Week 6 Stress and Coping Flashcards
Stress
an actual or alleged hazard to the balance of homeostasis in our body
Homeostasis
state of steady internal, physical, chemical, and social conditions maintained by living systems
Stressors
physical, psychological, or social stimuli that can produce stress and endanger homeostasis
Eustress
positive form of stress, serves a benefit
Distress
negative form of stress, does not serve a benefit
Appraisal
how a person interprets the impact of the stressor
Stress occurs 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
Acute stress
stress experienced on a daily basis from minor situations
Chronic stress
stress experienced on an ongoing basis (>6 months)
Post Traumatic Stress Disorder (PTSD)
begins when a person experiences or witnesses a traumatic event and they respond with an intense fear or feel intense feeling of helplessness
- traumatic events such as MVA, natural disaster, person violent or assault
- common among HCP, veterans, first responders
Secondary traumatic stress
The trauma a person experiences from witnessing suffering of others
- component of compassion fatigue
- common among HCP and first responders
- nightmares, difficulty relating, difficulty sleeping, withdraw
Crisis
occurs when coping mechanisms are ineffective and a change must be made
Developmental crisis
also called maturational crisis
- occurs when a person moves through different stages of life
Situational crisis
external crisis, typically unexpected trauma
Adventitious crisis
also called events of disaster
- occurs during a major national disaster, man-made disaster, crimes of violence
Primary appraisal
- appraising the event in terms of its personal meaning
- stress results when a person identifies an event or circumstances 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 demand of the event placed on the person exceeds their ability to cope
Coping
- cognitive and behavioral efforts to manage a stressor
- coping is unique for everyone, and can be impacted by goals, beliefs, personal resources, cultural background, age, and types of stress experienced
- there are good coping mechanisms and bad coping mechanisms
- coping can decide if something is a stressor or not
Factors Influencing Stress and Coping
the appraisal of stressors, the amount of type of social support, and coping strategies all depend on previous life experiences and affect how a person reacts to that stressor
- situational and social stressors place people who are vulnerable at higher risk for prolonged stress
- very unique from person to person
- not a one size fits all
Situational factors
- stressors in the workplace
- adjusting to a new diagnosis
Maturational factors
- stressors based on life stage
- Erikson’s developmental theory
- may include many milestones such as beginning a family and career, losing parents, seeing children leave home, accepting physical aging
Sociocultural factors
- environmental, social, and cultural stressors
- examples - poverty, physical disability, social isolation
General Adaptation Syndrome (GAS)
- 3 stage reaction to stress
- triggered by a physical or psychological event
- big in neuroendocrine system
- pituitary gland initiates the GAS after encountering a physical demand
- involves several body systems in responding to stress
- body is trying to return to allostasis
First stage
alarm stage
- central nervous system is aroused
- body defenses are mobilized
- fight or flight (freeze)
Second stage
resistance stage
- body stabilizes and responds
- body is compensating for the changes that occurred during the alarm stage
Third stage
exhaustion stage
- continuous stress causes a breakdown of the compensatory mechanisms in our body
- can no longer adapt to the stressor
- this state is associated with physiological problems
Immune response
- stress response directly influences the immune system
- stress causes prolonged changes in the immune system
- impairs immune function
- increases susceptibility to infection, high BP, diabetes, and cancer
Compassion fatigue
- a state of burnout and secondary traumatic stress resulting from physical and mental fatigue and exhaustion
- burnout occurs when perceived demands outweigh perceived resources
- feelings of irritability, restlessness, and inability to focus, and engage with others
- often affects HCP and other caregivers due to the nature of the work
Second victim syndrome
when a medical error occurs that inflicts significant harm on a patient and patient’s family
- can sustain complex psychological harm that can lead to detrimental outcomes such as anxiety, depression, and suicide
- can lead to symptoms similar to PTSD
Assess (subjective findings)
- stressors and client’s perception of the event
- available situational support
- methods of coping
- suicidality/homicidal thoughts
Assess (objective findings)
- pt’s appearance
- nonverbal behaviors
Assessment of stress and coping
- sensitive topic
- assess subjective and objective data
- consider the environment
- use open ended questions
Planning
- setting priorities and develop goals with the client
- state goal in terms of the client
- state goal broadly in terms of reducing the problem or enhancing the strength that was noted in dx
- set objectives with the client to achieve the goal
- SMART goals, 1 behavior per objective
Implementation
Health Promotion perspective
- regular exercise and rest, support systems, time management, guided imagery, visualizations, progressive muscle relaxation therapies, journal, mindfulness based stress reduction
- acute care - crisis intervention
- Restorative and continuing care = long-term impact of the crisis
Evaluation
- through the pt’s eyes, has the stress been reduced
- patient outcomes
- coping with stress takes time
- empowering the pt
Allostasis
the means by which homeostasis is reestablished, maintains stability
Physiological stress
body’s potentially harmful reaction to a stimuli
Psychological stress
Comprises the emotional and cognitive factors involved in the appraisal of a threat
Sociocultural stress
Occurs when social systems are challenged by factors such as racism, economic hardship, or political upheaval.
Fight or flight
- raising blood pressure, heart rate, respirations, and cardiac output,
- decreasing gastric motility and blood flow to the skin, and
- dilating the pupils.
Individual factors influencing stress response
- Nutrition status
- Genetic predisposition
- Stress appraisal, the person’s attribution of meaning to a stressful event
- The frequency and intensity of stress
- Personality factors, such as resilience, hardiness, and sense of coherence, can buffer the effect of stress
Anxiety
a response to stress that causes apprehension or uncertainty
Mild anxiety
Mild anxiety can be motivational, foster creativity, and actually increase the ability to think clearly
Moderate anxiety
Moderate anxiety narrows focus, dulls perception, and may challenge the person to pay attention or use appropriate problem-solving skills
Severe anxiety
results in the inability to make decisions or solve problems
Panic
multitude of physiologic changes as well as subjective feelings of extreme dread or terror
- causes the affected person to become immobilized and unable to concentrate, communicate, or think in a rational manner
Defense mechanisms
predominantly unconscious, protective coping methods that people may apply in response to a perceived threat
- defense mechanisms on a short-term basis initially may prevent harm to the person in distress
- long-term coping strategies that are based on defense mechanisms can prevent healthy growth and development.
Coping techniques
emotion focused vs. problem focused
- EF = prayer, meditation, self-blame, avoidance, talking with therapists
- PF = direct confrontation like hypervigilance, confronting others, generating solutions
Stress management approaches
- time mgmt
- anger mgmt
- support groups
- nutrition
Internal coping strategies
arise from a person’s feelings that are associated with stress
External coping strategies
arise from outside a person and can provide relief to specific stress symptoms experienced by a person
Crisis Intervention
short-term and immediate assistance provided to a person at a time of physical or emotional upheaval (e.g., death of a loved one, suicidal feelings) with the goal of helping the person who is in extreme distress regain balance
