Theoretical Model of Coping Among Relatives of Patients - Essay Example

Running Head: THEORY OF COPING A Discussion of the Theoretical Model of Coping Among Relatives of Patients in Intensive Care Units: A Simultaneous Concept Analysis A Discussion of the Theoretical Model of Coping Among Relatives of Patients in Intensive Care Units: A Simultaneous Concept Analysis Familial support is a vital component of successful recovery with patients in intensive care units. Family members are often expected to take up responsibility for many of the patient's long-term needs after discharge from hospital. As this process is often both difficult and demanding, it is necessary to create institutional programs that help relatives cope with their novel situation. It is necessary to understand the factors behind the coping methods of relatives in order to provide them with effective strategies to both care for themselves and their loved ones. There are several models of coping that are applicable to relatives. Within nursing research, several transactional models have been developed with an emphasis on family members. These models include the Resiliency Model of Family Stress, Adjustment and Adaptation, the Developmental Health Model, the Framework of Systemic Organization, the Roy Adaptation Model, and the Neuman Systems Model. While these have been successful in aiding family members through the coping process, they do not focus specifically or solely on the coping processes utilized by patients in intensive care and their relatives. An evidence-based theoretical model is a necessary continuation of nursing research. A further understanding of the coping methods that relatives utilize during the acute stages of the patient's illness may allow health care professionals to predict and prevent difficulties during the recovery period. Johansson et al. (2006) posited that this theoretical coping model must contain both the ICU-stay and home recovery in order to facilitate the distinction of possible maladaptive coping methods and to assist in the choice of effective nursing interventions. To follow is a discussion and analysis of the theory formulated by Johansson et al. (2006) as well as a discussion regarding the relevancy and application of this theory. In their 2006 study, Johansson et al. sought to develop a theoretical model of the coping methods of family members during the patient's ICU stay and the following recovery process by performing an analysis of concepts that were elicited from two empirically based, theoretical studies. The researchers defined a relative as a close acquaintance or friend. The theoretical model of the relative's coping methods was inductively derived during the time between 2004-2005 and was based on theories that were produced from the aforementioned empirical studies. A university ethics committee then approved these studies (Johansson et al., 2006). The researchers defined inclusion criterion as adult relatives of adult patients that had been on mechanical ventilation in an ICU (Johansson et al., 2006). In order to refine and combine multiple coping concepts from both the ICU-stay and the recovery period in a unified theoretical coping model, the researchers used simultaneous concept analysis that was in accordance with previous studies. Johansson et al. (2006) utilized the simultaneous concept analysis in order to explain all concepts simultaneously providing definitions that were mutually exclusive of one another while focusing on dynamics of their interrelationships and overall characteristics. The researchers utilized several procedures in order to achieve their goals. First, they developed a consensus group that included individuals that could contribute a particular proficiency and were willing to compromise and aid in the creation of a theoretical coping model (Johansson et al., 2006). The researchers then developed the concept clarification strategy that involved choosing which particular concept clarification method should be utilized regarding the concepts of coping that were selected from the two aforementioned empirical studies (Johansson et al., 2006). Next the researchers formulated a clarification of distinct concepts. This involved two parts; first, a critical and independent assessment of concepts from the two earlier studies was created and then each coping strategy was illustrated with an organizational framework (Johansson et al., 2006). The researchers then put together a series of validity matrices that compared the similarities and differences between concepts. The next step of their data analysis included further explanation of individual concepts by re-evaluating the clarity of the distinct antecedents, enablers, attributes and outcomes. In addition to this, they further explained the inherent interrelationships and differences of each coping strategy (Johansson et al., 2006). The researchers then provided validation against the formulation of definitions and re-assessment of the validity matrices. The following step of the researchers included the development and summarization of the process matrix as the antecedents, enablers, attributes, and outcomes were merged into a single process matrix (Johansson et al., 2006). After this, they defined and illustrated the theoretical elements of their coping model in order to present a hypothesis with an effective foundation of the various coping methods illustrated in their coping model (Johansson et al., 2006). The final step of the data analysis was the submission of the process matrix and their coping model for critical evaluation in order to validate their findings (Johansson et al., 2006). In their study, using the SCA method, Johansson et al. (2006) found a number of refined coping concepts to be included in their theoretical coping model. The following several themes encompass the aspects and effects of each concept. The family members of the ICU patients were masters of the situation due to the fact that they possessed adequate internal and external resources that they utilized in a sustainable manner. The relatives thoroughly calculated their methods of supporting their loved ones during the acute phase of treatment. Family members also utilized an alleviating coping approach. They utilized elements of distraction, verbalization, communication and hope in order to stabilize the chaotic circumstances of their loved ones in ICU treatment. Family members also used volunteering in the coping process as they put forward their resolution to help their loved ones without fully understanding the later implications that this process would involve (Johansson et al., 2006). Relatives would also utilize the approach of acquiescing by relinquishing their own well being in order to help their loved ones. In other words they passively accepted their role in the coping process without overtly expressing their approval of doing so. Sacrificing was another element that relatives used from which contradictory interests characterized their coping methods. Family members of the patients had to choose between their own interests and the patient's need for care (Johansson et al., 2006). The final theme of the coping process was preoccupying from which relatives consistently focused upon and ruminated about their challenging circumstances (Johansson et al., 2006). Each theme of the coping process had different effects regarding the management of the difficult conditions and the following period of recovery of the patient after release from hospital. The researchers argued that an effective coping strategy that combined these elements in different degrees would result in a more stable sense of wellbeing. They argued that coping is effective when a person's methods result in relief and recovery from difficult circumstances (Johansson et al., 2006). A person's coping methods are ineffective if their approach causes an increased level of difficulty in their situation. Thus, Johansson et al. (2006) put forward that the most appropriate form of coping for family members is to provide emotional support to their loved ones during the patient's ICU-stay and later provide both emotional and pragmatic aid during the recovery phase at home. The researchers illustrate their theoretical model of coping with the following chart: Figure 1: Diagram of the theoretical model of coping from Johansson et al. (2006). The researchers used the two axes of the graph to define their coping model. The horizontal axis illustrates levels of coping from ineffective to effective while the vertical axis illustrates the social support from weak to strong (Johansson et al., 2006). In their study, the researchers investigated the coping methods of family members in terms of demands, resources and outcomes of the patient during their acute phase of treatment was distinguished and formulated into a theoretical model of coping. In addition to this, they summarized definitions of each coping strategy based on the SCA method (Johansson et al., 2006). The researchers utilized the SCA method in order to attain a more comprehensive understanding of the meaning of individual ideas as coping and the mechanisms that drive both its forerunners and results (Johansson et al., 2006). The author of this essay found this theoretical model to be well researched, well formulated and applicable to health care practices. This study clarifies the abstract nature of coping and is helpful in trying to understand the ways that people handle these difficult situations. This study reminds us that we must consider the cognitive, social, psychological, cultural, and societal factors that influence this process that many people face in their lives. The author finds that both the implications of this theory and the results of this study are important. While many hospitals and rehabilitation centers offer programs for both family members and patients regarding this process, they often lack crucial elements that are necessary for effective coping. This study offers a framework to better understand this process and was specifically aimed at providing nurses with the necessary tools to support the coping efforts of the relatives of ICU patients. The author believes this theory to be useful in increasing the awareness and understanding of the coping process in relatives with loved ones in ICU care. In addition to this, the findings were based upon empirical data that strengthen the validity of the study. Unfortunately, many people experience this situation and it is important to help them through this process. This research can be used in health care settings when developing effective coping strategies for relatives of patients in ICU care. In summary, this theoretical model of coping is a middle-range theory of relatives' management of recovery and support for loved ones. While this theory may provide the possibility to visualize the effectiveness of the coping methods used, it is necessary to further test and validate these findings before they can be applied in ICU settings (Johansson et al., 2006). References: Johansson, I., Hildingh, C., Wenneberg, S., Fridlund, B., & Ahlstrm, G. (2006). Theoretical model of coping among relatives of patients in intensive care units: a simultaneous concept analysis. Journal of Advanced Nursing, 56 (5), 463-471. Read More