J Clin Nurs. 2007 Feb;16(2):372-81.
Chui WY, Chan SW.
Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong, China.
AIM: The present study aimed to investigate the stress and coping strategies of
Hong Kong Chinese families during a critical illness and to examine the
relationships between stress and coping. BACKGROUND: Admissions to intensive care
unit are usually an unanticipated event, which imposes stress on the family.
Family’s wellness is one of the significant factors affecting patient’s
well-beings. Much work has been conducted in Western societies. Stress and coping
in Chinese families of critically ill patients have rarely been discussed.
METHOD: Structured face-to-face interviews were conducted, using the Impact of
Events Scale and the Family Crisis Oriented Personal Evaluation Scales. A
convenience sample of 133 participants was recruited from a regional hospital in
Hong Kong. Many were patients’ children with age between 30 and 49. A total of
39.1% (n = 52) of the participants were males and 60.9% (n = 81) were females.
RESULTS: The participants experienced high level of stress (mean = 25.1, SD =
8.3). Higher level of stress were experienced by female (t = -4.6; d.f. = 1, 131;
P = 0.00), those with lower educational attainment (F = 3.0; d.f. = 2, 130; P =
0.05) and those whose relatives were admitted to the intensive care unit
unexpectedly (t = -2.2; d.f. = 1; P = 0.03). Patients’ length of stay in the unit
was significantly correlated with levels of stress (r = 0.5, P < 0.00). Level of
stress had significant correlation with coping strategies utilization (r = 0.5, P
< 0.00). Reframing strategies were frequently used whereas the passive appraisal
strategies were least used. Family members used positive-coping strategies, which
concurred with the Chinese stress-coping pattern ‘fatalistic voluntarism’.
RELEVANCE TO CLINICAL PRACTICE: This study contributes to the understanding of
Hong Kong Chinese families’ stress and coping during a critical illness.
Comprehensive assessments of family members’ psychosocial needs are important to
plan appropriate interventions to alleviate their stress and strengthen their
coping skills. The findings will serve as guidance for nurses in delivering
culturally sensitive and competent interventions.