INTERVIEW

TOPIC: COPING STRATEGIES OF NURSES DURING

COVID-19
 PART A
Research is an academic activity and as such the term should be used in a technical sense.
According to Clifford Woody research comprises defining and redefining problems,
formulating hypothesis or suggested solutions; collecting, organizing and evaluating data;
making deductions and reaching conclusions; and at last, carefully testing the conclusions to
determine whether they fit the formulating hypothesis. Research is, thus, an original
contribution to the existing stock of knowledge making for its advancement. It is the pursuit
of truth with the help of study, observation, comparison and experiment. In short, the search
for knowledge through objective and systematic method of finding solution to a problem is
research. The systematic approach concerning generalization and the formulation of a theory
is also research. As such the term ‘research’ refers to the systematic method consisting of
enunciating the problem, formulating a hypothesis, collecting the facts or data, analyzing the
facts and reaching certain conclusions either in the form of solutions towards the concerned
problem or in certain generalizations for some theoretical formulation (Kothari & Garg,
2018)

Qualitative psychological research is psychological research that employs qualitative

methods. Qualitative research methodologies are oriented towards developing an
understanding of the meaning and experience dimensions of human lives and their social
worlds. Qualitative analysis is not as reliable as quantitative analysis but is often far easier,
faster and cheaper to perform. Quantitative researchers typically start with a focused research
question or hypothesis, collect a small amount of data from each of a large number of
individuals, describe the resulting data using statistical techniques, and draw general
conclusions about some large population. Although this method is by far the most common
approach to conducting empirical research in psychology, there is an important alternative
called qualitative research. Qualitative research originated in the disciplines of anthropology
and sociology but is now used to study many psychological topics as well. Qualitative
researchers generally begin with a less focused research question, collect large amounts of
relatively “unfiltered” data from a relatively small number of individuals, and describe their
data using nonstatistical techniques. They are usually less concerned with drawing general
conclusions about human behavior than with understanding in detail the experience of their
research participants (Kothari & Garg, 2018)
Mode of data collection in Qualitative Analysis:

Qualitative researchers typically gather multiple forms of data, such as interviews,

observations, and documents, rather than rely on a single data source. This type of research
method works towards solving complex issues by breaking down into meaningful inferences,
that is easily readable and understood by all. Qualitative data collection allows collecting data
that is non-numeric and helps us to explore how decisions are made and provide us with
detailed insight. For reaching such conclusions the data that is collected should be holistic,
rich, and nuanced and findings to emerge through careful analysis. Qualitative data analysis
such as notes, videos, audio recordings images, and text documents. One of the most used
methods for qualitative data analysis is text analysis.

Characteristics of Qualitative Analysis:

 Qualitative research methods usually collect data at the sight, where the participants
are experiencing issues or problems. These are real-time data and rarely bring the
participants out of the geographic locations to collect information.
 Qualitative researchers typically gather multiple forms of data, such as interviews,
observations, and documents, rather than rely on a single data source.
 This type of research method works towards solving complex issues by breaking
down into meaningful inferences, that is easily readable and understood by all.
 Since it’s a more communicative method, people can build their trust on the
researcher and the information thus obtained is raw and unadulterated.

Researchers make use of qualitative research techniques when they need to capture
accurate, in-depth insights. It is very useful to capture “factual data”. Here are some examples
of when to use qualitative research.

 Developing a new product or generating an idea.

 Studying your product/brand or service to strengthen your marketing strategy.
 To understand your strengths and weaknesses.
 Understanding purchase behavior.
 To study the reactions of your audience to marketing campaigns and other
Communications.
 Exploring market demographics, segments, and customer groups.
  Gathering perception data of a brand, company, or product (Kim et al., 2017)

INTERVIEW

The word "interview" refers to face to face interpersonal situation in which one ask
questions from the other to get answer about a social problem. An interview is a method of
conversation with a specified purpose. Psychologists uses interview method in order to gain
information in an efficient and streamlined manner. It’s an oldest and most widely used
method. The conducting way of interview depends on the objectives or goals in question. It
helps to investigate issues in an in-depth way. It discovers how individuals think and feel
about a topic and why they hold certain opinions. Points should be noted while having an
interview. Researchers can ask different types of questions which in turn generate different
types of data. Interviews will be recorded by the researcher and the data written up as a
transcript (a written account of interview questions and answers) which can be analyzed at a
later date. The interviewer must ensure to provide special care when interviewing vulnerable
groups, such as the children. The language which the interviewer uses should be appropriate.

An interview is a social interaction, and the appearance or behavior of the interviewer may
influence the answers of the respondent. The gender, ethnicity, body language, age, and
social status of the interviewer can create an interviewer effect. For example: If a female
interviewer interviews a male interviewee, he will try to keep his impression good and this
may lead to interviewer effect (King, Horrocks & Brooks, 2018)

Importance of Interviews:

Interviews are designed to collect a richer source of information from a small number of
people about attributes, behavior, preferences, feelings, attitudes, opinions and knowledge.
Interviews are most effective for qualitative research. They help you explain, better
understand, and explore research subjects' opinions, behavior, experiences, phenomenon, etc.
Interview questions are usually open-ended questions so that in-depth information will be
collected.

King et. al. (2018) introduced the important steps of interview as:

 Design interview questions:

 Think about who you will interview
 Think about what kind of information you want to obtain from interviews
 Think about why you want to pursue in-depth information around your research topic
  Develop an interview guide:
 Introduce yourself and explain the aim of the interview
 Devise your questions so interviewees can help answer your research question
 Have a sequence to your questions / topics by grouping them in themes
 Make sure you can easily move back and forth between questions / topics
 Make sure your questions are clear and easy to understand
 Do not ask leading questions

 Plan and manage logistics:

 Do you want to bring a second interviewer with you?
 Do you want to bring a notetaker?
 Do you want to record interviews? If so, do you have time to transcribe interview
recordings?
 Where will you interview people?
 Where is the setting with the least distraction?
 How long will each interview take?
 Do you need to address terms of confidentiality? (Virginia Tech, 2018)

Aim of Interview:

The interview is a conversation in which the researcher and an interviewee exchange

information. Researcher’s objective is to get information about a specific topic from the
interview. The interviewer will try to determine whether you will be an asset to the
organization. The interview is a two-way discussion rather than an interrogation, as it is often
perceived to be. Interviewee need to be ready to answer questions about their career goals and
background. The researcher will also want to develop intelligent questions of their own to
help them to obtain the necessary information for making an informed decision. Furthermore,
preparation helps to build researcher’s self confidence in their interview skills and is the key
to successful interviewing. Some of the objectives of Interview Method of Data Collection
are as follows:

1) Direct Contact: The first and foremost aim of the interview method is to establish a direct
contact between the researcher and the interviewee, so that both can understand each
other’s feeling, attitude and needs. After the interviewer establishes a friendly relationship
 with the subject, certain type of confidential information may be obtained, that an
individual might be reluctant to put in writing. The interviewer can explain the purpose of
his investigation, and can explain more clearly just what information he wants if the
subject misinterprets the question, then the interviewer may describe it with a simple
clarifying question and collect various information from them.
2) Eliciting Intimate Facts: In modern complex society, experiences are highly
heterogeneous. Few people share a common lot, but their attitudes and values are quite
varied. Many People can live within the protective wall of anonymity. There are many
facts of personal life, one does not like to reveal. All other methods are not so effective in
order to collect these intimate or personal information’s from a respondent which he does
not want to share. But Young has rightly observed that interview is the most effective
method through which the interviewer can penetrate into this protective mask and elicit
these intimate facts. By establishing a rapport or a friendly relationship with the
interviewee, the interviewer can gain his confidence and may be able to extract various
confidential information from him.
3) Establishing Hypothesis: Through the interview techniques the researcher may stimulate
the subject to have greater insight into his own experiences, peculiar attitudes, outlooks,
aspirations and thereby explore significant areas not anticipated by him. These new
revelations help him in forming new hypothesis about personal and social behavior.
Young says, “Every verbal response and non-verbal reaction may be an “eye opener” for
a whole new train of thoughts. An answer may not only be a response to a question but
also a stimulus to progressive series of other relevant statements about social and personal
phenomena which might indicate cause-effect relationships and at times may lead to
formulation of hypothesis regarding socio-personal interaction”.
4) Verification of Unique Ideas: When a researcher elicits a novel idea about certain type of
behavior, it is always desirable to conduct interview with the concerned person and see
how far the ideas elicited are true or valid facts. So, one can examine its validity through
interview method and safely conclude about it (Chaudhary,2018).

Various sociologists have remarked that the objective of interview is two-fold:

i. Eliciting certain information from the interviewee, which is known only to him and
cannot be collected from any other source,
ii. Psychological study of verbal and non-verbal behavior under given circumstances. As
regards the first objective, the interviewer clarifies the topic or area of study to the
 interviewee. Then interviewee narrates the experience of his life and his reactions
pertaining to it. The interviewer listens to these descriptions carefully and tries to
collect useful information’s out of it (Chaudhary ,2018)

Types of Interviews:

An interview is a conversation between two or more people (The interviewer and the
interviewee) where questions are asked by the interviewer to obtain information from the
interviewee. Interviewing refers to the process used in conducting interviews. Interview can
be taken through Phone, Face-to-Face, online (e.g., Skype, Google meet, etc.) according to
the convenience of the interviewee. There are three types of interviews: unstructured, semi
structured, and structured, face-to-face and telephonic interview.

 Unstructured interviews:
These are interviews that take place with few, if any, interview questions. They often
progress in the manner a normal conversation would, however it concerns the research
topic under review. It is a relatively formless interview style that researchers use to
establish rapport and comfort with the participant, and is extremely helpful when
researchers are discussing sensitive topics. The researcher is expected to probe
participants in order to obtain the most rich and in-depth information possible. If you
select this interview style, just keep in mind that you may have to conduct several rounds
of interviews with your participants in order to gather all the information you need. Since
you do not use a standard interview protocol, sometimes participant’s narratives
maneuver the conversation away from other aspects of the research topic you want to
explore; it is a part of the conversational style this interview method requires.
Advantages: -
 The better understanding of the candidate than in a structured interview
 It is very flexible and more comfortable
 Very practical method to analyze the candidate
 It is a very valid and interactive way
 It breaks the communication gap between the interviewer and the candidate

Disadvantages: -

 They are time consuming and require a skilled interviewer

 They also produce large amounts of text which is difficult to analyses
  Positivist sociologists would be concerned that the method lacks reliability and is
therefore unscientific and subjective.
 Semi structured interviews:
These are interviews that use an interview protocol to help guide the researcher
through the interview process. While this can incorporate conversational aspects, it is
mostly a guided conversation between the researcher and participant. It does maintain
some structure (hence the name semi structured), but it also provides the researcher with
the ability to probe the participant for additional details. If you decide to choose this
interview method, understand that it offers a great deal of flexibility for you as a
researcher. You do not have to worry about needing to conduct several rounds of
interviews because your interview protocol will keep you focused on gathering all the
information that you need to answer your research question. Even though that is the goal
with an interview protocol, there may be a need for additional probing so that you can get
more details about participants’ thoughts, feelings, and opinions.
Advantages: -
 Interviewers can prepare questions beforehand to help guide the conversation and
keep respondents on topic.
 Allows for open-ended responses from participants for more in-depth information.
 Encourages two-way communication.

Disadvantages: -

 It's time-consuming to sit down with respondents and conduct an open-ended

interview.
 It requires extensive resources.
 It can be challenging to find an interviewer with the right amount of training to
conduct the interview properly.
 Structured interviews:
These are interviews that strictly adhere to the use of an interview protocol to guide
the researcher. It is a more rigid interview style, in that only the questions on the
interview protocol are asked. As a result, there are not a lot of opportunities to probe and
further explore topics that participants bring up when answering the interview questions.
This method can be advantageous when researchers have a comprehensive list of
interview questions, since it helps target the specific phenomenon or experience that the
researcher is investigating. It makes for expedient interviewing and will gather the correct
 information that you need, so there should not be much need for you to do follow-up
interviews for missed or forgotten questions.
Advantages: -
 Easily compare multiple job candidates
 Prepare and avoid missed opportunities
 Reduce biased opinions of potential candidates
 Conduct faster job interviews

Disadvantages: -

 Very little rapport

 Limited assessments as well as tensions
 Intimidating
 Internal disconnect
 Cannot alter questions
 Complex questions
 Limited scope
 Lack to test communication
 Face-to-face Interview:
One way to conduct a survey is to just walk up to a potential respondent and ask your
questions. You may have experienced this approach in shopping malls. Someone
approaches you and says, “Good afternoon, my name is Alison and I’m conducting a
survey for Mattel. The survey takes only 5 minutes. Would you care to participate?” As a
researcher, you hope that the person will agree. You may run into problems of sampling
bias if only a small minority of the people you approach agree to participate. Well, do you
participate? Can you spare 5 minutes?
If you are interested in obtaining information about consumer opinions or attitudes, it
makes a lot of sense to ask people shopping (and consuming) at a mall. Generally, if the
population you want to study is available at a particular location (e.g., mall, airport,
emergency waiting room) and your questions do not take more than about 5 minutes, then
the simplest approach is to go to where your group is and interview them in person. On
the other hand, if your interview takes more time; you may have to arrange for the
respondents to meet you somewhere.
Although you do not need to have respondents complete an informed consent form
before they answer your questions, you still need to consider the ethics of consent. As a
 researcher, you must consider what your respondents will need to know before they
decide if they want to answer your questions. It is good practice to be honest with your
potential respondents and tell them who the survey is for and how long it will take. This
way, if they agree to participate, they are giving their informed consent, and it makes it
more likely that once they start, they will continue to the end.
Advantages:
 Can gather information directly from the people you are interested in
 You can explore complex issues that do not lend themselves to multiple-choice
answers
 It’s useful to ask probing questions

Disadvantages:

 Your sample may be biased depending on where you position yourself to the
interviewee
 Be careful that your probing does not influence your data. It is easy to use these
probe questions to lead the respondent in one direction or another, so it is very
important that the probes be neutral.
 They can be very time-consuming and expensive
 A potential drawback to a face-to-face interview is that people may not feel
comfortable discussing personal or embarrassing topics. Although it is possible to
establish good rapport with the respondent, it is unlikely that anyone will feel
comfortable revealing intimate information to a stranger (and those who do may
not be representative of the population).
 People may engage in response management by answering in ways that may not
be totally honest but that make them look good
 Telephonic Interviews:
Survey by telephone is your best choice if your research question requires
interviewing a large number of respondents who are spread over a large geographical
area. Although this approach can be expensive and does require trained interviewers, it
will certainly be cheaper and faster than conducting face-to-face interviews. Of course,
the interview itself will take the same amount of time, but contacting your respondents
can be much faster. Rather than chasing after people, you can let your fingers do the
walking.
 Telephone interviews must be shorter than face-to-face interviews. In a face-to-face
interview, it is unlikely that your respondent will get up and leave partway through, but if
your telephone questions run too long, watch out. It is probably best to keep your
interview to about 10 minutes.
If you are doing research on a specific population, such as physicians, for example,
you might be able to obtain a list of telephone numbers through an organization.
However, largescale population studies may require specific samples, and often these lists
are purchased from survey sampling companies.
Often data are coded and entered into a computer directly by the telephone
interviewer.
Computer-aided telephone interview programs display the interview questions on the
screen for the interviewer and permit direct entry of each response. These programs also
provide probe questions on screen and branch to questions that follow as a consequence
of a certain response. These programs can certainly reduce training time for interviewers.
Advantages:
 You do not have to be in the same location as the respondent. This means that
your interviewers have no travel time, and you can interview people from across a
wide area.
 Telephone surveys allow us to contact a lot of people over a large geographic
area.

Disadvantages:

 Early telephone studies were flawed because not everyone had a telephone listing;
today, selection bias results from people screening their calls with answering
machines or call display
 They do require trained interviewers, and they do take time (Rooney & Evans,
2018)

Interviewing can be very expensive and time-consuming, and it requires trained

interviewers. However, an interview gives us that human contact that we can use to develop a
relationship with our respondents. This relationship may be particularly important if we are
interested in exploring sensitive topics. However, this rapport can be a double-edged sword.
It can work to our advantage by allowing probing questions as a result of a particular
response. But it can also work against us if we consciously or unconsciously influence the
respondent to answer in a particular way (Rooney & Evans, 2018).

PART B

COPING STRATEGIES OF NURSES DURING COVID 19 PANDEMIC:

As per Arnetz et.al. (2020); “The coronavirus disease (COVID-19) pandemic has
exposed nurses to conditions that threaten their health, well-being, and ability to work”. It is
therefore critical to study nurses’ experiences and well-being during the current crisis in order
to identify risk groups for ill health and potential sources of organizational intervention.
Healthcare institutions should provide opportunities for nurses to discuss the stress they are
experiencing, support one another, and make suggestions for workplace adaptations during
this pandemic.

COVID-19 has not only had an impact on people’s emotions, but their coping strategies
too have undergone a change. Coping is defined as the thoughts and actions that individuals
use to deal with stressful events. Research has identified two general coping strategies: one is
problem-focused coping where the purpose is to solve the problem or take action to change
the status quo; and the other is emotion-focused coping, which aims to reduce the emotional
distress associated with stressful situations. Studies have found that emotions lead to specific
coping strategies, and vice versa. Emotions are believed to have properties that motivate
certain behaviors. For example, fear is related to the desire to evade and protect themselves
from incidents, anger leads to a desire to attack, disgust leads to a desire to expel, and
happiness leads to a desire to entertain. Moreover, emotions have been linked to the use of
specific coping strategies. In particular, adults who report more anger and fear prefer to use
active-oriented coping strategies such as asking questions, while those who are sad are more
likely to use non-active coping strategies such as avoiding or accepting problems. In turn, the
successful use of coping strategies will help individuals manage stressful events and reduce
negative emotions. However, the direction of the relationship between emotional responses
and coping strategies is not clear, and the relationship is not always constant. Some studies
during the SARS epidemic have found that the relationship between them is age-specific. So,
the relationship between nurses’ coping strategies and emotional responses during a major
infectious disease such as COVID-19 needs further research to clarify. To our knowledge,
there has been no systematic assessment of the effects of COVID-19 on nurses’ emotional
responses and coping strategies (Huang et.al., 2020).

Nurses´ sources of stress and psychological distress:

The WHO conceptualizes mental health as a ‘state of well-being in which the individual
realizes his or her own abilities, can cope with the normal stresses of life, can work
productively and fruitfully and is able to make a contribution to his or her community’.
According to Lai et al. (2019), healthcare workers exposed to COVID-19 have a high risk of
developing unfavorable mental health outcomes and may need psychological support or
interventions. In addition, many studies have shown that nursing is one of the most stressful
occupations. Chan et al. (2000) studied the intensity of work stress in six professional groups
and they found that the level of overall work stress was higher for nurses than the average for
the six professional groups. Moreover, stress among nurses has been linked to negative
outcomes such as psychological distress, burnout, depression, anxiety, low-back pain, or
musculoskeletal symptoms and the quality of patients’ care may deteriorate (Leveck & Jones,
1996). Finally, hospitals may also lower their effectiveness and productivity indicators for
several reasons, such as staff exhaustion or intention to leave (Coomber & Barriball, 2007).

Nurses especially face stressors related to assuming responsibility for another person's life,
caring for a large number of patients suffering from disease and pain (Lee, et al., 2007).
During the peak of COVID-19, nurses’ stressors were intensified. Regular stressors became
acute and exacerbated (i.e., more patients, longer work shifts, risk of infection, etc.), whereas
there was a shortage of resources (i.e., lack of protective equipment, insufficient facilities,
lack of training or experience for this kind of situation, etc.). According to the Job Demands-
Resources Model (Bakker & Demerouti, 2014), high levels of demands and low levels of
resources clearly predict higher levels of stress in healthcare staff and the most adverse
reactions of psychological distress. In fact, the negative relationship between work stressors
and physical and psychological well-being has been well established. Psychological distress
refers to psychological symptoms an individual has experienced in the past few weeks
involving disruptions in normal or healthy functioning. It encompasses indicators such as
psychological feelings of depression, anxiety, and strain. The Conservation of Resources
(COR) Theory (Hobfoll et al., 2018) also provides a theoretical basis to study nurses’
stressful experience. According to this theory, ‘stress occurs (a) when central or key
resources are threatened with loss, (b) when central or key resources are lost, or (c) when
there is a failure to gain central or key resources following significant effort’. During the peak
of the pandemic, people experienced the loss of key personal and job resources and they were
constantly threatened by the risk of being infected and infecting others, (Maldonato et al.,
2020). A recent study involving 1563 health professionals in China found that about half of
the participants reported depressive and anxiety symptoms, (Li et al., 2020). Therefore, it
seems essential to study nurses’ work conditions during this health crisis, analysing the
factors that could alleviate their negative consequences for nurses´ mental health. The
objective of this study is to analyse nurses´ psychological distress, identifying the role of
different sources of stress, as well as the mediating role of coping strategies and resilience.
Previous studies have shown that, the following stress sources are especially relevant for
nurses: work overload, insufficient preparation, lack of support, death, and fear of infection
(Maldonato et al., 2020). In addition, some hospitals in Spain did not have sufficient or
adequate PPE (gloves, surgical masks, goggles, gowns medical, etc.) for fully effective
protection during the peak period of the pandemic.

Nurses´ coping strategies:

The transactional model of stress and coping by Lazarus and Folkman (1984) described
coping as a phenomenon that involves both cognitive and behavioural responses individuals
use in an attempt to manage internal and/or external stressors that are perceived to exceed
their personal resources. The different types of coping may be characterized either as direct
action or problem-focused coping (PFC) or palliative or emotion-focused coping (EFC).
Lazarus in 2000 points out that these two strategies are interdependent and work together,
one supplementing the other in the overall coping process, with coping being a critical
process that mediates the person–environment relationship (Lazarus & Folkman, 1984). PFC
refers to one's response of attempting to eliminate a perceived threat. It means reducing the
sources of stress at work to improve the situation. In turn, EFC aims to reduce emotional
discomfort or other negative effects triggered by the situation. Previous research has shown
that PFC is positively related to well-being indicators, decreasing anxiety, and psychological
distress (Grossi, 1999) whereas EFC presents more inconsistent results about its relationship
with well-being. In any case, coping responses, whether ‘fight’ or ‘flight’, are intended to
protect people from the negative effects of stressors on psychological and physical health
(Lepore & Evans, 1996). In one case, the protection stems from removing the taxing sources
of stress and, in the other case, it stems from avoidance or other cognitive or emotional
strategies. Nevertheless, not always the positive relation between EFC and well-being has
been found. Thus, it is also important to clarify how these two coping strategies might reduce
the negative effect of stressors on nurses´ mental health by mediating their relationship.
Previous research has shown evidence of a partial mediating role of coping in the stress and
health relationship and in the psychological capital and psychological distress relationship in
Chinese nurses. This mediation effect has, in some occasions, been shown differentiated for
both types of coping (Noda et al., 2018).

The relationship between PFC and EFC and their combined mediating role is important
and, to the best of our knowledge, it has not received much attention till present. Recently,
Stanisławski (2019) has formulated and integrated circumplex model of coping that considers
that PFC and EFC are not exclusive categories but rather two axes corresponding to the two
tasks (solving the problem and regulating their emotions) that individuals have to face and
that then can be combined. Thus, based on different circumstances, the combination of both
tasks may be more or less efficient and effective in coping. In the exceptional and highly
stressful circumstances considered in our study, we may expect that both coping tasks need to
be enacted. Especially PFC is required but it will only be efficiently enacted if EFC is also in
place as it is necessary for effective purposeful behaviour regulation. Thus, although there are
no conclusive results about the relationship between PFC and EFC, we hypothesize that in
this complex and high-risk situation where the healthcare system is overwhelmed, nursing
staff prioritize to control the problem by applying active planning and looking for
instrumental support to reduce the negative effects of stressors. This, in turn, is positively
related to EFC because reframing, acceptance, and looking for emotional support strategies
are also necessary in these circumstances. Thus, we expect that nurses will try to eliminate
the perceived threat by using PFC strategies in an attempt to improve the critical situation.
These strategies may require extra taxing efforts, which may in turn require high levels of
EFC behaviours that will be related to less emotional discomfort. This means that the more
frequent their PFC strategies are, the more EFC strategies will be enacted.

AIM:

To explore the coping strategies of Nurses during Covid-19 pandemic.

METHOD:

Participants:
 The participants were Nurses, because the nurses are one among those out there in a
group which faces a stressful situation because of this pandemic. Nurses have many duties,
including caring for patients, communicating with doctors, administering medicine and
checking vital signs. Researcher selected 8 Nurses as interviewee. All of them works under
different hospitals except two of them. The average age range of the selected nurses were
32%. The percentage of males and females are 12.5 and 87.5. 62.5% of nurses are working in
their districts itself. 25% are working in another state and 12.5% of them are working in the
next district of their homeland. 100% of them are from semi-urban domicile and all of them
are qualified BSc Nursing.

Procedure:

The interviewee were Nurses and the researcher selected them to check the Coping
Strategies which was used by them to reduce stress during this Covid-19 Pandemic. Nursing
is a profession within the health care sector focused on the care of individuals, families, and
communities. Researcher prepared an interview schedule with 28 questions and was collected
data through online. That is; data was collected through videocalls using Apps such as
WhatsApp, Instagram etc. All those Nurses contributed their level best for a better result.
They were very open to the questions which was asked. They were very much cooperative to
the researcher and the 28 questions which was asked by the researcher. Researcher thanked 8
participants after data collection. Finally, the data was coded using percentages and the report
was prepared.

Major Objective:

 To study the strategies which the nurses apply to cope with their job stress during
covid-19 pandemic

Specific Objective:

1. To study the influence of job satisfaction of Nurses in coping with their stress
2. To explore the challenges faced by Nurses during covid-19
3. To study the influence of major stressors during Covid -19
4. To find the effect of job stress in their daily life activities
5. To find the effect of family in their stress coping

RESULTS AND DISCUSSION:

 The aim of this study was to explore the coping strategies of Nurses during Covid-19. The
major objective of the study was to find what strategies do the nurses apply to cope with their
job stress during covid-19 pandemic. Nursing staff encounter a lot of physical, psychological
and social stressors at work; because of the adverse effects of job stress on the health of this
group of staff and subsequently on the quality-of-care services provided by nurses. Studying
and identifying how nurses cope with the job stress are very important and could help to
prevent the occurrence of unfavorable outcomes.

Researcher had prepared an interview schedule to find the coping strategies of nurses. The
average age range of nurses was 32% and the percentage of males and females are 12.5 and
87.5. 62.5% of nurses are working in their districts itself. 25% are working in another state
and 12.5% of them are working in the next district of their homeland. 100% of them are from
semi-urban domicile and all of them are qualified BSc Nursing.

While asking about the job satisfaction the first question was to know the most satisfying
aspect of their job as a nurse; and 37.5% of them were satisfied while they saw their patients
and when they treat them and the smile of the patient when they get better. Another 37.5%
were satisfied when positive changes get happened in the life of a dying patient after their
cares, when they help the patients to get out of their problem and also, they are working in the
most trusted professional. Forming relationships with patients and pride while thinking about
their job is the most satisfying aspect for 12.5% of nurses. Learning new things were the most
satisfying aspect for the 12.5% of nurses. This indicates that the patient’s smile after getting
cured was the most satisfying aspect for most of them.

The second question was about the least satisfying aspect of their job and salary was the
least satisfying aspect for 37.5% of people and for 25% of people the least satisfying aspect
of their job was the interference of their hospital management or hospital administration in
their duties. They were not getting enough money according to their hardship. Mostly they
suffer a lot because of their field work and all, but the nurses were not getting enough wages.
Usually, the hospital managements give more importance for the doctors. But exactly what
happens is nurses were giving more effort than the doctors are giving because they people are
always with the patients and doctors are coming mostly in some scheduled time. The lack of
extra payment even though the nurses are doing overtime work is the least satisfying aspect
for the12.5% of nurses. Long shift and usage of time-consuming technologies are the least
satisfying aspect of their job for the12.5% of nurses. The least satisfying aspect for 12.5% of
nurses is doing something and not getting better result and also getting scolded by the
patients or the administration if anything happened wrong. This indicates that, for most of the
nurses the least satisfying aspect of their job was their salary. If they got good salary, they
would be treating the patients in a better way.

Third question was to know whether they get the respect from the society which they
deserve. 62.5% of people said it as they get respect from the society. But asper 37.5% of
people, they were not getting good respect from the society. There was another question for
the people who said ‘Yes’. And that was to know about the feelings of Nurses when they get
the respect from the society which was deserved by them and the 25% of them replied as they
get respect only up to a limit and feels happy when they get respect from the society. As per
25% of nurses, they got respect when the covid pandemic was started. Until the pandemic
there was no such type of respect given for the nurses from the society. 12.5% of them feels
pride about themself when they are thinking about the respect from the society. Most Nurses
gets respect from the society and they feel happy when they get respect which they deserve.

37.5% of people replied that they are not getting the respect from the society. Another
question for the people who replied as they are not getting the respect which they deserve
from the society was to know how the nurses approaches to the disrespect. 25% replied that
people are moving from them and they are also keeping themselves from the nurses for their
safety since those nurses are coming after the duty. 12.5% of them replied that nurses get
respect from the society in other countries. But in our country, it’s not commonly seen. But
there is a change in that situation when the pandemic was started. Some of them are not at all
aware about our problems and sufferings.

100% of Nurses which researcher had taken as sample told that they were getting adequate
training from their hospitals. Among them, 50% told that they are getting trained mainly
through meditation for their stress management. And 25% of nurses are getting information
or training when their hospitals have been introduced for them. Another 25% of nurses said
that they usually get training on covid blues. The happiest fact is that all Nurses who works in
different hospital gets adequate training in one way or in another way from their hospitals.

When they were asked about the benefits they had acquired as a nurse 37.5% of them told
it as self-efficacy and emotional stability formation, caring for others, growth in their jobs,
opportunities for their advancement, flexibility and strong personal satisfaction. The benefits
acquired by the 25% of nurses was strong personal satisfaction and work with many kinds of
peoples with different cultures, self-sufficiency and better symptom management. The
benefits as per another 25% of nurses was knowledge and also, they got some chances to
provide that knowledge for others also they can practice even more for being a better nurse,
and knowledge about the hospitality and management was the benefit for another 12.5% of
nurses. Most of the Nurses has a belief in his or her capacity to execute behaviors, necessary
to produce specific performance attainments, they’ve got growth in their jobs, and these were
the benefits they had acquired as Nurses.

87.5% of nurses thinks that their job satisfaction matters for the patients. But 12.5% of
nurses replied as their job satisfaction does not matters for the patients. While asking them
why do they think so, 12.5 & of them who replied job satisfaction does not matter to the
patient because nurses try to treat the patients far better than we could expect. And they won’t
misbehave towards their patients at any cost. Even though nurses who replied job satisfaction
of nurses matters to the patients also had an opinion like 12.5% of them, also they had other
opinions too. 37.5% think so only if the harassments they faced is more, the pain from their
stress or problem may affect the patients while they are being treated. 25% of them tries to
treat patients in a better way. But if they are stressed, they may get angry towards the patients
even for silly reasons. 12.5% of them thinks so when they are dissatisfied, they lack the
interactions between the patients and the nurses and this results in a problem which those
patients may not be treated for their actual disease. As per the remaining 12.5% of nurses
current state may affect the patient’s safety when they become out of mind. Mostly all Nurses
thinks that their job satisfaction matters for the patient. But they also told that they couldn’t
express their dissatisfaction to their patients. It indicates that those Nurses were very much
passionate about their job.

To check the stress faced by the nurses in this covid-19 pandemic some questions were
asked to know whether they had treated their patients when they are stressed. 37.5% of them
replied that they treat the patients even if they are stressed. Also, they forget about their
actual problems while treating the patients and it’s a relief seeing the smile of a patient after
getting a cure for their problems. 25% of them gets free from their problems while seeing the
patients even if they are in a stressful situation. 12.5% becomes angry even for silly things.
But will try to treat them in a comfortable way and will never reject the patients without
giving them proper treatment. 25% of them treat their patient maximum in a better way and
their satisfaction is nurse’s satisfaction. Nurses does their job neatly even if they are stressed.
They forget about their actual problems while treating their patients.
 While asking whether the patient’s condition makes them stressed, 100% of them replied
“yes”. When they were asked to briefly explain about those situations. 37.5% of them replied
that disease itself gives us stress and they get stressed when the dying patients are not getting
better even if they try their best. 25% of them were stressed while seeing children who were
covid positive while their family is covid negative. Their parents will be crying because of
the separation from their children. Nurses are always for them but children need their parents
the most. Another 25% becomes stressed when they see the reaction of the people when they
receive covid result as positive. 12.5% of them becomes stressed while they hear the tragic
stories of patients. This shows how much empathy each Nurses have. Those Nurses has the
ability to understand the experiments and feelings of others outside of their own perspective.

Except 12.5% among them nobody had become covid positive, and the 12.5% who had
become covid positive had overcome that situation through staying at home by self-isolation.
She sanitized within 20 minutes daily. When they were asked about the duration of their
stress 50% of them replied that they cope up with the stress easily because their reaction and
coping is better. For 12.5% nurses stress lasts maximum for half an hour. And stress of
another 12.5% lasts for one day. But for another 12.5% stress duration changes according to
the situation.

100% of them shows some warning signs before they are being stressed. For the 62.5% of
them, the warning signs was headache, mood swings, anxiousness and depression. For 25%,
aggression and headache are the warning signs of stress. 12.5% of them do not know what to
do and also, they feel mood off before stress and they understand at what level their problem
will make a stress for them. This indicates that they feel like something wrong is going to
happen as some warning signs before they got stressed.

100% of them thinks that it’s better to get a break at least once in a while. 62.5% becomes
tired when they do antigen test and all continuously without any break. 37.5% of them used
to think to get a break at least once when they do their duty for more than 8 days and finishes
their hectic works and work pressure.

100% of nurses had tried to observe themselves. And when they were asked about their
feeling about their own moods; 37.5 of them replied that they often feel emotional outburst
and feels sad while others are not thinking in a way which she thinks like. Another 37.5%
feels more stressed when they observe themselves, because they understand what their moods
and feelings look like. 25% tries to maintain their happiness even if their mood changes from
one mood to another. Most of them feel emotional outburst and they feels sad.

100% of nurses had felt that their emotions do interfere with their decision making. As per
37.5% of them emotions do interfere their feelings but they want another person for taking an
exact decision in their life. 25% of them always hears what their emotion says than their
brain. 25% of them usually take their decision very fastly when they are depressed or
emotionally weak. When decisions are taken according to their emotions sometimes there
happens a wrong selection of decision for 12.5% of them. All of them told that their emotions
do interfere with their decision making. This shows that they are taking decisions by
considering what their emotions communicates with them.

100% of them had wondered at least once thinking about why they are being stressed even
for every single thing. As per 25% of nurses, this happens because of their emotional
instability. Another 25% of them had changes in their feelings always and hence they are
stressed for every single thing. But another 25% usually does not becomes stressed for every
single thing. They become stressed only for some valid reasons. Even though the 25%
becomes stressed for every single reason they try to become happy in all situations. This
indicates that they wanted to be free from their stressful thoughts.

While talking about the stress in their daily life; they were asked whether they were on
covid duty and 100% of them started before covid pandemic had started. Also, all of them
have been isolated except 25% among them; on their way back to home from hospital in one
way or in another way because of the covid pandemic. When they were asked to describe
such situations which they become isolated 37.5% said a story which they had faced from the
KSRTC. When a group of nurses entered the bus after their duty time, one old man said that
these people’s body is with full of corona virus and this hurted them a lot, the passengers in
the bus too are daily customers and they used to hesitate to sit with those nurses. 25% of them
travels in their bike. But when they go to some hotels and all by wearing their identity card of
hospitals, they feel isolated even from the hotel managements without thinking that they are
customers. 12.5% of them are travelling in their hospital’s vehicle itself. Since the passengers
in that vehicle are nurses there are no problem with social isolation for them. This indicates
that Nurses felt isolated from public places since they had Covid duty.

When they were asked how does the covid patients behaves towards the nurses, 37.5% of
them replied that the patients will be very sad. There are parents who cries when they hear
their children are covid positive. But when they go for field work in tribal areas, they won’t
be ready to accept the situation. They won’t hear what the nurses are telling. According to
another 25%, the patients give respect for them for better treatment, those nurses who are
attached with them always in their room. As per 25% of the nurses those patients always need
an emotional support from the nurses as they are isolated in a room and they are always
seeing nurses than the doctors. And if the patients are children, they want nurses to play with
them. As per 12.5% of them, there are changes in the behavior of patients according to their
culture and their literacy. This indicates that these people are the pillar of strength for patients
to become stronger.

100% of them gets enough time to do their personal hobbies. The personal hobby of 75%
of them is listening to music, singing, video making, dancing, watching films etc. and they
find time to listen music while they are travelling, and they are trying to do it while they get
break in their duty and also during their duty time also because it would make their mind
relaxed. As per 25% of them, football playing, modelling, having food is the main hobbies.
And they try to do their hobbies while they get a break. All of them got enough time to do
their personal hobbies without interfering their jobs. This shows how much committed they
are towards their job as a Nurse.

100% of them had tried to make some notes about their achievements and abilities. 62%
of them makes notes to develop a self-respect, emotional stability, comfort. 25% of them
makes notes for emotional support, confidence through noting their achievements and
abilities and they can change their emotions when they need to give up. 12.5% of them notes
one’s own achievements and abilities are assessed to check whether it has improved or not.
This may help them to improve their self-respect, emotional stability etc.

While talking about their family; asper 75% of them, their family is very much supporting
and also, they can understand her situation when they come back home after duty. 25% of
them gets an emotional support and care since they know the character of their job. 12.5% of
them goes with the self-quarantine but her family is also virtually supporting her. This
indicates that their family members are very much supportive to do their jobs.

100% of them had got a place appropriately when they were everyone was provided with
bed, TV, good food and treatments. Their quarantine rooms were spacious enough with good
facilities inside not to get bored by them. They got treated well during their quarantine days
by their hospital managements itself.
 All of them tries to share all their problems with their family. The support which all of
them gets from their family is providing solutions for their problems. 50% of them got the
support husband and mother. Husband gives solutions for their problems whereas mother
becomes emotional. Parents and siblings are the motivating and supporting people for 25% of
them. Their family tells them how to overcome a problematic situation. The supporting
person for 12.5% of them tells how to handle problem and that person is their best friend. The
result indicates that the family is who always stands beside of the Nurses even if they have
friends and all others.

They were asked when they were relaxed and most of them replied it as the time they were
in hospitals or their home. According to 62% of them, they become relaxed when they are in
hospitals and also when in home. They get relaxed while they treat the dying patients,
patients smile to them and they thank them. That was the main factor which makes them
relaxed. Also, they get relaxed while seeing their children’s face. 25% of them gets relaxed
on the way back to their home after their duty while listening music because of the
satisfaction that they could treat some more people that day, loves to treat patients. 12.5%
gets relaxed when they reach their homeland and while seeing their friends, ramp walk with
that background music and all he feels so happy and gets relaxed. Because it’s passion. And
also, they get a relaxation when haves’ food and when watches some funny videos in the
phone and when observes the nature. Most of the were relaxed when they were at hospitals or
at houses. This indicates that their main passion is to take care of the patients and also to give
love for their family.

They were asked what was the coping mechanisms they choose to cope with a stressful
situation. 37.5% of them uses rejection as a coping mechanism most of the time. Sometimes
they used to get adjusted with that stressful situation. 25% gets relaxed while they meditate.
12.5% of them goes to park to gets relaxed and while seeing the children playing in the park,
they get relaxed. Reading trolls, listening music, observing the nature are the coping
mechanisms for 12.5% of them. Through rejecting the stressful situations, Nurses could
become more resilient. They may have the capacity to recover quickly from difficulties and
toughness.

While they were asked whether their coping mechanisms were effective or not all of them
replied ‘yes’ without any second thought. They were also asked whether those coping
mechanisms helped her to lead a good life. 50% of them gets self-confidence when they
reject or adjusts the solutions. Those coping mechanisms are a motivating factor to lead a
good life. 25% of them gets an emotional support and gets motivated and they realize that
they can overcome that situation too. For another 25% of them, those mechanisms give a
lesson about how they can enter a new life without that stress. This indicates that the coping
mechanisms used by them are very much effective to reduce their stress.

When negative thoughts become a continuing pattern, nobody tries to choose drugs as
solution. 12.5% of them used to drink beer, but after the entry of his would be to his life he
stopped even taking that beer. The remaining 87.5% used their coping mechanisms such as
adjusting, listening music, nature observation and all not to use drugs. Even though some of
them uses beer and cigarettes during special occasions; nobody uses any type of harmful
drugs when negative thoughts become a continuing pattern.

All of them were able to experience an increase in their confidence level when they were
able to overcome a stressful situation. Positive changes and happiness were seen among the
50% whereas the self-realization is the changes seen among 25% of them. Changes in
emotional stability, increase in confidence and the realization that he can do it is the changes
in the remaining 12.5% of them. This indicates that Self Efficacy has been increased for all of
them when they were able to overcome a stressful situation.

All of them had visualized sitting calm while they are in a stressful situation and they get
relief while visualizing it. The 37.5% of them tries to visualize it and they feels some mood
changes whereas the 25% of them usually gets no time to visualize it when they are in a
stressful situation but they get a positive energy when they think about it. Another 25% gets a
relief from the stressful situation when visualizing themself sitting calm. Whatever their
situation is when they think that they are sitting calm and they could get relaxation and that
feeling makes them happy for some12.5% of them. And this makes them even more happy
and satisfied. This indicates that they get a relief even if they are visualizing sitting calm.

“Nurse” is just a word to describe a person strong enough to tolerate everything and soft
enough to understand everyone. The nurses whom I took as my sample was very much
cooperative with me and also, they were easily responding. And they spent their valuable
time for me. All of them takes coping mechanisms in one way or in another way and they get
relaxed while doing it. Most of them used self-controlling, avoidance, seeking help etc.

Exploring experiences of nurses on how to cope with job stress emerged context-
dependent and original strategies and this knowledge can pave the ground for nurses to
increase self-awareness of how to cope with job stress. And could also be the basis for
planning and the adoption of necessary measures by the authorities to adapt nurses with their
profession better and improves their health which are essential elements to fulfil high-quality
nursing care.

CONCLUSION:

From the current study, it can be concluded that all Nurses used coping strategies to
reduce their stress during covid-19 pandemic. Most observed coping strategy were treating
then patients to reduce their stress. All of them were satisfied with their job and they felt
proud of themselves. They did not interfere their jobs with their personal issues. Because,
they are so much committed to their job. There are some challenges for Nurses and they are
patient’s issues and stress given by their management etc. The major stressors during this
pandemic were salary, stress form management, stress while seeing the patient’s by-standers
grief. Their job stress affected their daily life activities such as they felt isolated on the way
back to their homes after Covid duty from their hospitals. Their family supported them to
overcome their job stress and also all stressful situations.
 APPENDIX
INTERVIEW SCHEDULE:

Demographic Variables:

1. Name:

2. Gender:

2.(a) Male (b) Female (c) Transgender

3. Age:

4. Place of Residence:

5. Domicile:

5.(a) Urban (b) Semi Urban (c) Rural

6. Education Qualification:

7. Where do you work?

7.(a) From how long you have been working here?

8. Are you working in a government running hospital?

8.(a) Yes (b) No

Job Satisfaction:

1. What did you find most satisfying about your job as a nurse?

2. What’s the least satisfying aspect of your job?

3. Do you get the respect you deserve from the society?

3.(a) If yes, how do you feal it when they give respect?

3.(b) If No, how do they approach you?

4. Do you feel your hospital provides nurses with adequate training?

5. What are the benefits you got as a nurse?

6. Do you think that your job satisfaction matter to patients?

 6.(a) If yes, why do you think so?

Stress:

7. How do you treat your patients when you are stressed?

8. Does the patients’ condition make you stressed?

8.(a) If yes, can you briefly explain about those situations?

9. Have you ever been Covid positive?

9.(a) If yes, how did you overcome it?

10. If you are tensed how long can it lasts?

11. Do you often feel some warning signs for stress?

11.(a) If yes, what are them?

12. Do you think it would be nice to get a break at least once in a while?

13. Do you ever observe yourself?

13.(a) If yes, what do you usually feel about your moods and feelings?

14. Have you ever felt that your emotions interfere with your decision making?

14.(a) If so, what are the most common causes of it?

15. Have you ever wondered why it is just stressful for every single thing?

Daily Life:

16. Have you been on duty since Covid started?

16.(a) If not, when did it started?

17. Do you feel isolated on your way back from the hospitals?

17.(a) If yes, which are those situations?

18. How does the Covid patients behaves towards you?

19. Do you get enough time to do personal hobbies?

19.(a) If yes, what is your hobbies?

 19.(b) How do you find time for your personal hobbies in between your duties?

19.(c) If No, do you just ignore those situations or if you don’t get enough time?

20. Have you ever tried to make some notes about your achievements and abilities?

20.(a)If yes, you are making notes for what?

Family:

21. How does the family behaves when you came back home after your duty?

22. Have you got a place appropriately when you were in need of a quarantine?

22.(a) If yes, can you tell me about that place?

23. Do you try to share your problems with your family if things are bothering you?

23.(a) If yes, what support do you get from them?

Coping Strategies:

24. When will you get some relaxation?

24.(a) You gets relaxed while you are doing what?

25. What are the mechanisms you choose to cope with a stressful situation?

25.(a) Whether those taken mechanism becomes effective or not?

25.(b) If yes, how does it helps you to lead a good life?

26. When negative thoughts become a continuing pattern, do any drugs seem to be used?

26.(a) If yes, which drug you prefers mostly?

26.(b) If No, what have you done not to think about drugs?

27. Have you experienced changes in your confidence when you are able to overcome a
stressful situation?

27.(a) If yes, what are those changes?

28. Have you visualized sitting calm while you are in a stressful situation?

28.(a) If yes, can you tell me what relief you got while that visualizing?

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