Stress and Coping Flashcards
What are the effects of short/medium term stress?
– immune system upregulated
– prepare to repair damage and resist infection: cell mediated
immunity e.g. lymphocytes
– prepare to fight off pathogens: antibodies, B-cells
What are the effects of long term stress?
depressed immune function, inflammation: cortisol
IT IS DAMAGING
Draw the transactional model of stress
See notes Demands Resources Appraisal Stress response
Describe the process of appraisal
Primary Appraisal
– Is this event a threat? How bad could it be?
(benign, challenging, threatening)
Secondary Appraisal
– Do I have the resources or skills to cope?
Reappraisal
– Reconsider the situation once have tried to cope with it (may
decide it’s more or less stressful than thought)
What factors cause stress in individuals?
Features of the stressor – Novelty – Unpredictability / ambiguity – How important (salience) – Control Individual differences – How stressed already (overload) – Personality characteristics e.g. optimism hardiness – Resources social support, time, money, health, education etc – Coping strategies
Name the 4 ways Cox et al identified how stress impacts health
- Physiological responses causes physical damage, especially when intense and/or prolonged
- Effects on the immune system can increase vulnerability to infection
- Coping efforts: increase in unhealthy behaviour
- Negative impact on mental health (e.g. anxiety, depression) affecting coping and illness behaviour
Give examples of stress management
Cognitive strategies - e.g. cognitive restructuring, hypothesis testing
Behavioural strategies – skills training e.g. assertiveness, time-management
Emotional strategies – counselling, emotional disclosure, social support
Physical strategies – relaxation training, biofeedback, exercise
Non-cognitive strategies – drugs
What is regarded as stress promoting behaviour?
Smoking
Alcohol
Unhealthy eating
Reduced exercise
What is coping?
- Coping is about finding ways to manage events/experiences that are appraised as threats or demands, and which tax or exceed a person’s available resources
- Strategies to reduce or deal with the threat or, increase resources
Name life events that patients have to cope with
Family - bereavement, divorce, pregnancy
Workplace - dismissal, retirement, change in responsibility
Personal - imprisonment, xmas
Financial - mortgage, financial state
Name illness related events that patients have to cope with
Diagnosis
Physical impact
Treatment
Hospitalisation
How can you aid coping?
Increase/mobilise social support
Increase personal control
Prepare patients for stressful events (reduce ambiguity)
What is problem focused coping?
CHANGE THE PROBLEM OR RESOURCES
- Reduce demands of a stressful situation e.g. find out how to cope with feelings of claustrophobia in mask for radiotherapy
- Expand resources to deal with it e.g. if mobility a problem, focus on physiotherapy exercises, but a motorised wheelchair etc.
What is emotion focused coping?
CHANGE THE EMOTION
Behavioural approaches; do something e.g. talking to friends, alcohol, finding a distraction
Cognitive approaches: change how you think about the situation, e.g. denial, focus on positive aspect of problem – have to give up job you don’t like, chance to do something different
What are 5 stress managing techniques?
–Cognitivestrategies
•e.g.cognitiverestructuring,hypothesistesting
– Behaviouralstrategies
• Skillstraining
–Emotionalstrategies
• Counselling,emotionaldisclosure,socialsupport
–Physicalstrategies
• Relaxationtraining,biofeedback,exercise
– Non‐cognitivestrategies
• Medication
What can be an emotional response to chronic illness?
Anxiety and depression
Why is it important to treat anxiety and depression?
Compromises quality of life
Patients cope less well with treatment
Association with poor HRB e.g. drinking, smoking (HRB= health related behaviour)
Association with lower adherence to treatment
Increased risk of morbidity and mortality
