Transcript Human Response to Threat, Stress, and Anxiety

Human Response to Threat,
Stress, and Anxiety
NUR 210
Nursing Concepts, Processes, and
Skills
Stress Principles
• Primary response to a stressor is behavioral
• The impact is cumulative
• Circumstances alter the impact or harm
done by a stressor
Continued….
• People are remarkably adaptable.
• Various psychological or social factors can
ease or exaggerate the effects of a stressor
• There are definite low points when stressors
are poorly tolerated.
Continued…
• Conditioning is an important protection.
• Responses to stress throughout life are both
local and general.
General Adaptation Syndrome
“GAS”
• Hans Selye (1947)
• Stressors: Internal and External stimuli that
cause stress
– Internal: originate inside a person
– External: originate outside a person
STRESS
A nonspecific response both physiological and
psychological to any disruption of one’s
homeostasis or equilibrium.
– Distress:
damaging to health
– Eustress:
protects health
– Posttraumatic Stress Disorder
MAJOR MECHANISMS OF
ADAPTATION
• Medulla Oblongata
• Reticular Formation
• Pituitary Gland
MODELS OF STRESS
• Selye
• Lazarus
• Holmes and Rahe
Selye: Adaptation Model: GAS
• A defense response of the whole body to
stress
– Alarm Reaction
– Resistance Stage
– Exhaustion Stage
GAS
• Immediate response to stress
– ANS
– Endocrine system
• Prolonged state of stress can cause disease
Holmes and Rahe: Stimulus-based
Model
• Holmes and Rahe (1976)
• Focuses on disturbing/disruptive events
within an environment
• No flexibility, does not allow for individual
differences in perception and response
Lazarus and Folkman:
Transaction-based Model
• Lazarus and Folkman (1984)
• Persons and environment
dynamic/interactive relationship
• Individual perceptional response rooted in
psychological and cognitive process
– beliefs
– perception of control
– uncertainty
RESPONSE TO STRESS
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Physiological functioning
Personality
Behavioral characteristics
Nature of the stressor
Influenced by:
– intensity, scope, duration
– # and nature of other stressors
– predictability
Types of Stressors
• Situational: job changes, chronic illness
• Maturational: stressors vary with life stage
• Sociocultural: environmental and social
ASSESSMENT
• Physiological indicators
• Psychological indicators
• Developmental indicators
• Emotional Behavioral indicators
ASSESSMENT
• Intellectual indicators
• Family indicators
• Lifestyle indicators
• Sociocultural indicators
• Spiritual indicators
NURSING DIAGNOSIS
• “ineffective coping”
• Requires the presence of appropriate
defining characteristics
• Identify the probable etiology for the
problem
PLANNING
• Outcome: effective coping
• Select nursing interventions to promote
adaptation to stress
• Consult
• Involve client, family and peers
• Identify community resources
IMPLEMENTATION
• Health Promotion
– time management, exercise, diet, rest, support
system
• Acute Care
– crisis intervention
• Restorative Care
– humor, enhancing self-esteem, relaxation
techniques, spirituality, stress management
workshops, guided imagery,
EVALUATION
• Reassess presence of new or recurring stress
related problems/symptoms
• Determine if change in care promoted the
client’s adaptation to stress
• Ask of the client’s expectations are being
met