<p>The aim of this study was to describe how nurses cope with their daily stress at work. A literature review was made to answer the research question, data was gathered from two databases; Academic Search Elite and Medline (via Pubmed). The result which was based on 20 scientific articles showed that nurses used problem-focused and emotional-focused coping strategies to deal with the stress at work. Most of the nurses used emotional-focused coping strategies by practise some kind of physical activities, avoid and take distance from the problem. Using these strategies was negative correlated with burnout and psychological health. In four of the studies problem-focused coping strategies was the most dominant, by trying to find a concrete problem solving strategy and to find direct alternative to deal with the stress. The use of these strategies had a negative relation to psychological and physical health, but a positive correlation to feel satisfaction at work and the nurses that used this strategies experienced lower stress than those who used emotional- focused strategies.</p> / <p>Syftet med denna studie var att beskriva hur sjuksköterskor hanterar sin dagliga stress i arbetet. För att besvara frågeställningen gjordes en litteraturstudie, data samlades in från databaserna Academic Search Elite och Medline (via Pubmed). Resultatet som baserades på 20 vetenskapliga artiklar visade att sjuksköterskor hanterade sin dagliga stress på arbetet genom problemfokuserade och känslomässiga copingstrategier. De flesta använde sig av känslomässiga copingstrategier genom att bland annat utöva någon form av fysisk aktivitet, undvika och distansiera sig från problemen. Användningen av dessa strategier hade ett negativt samband med utbrändhet samt psykisk ohälsa. Fyra av studierna tog upp problemfokuserade copingstrategier som de mest använda strategierna, genom att bland annat försöka finna en konkret problemlösning och hitta direkta alternativ att hantera stressen. Användningen av dessa strategier hade ett negativt samband till psykisk och fysisk hälsa, men positivt samband till att känna tillfredsställelse på arbetet samt att sjuksköterskor som använde sig av dessa strategier upplevde lägre stress på arbetet än de som använde sig av känslomässiga copingstrategier.</p>

The aim of this study was to describe how nurses cope with their daily stress at work. A literature review was made to answer the research question, data was gathered from two databases; Academic Search Elite and Medline (via Pubmed). The result which was based on 20 scientific articles showed that nurses used problem-focused and emotional-focused coping strategies to deal with the stress at work. Most of the nurses used emotional-focused coping strategies by practise some kind of physical activities, avoid and take distance from the problem. Using these strategies was negative correlated with burnout and psychological health. In four of the studies problem-focused coping strategies was the most dominant, by trying to find a concrete problem solving strategy and to find direct alternative to deal with the stress. The use of these strategies had a negative relation to psychological and physical health, but a positive correlation to feel satisfaction at work and the nurses that used this strategies experienced lower stress than those who used emotional- focused strategies. / Syftet med denna studie var att beskriva hur sjuksköterskor hanterar sin dagliga stress i arbetet. För att besvara frågeställningen gjordes en litteraturstudie, data samlades in från databaserna Academic Search Elite och Medline (via Pubmed). Resultatet som baserades på 20 vetenskapliga artiklar visade att sjuksköterskor hanterade sin dagliga stress på arbetet genom problemfokuserade och känslomässiga copingstrategier. De flesta använde sig av känslomässiga copingstrategier genom att bland annat utöva någon form av fysisk aktivitet, undvika och distansiera sig från problemen. Användningen av dessa strategier hade ett negativt samband med utbrändhet samt psykisk ohälsa. Fyra av studierna tog upp problemfokuserade copingstrategier som de mest använda strategierna, genom att bland annat försöka finna en konkret problemlösning och hitta direkta alternativ att hantera stressen. Användningen av dessa strategier hade ett negativt samband till psykisk och fysisk hälsa, men positivt samband till att känna tillfredsställelse på arbetet samt att sjuksköterskor som använde sig av dessa strategier upplevde lägre stress på arbetet än de som använde sig av känslomässiga copingstrategier.

This study was designed to investigate psychological factors involved in the adjustment to Rheumatoid Arthritis (RA). In particular, the study examined perceptions of control over daily symptoms, knowledge of RA and the use of coping strategies, and looked at how these factors related to emotional adjustment, clinical disease activity and subjective physical functioning in RA outpatients. The study also aimed to determine aspects of RA which patients perceived as most stressful. The main study was cross-sectional and designed in two parts. The first part was a quantitative design in which 50 participants completed questionnaires to assess perceptions of RA stressors; health locus of control beliefs over RA symptoms; levels of RA-related knowledge; coping strategies used; emotional adjustment and physical functioning. An objective measure of disease activity was also taken. The second part was a qualitative design consisting of semi-structured interviews with 14 participants, exploring perceptions of stress, control, knowledge, coping and adjustment. Quantitative data were statistically analysed and compared with previous research findings. Qualitative data were transcribed into predefined themes and compared with the quantitative data. Results showed that participants consistently rated fatigue and disability as the most stressful aspects of RA. Participants reported more symptoms of anxiety than depression and used a wide range of coping strategies. Quantitative data suggested that participants perceived high levels of chance control over their daily RA symptoms, however, qualitative findings did not support this view. Participants knew most about RA-related issues that were directly relevant to them. Significant associations were found between coping strategies and psychological outcome, particularly for positive affect. Associations were also found between maladaptive coping and positive physical adjustment and between adaptive coping and negative physical adjustment. Adaptive coping strategies were associated with `internal' and `doctor' locus of control and increased knowledge. Few associations were found between outcome and either control or knowledge. Regression analyses found coping strategies to account for some of the variance in outcome variables, particularly positive affect. The implications for clinical practice were considered. Methodological limitations of the study and implications for future research were also discussed.

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Bakgrund: Bröstcancer är den vanligaste cancersjukdom bland kvinnor i Sverige och i världen. Mellan 15 och 20 kvinnor insjuknar varje dag. Att få beskedet bröstcancer skapar förde flesta förvirring, ångest och chock såväl hos den som är sjuk som hos de som står den drabbade kvinnan nära. De förändringar som uppstår i samband med sjukdomen och de olika behandlingarna har stor inverkan på kvinnornas självkänsla och upplevelse av hälsa. Syftet: Syftet med den här uppsatsen är att beskriva kvinnors upplevelse av att leva med bröstcancer. Metod: Kvalitativ metod har används för att få en djupare förståelse i människors upplevelse och erfarenheter. Två själbiografiska böcker valdes ut för analys. Resultat: I resultatet redovisas ett tema; Kvinnors upplevelse av att leva med sjukdomen bröstcancer och fyra kategorier; Att få besked, att få behandling, efter diagnos och uppleva stöd, samt niounderkategorier; tankar och känslor kring beskedet, förnekande av sjukdom, oro och rädsla,ångest och lidande, fysiska förändringar, psykiska förändringar, av familjen, omgivningen ochandra i samma situation samt sjukvårdpersonalen. Resultatet beskriver bland annat kvinnornas känslomässiga upplevelse samt vad det innebär att leva med bröstcancer. Slutsats: För att en bröstcancer patient ska få den ultimata omvårdnaden så är det av stor betydelse att ta vara påpatientens individuella upplevelse och behov. / Background: Breast cancer is the most common type of cancer among women not only in Sweden but worldwide. Somewhere between 15 to 20 women are diagnosed with this type of cancer each day. Being told that you have breast cancer usually results in confusion, anxiety and shock for the one who is ill as well as for those closely related to the affected women. Symptoms of the sickness and side effects of the various treatments have a major impact on women's self-esteem and health experience. Purpose: The purpose of this paper is to describe women's experience of living with breast cancer. Method: Qualitative methodology is used to understand and penetrate deeper into people's perception and experience of the disease. Two autobiographical books were selected to analyze. Results: The result is presented in one theme; Women’s experience of living with the sickness breast cancer and four categories;Receiving the diagnose, getting treatment, after the diagnose and to experience support, as well as nine sub-categories, thoughts and feelings about diagnose, denial of illness, anxiety and fear, anguish and suffering, physical changes, mental changes, the family, surroundings and others in the same situation and finally medical personnel. The results describe among other things women's emotional experience and what it means to live with breast cancer. Conclusions: For a breast cancer patient to receive the best possible care, it is of the greatest importance to be aware of the patient's individual experience and needs.

The primary aim of this thesis was to conduct a longitudinal study, to investigate the quality of life (QOL) in a large sample of people diagnosed with colorectal cancer (CRC), immediately post-diagnosis and one-year later. Various measures were utilised to capture the multifaceted concept of QOL, including psychological distress, satisfaction with life, positive affect and cancer-related quality of life. The investigation was conducted within Lazarus and Folkman’s stress and coping framework. Specifically, this research aimed to test the utility of the stress and coping framework in the context of CRC, and to explore the role of benefit-finding within the context of the stress and coping model components. One thousand, eight hundred participants (1078 men and 722 women) with a CRC diagnosis duration of 1 to 12 months, completed a telephone interview and written questionnaire, assessing demographics, disease/treatment characteristics, threat appraisal, social support, optimism, coping, benefit-finding and quality of life domains, at approximately five- and 12-months post-diagnosis. To identify CRC-specific coping strategies, the Coping with Colorectal Cancer measure was developed in the initial study. The eight factor structure was confirmed, and the subscales (Positive Perceptual Change; Religion/Spirituality; Rumination; Acceptance; Humour; Palliative; Seeking Social Support; and Lifestyle Reorganisation) found to have reliability and preliminary criterion-related validity within the context of the stress and coping framework. As predicted, regression analyses showed that, after controlling for demographics, disease/treatment characteristics and stress/coping variables, the coping subscales uniquely predicted Time 1 QOL outcomes, with Seeking Social Support continuing to predict Time 2 Positive Affect. In the second study, the benefit-finding domains specific to those with CRC were identified, and relationships with quality of life outcomes assessed, to determine the inclusion of benefit-finding in the path model. Based on completed data from 1757 of the initial 1800 participants, confirmatory factor analyses revealed three domains of benefit-finding: Personal Growth; Interpersonal Growth and Acceptance. As hypothesised, regressions analyses found that benefit-finding domains at Time 1 was associated with Time 1 QOL outcomes, specifically, Positive Affect and Cancer-related Quality of Life (both the aggregate score and its Social/Family, Functional and Colorectal Cancer-specific Well-being subscales). Time 1 Personal Growth also predicted Time 1 Psychological Distress. After controlling for Time 1 Positive Affect, Personal Growth continued to predict Time 2 Positive Affect. The final study drew on the results of the first two studies, which informed the coping strategies and benefit-finding domains to be included in regression analyses initially, and then, structural equation modelling. The final study included 1276 complete data sets of the initial 1800 participants. Parameters of the initial hypothesised model of the stress and coping framework, including relationships with benefit-finding (based on empirical findings) failed to fit the model to the data. After several revisions, the analysis revealed that the final model fit the data, where stress, coping and benefit-finding accounted for 63% of the variance in Time 1 QOL. The model showed that threat appraisal, coping resources, avoidant coping and benefit-finding directly impacted on Time 1 QOL, while threat appraisal, social support and approach coping directly impacted on benefit-finding. In this study, the approach coping strategies included in the path model could also be conceptualised as meaning-based coping strategies, as they appeared to facilitate a meaning-making process. However, benefit-finding, which some researchers have suggested is also a meaning-based coping strategy, had differential relationships with stress, coping and outcome variables, compared with the approach coping strategies. These results indicate that benefit-finding is an empirically distinct construct in the context of CRC. Finally, in this study, the impact of stress, coping and benefit-finding on Time 2 QOL, was indirect, being mediated by Time 1 QOL outcomes. The accumulated findings of these three studies have extended the cancer coping and benefit-finding research by revealing new relations between stress, coping and benefit-finding and QOL in a mixed-gender, older population with CRC. There are implications for measurement of, and theory building around benefit-finding. Finally, these studies inform the development of clinical interventions to enhance the quality of life in the short- and longer-term for individuals diagnosed with CRC.

The primary aim of this thesis was to conduct a longitudinal study, to investigate the quality of life (QOL) in a large sample of people diagnosed with colorectal cancer (CRC), immediately post-diagnosis and one-year later. Various measures were utilised to capture the multifaceted concept of QOL, including psychological distress, satisfaction with life, positive affect and cancer-related quality of life. The investigation was conducted within Lazarus and Folkman’s stress and coping framework. Specifically, this research aimed to test the utility of the stress and coping framework in the context of CRC, and to explore the role of benefit-finding within the context of the stress and coping model components. One thousand, eight hundred participants (1078 men and 722 women) with a CRC diagnosis duration of 1 to 12 months, completed a telephone interview and written questionnaire, assessing demographics, disease/treatment characteristics, threat appraisal, social support, optimism, coping, benefit-finding and quality of life domains, at approximately five- and 12-months post-diagnosis. To identify CRC-specific coping strategies, the Coping with Colorectal Cancer measure was developed in the initial study. The eight factor structure was confirmed, and the subscales (Positive Perceptual Change; Religion/Spirituality; Rumination; Acceptance; Humour; Palliative; Seeking Social Support; and Lifestyle Reorganisation) found to have reliability and preliminary criterion-related validity within the context of the stress and coping framework. As predicted, regression analyses showed that, after controlling for demographics, disease/treatment characteristics and stress/coping variables, the coping subscales uniquely predicted Time 1 QOL outcomes, with Seeking Social Support continuing to predict Time 2 Positive Affect. In the second study, the benefit-finding domains specific to those with CRC were identified, and relationships with quality of life outcomes assessed, to determine the inclusion of benefit-finding in the path model. Based on completed data from 1757 of the initial 1800 participants, confirmatory factor analyses revealed three domains of benefit-finding: Personal Growth; Interpersonal Growth and Acceptance. As hypothesised, regressions analyses found that benefit-finding domains at Time 1 was associated with Time 1 QOL outcomes, specifically, Positive Affect and Cancer-related Quality of Life (both the aggregate score and its Social/Family, Functional and Colorectal Cancer-specific Well-being subscales). Time 1 Personal Growth also predicted Time 1 Psychological Distress. After controlling for Time 1 Positive Affect, Personal Growth continued to predict Time 2 Positive Affect. The final study drew on the results of the first two studies, which informed the coping strategies and benefit-finding domains to be included in regression analyses initially, and then, structural equation modelling. The final study included 1276 complete data sets of the initial 1800 participants. Parameters of the initial hypothesised model of the stress and coping framework, including relationships with benefit-finding (based on empirical findings) failed to fit the model to the data. After several revisions, the analysis revealed that the final model fit the data, where stress, coping and benefit-finding accounted for 63% of the variance in Time 1 QOL. The model showed that threat appraisal, coping resources, avoidant coping and benefit-finding directly impacted on Time 1 QOL, while threat appraisal, social support and approach coping directly impacted on benefit-finding. In this study, the approach coping strategies included in the path model could also be conceptualised as meaning-based coping strategies, as they appeared to facilitate a meaning-making process. However, benefit-finding, which some researchers have suggested is also a meaning-based coping strategy, had differential relationships with stress, coping and outcome variables, compared with the approach coping strategies. These results indicate that benefit-finding is an empirically distinct construct in the context of CRC. Finally, in this study, the impact of stress, coping and benefit-finding on Time 2 QOL, was indirect, being mediated by Time 1 QOL outcomes. The accumulated findings of these three studies have extended the cancer coping and benefit-finding research by revealing new relations between stress, coping and benefit-finding and QOL in a mixed-gender, older population with CRC. There are implications for measurement of, and theory building around benefit-finding. Finally, these studies inform the development of clinical interventions to enhance the quality of life in the short- and longer-term for individuals diagnosed with CRC.

This work investigates various methods for measurement of stress coping. Theoretical part introduces basic theoretical constructs that deal with stress coping which are also related to the presented Stress coping questionnaire inventory. Other methods for measurement of stress coping are also discussed. The end of the theoretical part introduces the Stress coping questionnaire itself. Empirical part establishes the basic psychometric characteristics of the inventory and analyses suitability of implementation of specific norms for various demographic groups. Se- cond study within the empirical part investigates convergent validity of the method against other inventories. The results indicate that the inventory is a valid method for measurement of stress coping, although some of its scales are affected by social desirability. Recommendations for improvements of the method are mentioned in the end of the work. Keywords: stress, stress coping, psychodiagnostics