The research conducted by Orzechowska, Zajaczkowska, Talarowska, and Galecki (2013) explored the problem of the adverse impact of stress on depression. The scholars indicated that the issue has started gaining increased attention in psychology and psychiatric research, as well as became important for healthcare providers to address. The study aimed the solve an important issue pertinent to nursing since depression can influence any patient (Zamanzadeh et al., 2014).
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The main objective of the research was to determine the most commonly used strategies of stress coping among people with depression as compared to healthy individuals. Studying mental health is crucial in the context of nursing because the treatment of a physical issue usually includes addressing psychological considerations.
Review of the Literature
In the literature review, the researchers have explored several topics pertinent to their study problem. The identification of stressors that trigger the development of depression and coping mechanisms for dealing with stressful situations have been explored in the context of the cognitive transactional model. If to look at the publication dates of references used in the study, the researchers have used an array of current and old articles. The main reason for this was the need to incorporate a diverse look on stress and depression, and the 1990s represented the beginning of advanced studies on this topic.
The cognitive-transactional model was the main theoretical framework on which the researchers based their study. It explained that in order to cope with stress, patients had to implement consistent behavioral and cognitive efforts of dealing with internal and external demands, which are often “excessive or overwhelming” (Orzechowska et al., 2013, p. 1050). The theory has been drawn both from nursing and psychology to develop an overview of the most common methods of dealing with stress among depressive and non-depressive patients. The cognitive-transactional model was chosen as the main theoretical framework for the study because the process of coping with stress is responsive and dynamic, which means that strategies and coping methods can be substituted by others. Overall, the researchers focused on the individual activity of patients rather than the impact of their environments.
In the study, independent variables were the following: factors influencing the onset and progression of depression and patients’ diagnosis. Dependent variables included the strategies of stress coping among depressive and non-depressive patients. The list of these variables was extensive and included such strategies as planning, seeking social support, active coping, suppression, acceptance, and multiple others. No operational definitions to variables were given; however, Orzechowska et al. (2013) made sure to mention that the variables depended on patients’ abilities to deal with stress.
For the study, three research hypotheses were generated. First, the scholars hypothesized that individuals who were diagnosed with depression used such ineffective strategies as avoidance for addressing stress factors as compared to the healthy control group. Second, it was suggested that there was a connection between the extent of depression as identified by the Hamilton Depression Rating Scale and different methods of stress coping. Third, Orzechowska et al. (2013) hypothesized that “women and men differ significantly in preferred methods of coping with stress” (p. 1051).
The researchers took a qualitative approach to the study when aiming to explore the most widespread use of coping strategies for dealing with stress. Deductive reasoning was used in order to reach specific conclusions about the identified problem. In order to study common ways in which patients with depression deal with stress, a sample of 80 participants was involved (32 men and 48 women). All patients were enrolled from the Department of Adult Psychiatry at the Medical University of Lodz. In order to have a control group for comparison, the scholars enrolled 30 (10 men and 20 women) individuals without the diagnosis of depression as well as absent family history of any psychiatric disorders and conditions. Unfortunately, the methods section of the research article did not include the description of the sampling method.
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The survey used in the study relied on the Coping Orientations to Problems questionnaire developed by Carver, Scheier, and Weintraub. The survey included sixty statements with answers provided on a four-point rating scale, such as
- – almost never,
- – rarely,
- – often,
- – almost always” (Orzechowska et al., 2013, p. 1052).
There could be some issues associated with the reliability of the chosen study method because patients may not give honest answers to the questions because of the fear to be misunderstood or judged. When it comes to validity, there have been concerns because the chosen measurement tool measured what it was intended to measure. It should be mentioned that the way in which ethical considerations were addressed was not mentioned in the article, which is a significant disadvantage. Since depression and stress are complex issues that require sensitivity on the part of researchers, the article should have included at least a short description of how the scholars dealt with the problem.
For data analysis, the STATISTICA 10.0 PL tool was used. The analysis was conducted on the basis of the t-test and Pearson’s r correlation coefficient. To present study results, the authors developed a table called “Results of the coping orientations to problems questionnaire in tested groups” (Orzechowska et al., 2013, p. 1052). The columns included the results for patients with depression and the control group as well as the t- and the p-values.
The results were presented for each of the identified strategies of coping with stress. Another table was created to depict the statistical significance between the extent (severity) of depression and strategies for dealing with stress. In terms of the findings, the study identified that compared to depression-free individuals, patients diagnosed with recurrent depression were more inclined to use such coping strategies as denial and behavioral disengagement. In patients with first episodes of depression, behavioral disengagement was the most common.
The main advantage of the research by Orzechowska et al. (2013) is a detailed look at specific methods of addressing stress in the population of depressed patients. Its key disadvantage was the lack of attention to ethical considerations because they play a large role in studies of mental health.
Generalization to other populations is not possible in this case because the focus was placed on patients diagnosed with depressive disorders, and people with other psychiatric diagnoses may show different strategies of coping with stress. The study is important to nursing as a discipline because the treatment of patients encompasses both physical and psychological aspects. If, for example, a person diagnosed with diabetes also has depression and poor stress coping skills, nurses will be significantly challenged in terms of finding the right treatment (Holt, de Groot, & Golden, 2014). The implications for future research are vast since strategies for dealing with stress are continuously developing.
Holt, R. I. G., de Groot, M., & Golden, S. H. (2014). Diabetes and depression. Current Diabetes Reports, 14(6), 491.
Orzechowska, A., Zajączkowska, M., Talarowska, M., & Gałecki, P. (2013). Depression and ways of coping with stress: A preliminary study. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 19, 1050-1056.
Zamanzadeh, V., Rassouli, M., Abbaszadeh, A., Nikanfar, A., Alavi-Majd, H., & Ghahramanian, A. (2014). Factors influencing communication between the patients with cancer and their nurses in oncology wards. Indian Journal of Palliative Care, 20(1), 12-20.