Anxiété et coping des soignants : la prison est-elle un facteur de protection ?

Abstract

Anxiety and stress are current and real human issues. These may worsen in certain situations whereas mechanisms known as coping mediate the effect of stress and anxiety, state-anxiety more specifically. The aim of this study concerns this issue, via a research on state-anxiety and coping among nursing staff in French prisons. The nursing staff of prisons was chosen for two major reasons. First, nursing is typically described as a stressful occupation, consequently stress, coping and anxiety have been widely studied in this population. Second, prisons are generally considered as “tough” places in which the inmates are perceived as “dangerous”. Indeed, assaults occur frequently in prison. Therefore prison nursing staff should in all probability report stress and anxiety and the ways in which they try to cope with them. Consequently, the author assumed that state-anxiety levels should be high for nursing staff due to the unpredictable prison setting. The author also assumed that this staff should report emotion-focused coping instead of problem-focused coping because of the high levels of state-anxiety. The research comprised two steps. The first one was an exploratory study comprising interviews of 13 members of the nursing staff (physicians, nurses, caregivers, etc.) working in a French prison in the north of France. The author reviewed all stressful events and how the staff coped with them. Then a coping inventory was designed on the basis of the “Way-of-Coping Check-List”. This was accomplished by a re-transcription of the coping cases collected during the interviews. The second study was experimental. Fifty other members of the nursing staff working in other prisons in the north of France were involved. They were asked to fill out the “state form” of the STAI-Y and the Coping Inventory. The effects of demographic and “prison-inmate” variables on state-anxiety and coping were analysed. The results do not support the author's assumptions. First of all, state-anxiety levels remained low in the sample. There were no significant differences between the subjects’ state-anxiety levels according to demographic and prison-inmate variables. Second, contrary to the assumptions, nursing staff used problem-focused coping more frequently than emotion-focused coping. Coping frequencies used did not differ according to the demographic variables but according to the prison-inmate variables. In fact, nursing staff in jail more frequently use problem-focused coping than prison nursing staff. In fact, permanent prison nursing staff use problem-focused coping more frequently than part-time nursing staff. Moreover, nursing staff who work with inmates every day use problem-focused coping more frequently than nursing staff who work with inmates part-time. The author discusses and explains the results on the basis of the cognitive-transactional theory of stress and coping, and of anxiety and the cognitive construction of danger (cognitive evaluation of the prison and the inmates). The results are likely to have implications on psychotherapy and staff training.