COPING WITH

LOSS DEATH AND

GRIEF
Miss.Srimalathi.R
1st yr MSc Nursing
PSG College of Nursing
 COPING

• A response to adapt or modify the impact of

stressor.

• It is defined as “being action oriented towards

a goal of changing a situation.

- Ray and collegues

COPING STRATEGIES:
 PROBLEM FOCUSED

• Cognitive process of evaluating the situation

and taking an action to manage or the situation
that are associated with the stressor.

• Focus: mainly to eliminate or reduce the

underlying causes of the stressor.
 EMOTION FOCUSED

• Regulation of emotional responses

• No attempt is made to address the situation or

the stressor.

• Focus: controlling the emotional response

 MEANING FOCUSED

• A process where the individual draws on

values, beliefs and goals to modify the
personal interpretation.
RISK FACTORS AFFECTING
EFFECTIVE COPING:
Impaired cognition

Limited psychological
resources

Age

Health
COPING MEASUREMENT
INSTRUMENT:
• Miller behavioral style scale

• Mainz coping inventory

• Brief Cope Inventory (BCI)

• Billings and Moos coping measures

• Ways of coping questionnaire

• Coping Strategy Indicators (CSI)

• Life Events and Coping Inventory (LECI)

(children)

• Adolescent Coping Orientation for Problem

Experiences Inventory (A-COPE)
(adolescents).
• Life Situations Inventory (LSI) (middle and
older adults)

• Stress and Coping Process Questionnaire

(SCOQ)

• Coping Inventory for Stressful Situations

(CISS)
 LOSS

• Loss is a part of life cycle all the people

experience loss in the form of change, growth
and transition.
TYPES OF LOSS:
Necessary Actual
loss loss

Situational
Perceived loss
loss
TYPES
Maturational OF LOSS Known
loss environment

Loss of Aspect of
external Loss of life
objects life
GRIEF
TYPES OF GRIEF:

Anticipatory
Normal grief
grief

Complicated Disenfranchised
grief grief
 NORMAL GRIEF

• Normal feeling, behaviour and changes to loss.

• Helps one to mature

• Sorrow, anger, crying etc.

 ANICIPATORY GRIEF

• The process of disengaging or letting go that

occur before a actual loss or death has
occurred is called anticipatory grief.

• Eg: A family member with terminal illness

 COMPLICATED GRIEF
• When the person has difficulty in progressing
through the normal phases of grieving,
bereavement it becomes complicated.
• This can threaten a person’s relationship with
others
• Chronic grief, delayed grief, exaggerated grief
and masked grief.
 DISENFRANCHISED GRIEF

• Person experience grief where the person

cannot openly acknowledged.

• Eg: A patient with AIDS

LINDEMAN’S STAGES OF GRIEF
PARKES FOUR STAGE MODEL
WARDEN’S TASKS OF
MOURNING
DUAL PROCESS MODEL
DUAL PROCESS MODEL
 BEREAVED CHILDREN

• Variables:

– The child’s age

– The child’s experience of death and dying

THE CHILD’S AGE:

• Nagy (1948)

• Stage 1: 3 to 5 yrs of age

• Stage 2: 5 to 9 yrs of age

• Stage 3: 9 yrs and above

 COPING WITH DISABILITY
• Factors influencing the coping
• Wikinson (1989)
– Insidious vs traumatic condition
– The stability and prognosis
– The severity of disability and degree of dependency
– Intellectual functioning
– Pain and other illness
 Evaluation of a stress coping course
for psychological resilience among a group of
university nursing students.
• Onan N1, Karaca S2, Unsal Barlas G
• PURPOSE:
• This study was conducted to evaluate a
stress coping course for psychological resilience
among a group of university nursing students.
CONCLUSION:
• The findings emphasized that more attention
should be given to the potential role
of psychological resilience in dealing with the
inevitable sources of stress in the education of
nursing students.
A cross-sectional survey in China
Moderating effects of coping on
work stress and job performance
for nurses in tertiary hospitals: a
cross-sectional survey in China
• Moderating effects of coping on work stress and
job performance for nurses in tertiary hospitals.
• Conclusion :This study was a preliminary
attempt to explore the relationship between work
stress, coping strategies, and job performance for
nurses in China. Results of this study indicate that
positive coping strategies moderated the
relationship between Patient Care and job
performance, while negative coping strategies
moderated the relationship between Workload and
time and job performance as well as between
Working environment and resources and
performance.
• As coping strategies can only moderate the
effects of some subscales of work stress on job
performance, managers should utilize multiple
measures to help nurses to reduce work stress.