Impact of Coping Strategies on Nurses’ Well-Being and Practice

Tony Szu Hsien Lee, Wen Chii Tzeng, Hui Hsun Chiang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)


Objectives: To examine the mechanisms of coping strategies on nurses’ psychological well-being, practice environments and safety attitudes. Methods: A cross-sectional study design was used. Structural equation modeling was performed to analyze the results. Five hundred clinical nurses were randomly selected from a large group of 1,500 from a medical center with 1,350 beds in Taipei, Taiwan, from July to October 2015. Self-report questionnaires were administered to measure coping strategies (Brief COPE), psychological well-being (Ryff's Psychological Well-being Scale), nurses’ practice environments (Practice Environment Scale of the Nursing Work Index), and safety attitudes (Safety Attitudes Questionnaire). Results: Of the 500 participants who gave written consent, 474 (94.8%) filled out the questionnaire. Results showed that using more approach-oriented coping strategies and fewer avoidant coping strategies was associated with greater psychological well-being. Psychological well-being was directly associated with quality of nurses’ practice environments and safety attitudes. The impact of psychological well-being on safety attitudes was mediated significantly by the quality of the practice environment. The use of approach-oriented coping strategies was significantly predictive of positive psychological well-being, a good practice environment, and good safety attitudes. Conclusions and Clinical Relevance: This study found a distinct pathway for the relationships between clinical nurses’ psychological well-being, practice environment, and safety attitudes. Psychological well-being in clinical nurses was higher for those with more approach-oriented coping strategies. Psychological well-being directly impacted safety attitudes, which mediated nurses’ practice environments. The practical implications of the results suggest that interventions designed to promote positive psychological well-being may help improve nurses’ practice environments, which, in turn, may result in better safety attitudes and nursing care outcomes.

Original languageEnglish
Pages (from-to)195-204
Number of pages10
JournalJournal of Nursing Scholarship
Issue number2
Publication statusPublished - 2019 Mar


  • Nurses
  • practice environment
  • psychological well-being
  • safety attitudes
  • stress coping

ASJC Scopus subject areas

  • General Nursing


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