Unit I (d) Stress and Coping
Tanzeel Ul Rahman
Nursing Instructor
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Tanzeel Ul Rahman Nursing Instructor
OBJECTIVES
At the end of this session the learner will be able
to:-• Define stress.
• Demonstrate understanding of different forms of stress.
• Describe nature of stressor. • Identify causes of stress.
• Discuss effects of stress on human body.
Introduction
Stress is any change in the environment that requires your body to react and adjust in response. The body reacts to these changes with physical, mental and emotional responses
Definition
The nonspecific response of body to any kind of demand made upon it.
(Selye 1956,1974)
Stress is the wear and tear that life causes on the body
Definition cont
….
A stimulus, a life event or a set of circumstances that arouses physiological and/or psychological reactions that may increase the individual’s vulnerability to illness.
Examples of Stress
Causes of Stress
Stress is conventionally divided into two types
• Physiological stress: It includes temperature, noise, hunger, disease.
STRESSOR
• Events that produce physical and psychological demands on a person
• Situations, activities, and relationships that
Sources of Clinical Stress
For Patient Uncertainty Fear
Pain Cost
Lack of knowledge Risk for harm
Sources of Clinical Stress
• For Nurses
Nature of Stressors
oThreat
EFFECTS OF STRESS
PHYSICAL MANIFESTATION OF STRESS
Increased heart rate.
Dilation of pupils
Dry mouth
Pilo-erection.
Sweating and sweaty palms.
Headache.
Stiff neck and/or tight shoulders.
Rapid breathing.
EFFECTS OF STRESS
• EMOTIONAL MANIFESTATION OF STRESS:
Irritability
Intolerance
Short Temper
Exhaustion
Lack of concentration
Frustration over minor challenges
Anger, Apprehension, anxiety, fear
EFFECTS OF STRESS
• BEHAVIOURAL MANIFESTATION OF STRESS:
Social withdrawal.
Poor sleeping
Poor eating habits
Smoking
Drug abuse
BEHAVIOURAL MANIFESTATION
CONTI
….
Talking too fast
Over reacting
Defensive
Burnout
Grinding teeth
EFFECTS OF STRESS
EFFECTS ON PERFORMANCE:
Decrease effectiveness
Poor judgments
Poor decisions
Short attention span
Poor concentration
Low self confidence
Increase absenteeism
LONG TERM EFFECTS
Long terms effects of stress are harmful, a persons
Become depressed
Feel helpless/hopeless
Explosive/impulsive
Personality changes
Mental illness
LONG TERM EFFECTS CONT…
Physical Conditions Related to
Stress:-• Heart diseases
• Gastrointestinal problems
• Skin problems
• Diabetes
• Immune system diseases/Infections
• Chronic pain
FORMS OF STRESS
Eustress
• Good stress.
• Moderate levels of stress may actually improve performance and efficiency
Example
Getting nervous in anticipation of an
FORMS OF STRESS
Distress
Too much stress may cause an unproductive anxiety level
Examples
FORMS OF STRESS
• Too little stress may result in boredom
Generalized Adaptation Syndrome
PHYSIOLOGICAL RESPONSE OF
BODY TO STRESS
STAGE I- ALARM REACTION
Fight and flight response which alert the body against stressor.
ANS react and release large amount of adrenaline and cortisone.
PHYSIOLOGICAL RESPONSE OF
BODY TO STRESS
STAGE II- STAGE OF
ADAPTATION/RESISTANCE:
PHYSIOLOGICAL RESPONSE OF
BODY TO STRESS
STAGE III- STAGE OF EXHAUSTION:
Stress in Critical Care
Pathophysiology of stress
Anxiety
• Anxiety is an emotional state of apprehension in response to a real or perceived threat that is associated with motor tension, increased sympathetic activity, and hyper vigilance It is important to assess patients and family members for anxiety. The top five physiological and behavioral indicators of anxiety are
• Agitated behavior,
• Increased blood pressure,
• Increased heart rate,
Stress Management and Coping
Management of stress and anxiety entails
eliminating or minimizing the stressors. For the critically ill patient,
• Providing supportive care (eg, nutrition,
oxygenation, pain management, sedatives, and anxiolytics) is indicated.
• Mind–body strategies that may be employed to lessen stress and anxiety.
Stress Management and Coping
• Fostering trust. When patients or family
Stress Management and Coping
• Providing information. Anxiety can be greatly
relieved with simple explanations. Critically ill patients and their family members need to know what is happening at the moment, what will happen to the patient in the near future, how the patient is doing, and what they can expect. Many patients also need frequent explanations of what happened to them.
Stress Management and Coping
References
• Semple, D. & Smyth, R. 2013. Oxford handbook of psychiatry, Oxford University Press.
• Videbeck, S. 2013. Psychiatric-mental health nursing, Lippincott Williams & Wilkins.
• Reference: Morton, P. G., & Fontaine, D. K. (2013). Essentials of critical care nursing: Wolters Kluwer Health/Lippincott Williams & Wilkins.