Page 523 - Encyclopedia of Nursing Research

490 n STReSS

control, uncertainty, social support, and har- The phenomenon of stress is not a
diness. Appraisal of threat versus appraisal new interest within the context of nursing
S of challenge is commonly studied as a medi- research, as previously stated. literature from
ating factor between resource strength and 2000 to 2010 indicated that the vast major-
coping responses. Dependent variables often ity of the findings are focused on reported
include somatic outcomes such as pain, emo- sources of stress, potentially harmful physio-
tional disturbances such as anxiety and logical effects of prolonged periods of stress,
depression, and well-being. The transactional categorization of reported coping strategies,
model was deemed by lyon and Werner identification of possible interventions aimed
(1987) to be compatible with nursing’s philo- at reducing the negative effects of stress, and
sophical suppositions. transdisciplinary collaboration to advance
lyon and Werner (1987) published a crit- the science related to stress.
ical review of 82 studies conducted by nurses A total of 41 studies were identified
from 1974 to 1984. The studies reviewed fell between 2000 and 2010. Key concepts that
evenly across the three different theoretical emerged from the literature include that of
orientations, and approximately 25% of the hardiness, resiliency, workload, and coping
studies were atheoretical in nature. In 1993, strategies. The researchers provided recom-
Barnfather and lyon edited a monograph mendations for future research.
of the proceedings of a synthesis confer- It is clear from all of the aforementioned
ence on stress and coping held in conjunc- critical reviews that our knowledge of how
tion with the midwest nursing Research stress affects health is evolving. The sig-
Society. This critical review of the research nificance of nursing research in the area of
covered 296 studies published from 1980 stress grows even more important in the era
to 1990. Both the 1987 and the 1993 critical of escalating costs for health care services. It
reviews noted a disturbing absence of pro- is widely recognized that as many as 65% of
grams of research, making it difficult to visits to physician offices are for illnesses that
identify what we have learned from the dis- have no discernible medical cause, and many
cipline’s research efforts. A compilation of of those illnesses are thought to be stress
critical reviews of the nursing research lit- related. Furthermore, productivity in the
erature from 1991–1995 focused on stressors workplace is thought to be greatly affected
and health outcomes, stressors and chronic by the deleterious effects of stress.
conditions, coping, resources, and appraisal Future opportunities for nursing
and perception; the influence of nursing research include (a) psychosomatic illness
interventions on the stress-health outcome as it relates to prolonged presence of stress,
linkage consistently noted the increase in debility over time, and long-term effects
well-designed studies (Werner & Frost, on quality of life; (b) personal resiliency;
2000). each of these critical reviews noted (c) vulnerability to illness based on style
knowledge gained and gaps in knowledge of coping stress; and (d) evaluation of var-
to guide future research. ious coping strategies for effectiveness to
In the landmark Handbook of Stress, include meditation, quality family or lei-
Coping, and Health: Implications for Nursing sure time, regular physical activity, and
Research, Theory and Practice (Rice, 2000), the educational sessions designed to present
evolution of the efforts of nurse researchers information about the concept of stress,
to test various theoretical models of stress, internalization of stress, alternate coping
coping, and health is critically reviewed. strategies, avoidance of stress, and adapta-
Importantly, the handbook includes critical tion to stress.
reviews of developing programs of nursing
research. Kimberly B. Hall