Final: Stress and Coping Flashcards
Stress
An actual or alleged hazard to the balance of homeostasis
Homeostasis
The state of steady internal, physical, chemical, and social conditions maintained by living systems
Stressors
The Force causing the stress
Physical, psychological, or social stimuli that can produce stress and endanger homeostasis
Can range in strength, scope, & duration
Appraisal
How a person interprets the impact of the stressor
Personal Evaluation
When does stress occur
When an individual considers the event as a threat and the ability to respond to the demands placed on the individual by the event to be overwhelming
Trauma
When symptoms of stress persist beyond the duration of the stressor
Eustress
-Positive stress
-Within coping ability
-Motivate
-Improve performance
Distress
-Negative stress
-Outside of coping ability
-Anxiety/ concern
-decrease performance
Acute stress
Stress experienced on a daily basis from minor situations
Ex. Running a few minutes late to work
Ex. Important meeting
Ex. Waking up for exam
Chronic Stress
Stress experienced on an ongoing basis (typically >6 months)
Post-traumatic Stress Disorder (PTSD)
-Experiences or witnesses a traumatic event and respond with intense fear or helplessness
-Ex. Motor vehicle accident, natural disasters, violence
Who is common to have PTSD
-Military Personal
-Veterans
-First Responders
-HCP
Symptoms of PTSD
-Nightmares
-Flashbacks of event
-Recurrent & intrusive recollection of event
-Emotional detachment
-Anxiety and depression
Secondary Traumatic Stress
-The trauma a person experiences from witnessing suffering of others
-A component of compassion fatigue
Symptoms of Secondary traumatic stress
-Nightmares
-Anxiety
-Trouble sleeping
-Avoid Interactions
Who is common to have Secondary traumatic stress?
HCP and First Responders
Crisis
Occurs when coping mechanisms are ineffective and a change must be made
-“Turning point”
Developmental Crisis (aka Maturational Crisis) with Examples
-Occurs when person moves through different stages of life
Ex. Stress of gaining independence, Marriage, and Kids
Situational Crisis with Examples
External crisis, typically unexpected trauma
Ex. Car Crash, Medical Diagnosis, New Job
Adventitious Crisis with Examples
Events of disaster
Occurs during a Major disaster, man-made disaster, crimes of violence
Ex. COVID, Wildfires, Tornadoes, 9-11
Primary Appraisal
-Appraising the event in terms of its personal meaning
-Deciding if an event is beneficial or harmful
-Stress results when a person identifies an event or circumstance as a harm, loss, threat, or challenge
Secondary Appraisal
-Concurrently happens with primary appraisal
-A person considers available resources and coping strategies
-Stress occurs if the demands placed on the person by the event exceed the ability to cope
Coping
-Cognitive and behavioral efforts to manage a stressor
-Coping is unique for everyone
-Can be impacted by goals, beliefs, personal resources, cultural background, age, and types of stress experienced
What affects how a person reacts to a stressor?
- The Appraisal of Stressor
- Social Support
- Coping strategies
- Previous Life experiences
Situational Factors
Stressors in the workplace or adjusting to a new diagnosis
Maturational Factors
-Stressors based on life stages
-Ericksons Developmental Theory
Ex. Milestones such as beginning a family and a career, losing parents, seeing children leave home, accepting physical aging
Sociocultural Factors
Environmental, social, and cultural stressors
Ex. Poverty, Physical Disability, social isolation,
General Adaptation Syndrome (GAS)
-A 3-stage reaction to stress (Alarm, Resistance, Exhaustion)
-Triggered by a physical (direct) or psychological (indirect) event
-Body is trying to return to allostasis (balance)
The _______ initiates the General Adaptation Syndrome after encountering a physical demand
Pituitary Gland
Alarm Stage of GAS
-CNS is aroused
-Body defenses are mobilized
-“Fight or Flight”
Resistance Stage of GAS
-The body stabilizes and responds
-Body is compensating for the changes that occurred during alarm stage
-If stressor isn’t alleviated in this stage will progress to Exhaustion stage
Exhaustion Stage of GAS
-Continuous stress causes a breakdown of compensatory mechanisms
-Can no longer adapt to the stressor
What physiological problems come from the exhaustion stage?
-Sleep Problems
-Chronic Hypertension
-Chronic Fatigue
-Autoimmune problems
-Depression
The stress response directly influences the
immune system
-Increases susceptibility to infection
-High blood pressure
-Diabetes
-Cancer
Compassion Fatigue
A state of burnout and secondary traumatic stress resulting from physical and mental fatigue and exhaustion
When does burnout occur?
When perceived demands outweigh perceived resources
What are symptoms of compassion fatigue?
-Irritability
-Restlessness
-Inability to focus and engage with others
Second victim syndrome
-When a medical error occurs that inflicts significant harm on a patient and the patients family
-Can sustain complex psychological harm that can lead to detrimental outcomes such as suicide
Symptoms of Second victim syndrome
-Similar to PTSD
-Nightmares
-Flashbacks of event
-Recurrent & intrusive recollection of event
-Emotional detachment
-Anxiety and depression
Assessment of stress and coping
-Sensitive topic
-Establish trust nurse-client relationship
-Seen alot in ER
-Assess subjective findings
-Assess objective findings
-Consider the environment
-Use open ended questions
Assessment of stress and coping: Subjective
- Stressors and clients perception of the event
- Available situational supports
- Methods of coping
- Suicidality /homicidal thoughts
Assessment of stress and coping: Objective
- Appearance
- Nonverbal Behavior
Assessment of stress and coping: Environment
-Nonthreatening
-Quiet
-Feels safe
-Comfortable
-Sit at height of pt
-Eye contact
-Time
-No interupptions
Planning phase of stress and coping
-Set priorities and develop goals together with the client
-State goal in term of client
-Broad Goal to reduce problem or enhance strength
-SMART goals
-One behavior per objective
Implementation phase of stress and coping
Put it into action
Educate
Interventions
Stress management
Evaluation phase of stress and coping
-Does the patient believe their stress has been reduced?
-Empower the patient
-Coping with stress takes time
