According to the new shorter Oxford dictionary, coping is to contend successfully with (an opponent, difficulty situation, etc), to deal completely with one’s or situation (Thompson, 1993). Reflecting on this, it is a lay definition. This is sharply contrasted by a more elaborate definitions offered by academicians such as Lazarus and Folkman(1984), who define the term ‘coping’ as constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as exceeding the resources of an individual. The above contrasting definitions depict that as much coping is used both as a lay and an academic term; there is a significant difference in its interpretation. The academic concept is vested in psychology theory. According to this theory, stress involves both the person and the environment. It is the relationship and the reaction of the individual and the environment that is of paramount importance. Notably, where either the internal or external demand of the environment surpasses the individual’s ability to manage them, they are viewed as in need of coping for them to avoid being stressed. Despite this elaborate point of view, this may not be the interpretation of the concept when it comes to nursing. This is not the interpretation nurses use in their conversations while practicing, or in their reflections of themselves or patients.
In specific cases, it may be clear to assess an individual’s success to cope with a given circumstance. However this is not the case in some examples which do not portray the full range of the concept nor will they give provisions for adequate predictable tools to asses the outcomes. A term like coping refers to a collection of abstract ideas ranging from effective to behavioral. It is therefore impossible to make useful, meaningful, predictive, prescriptive and other kinds of statements because there is no one agreed meaning of such terms (Gordon, 1998). The purpose of this paper is to provide some theoretical insights for the use of the term. Therefore, concept analysis is the process of examining ideas with an objective of arriving at a consensus over the use of the terms. It uses etymology to show meaning. To achieve this, it establishes a range for the use of the term right from the paradigmatic, the appropriate and down to the questionable (Rescher, 1969).
A review of the Literature
Formal and Informal Approaches
Walker and Avant (1995) came up with a structured series of steps that are to be used in concept analysis. However, their approach is criticized by Paley (1996). Paley suggests that, the process through which a concept’s defining attributes is arrived at should be arbitrary. Cahill (1996) on the other hand puts forth the suggestion that, using a linear approach to concept analysis does not reflect reality. He further argues that, a number of aspects being analyzed are manipulated simultaneously. Despite the rigidity in Walker and Avants approach, some aspects of their approach are very useful.
Walker and Avant (1995) argue that, selection of a concept should be followed by the identification of the various uses of the concept. It is equally important to recognize and consider the etymological derivations of the term in question.
When examining the concept of coping, Walker and Avant recognized that the term ‘coping’ includes uses which are derived from a very different word. Etymologically the ‘cope’ has a primary meaning of hitting or cutting. It is this that produced the secondary sense of contending with and finally to overcome. Etymologically, the term ‘cope’, solicits the secondary meaning of cover or protect (Thompson 1993). Before analyzing a concept, getting its etymological difference is important because a lack of this distinction between the two words, according to Walker and Avant, makes the concept to become a paradigm. This is an instance which is not within the range of the concept. When carrying out a concept analysis on coping, the primary meaning of overcoming is adopted in the discussion that follows.
The range of usage of a term like coping is bound to be found in language both in everyday and in technical as opposed to its analytical relationship. In a nutshell, the study of usage becomes an important analytical tool. It is through usage that one gets a deep insight of the characteristics attributed with a particular concept. However, caution must be taken because at times the frequency within which characteristics are assigned to a concept in the real usage may be misleading. Take an example of a ‘bird’, which is frequently attributed to flight. It is stunning that an Ostrich which is a bird cannot fly while a bat which is not, flies. Therefore it is apparent that, while a concept may posses one or several exclusive features, it will tend to share some attributes with other concepts since concepts do overlap. (Rescher, 1969).
Putting coping and managing into consideration for instance, they do share some characteristics and associated attributes in their usage but each is distinct from each other in some. The two concepts share the attribute of success and control but differ in the sense that, coping does involve some psychological reality which is significantly absent in managing. On the other hand, manage has the aspect of overseeing and supervising which is also absent in coping. Abstract terms when analyzed, are limited by language usage and culture. Culture has significant implications on concepts; coping for instance as used in modern British society, is viewed as achieving minimal level of success as opposed to managing which is more positive.
Coping therefore encompasses dealing with very stressful or difficult situations. Because of the psychological features present in the concept, coping entails modification or changes. The changes can be in terms of alteration of external factors or internal adaptation to the environmental factors (Folkman & Lazarus, 1980). The sole objective of coping is to reduce stress. This is done by; either removing or altering the external stressor or try to internally accommodate them in order to reduce stress. According to Roy and Andrew (1999), an individual’s adaptive coping does take place in varying levels. Some of this may be unconscious and automatic regulatory responses which are brought about by the endocrine or the nervous system. Referring to Roy’s adaptation model, adaptation is propelled in different proportions by semantic, perceptual and cognitive modes. It is these modes that interact to produce the strategies needed for coping especially if the individuals do not have enough resources for coping (Roy & Andrrew, 1999). It is pretty obvious that the degree of coping varies significantly between individuals. The variance may be as a result of individual personality type, social conditions, and gender (Remenick, 2001). According to Peacock and Wong (1996), the personality variable’s effect on personality is not clear. They however argue that, optimism is an important personality trait that directly affects one’s ability to cope. They further assert that, attempts to cope with a stressor begin with the appraisal of the stressing situation, this is important because it will aid in controllability. Personality will be manifested in this appraisal. The assessment will then aid in the selection of the coping strategy. Therefore, coping draws its features both from the way personality colors perception together with other elements of modification.
At this point, it is important to note that, two issues come along with coping; success or failure. Webb (1996) is categorical though that, success or failure is not major in the concept of coping since all reactions are some form of coping. Each individual copes with life events what is the center of the debate is the effectiveness of the responses they apply. A response to a given situation will always be influenced by several factors. Folkman and Lazarus (1980) identified two approaches when responding to a situation Problem focused and emotion focused approaches. They asserted that, coping was a process that changes with situations and timing. On the contrary others have viewed it in more personality terms.
It is apparent that, most responses to stressful circumstances will employ both external and internal responses. The balance shown by these responses varies significantly with age, gender and personality. The aspect of how individuals relate to their environment and makes a choice as to the bets strategy for coping depends with where the control of the situation lies. Importantly the choice of approach with together problem focused or emotion focused approach will vary significantly in function ability depending on the nature of the stress encountered. Furthermore all strategies for coping ranging from those that concentrate in the modification of the external factors to those advocating for emotional change in an individuals emotional response to a given situation are internally generated by an individual. Since the, many studies and researches have been undertaken to identify resources individuals deploy when faced with stressful situations. Among these is Antonovsky (1979), who developed a solutogenic model of health. His model specifically focused on a sense of coherence. Another person to contribute to this is Seligman, (1975) who developed what he termed as “learned helplessness”. He dedicated his work to pathogenic with insights in the study of depression. All the above approaches are trying to determine the reasons as to why some people can cope while others cannot (Gordon, 1994), however included coping-stress tolerance as one of her functional health patterns. This has made the study of the concept of coping an important undertaking. Because of this, coping and the related states, and behaviors have been featured in nursing classification systems (Gordon, 2002).
The defining attributes are the characteristics which describe a concept. The defining attributes present in coping are: Success in dealing with stress, control of the situation, rationality when making decisions in a stressful situation, and calmness.
Antecedents and Consequences
It is importance to enumerate and discuss antecedes of coping. Antecedents are the events or incidents that must occur prior to the occurrence of the concept (Walker &Avant). Therefore, antecedents are determinants of the concept. In antecedents of coping is therefore stress. Stress is seen as the main factor or a set of conditions requiring coping. Nurses in their day to day professional lives are often faced with stressing situations. Among these are; becoming a nurse, suffering loss and death of the patient they care for and even challenges facing them outside the wok environment. Patients on the other hand get stressed with hospitalization, terminal diagnosis, chronic illness and pain. The above mentioned stressors therefore need coping.
Consequences on the other hand according to Walker and Avant (1995), refer to the events occurring as a result of the concept. These are things that follow the concept. In coping, the consequences are; success, calm, control and failure. The first three are achieved when an individual employs the concept well. The outcome of the concept of coping can however be negative and in our case failure.
Walker and Avant (1995) put forth the importance of case approach to help in creating a conceptual meaning to various phenomenons. The cases constructed are in form of scenarios which aid in the illustration and provide clear examples of what the concept does not entail.
The following cases have been constructed to show; a model case, a contrary case, and a borderline case. The cases will be based on the following scenario:
Mr. B was admitted in hospital, he was in the company of his wife and son. Several minutes later his wife and son were told that his diagnosis showed that he only had a few days to live. The nurse gave him morphine for his pain and breathlessness and further rearranged his pillows until he was comfortable. She also explained that his symptoms would soon go away and the other option available for treatment.
A model case is the one that represents the concept to the best of present understanding. In the above scenario, Mr. B would take the Nurse’s hand and thank her for helping him and even thank his family members. The family members despite being told that Mr. B. was to live only for a few days, would still be able to smile and encourage him. All the people involved, that is, the nurse Mr. B. and the family members’ exhibit calm.
A contrary case represents that which is certainly not the case. In this Scenario, the family members upon being given the diagnosis would dispute the results and seek for an alternative doctor. They would be crying and totally worked up. Mr. B on the other hand would want to be told his diagnosis and would not accept it when given. He would want to get another doctor to attend to him. Furthermore, he would be rude to the nurse. The nurse would also be very sad on learning the condition of his patient.
Borderline case is one that is hard to classify. It possesses some of the characteristics of the concept but not all. Referring to the above scenario, Mr. B’s son upon being given his fathers diagnosis would take it calmly and understand. Mr. B’s wife on the other hand, would start crying and asking why it had to be her husband. Mr. B. himself would be calm and resting. To the nurse he would be sympathetic to both Mr. B. and his wife, she will feel sad.
An invented case is one which takes the concept out of its normal context and places it in an invented situation. This situation is usually out of the ordinary. According to the above scenario, Mr. B’s family after being told that Mr. B. would only live for few days, sit together in Mr. B’s bed and explain to him the Doctors diagnosis and calmly converse with him the good times they shared together and promise to remember him even after he passes on. Mr. B on the other hand tells them to take good care of themselves and all nod calmly.
Related case on the other hand is one where none of the defining attributes are present. Nonetheless, the concept is still the same as the one being analysed. In the concept of coping the related concept can be anxiety. Redirected to the scenario above, Mr. B’s family will be walking up and down while they await the doctor’s diagnosis. Mr. B on the other hand would not rest until he is given his diagnosis.
An illegitimate case is a real life example of the case being used inappropriately for the purpose of analysis. When analyzing the concept of coping, an illegitimate case may be; a man saying that he is coping with power failure.
The information gained in the literature review used for this concept analysis failed to identify and clearly show the empirical referents for the existence of coping. The literature has however been able to show that, there are degrees for coping and that coping response is distinct in individuals and the situation. In addition, common empirical indicators include the degree in which the individuals’ behavior is socially acceptable. In the society, coping is expected, and when it is successful, it brings about calm control and rationality. A person depicting the above mentioned traits is easier to care for and makes the nurses’ role easier. Therefore lack of coping is not accepted socially. Nurses in their day to day practice should consider their requirement for patients to cope to be beneficial to the patients themselves or the nurses. Successful coping for and individual may be a total failure in the other. Therefore it is only the individual undergoing stress is able to who is able to ascertain the resources available for coping. Showing an n external calm and control does not necessarily denote coping.
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