Buffering Effect of Coping Style on the Stress-Depression Relationship Among Taiwanese ICU Nurses: A Multi-Group Structural Equation Model with Two-Factor Nurse Stress Checklist

Monday, 30 July 2012

Huey-Shyan Lin, PhD
School of Nursing, Fooyin University, Kaohsiung, Taiwan

Learning Objective 1: The learners, including ICU nurses, nursing educators, and nursing managers will be able to understand the importance of coping style on the stress-depression relationship.

Learning Objective 2: The learners, in particular ICU nurses will be able to benefit from the recommendations to understand some methods to reduce depression in ICU nurses.


The purposes of this study were (1) to investigate the buffering effect of coping style on the “overall job stress”-depression relationship among ICU nurses, and (2) further to explicate paths associated with an interaction effect of coping style on the stress-depression relationship among ICU nurses.


A sample of 509 ICU nurses who were female and status below vice-head-nurse was recruited from 18 hospitals in Taiwan. The instrument adopted was a structured questionnaire. Multi-stage multiple linear regression analyses and a multi-group structural equation model based on refactoring structure of the Nurse Stress Checklist were used to investigate the buffering effects of coping style on the job stress-depression relationship.


Coping style did not have a buffering effect on the “overall stress”-depression relationship among ICU nurses, but there was support for the buffering effect of coping style on the “competency stress”-depression relationship. However, “competency” stress had significant and positive association with depression only for avoidant coping group. On the other hand, the direct effects of “work adaptation” stress on depression were significant in both coping groups and the effect strength did not significantly differ.


Death education should be included in the cultivating education of nursing students. The nursing manager should endeavor to increase his/her observational skills in order to detect increased signs of depression among his/her personnel in the early stages; and nurses should be encouraged to take advantage of available therapies early to assure safety of patients’ care. Preparing programs such as effective coping with stress and continuing professional training should be taken into account in hospital training. It is important to develop systems for effective two-way communication, especially communication between nurses and physicians, as well as communication between nurses and patients’ family. Additionally reducing workload may be more effective than stress management.