Moderating Effects of Coping Styles on the Relationship Between Nursing Stress and Mental Health Among NICU Nurses.

Abstract

Objective: To examine whether coping styles moderate the relationship between nursing stress and mental health in NICU nurses.

Design: Cross-sectional observational study.

Setting: Four Level 3 and 4 NICUs in New South Wales, Australia.

Participants: A total of 123 NICU nurses.

Methods: Participants completed self-report questionnaire measures of nursing stress (Nursing Stress Scale), dispositional stress coping styles (Brief Coping Orientation to Problems Experienced Inventory [Brief COPE]), and mental health (Mental Health Inventory-21). I conducted exploratory factor analysis of the Brief COPE to show that it comprises four factors: support-oriented coping, problem-oriented coping, emotion-oriented coping, and denial-oriented coping. I used hierarchical multiple regressions with interactions and simple slopes analyses to conduct moderation analysis.

Results: I found that the interaction between nursing stress and problem-oriented coping style (i.e., positive reframing, planning, religion, and active coping) was significant and explained further variance in psychological distress (ΔR² = .05, p = .013), emotional well-being (ΔR² = .03, p = .027), and hopelessness (ΔR² = .06, p = .005). The moderation effects on mental health were significantly different at high versus low levels of problem-oriented coping for psychological distress (t = 2.55, p = .011), emotional well-being (t = 2.26, p = .024), and hopelessness (t = 2.89, p = .004). The other coping styles did not have significant moderator effects.

Conclusion: Problem-oriented coping buffered the ill effects of nursing stress on positive and negative dimensions of mental health in NICU nurses. Accordingly, cognitive behavioral therapy may be the most effective counseling modality for NICU nurses. Understanding how and why problem-oriented coping might not be effective in certain clinical situations that are controllable and theoretically solvable should inform further mixed methods research in NICU nurses.