# Situation: The nurse in a community mental health program leads a psychoeducation session for families of service users about stress and mental illness. A mother says her greatest worry is that she can no longer afford her son's monthly maintenance medicines. Which response by the nurse uses the type of coping that BEST fits this stressor?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=629971  
> language: ko  
> subject: Nursing Practice V — Care of Clients with Maladaptive Patterns of Behavior; Care of Clients with Life-Threatening Conditions, Acute Multi-Organ Problems, High Acuity and Emergency Situations

## 문제

Situation: The nurse in a community mental health program leads a psychoeducation session for families of service users about stress and mental illness.

A mother says her greatest worry is that she can no longer afford her son's monthly maintenance medicines. Which response by the nurse uses the type of coping that BEST fits this stressor?

## 보기

1. Invite her to a caregivers' prayer and sharing group
2. Refer her to the hospital's medicine assistance office **✔ 정답**
3. Encourage her to talk about her fears with the family
4. Teach her slow breathing to use when she feels worried

**정답: 2**

## 해설

The transactional model of stress separates problem-focused coping, which changes the stressor, from emotion-focused coping, which manages the feelings it causes. The cost of medicine is a stressor that can be changed, so problem-focused coping that removes the barrier fits best; emotion-focused strategies suit stressors that cannot be changed.

## 심화 해설

Match the coping style to the stressor
In the transactional model of stress, a person first appraises whether a situation is threatening and then whether it can be changed. Problem-focused coping acts on the stressor itself to change or remove it, while emotion-focused coping manages the feelings the stressor causes. The mother's stressor, the cost of her son's maintenance medicines, is something that can be changed, so problem-focused coping that removes the barrier fits best. Referring her to the hospital's medicine assistance office directly addresses the cause of her worry.

Why the fit matters
Coping is most effective when its type matches how controllable the stressor is. When a problem can be solved, such as by finding financial help, problem-focused coping reduces stress at its source. When a stressor cannot be changed, such as a chronic diagnosis or a death in the family, emotion-focused coping helps the person tolerate what cannot be altered. Using only emotional support for a solvable problem leaves the problem in place, and the stress returns.

| Response | Type of coping | Changes the stressor? |
| --- | --- | --- |
| Prayer and sharing group | Emotion-focused | No |
| Referral to medicine assistance office | Problem-focused | Yes |
| Talking about fears with the family | Emotion-focused | No |
| Slow breathing when worried | Emotion-focused | No |

Why the other responses rank lower
A caregivers' prayer and sharing group gives comfort and support, talking with the family lets her express fear, and slow breathing eases the physical feeling of worry. All three are useful, and the nurse may offer them as well, but each manages emotions while the cost of medicine remains unsolved. If the son runs out of medicines, the risk of relapse rises, which would add a new stressor.

Watch out! In psychoeducation for families of people with mental illness, practical barriers such as cost, transport, and access to medicines are common causes of relapse. Linking families to financial assistance and social services is part of the nurse's role.

Exam takeaway
Key point! Problem-focused coping fits stressors that can be changed; emotion-focused coping fits those that cannot. When the question asks for the coping type that best fits the stressor, first decide whether the stressor is controllable.

## 임상 시나리오

Problem-Focused CopingMatching coping to a changeable stressor
Problem-focused coping changes or removes the stressor. Emotion-focused coping manages the feelings it causes.

The cost of maintenance medicines can be changed, so referral to the medicine assistance office fits best and also protects the son from relapse.

Prayer groups, talking about fears, and relaxation are emotion-focused. They support her but leave the cost unsolved.

CautionFor a stressor that cannot be changed, emotion-focused coping is the better fit.

## 핵심 개념

- **Transactional model of stress** — A model in which stress depends on how a person appraises a situation and the resources to cope with it.
- **Problem-focused coping** — Coping that acts on the stressor to change or remove it.
- **Emotion-focused coping** — Coping that manages emotional distress when the stressor itself cannot be changed.
- **Psychoeducation** — Structured teaching for clients and families about mental illness, treatment, and coping.

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