Stress, Anxiety and Coping Chapter 8
description
Transcript of Stress, Anxiety and Coping Chapter 8
Stress, Anxiety and CopingChapter 8
West Coast UniversityNURS 204
StressA broad class of experiences in which a demanding situation taxes a person’s resources, or coping capabilities, causing a negative effect
Figure 8.2 Factors involved in stress. Several important factors are involved in understanding stress. They include personality factors (such as how we handle
anger), cognitive factors (such as whether we perceive an event as a challenge or threat), physical factors (such as how the body responds to stress), environmental
factors (such as fog, fire, or snow), cultural factors (such as our learned beliefs about religion, health, and family), and coping strategies (such as what we do to
manage stress).
Conflict SourcesUnconscious needs
Everyday and family life
Social Issues
Ethical Issues
Types of ConflictApproach-Avoidance
Avoidance-Avoidance
Vacillation
Biopsychosocial Theories
Fight or FlightMaladaptivePhysiologic stress
Life Change Theory of Stress
Life change units (LCU)
Holmes and Rahe Scale
Assumptions/cautions when applying the theory to mental health
Assumptions/ CautionsSame response to stress
Common threshold for stress effect
Same event = same stress
Same amount of adaptation required
Stress = change
Some life events irrelevant to some people
Stress as a Transaction
Primary appraisal
Secondary appraisal
Coping
Reappraisal
Psychoneuroimmunology Framework
Self-healing personalities
Hardiness and health
Disease-prone personalities
AnxietyNeurobiological basis
Measurable
AssessmentEmotional/behavioralPhysiologicalCognitive
Anxiety - continuedLevels of Anxiety
MildModerateSeverePanic
CopingTask-oriented
Problem solving
Defense-orientedProtective
Coping StrategiesSeeking comfortRelying on self-disciplineIntense expression of feelingAvoidance and withdrawalTalking it outPrivately thinking it throughWorking it off
Coping Strategies - continued
Engaging in self-healing and mind/body practices
Spirituality and prayer
Symbolic substitutes
Somatizing
Coping ResourcesSense of Coherence
-Comprehensible
-Manageable
-Meaningful
Generalized Resistance Resources (GRR)
Coping Resources - continue
Generalized Resistance Resources (GRR)Physical and biochemicalArtifactual and materialCognitiveEmotional Valuative and attitudinalInterpersonal-relationalmacrosociocultural
Defensive MechanismsRepression-Unconsciously keeping unacceptable feelings out of awarenessA man jealous of a good friend’s success but is unaware of his feelings
Suppression-Consciously keeping unacceptable feelings and thought out of awarenessA student taking an examination is upset about an argument with her boyfriend but puts it out of her mind so she can finish the exam
Interventions – support, protect, and help client develop objectivity
Defense MechanismsDissociation-Handling emotional conflicts, or internal or external stressors, by a temporary alteration of consciousness or identity. A woman has amnesia for the events surrounding a fatal
auto accident in which she was the speeding driver Intervention – help client recall and resolve past
conflicts
Projection-Attributing one’s own unacceptable feelings and thoughts to others A man who is quite critical of others thinks that
people are joking about his appearance Intervention – respect, separate feelings from facts
Defense Mechanisms
Identification - Unconscious assumption of similarity between between oneself and another After hospitalization for minor surgery, a woman
decides to be a nurse
Introjection - Acceptance of another’s value and opinions as one’s own A woman who prefers a simple lifestyle assumes the
materialistic, prestige-oriented values of her husband
Identification/introjection – clarify roles, assist with client self-care plan and self-awareness
Defensive MechanismsDenial – Blocking out painful or anxiety-inducing events or feelings A manager tells an employee he may be laid
off. On the way home, the employee shops for a new car.
Discern protective function, then either support denial or focus on reality
Fantasy – Symbolic satisfaction of wishes through nonrational thought A student struggling through graduate school
thinks about a prestigious, high-paying job.
Focus on realistic plans and expectations
Defense MechanismsRationalization – Falsification of experience through the construction of logical or socially approved explanations of behavior. A man cheats on his income tax return and tells
himself
Focus on strengths and past success
Reaction formation – Unacceptable feelings disguised by repression of the real feeling and by reinforcement of the opposite feeling. A woman who dislikes her mother-in-law is always
very nice to her. respect and support, provide security
Respect and support, provide security
Defense MechanismsDisplacement – Discharging pent-up feelings on
people less dangerous that those who initially aroused the emotion A student who has received a low grade on a term paper
blows up at his girlfriend when she asks about his grade.
Focus on reason for anger
Intellectualization – Separating an emotion from an idea or thought because the emotional reaction is too painful to be acknowledge. A man learns that he has cancer. He studies the
physiology and treatment of cancer without experiencing any emotion.
Explore emotional reactions
The multicausational concept of the illness process. The phrase “Meaning and Symbol” refers to the fact that clients interpret all experiences in a highly individual manner according to their specific meaning and the broader meaning in the client’s
culture.
Conditions with Psychological Components
Cardiovascular
Gastrointestinal
Hormonal
Immune
Integumentary
Neuromuscular and Skeletal
Respiratory
The ChallengeAs nurses work with individuals to increase their awareness of stress and improve health-promoting behaviors, they will find that these tasks are not always easy, nor do they always result in change.