The document outlines the Stress Adaptation Model, which describes how the body responds and adapts to stress. It discusses three stages of the stress response - alarm, resistance, and exhaustion. In the alarm stage, the body prepares for "fight or flight" through increased heart rate and adrenaline. During resistance, the body tries to adapt to prolonged stress which can weaken the immune system over time. In exhaustion, stress hormones are continually released to restore balance, but suppress the immune system. The model shows how stress can lead to illness if the stress response becomes chronic.

1. Stress Adaptation Model

2. Introduction
Stress is everywhere.
stress is impossible to avoid.
It can be acute, such as the stress that
occurs in the face of immediate danger, or it
can be chronic when a person is dealing with
a long -term stressful situation.

3. Coping and Stress
Stress—normal, automatic non-specific, local or
general reaction to any external change or
threat” Produces changes in the structure and
chemical composition of the body.
Definition: Any situation in which a nonspecific
demand requires an individual to respond or
take action.
• It involves physiological and psychological
responses.
• Stress can be positive or negative.
• Sympathetic nervous system takes over: flight,
fright, or fight.

4. Coping and Stress..
People react in different ways to stressors:
1. people always try to adapt to stress
2. attempts at adaptation lead to new stressors
3. stresses can be so severe or so prolonged they
can overwhelm adaptive capabilities of most
well-adjusted individuals.
• Stress over a long period of time can cause
changes in the body.
• Can cause illnesses.

5. Coping and Stress…
• Stressors—the stimuli preceding or
precipitating a change.
• Examples: physiological, psychological, social,
environmental, developmental, spiritual, cultural
• Internal stressors—originate inside a person.
Example: fever or guilt
• External stressors—originate outside a person.
Example: environmental temperatures, change
in family role, peer pressure
• Physiological adaptation—the body’s ability to
maintain a state of relative balance-
homeostasis.

6. Levels of Stress
• Mild stress— that everyone encounters
regularly. Situation usually lasts a few minutes to
a few hours.
• Not significant by themselves, but multiple mild
stressors over a short time can increase risk of
illness.
• Moderate stress—lasts longer, from several
hours to several days.
• Severe stress—chronic situations that may last
several weeks to several years.
• The more intense and longer the stress
situation, the higher the health risk.

7. Levels of Stress..
• The response to any stressor depends on
our internal makeup-- physiological
functioning, personality, and behavioral
characteristics, as well as the nature of the
stressor.
• The nature of the stressor involves:
intensity, scope, duration, number and
nature of stressors.

8. Three Stages of Stress
 An endocrinologist named Dr. Hans Selye
outlined a three stage model of the body's
response to stress.
 He called his model the General Adaptation
Syndrome.
 Understanding these three stages will give you
a better idea as to the symptoms that occur
with stress and how to manage them.

9. General Adaptation Syndrome:
1. Alarm
2. Resistance or Adaptation
3. Exhaustion

10. Alarm Stage
 This is the "fight or flight" reaction to a particular
stress.
 It may occur as a response to imminent danger,
or it may be the first stressful reaction feel upon
hearing stressful news, such as the loss of a
loved one.
 In this stage, body physical reacts to the stress
by releasing adrenaline to increase your heat
and breathing rate and help you move quicker in
a dangerous situation.

11. Alarm Stage…..
 A hormone called corticotropin is also released by
the anterior pituitary gland to help the body
prepare for danger.
 Other physical responses to stress include
butterflies in stomach, a rise in blood pressure,
dilation in the eyes, dry mouth, tensing of
muscles, and difficulty concentrating.

12. Resistance or Adaptation Stage
 During this stage, body is still on alert for
imminent danger.
 If this stage of stress becomes prolonged, such
as when dealing with a long-term stressful
situation, body will become taxed by the
physical responses.
 Over time, your immune system may become
compromised, leaving you more susceptible to
illness.
 It only takes a few days in the resistance and
adaptation stage for the immune system to
become weakened.

14. Exhaustion Stage
• The final stage in the GAS is the exhaustion stage
where body readjusts to normal.
• Additional hormones, called cortisols, are released
to help relieve the damaging effects of stress.
• They are continually released until body's chemistry
comes back into balance.
• These hormones ultimately suppress the immune
system and have the potential to worsen biological
and psychological diseases and disorders.

15. MODELS OF ADAPTATION:
• Stimulus Based Model of stress: (Homes &
Rahe) cause & effect response, stress if viewed
as stimulus& results in strain.
• Focuses on disturbing or disruptive
characteristics within the environment.
1. Life change events are normal, they require the
same type and duration of adjustment
2. People are passive recipients of stress, and their
perceptions of the event are irrelevant
• All people have common threshold of stimulus
and illness results at any point after the threshold

16. MODELS OF ADAPTATION
• Response-based Model (Selye)- a model that
defines stress as a nonspecific response of the
body to any demand made on it.
• Nature of stressor, No. of stressors at one time,
duration of exposure, experience with a
comparable stressor.
• Stress is demonstrated by a nonspecific
physiological reaction, the (GAS) general
adaptation syndrome.

17. MODELS OF ADAPTATION
Two physiological responses:
1. GAS (generalized adaptation response
2. LAS (localized adaptation syndrome)

18. Generalized Adaptation
Response (GAS)
Three phases
1. Alarm reaction/shock phase reaction—
body recognizes stressors and produces
“fight or flight” reaction—release of
epinephrine.
2. State of resistance or countershock—
body adapts to stressor
3. Stage of exhaustion—alarm reaction
symptoms reappear

20. Localized Adaptation Syndrome
(LAS)
• Response is localized
• Response is adaptive—stressor must stimulate
• Short term
• Response is restorative—restores homeostasis

21. Localized Adaptation Syndrome
(LAS)
Two localized responses:
• Reflex pain response—response of the
nervous system to pain (localized)
• Inflammatory response—stimulated by trauma
or infection. Localizes= the inflammation,
prevents spread and promotes healing.
Produces pain, redness, swelling and changes
in functioning.
• Increases blood flow to area

22. Transaction Based
Model (Lazarus)
• views the person and environment in a
synamic, reciprocal interactive relationship.
• Views the stressor as an individual perceptual
response rooted in psychological and cognitive
processes.
• Function of coping is problem solving and
controlling emotional reaction.

23. Transaction Based
Model (Lazarus)…
• This is problem solving, critical thinking.
• primary appraisal—evaluate significance of
transaction—Am I in danger.
• If event is viewed as stressful, a secondary
appraisal is initiated.
• Must realize there is stress in life.
• secondary appraisal—coping decision ”What am
I going to do?”

24. Constructive vs. Destructive
Anxiety:
• Mild to moderate: can be effective, helps
to focus attention, generates energy,
motivates, contributes to growth.
• Severe anxiety and panic narrow attention;
decreases alertness and learning and can
cause total personality disintegration.
Signs and symptoms: N/v, H/A, insomnia,
diarrhea, fatigue, restlessness

25. BEHAVIORAL INDICATORS OF
STRESS
• Decreased productivity & quality of job performance
• Tendency to make mistakes
• Forgetfulness and blocking
• Diminished attention to detail
• Preoccupation—daydreaming or “spacing out”
• Reduced creativity
• Increased absenteeism and illness
• Lethargy—tired, draggy
• Loss of interest
• Accident proneness

26. PHYSICAL INDICATORS OF
STRESS
• Dilated pupils
• Diaphoretic (sweating)
• Tachycardia (fast heart rate) greater than 100
• Pale skin (vasoconstriction) less blood flow to skin
• Increased blood pressure-blood vessels constrict
(pressure goes up—has to pump harder)
• Increased respiratory rate & depth-heavy, deep
breath
• Decreased urine (blood doesn’t get to kidneys)-mild
stress can increase urinary output
• Dry mouth

27. EMOTIONAL RESPONSE TO
STRESS
• Anger—expectations not met—strong
displeasure—a mechanism of tension relief
• Depressed—anger turned inward—involves real
or imagined loss of a particular function
• Guilt—worry—failure to meet moral/ethical
standards, internalized by the individual
• Fear—emotional response characterized by
expectation of harm
• Anxiety—feeling of dread, apprehension or
unexplained discomfort.

28. Diseases and Stress
• Scientists have found a direct link between
stress and the development of many
physical illnesses and diseases.
• Emotional stress can weaken the immune
and in the same regard, the reduction of
stress can help to strengthen the immune
system.

29. Causes of stress:
• Organizational factors
• Interpersonal factors (between people)
• Individual factors (intra-personal)
• Results of stress:
• Anxiety, phobias, persistent state of fear
• Abrupt changes in mood and behavior
• Depression
• Perfectionist
• Physical illness
• Burnout
• Increased absenteeism, turnover
• Decrease in job performance

30. STRESS
MANAGEMENT
• Take care of yourself
• Lessen your load if you can—redefine what
you do—prioritize, makes lists
• Learn to relax—find something that makes you
relax, and DO IT!
• Teach your patients to relax
• Find social support—support groups, religion,
etc.
• Build a team—work together, become
cohesive

31. STRESS MANAGEMENT:
• Exercise—known to be the best way to reduce
tension
• Humor—necessary to survive
• Nutrition and diet—need protein for healing of
bones, muscles and tissues
• Rest—be sure to get enough.
• Adults need 6-8 hours of sleep. Older adults
sleep in 4 hour blocks, take frequent naps.

32. COPING STRATEGIES:
1. Information seeking—gather information to
make a decision
2. Direct action—action is taken
3. Inhibition of action—hold back impulses that
may do harm or conflict with moral, social or
physical constraints. Can restrain chemically or
physically.
4. Intrapsychic modes:—cognitive processes
designed to regulate emotions. Yoga, meditation
Team building important for both nurses and
patients: cardiac rehab

33. COPING STRATEGIES…
• Defense Mechanisms: operations
outside a person’s awareness that the ego
calls into play to protect against anxiety—
adjustments to the environment
• Mature coping strategies—be sure to
know these:
• Suppression—have unacceptable
feelings and thought, so try to hide that it
bothers you—hold them in

34. COPING STRATEGIES..
• Sublimation—transpose one behavior for
another—if very very angry, come out
smiling, over happy—drugs, alcohol,
eating. See this if kids are mad—throw
toy across the room when they are mad
about something else.
• Repression—hide feelings, keep out of
thought processes, may be unconscious.

35. COPING STRATEGIES..
Neurotic coping mechanisms:
• Dissociation—pull away from
something that you feel is
threatening.
• Reaction formation—behave
the opposite of what you are
feeling

36. COPING STRATEGIES..
• Immature coping mechanisms:
• Passive-aggressive—want to be
assertive, not passive-aggressive;
• Hypochondria—always think they are
sick
• Displacement—discharging of pent up
feelings on persons less dangerous than
those who initially arouse the emotion.
Take it out on nurse.

37. Levels of Intervention:
Primary—prevent stressors from disrupting state of
wellness—take care of yourself
• Decrease possibility of encountering stressor
• Decrease strength of stressor
• Strengthen state of wellness
Secondary—preventative early detection of stress
reactions and treatment of symptoms
• Prevent exhaustion. Learn how to cope.
Tertiary preventive –initiate after treatment
• Focus on re-adaption to stress
• Maintain stability

38. Interventions focus on;
• Decreasing number of stressors
• Decreasing intensity
• Decreasing the scope
• Decreasing the duration of stressors
• Providing emotional and physical support