Stress and coping of Hong Kong Chinese family members during a critical illness


  • Winter Y-Y Chui MN, RN,

  • Sally W-C Chan PhD, RN

Professor Sally Wai-Chi Chan
Room 732
Esther Lee Building
The Nethersole School of Nursing
The Chinese University of Hong Kong
New Territories
Telephone: +852 260 96222


Aim.  The present study aimed to investigate the stress and coping strategies of Hong Kong Chinese families during a critical illness and to examine the relationships between stress and coping.

Background.  Admissions to intensive care unit are usually an unanticipated event, which imposes stress on the family. Family's wellness is one of the significant factors affecting patient's well-beings. Much work has been conducted in Western societies. Stress and coping in Chinese families of critically ill patients have rarely been discussed.

Method.  Structured face-to-face interviews were conducted, using the Impact of Events Scale and the Family Crisis Oriented Personal Evaluation Scales. A convenience sample of 133 participants was recruited from a regional hospital in Hong Kong. Many were patients’ children with age between 30 and 49. A total of 39·1% (n = 52) of the participants were males and 60·9% (n = 81) were females.

Results.  The participants experienced high level of stress (mean = 25·1, SD = 8·3). Higher level of stress were experienced by female (t = −4·6; d.f. = 1, 131; P = 0·00), those with lower educational attainment (F = 3·0; d.f. = 2, 130; P = 0·05) and those whose relatives were admitted to the intensive care unit unexpectedly (t = −2·2; d.f. = 1; P = 0·03). Patients’ length of stay in the unit was significantly correlated with levels of stress (r = 0·5, P < 0·00). Level of stress had significant correlation with coping strategies utilization (r = 0·5, P < 0·00). Reframing strategies were frequently used whereas the passive appraisal strategies were least used. Family members used positive-coping strategies, which concurred with the Chinese stress–coping pattern ‘fatalistic voluntarism’.

Relevance to clinical practice.  This study contributes to the understanding of Hong Kong Chinese families’ stress and coping during a critical illness. Comprehensive assessments of family members’ psychosocial needs are important to plan appropriate interventions to alleviate their stress and strengthen their coping skills. The findings will serve as guidance for nurses in delivering culturally sensitive and competent interventions.