Defence Mechanisms and Coping Strategies among Caregivers in Palliative Care Units

This article focuses on the relationship between defence mechanisms, coping strategies, palliative attitude, and the well-being of caregivers in palliative care units, who are confronted with death, suffering, and pain. They use many different defence mechanisms; however, studies linking their coping strategies and defence mechanisms are rare. This study uses a quantitative and qualitative design and is based on 18 caregivers (nurses) in 2 palliative care units in Belgium. Defence mechanisms are tested through a semi-structured interview, TAT, and DSQ-60. Coping strategies are evaluated through a semi-structured interview, COPE, and WCO. To maximize our global approach, coping strategies and defence mechanisms are associated with measures of wellbeing and palliative attitude. We determined that defence mechanisms and coping strategies should not be seen as obstacles to professional practices. Palliative caregivers are more likely to adopt "mature" and "mental inhibition and compromise formation" defence mechanisms, as well as "emotion-focused" and "problem-focused" coping strategies. Defence mechanisms are more unconscious and constitute appropriate answers in extreme emotional situations. Coping strategies allow for more conscious processes of adaptation to the environment of palliative care units. This study shows positive relationships between different defence mechanisms and coping strategies, palliative attitudes, and caregivers' well-being. Institutions should improve the conditions for group exchange and for caregivers' individual introspection so that caregivers develop adapted capacities to cope with anxiety.