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Concept of Anxiety
 

Concept of Anxiety

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    Concept of Anxiety Concept of Anxiety Presentation Transcript

    • CONCEPT OF ANXIETY Prepared by: Eric F. Pazziuagan, RN, MAN
    • Anxiety The initial responses to a psychic threat (Peplau).  Anxiety in response to stress is inevitable in everyday life.  The way in which individuals cope with anxiety and stress is important in understanding the quality with which individuals are functioning in their personal, social, and occupational roles. 
    • LEVELS OF ANXIETY
    • Mild: +1  Psychomotor symptoms: ◦ Preparation of body for constructive action. ◦ Slight muscle tension. ◦ Slight fidgeting. ◦ Energetic. ◦ Good eye contact.
    •  Emotional symptoms: ◦ Occasional slight irritability. ◦ Feeling challenged. ◦ Confident (Use of adaptive coping mechanisms)  Cognitive symptoms: ◦ ◦ ◦ ◦ ◦ ◦ Alertness Awareness of surroundings Concentration Accurate perceptions Attentiveness Logical reasoning and problem-solving skills
    •  Interventions: ◦ Discuss source of anxiety (steps of learning) ◦ Problem solve ◦ Accept anxiety as natural; tolerate and benefit from it.
    • Moderate: +2  Psychomotor Symptom: ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Preparation of body for protective action. Moderate muscle tension. Increased BP, pulse, and respirations. Startle reflex. Slight perspiration. Difficulty sitting still. Repeated fidgeting. Periodic slow pacing. Increased rate of speech. Sporadic eye contact.
    •  Emotional symptoms: ◦ Feeling uncomfortable, on edge, keyed up ◦ Motivated to decrease anxiety. ◦ Increased irritability. ◦ Decreased confidence (use of palliative coping mechanisms).
    •  Cognitive symptoms: ◦ Difficulty in concentrating ◦ Easily distracted, can focus with assistance ◦ Circumstantiality ◦ Tangentiality ◦ Loose associations ◦ Narrowed perceptions ◦ Decreased attention span ◦ Misperception of stimuli ◦ Problem solving and reasoning skills with effort, or assistance.
    •  Interventions: ◦ Decrease anxiety- ventilation, crying, exercise, relaxation techniques. ◦ Refocus attention; relate feelings and behaviors to anxiety; then use problem-solving techniques; give oral medication, if needed.
    • Severe: +3  Psychomotor signs: ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Preparation of body for fight or flight. Extreme muscle tension. Increased perspiration. Continuous and rapid pacing. Reflex responses. Loud or rapid speech, or both. Poor eye contact. Somatic symptoms. Sleep disturbance.
    •  Emotional symptoms: ◦ Extreme discomfort. ◦ Feeling of dread. ◦ Hypersensitivity. ◦ Defensiveness with threats and demand. ◦ Use of maladaptive coping mechanisms.
    •  Cognitive symptoms: ◦ Distorted perceptions. ◦ Difficulty focusing, even with assistance. ◦ Flight of ideas. ◦ Ineffective reasoning and problemsolving skills ◦ Disorientation. ◦ Delusions and hallucinations, if prolonged. ◦ Suicidal or homicidal ideations, if prolonged.
    •  Interventions: ◦ Decrease anxiety, stimuli and pressure. ◦ Use kind, firm, simple directions. ◦ Use time out (seclusion) ◦ Give intramuscular medications, if needed.
    • Panic: +4  Psychomotor symptoms: ◦ Actual flight, fight, or immobilization. ◦ Suicide attempts or violence. ◦ Depletion of body resources. ◦ Eyes fixed. ◦ Hysterical or mute. ◦ Incoherent.
    •  Emotional symptoms: ◦ Feeling overwhelmed and out of control. ◦ Rage ◦ Desperation. ◦ Feeling totally drained (Use of dysfunctional coping mechanisms)
    •  Cognitive symptoms: ◦ Disorganized perceptions ◦ Disorganized or irrational reasoning and problem solving ◦ Neologisms. ◦ Clang associations. ◦ Word salad. ◦ Out of contact with reality. ◦ Personality disorganization.
    • Interventions: ◦Guide firmly, or physically take control ◦Give intramuscular injection ◦Order restraints, if needed
    • COPING WITH ANXIETY
    • Adaptive Solves the problem that is causing the anxiety, so the anxiety is decreased. The patient is objective, rational and productive.
    • Palliative  Temporarily decreases the anxiety but does not solve the problem, so the anxiety eventually returns.  Temporary relief allows the patient to return to problem solving.
    • Maladaptive Unsuccessful attempts to decrease the anxiety without attempting to solve the problem. The anxiety remains.
    • Dysfunctional Is not successful in reducing anxiety or solving the problem. Even minimal functioning becomes difficult, and new problems begin to develop.
    • Most common adaptive techniques: Problem-solving  Assertiveness  Positive self-talk and self-acceptance  Stress and anger management  Learning skills needed for communication and relationships  Conflict management  Time management  Community living skills 
    • Assignment: Give actual patient examples of the following types of coping: 1. ◦ ◦ ◦ ◦ 2. 3. 4. Adaptive Palliative Maladaptive Dysfunctional What are the palliative techniques that can be used to decrease the effects of anxiety? What is crisis? How does it differ from stress? What are the strategies for crisis intervention?