Stress, appraisal and coping in nursing home residents relocated to hospitals: Outline of a research project in progress   

Janig H., Kada O.
First author's affiliation: Alps-Adriatic University of Klagenfurt, Klagenfurt, Austria

Nursing home residents are frequently relocated to hospitals; a substantial proportion of these hospitalizations is potentially preventable (Grabowski et al., 2008). For Europe there is a lack of data in this area (Ramroth et al., 2006). A hospital stay itself can lead to functional decline in the elderly (Creditor, 1993) and hospitalization adds a change in environment and habits and a dependence on others (Bruchon-Schweitzer et al., 1995). Terms like ‘relocation stress’ or ‘transfer shock’ indicate the assumed negative consequences associated with relocation and hospitalization (Castle, 2001; Manion & Rantz, 1995). Many empirical work was done on mortality and morbidity in the elderly following relocation (Castle, 2001), but little is known about the stress process during such experiences. According to Lazarus and Folkman (1984) appraisal and coping are essential components of the stress process. Self-constructed items and open-ended questions are used to assess the stressors experienced by hospitalized nursing home residents as well as primary appraisal (threat, harm/loss, and challenge), secondary appraisal and the employed coping strategies. Perceived stress is measured by the German version of the Perceived stress questionnaire (PSQ; Fliege et al., 2001). The Sense of coherence (SOC; Antonovsky, 1997) – a protective factor regarding stress – is assessed using the SOC-L9 (Singer & Brähler, 2007). Lazarus (2000) points out the importance of multiple assessments in order to be able to capture changes in the stress experience as the situation proceeds. Hence, in the present study subjects are interviewed shortly after admission (t1) and after a few days of familiarization (t2). Additionally, in a second step, the documentations of a Carinthian hospital are analysed to describe the frequency of patient transfers from nursing homes to hospitals as well as patient characteristics and the proportion of potentially avoidable transportations.