocial Variables and Working Conditions in Predicting Nurses’ Coping Strategies during the SARS Crisis: An Online Questionnaire Survey. International Journal of Nursing Studies, 44 (6), 991–998.

Man M.A., Toma C., Motoc N.S., Necrelescu O.L., Bondor C.I., Chi A.F., Lesan A., Pop C.M., Todea D.A., Dantes E., Puiu R., Rajnoveanu R.M. (2020) Disease Perception and Coping with Emotional Distress during COVID-19 Pandemic: A Survey among Medical Staff. International journal of environmental research and public health, 17 (13). (Retrieved form: https://pubmed.ncbi.nlm.nih.gov/32645962/(Review date: 04.02.2020). DOI: 10.3390/ijerph17134899

MaslachC., LeiterM.P.(2008)Early predictors of job burnout and engagement.Journal of Applied Psychology, 93, 498–512.

Pearman A., Hughes M.L., Smith E.L., Neupert S.D. (2020) Mental Health Challenges of United States Healthcare Professionals during COVID-19. Frontiers in Psychology, 11. (Retrieved form: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.02065/full (Review date: 04.02.2020). DOI: 10.3389/fpsyg.2020.02065

Prokhorov A.O. (2020) Structure-functional model of mental regulation of subject’s psychic states. Psikhologicheskii zhurnal (Psychological Journal), 41 (1), 5–18. (in Russ.).

Prokhorov A.O., Chernov A.V. (2015) Representation of mental state: phenomenology of imagenative level. Obrazovanie i samorazvitie (Education and Self Development), 43 (1), 16–23. (in Russ.).

Protasova L.M., Masunov V.N., Boikov V.A., Deev I.A., Kobyakova O.S., Suvorova T.A., Shibalkov I.P., Shnaider G.V. (2019) Experience in introducing lean manufacturing into health care: overview of best practices. Sotsial'nye aspekty zdorov'ya naseleniya (Social Aspects of Population Health), 65 (4). (Retrieved from: http://vestnik.mednet.ru/content/view/1084/30/lang,ru/ (Review date: 04.02.2021). (in Russ.). DOI: 10.21045/2071-5021-2019-65-4-1

Ryan A.M., Tompkins C.P., Markovitz A.A., Burstin H.R. (2017) Linking Spending and Quality Indicators to Measure Value and Efficiency in Health Care. Medical Care Research and Review, 74 (4), 452–485. (Retrieved form: https://journals.sagepub.com/doi/full/10.1177/1077558716650089 (Review date: 04.02.2020).DOI: 10.1177/1077558716650089

Schoenpflug W. (1986) Behavior Economics as an Approach to Stress Theory. In M.H. Appley, R. Trumbull (Eds.). Dynamics of stress(pp. 81–97). New-York.: Plenum Press.

Starchenkova E.S. (2020) Phenomenon of proactive coping behavior in occupational health psychology (in English). Organizatsionnaya Psikhologiya (Organizational Psychology), 10 (4), 156–183. Retrieved from: https://orgpsyjournal.hse.ru/2020-10-4/431247932.html (Review date: 04.02.2021).

Starchenkova E.S. (2016) Training program to learn constructive coping behaviour in difficult professional situations. Vestnik Sankt-Peterburgskogo universiteta. Seriya 16. Psikhologiya. (Vestnik of Saint Petersburg University. Psychology), 2, 122–134. (in Russ.).

Tyazhel'nikov A.A., Kostenko E.V., Gushchin M.V., Kuznetsova A.S. (2020) Features of professional burnout and subjectively significant stress factors in doctors who provided remote telemedicine services during COVID‑19 pandemic. Meditsinskii alfavit (Medical Alphabet), 33, 21–25. (in Russ.).

Udod S., Cummings G., Care W., Jenkins M. (2017) Role Stressors and Coping Strategies among Nurse Managers. Leadership in Health Services, 30 (1), 29–43.

Velichkovskaya S.B., Grebennikova T.O. (2017) Subjective work image as a factor of stress development at different stages of professional training (medical students experience) // Professional'nye predstavleniya (Professional Representations), 1 (9), 61–69. (in Russ.).

Vodop'yanova N.E., Starchenkova E.S.(2008) Burnout Syndrome: assessment and prevention. Sankt-Petersburg: Piter. (in Russ.).

Wang Х., Zhang X., He J. (2020) Challenges to the System of Reserve Medical Supplies for Public Health Emergencies: Reflections on the Outbreak of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Epidemic in China. Bioscience Trends, 14 (1), 3–8.

Zurlo M.C., Valloneb F., Smith A.P. (2018) Effects of Individual Differences and Job Characteristics on the Psychological Health of Italian Nurses. Europe's Journal of Psychology, 14 (1), 159–175.

Yas'ko B.A., Kazarin B.V. (2020) Personality of healthcare professionals: methodological justification of model through study. Organizatsionnaya Psikhologiya (Organizational Psychology), 10 (4), 109–137. (Retrieved from: https://orgpsyjournal.hse.ru/2020-10-4/43096891 (Review date: 04.02.2021).(inRuss.).