Influence of stress, cognitive appraisal, resilience, and social support on coping of older women whose spouses have undergone coronary artery bypass surgery

Abstract

<p>Purpose. To describe the influence of stress, cognitive appraisal, resilience and social support on coping of older women in relation to the coronary artery bypass graft surgery (CABG) of their spouse. Many older men are having coronary artery bypass graft surgery (CABG) and as the population ages these numbers are anticipated to increase. Surgery is a stressful experience and how the spouse of the patient appraises the surgical event may enhance her coping. Additionally, it is anticipated that resilience and social support will impact spousal coping. Design. A survey assessing the influence of stress, cognitive appraisal, resilience, and social support on coping was distributed to all women 55 years or older, whose spouses underwent CABG in the previous three months within one of five Midwestern hospitals. The theoretical framework for this study combined Lazarus and Folkman's theory of stress and coping and Wagnild and Young's resilience theory. Methods. Descriptive statistics and multiple regression were used to answer the research questions. Stress was measured by the Family Inventory of Life Events (FILE: McCubbin, Patterson &amp; Wilson, 1983), cognitive appraisal by the Spouse Perception Scale (SPS: Palmer, 1965; Silva, 1976) resilience by the Resilience Scale (RS: Wagnild &amp; Young, 1993), social support by the Social Support Inventory (SSI: McCubbin, Patterson &amp; Glynn), and coping was measured by the Ways of Coping Questionnaire (WCQ: Folkman &amp; Lazarus, 1988). Findings. The women were 55&ndash;81 years of age with a mean age of 66 years. In regression analyses seeking to predict different ways of coping, demographic variables had an unexpectedly strong role. Positive aspects of these female spouses, specifically resilience, positive CABG appraisal, and seeking social support, had most frequent and consistent positive correlations with positive reappraisal coping and distancing coping. Higher levels of these positive aspects were associated with lower levels of reported stress. Overall, ways of coping as measured by the WCQ were not strongly predicted by demographic variables or by the components of the stress and coping process measured in this study. While statistically significant, the amount of variance in ways of coping (WCQ) predictable by these variables was not large, never exceeding 20% in the regression analyses. Conclusions. In a sample of 96 women whose spouse were undergoing CABG surgery, personal characteristics such as resilience and family characteristics predicted ways of coping with this particular stressful event. This study has implications for nursing practice to better identify and support the coping efforts of nonresilient women.</p>