Relationship between coping strategies, burnout, bullying, and distress in intensive and progressive care nurses: A single-centre cross-sectional survey.

BACKGROUND

Critical care nurses are exposed to challenging work situations and experience high rates of occupational stress and burnout, potentially aggravated by exposure to bullying. Specific coping strategies may alleviate the risk of adverse psychological outcomes such as these.

AIM/OBJECTIVE: The aim of this study was to investigate the association between coping strategies, burnout, bullying, and psychological distress.

METHODS

Intensive/progressive care registered nurses (n = 116) from a single centre completed a cross-sectional survey incorporating (i) demographic and work characteristics and (ii) standardised questionnaires including Coping Orientations to Problems Experienced Inventory (Brief-COPE), Maslach Burnout Inventory, General Health Questionnaire-12, and Negative Acts Questionnaire-Revised. Univariate and linear regression analyses explored the associations between demographic and work characteristics and the questionnaires. Stepwise multiple regression explored the degree to which coping strategies, bullying, and demographic and work variables (independent variables) predicted burnout and psychological distress (dependent variables).

RESULTS

Gender (t = 3.34, p = 0.001) was associated with Emotion-Focused Coping, while ethnicity was associated with both Emotion-Focused (ƞ = 0.12, p = <0.001) and Problem-Focused coping (ƞ = 0.07, p = 0.018). Working in the Progressive Care Unit was associated with higher Emotional Exhaustion (t = 4.74, p = <0.001) and higher Depersonalisation (t = 3.61, p < 0.001) than working in the Intensive Care Unit. Less experienced nurses reported higher Emotional Exhaustion (t = 3.14, p = 0.002), higher Depersonalisation (t = 3.75, p < 0.001), and lower Personal Accomplishment (t = 2.42. p = 0.017). After controlling for associations between independent covariables, the regression analysis showed that all three Brief-COPE scales contributed significantly (F = 9.22-21.71, p < 0.001) to Emotional Exhaustion and Depersonalisation subscales.

CONCLUSION

The study largely supports previous findings of associations between workforce factors, exposure to bullying, and deleterious effects such as burnout symptoms and psychological distress. After controlling for significant moderating factors, coping responses independently contribute to emotional exhaustion and depersonalisation. Understanding how coping responses are activated or are affected by adverse psychological states and events remains important. While interventions that specifically focus on protective coping responses may be especially helpful in alleviating particular components of burnout, nuances of the relationship require further investigation.