This document discusses stress management for residents and fellows. It outlines various stressors they may face including demands from work and personal life. It describes Hans Selye's research on the body's stress response and Lazarus and Folkman's theory on psychological stress and coping. Five personality factors are discussed that relate to stress, including neuroticism, extraversion, openness, agreeableness, and conscientiousness. Effective coping strategies are suggested such as rest, asking for help, and anger management techniques.

1. Stress management
Akihiro Shiroshita (PGY7)

2. Keep eustress status !
Stress

3. ➢ First career
➢ Emotional work
➢ Not have a feeling of belonging
➢ Double bind
➢ Drastic change of environment
Residents

4. ➢ Internal demand vs External demand (over-
adaptation)
➢ Demand control model (Karasek 1979)
➢ Little reward
➢ Over-working
➢ Coping with difficult patients
➢ Little social support (Karasek 1988)
➢ Academic
➢ Multi-layered education
➢ Family
Fellows

5. Stressor and Stress response
➢ Alarm phase
➢ Resistance or adaptation
➢ Exhaustion
Hans Selye’s research

6. ➢ Mood
➢ Action
➢ Somatization
Stress response

7. Psychological stress and coping theory
➢ Catastrophe
➢ Life event
➢ Daily hassles
Lazarus and Folman

8. Proportion of mental
disorders
➢ 50%: 150 points/year
➢ 80%: 300 points/year
Social readjustment rating scale

9. Five factors and stress (Costa 1992)
Openness to
experience
Neuroticism
Agreeableness
Extraversion
Conscientiousness

10. Japanese version ? (Kobayashi)
凝縮性 受容性 弁別性 拡散性 保全性
Positive 指導的 教育的 理論的 活動的 強調的
Negative 独善的 介入的 機械的 衝動的 追随的
My personal trait
1. 拡散性
2. 弁別性
3. 凝縮性
4. 受容性
5. 保全性

11. ➢ Effective
➢ Low cost
✓ Cognitive
✓ Action
Coping

12. Examples
➢ Evacuation
➢ Don’t be energized from expectations from
other people
➢ Knowing your limitations
➢ Asking small helps
➢ 72 hours complete rest
➢ Hearing space
➢ Third place
➢ Stop juggling -> Get thins done
➢ Self-esteem
Coping

13. 1. Sleep
2. Knowledge and skills
3. Attitude toward patients and other health care
workers
My opinion

14. “6 minutes” peak
✓ Breathing
✓ Count
✓ Scaling
✓ Time-out
Anger management

15. “More the knowledge, lesser the ego.
Lesser the knowledge, more the ego”
Albert Einstein

16. Supplement

17. Five factors and stress (Costa 1992)
Openness to
experience
Neuroticism
Agreeableness
Extraversion
Conscientiousness

18. ➢ Creative
➢ Open to trying new things
➢ Focused on tackling new challenges
➢ Happy to think about abstract concepts
Openness to experience

19. ➢ Spending time preparing
➢ Finishing important tasks right away
➢ Paying attention to details
➢ Enjoying having a set schedule
Conscientiousness

20. ➢ Enjoying being the center of attention
➢ Likes to start conversations
➢ Enjoy meeting new people
➢ Having a wide social circle
➢ Easy to make new friends
Extraversion

21. ➢ Has a lot of interests in other people
➢ Feeling empathy
➢ Concern for other people
➢ Enjoy helping and contributing to the
happiness of other people
Agreeableness