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stress and adaptation ppt.pptx

Stress is the body's non-specific response to any demand placed upon it. There are several models that describe stress, including stimulus-based models that view stress as arising from life events or stressors, response-based models like the general adaptation syndrome that describe the body's physiological response to stress over time, and transactional models that emphasize cognitive appraisal of stressors and individual differences in coping. Nurses can help patients manage stress through assessment, teaching stress management techniques like relaxation, and supporting healthy coping behaviors.

Education◦
Stress and adaptation
Modern world is full of hassles, deadlines, frustrations and demands. For many people stress is so common place that it has become a way of life. Stress is not always bad, in small doses, it can help people to perform under pressure and motivate person to do their best.
DEFINITION • Stress is the non-specific response of the body to any demand. The nonspecific response is always the same, it is the degree of the response that changes.’ - Selye, 1958. • According to Selye (1956), it is the non-specific response of the body to any kind of demand upon it. • According to Schafer (2000):- It is the arousal of mind and body in response to a demand made upon them. • A stressor is any person or situation that produces anxiety responses. It is important for the nurse to seek information about the stress producer for that patient.
• Environment stressors:- Noise, pollution, traffic, crowding & weather • Physiological stressors:- Illness, injuries, hormonal fluctuation, inadequate sleep & nutrition • Social stressors:-Financial problem, work demands, social event, losing a loved one • Thought:-Negative self-talk, perfectionism
(A) Alarm Reaction or Fight or Flight Response : It is the body’s initial reaction to a stressor. It is a set of the reaction include:- Stressor ↓ ← stimulate Hypothalamus ↓ ← stimulate SNS(sympathetic nervous system) ↓ ← stimulate Adrenal medulla ↓ ← Releases Catecholamine (epinephrine norepinephrine produces) ↓ Alarm reaction (Fight or flight response)
A stress response is characterized by alarm reaction include:- • Heart rate, the strength of cardiac muscle contraction increases, this circulate blood quickly to area. • Blood vessels that supply to the skin, viscera except heart and lung constrict at the same time, blood supplying to skeletal muscle & brain dilates, these responses provide more blood to organs active in stress response. • Red blood cells (RBC) production is increased leading to an increase in the ability of the blood to clot. It helps to control bleeding. • The liver converts glycogen to glucose & release into the bloodstream which provides energy to fight. • The rate of breathing increases & respiration passage widens to accommodate more air which enables the body to acquire more oxygen. • production of saliva & digestive enzymes decreases
oIn this, the cell starts to die & the organ weakens. A long term resistance reaction put a heavy demand on the body.
Types of stress • EUSTRESS OR POSITIVE STRESS. • DISTRESs OR NEGATIVE stress.
Stress Continuum • Stress can be considered to be a continuum. • Eustress is a normal response, i.e. fight or flight response, like the sensation after a near-miss with another car. • Distress occurs when the elevated blood pressure does not return to normal in between stressors, i.e. stressors that come one after the other all day at work. • Severe Distress shows up as burnout, obesity, clinical hypertension after prolonged distress without adequate recovery time such as single parenting or working for a jerk or with malicious co-workers.
COPING MECHANISM • All people under stress use coping strategies to improve their situations. • These coping strategies or coping mechanism can be thought of simply as ways of getting along in the world.
COPING MECHANISM: • Stress management involves the use of coping strategies in response to stressful situation. Coping strategies are adoptive when the protect the individual from harm or strengthen the individuals ability to meet challenging situations. • Adoptive response help restore homeostasis to the body and impede the development of disease of adoption. • Coping strategies are considered malladoptive when the conflict being experienced goes unresolved or intensifies.
Stuart Stress Adaptation Model • Stuart Stress Adaptation Model is a model of psychiatric nursing care, which integrates biological, psychological, sociocultural, environmental, and legal-ethical aspects of patient care into a unified framework for practice. • The Stuart Stress Adaptation Model of health and wellness provides a consistent nursing-oriented framework (Stuart, 2009). • This model is based on standards of psychiatric nursing care and professional performance
Concepts • Biopsychosocial approach - a holistic perspective that integrates biological, psychological, and sociocultural aspects of care. • Predisposing factors -risk factors such as genetic background. • Precipitating stressors - stimuli that the person perceives as challenging such as life events. • Appraisal of stressor - an evaluation of the significance of a stressor. • Coping resources - options or strategies that help determine what can be done as well as what is at stake. • Adaptation/maladaptation -
• Levels of Prevention – Primary – Secondary – Tertiary • Four stages of psychiatric treatment & nursing care – Crisis stage – Acute stage – Maintenance stage – Health promotion stage
MODELS OF STRESS • Models of stress assist nurses’ to identify the stressor in a particular situation and to predict the individual’s responses. • Nurses can use the knowledge of these models to assist patients in strengthening healthy coping responses and in adjusting unhealthy, unproductive responses. The main models of stress are: I. Stimulus-based model II. Response-based model III. Transaction-based model
STIMULUS-BASED MODEL (Holmes and Rahes Model-1960) • According to this model, stress is defined as a stimulus, a life event, or a set of circumstances that arouse physiologic and psychological reaction that may increase the individual’s vulnerability to illness. • Holmes and Rahe developed the social Readjustment Rating Scale [SRRS] consisting of 43 life changes or events which are both positive and negative in nature and considered stressful. • The SRRS provides a general impression of the stressors in person’s life.
• The more stressors a person experiences in short period (1-2 years) the more likely that physical illness, mental disorders or other stress responses will follow. • The theory also explain that many people with high scores on the SRRS do not subsequently experience serious problems. In addition, low scores do not guarantee a life free of dangers of stress. • One reason is that mediating factors such as how the individual perceives and copes with each stressor, plays an important role in determining the impact of stressors on each individual.
SOCIAL READJUSTMENT RATING SCALE (SRRS) SCALE • A scale that adds up the total "life change units" in order to measure the amount of stress in a person's life over a year. • For the chance of future illness/accident through by measuring the amount of "life change units" • Holmes and Rahe (1967) developed a questionnaire called the Social Readjustment Rating Scale (SRRS) for identifying major stressful life events. • Each one of the 43 stressful life events was awarded a Life Change Unit depending on how traumatic it was felt to be by a large sample of participants
SOCIAL READJUSTMENT RATING SCALE (SRRS) SCALE
INTERPRETATION • A total value for stressful life events can be worked out by adding up the scores for each event experienced over a 12 month period. • If a person has less the 150 life change units they have a 30% chance of suffering from stress. • 150 - 299 life change units equates to a 50% chance of suffering from stress. • Over 300 life units means a person has an 80% chance of developing a stress related illness.
RESPONSE-BASED MODEL • In 1956, Hans Selyes explained that stress response is characterized by a chain or pattern of physiologic events called as General Adaptation Syndrome (GAS). • GAS is a three-stage process that describes the physiological changes the body goes through when under stress. The stages are : i. Alarm reaction ii. Resistance reaction iii. Exhaustion stage
TRANSACTION-BASED MODEL • Transaction theories of stress are based on the work of Lazarus(1966). Thetransactional stress theory encompasses a set of cognitive, affective and adaptive (coping) responses that arise out of person- environment transaction. • The person and the environment are inseparable; each affects and is affected by the other. The individual responds to perceived environmental changes by adaptive or coping response. • Lazarus recognizes that certain environmental demands and pressures produce stress in substantial number of people
• He emphasizes that people and group differ in their sensitivity and vulnerability to certain types of events, as well as in their interpretations and reactions. • For example, in terms of illness, one person may respond with denial, another with anxiety and still another with depression. • To explain variations among individuals under comparable conditions, the Lazarus model takes into account cognitive processes that intervene between the encounter and the reaction and the factors that affect the nature of this process. •
ROLE OF NURSE IN STRESS MANAGEMENT: • Assessment: The nurse should- • Identify the actual or potential stressors. • Identify clients appraisal of stressors. • Assess the available coping resources. • Positive health behaviour. • Adherence to healthy practices
STRESS MANAGEMENT ABC’s of Stress Management • Awareness • Belief • Commitement. • Diet. ; • Physical relaxation techniques- Individual experiences relaxation in different ways. Some individual relax by engaging in large motor activities such as sports, jogging, and physical exercise. Still others use technique such as breathing exercise and progressive relaxation to relieve stress. •
• Thought awareness, or awareness: The initial step in managing stress are awareness: To become aware of factors that creat stress or feeling associated with stress response. Stress can be controlled only when one recognizes that is experienced. As one becomes aware of stressors, they can be omitted, avoided or accepted.
• Rational thinking and positive thinking. • Anger management. • Building self-confidence. • Acupuncture. • Physical Health Management Take a deep breath! Stand up straight. Go to bed early. Relax. Take a break Eat properly Exercise. Mental Health Management Realistic expectation. Reframe your thought. Laugh Social Support Massage
• Music Therapy: Research has shown that music has a profound effect on body on mind. In fact, there is field of health care known as music therapy, which uses music to heal. Those who practice music are finding a benefit in using music to help cancer patients, children with ADD, and others and even hospitals are beginning to use music and music therapy to help with pain management, to help in ward off depression, to promote movement, to calm patients to ease muscle tension, and many other benefits that music and music therapy can bring. • Meditation: Practice 20 minutes ones or twice daily. Meditation has been shown to produce a lasting reduction in blood pressure or other related symptoms. Meditation involves assuming a comfortable position, closing the eyes, concentrating on a single words, sound or phrase, that have positive meaning to the individual. • Yoga. • Biofeedback • Sound therapy.