Effects of attribution and appraisal of control on emergency department nurse stress when treating patients with severe mental illness

ABSTRACT

As the prevalence of severe mental illness continues to rise and access to mental health care is scarce, an increasing number of U.S. adults seek treatment in emergency departments. Nurses who triage the severity of a medical emergency may appraise the situation both through the lens of mental illness stigma and the degree of confidence they have to control the outcome. However, the research community knows little about the extent to which attribution and appraisal of control affect nurses' appraisal of stress. The purpose of this quantitative nonexperimental, canonical correlational study was to examine the extent to which various combinations of attribution and control predicted different types of appraisals of stress among emergency department nurses treating patients with severe mental illness. Grounded in attribution theory and the cognitive-relational theory of stress and coping, the research was focused on revealing the effect conscious and unconscious thoughts and feelings have on anticipatory stress and resulting behavior. The sample included 133 nurses from a large nonprofit Catholic health system in the U.S. Midwest. A canonical correlation analysis examined the multivariate relationships of nurses' appraisal of control and attribution in predicting primary appraisal of stress. The overall canonical correlation was statistically significant, Wilks's LAMBDA = .19, F(33.0, 351.3) = 8.03, p < .001;therefore, the null hypothesis was rejected. By developing literacy of mental illness to diminish stigma and equipping clinicians with the tools to confidently and competently feel in control, there is an opportunity for positive social change by minimizing the negative appraisal of threat, thus reducing occupational stress and improving quality of care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)