unit 4 stress - psychology for nurses

STRESSSTRESS

INTRODUCTIONINTRODUCTION

The word stress is derived from the Latin word, “string” which means “to be drawn tight”.

Most of us experience stress at one time or another, without stress there would be no life. However excessive or prolonged stress can be harmful. Stress is a common problem that affects all of us at some point in our lives.

DEFINITIONDEFINITION In medical term stress is defined

as a, “physical or psychological stimulus that can produce mental tension or physiological reactions that may lead to illness”.

S = P > R Stress occurs when the pressure is

greater than the resources.

CAUSES OF STRESSCAUSES OF STRESS

ExternalInternal

EXTERNAL STRESSORSEXTERNAL STRESSORS

– Physical environment– Social interaction– Organizational– Major life event– Daily hassles

Physical EnvironmentPhysical Environment• Change in climate or weather• Pollution• Noise• Due to any chemical substance

Social Interaction Rudeness Aggressiveness by others Change in economic condition

Organizational Organizational Rules Regulation Dead lines

Major Life EventsMajor Life Events Birth Death Lost job Promotion Marital status change

Daily HasslesDaily Hassles

– Losing a wallet– Getting stuck in a traffic jam– Arguing with family members – Misplaced keys

INTERNAL STRESSORSINTERNAL STRESSORS  

Life – style choicesNegative self talkPersonality traits

SYMPTOMS OF STRESSSYMPTOMS OF STRESS

Physiological symptomsMental symptomsBehavioral symptomsEmotional symptoms

Physiological Physiological symptomssymptoms

Sleep pattern changesFatigueDigestion changesHeadacheAches & pains InfectionDizziness

Fainting, increase cardiac outputSweatingPupils dilatedTingling of hands & feet’sBreathlessnessPalpitationMissed heart beatsIncrease blood pressure

Mental symptoms Mental symptoms

Lack of concentrationMemory lapsesDifficulty in making decisionConfusionDisorientationPanic attack

Behavioral symptomsBehavioral symptoms

Appetite change : too much or too littleEating disorder : anorexia or bulimiaIncrease intake of alcohol & drugsIncreased smokingRestlessnessNail biting

Emotional symptomsEmotional symptoms

Depression TearfulnessDeterioration of personal hygiene&

appearance

GENERAL ADAPTATION GENERAL ADAPTATION SYNDROMSYNDROM

It was given by Hans SelyeAlarm responseAdaptation or ResistanceExhaustion

Alarm is the first stage, which is divided into two phases: the shock phase and the antishock phase.

Shock phase: During this phase, the body can endure changes such as hypovolemia, hypoosmolarity, hyponatremia, hypochloremia, hypoglycemia.

Antishock phase: When the threat or stressor is identified or realized, the body starts to respond and is in a state of alarm. During this stage, adrenaline are being produced, hence the fight-or-flight response. The result is: increased muscular tonus, increased blood pressure due to peripheral vasoconstriction and tachycardia, and increased glucose in blood. There is also some activation of the HPA axis, producing glucocorticoids.

Resistance is the second stage

increased secretion of glucocorticoids play a major role, increased glucose, fat and protein concentration in blood. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.

The third stage could be either exhaustion or recovery :

Recovery stage follows when the system's compensation mechanisms have successfully overcome the stressor effect. Exhaustion is the alternative third stage in the GAS model. At this point, all of the body's resources are eventually depleted and the body is unable to maintain normal function. The initial autonomic nervous system symptoms may reappear (sweating, raised heart rate, etc.). If stage three is extended, long-term damage may result (prolonged vasoconstriction results in ischemia which in turn leads to cell necrosis), as the body's immune system becomes exhausted, and bodily functions become impaired.

STRESS CONTROL A B C STRESS CONTROL A B C STRATEGY STRATEGY

A = AWARENESS What causes you stress? How do you react?

B = BALANCE There is a fine line between positive / negative stress How much can you cope with before it becomes negative ?

C = CONTROL What can you do to help yourself combat the negative

effects of stress?

Stress management Stress management strategy strategy

Avoid unnecessary stress Learn how to say “no” Avoid people who stress you Take control of your environment Avoid hot-button topics Pare down your to-do list

Alter the situation Express your feelings instead of bottling them

up Be willing to compromise Be more assertive Manage your time better

Adapt to the stressor Reframe problems. Look at the big picture Adjust your standards Focus on the positive

Accept the things you can’t change Don’t try to control the uncontrollable Look for the upside Share your feelings Learn to forgive

Make time for fun and relaxation Set aside relaxation time Connect with others Do something you enjoy every day Keep your sense of humor

Adopt a healthy lifestyleExercise regularlyEat a healthy dietReduce caffeine and sugarAvoid alcohol, cigarettes, and drugsGet enough sleep

STRESS MANAGEMENT STRESS MANAGEMENT TECHNIQUESTECHNIQUES

Change your behaviorBe AssertiveVentilationHumorDiversion and Distraction

Change your ThinkingRe-framingPositive Thinking Forget powerlessness and failure Stress leaves us vulnerable to negative

suggestion so focus on positives; Focus on your strengths Learn from the stress you are under Look for opportunities Seek out the positive - make a change

Change Your LifestyleDietSmoking and AlcoholBenefits of ExerciseSleepLeisure

NON PHARMACOLOGICAL NON PHARMACOLOGICAL MANAGEMENTMANAGEMENT

Counseling & psychotherapy Relaxation Meditation Massage Yoga Biofeedback Pet Therapy

PHARMACOLOGICAL PHARMACOLOGICAL MANAGEMENT MANAGEMENT

Benzodiazepines (Diazepam) :

It is anti anxiolytic drugs.

Eg - Alprazolam & lorazepam

Barbiturates :

Barbiturates such as

Eg - amobarbital, Phenobarbital

Antipsychotic agent :

Their major use in the states of acute psychotic terror, but they may be helpful in certain anxious behavior.

Antihistamines :

It helps in decrease the anxiety levels.

Eg: Hydroxyzine

Anti depression :

Anti depression medication such as Imipramine may be beneficial for blocking panic attack due to depression.