Human Response to Threat, Stress, and Anxiety

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Human Response to Threat, Stress, and Anxiety

• NUR 210
• Nursing Concepts, Processes, and Skills

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Stress Principles

• Primary response to a stressor is behavioral
• The impact is cumulative
• Circumstances alter the impact or harm done by a
  stressor

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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.

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Continued

• Conditioning is an important protection.
• Responses to stress throughout life are both
  local and general.

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General Adaptation SyndromeGAS

• Hans Selye (1947)
• Stressors Internal and External stimuli that
  cause stress
• Internal originate inside a person
• External originate outside a person

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STRESS

• A nonspecific response both physiological and
  psychological to any disruption of ones
  homeostasis or equilibrium.
• Distress damaging to health
• Eustress protects health
• Posttraumatic Stress Disorder

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MAJOR MECHANISMS OF ADAPTATION

• Medulla Oblongata
• Reticular Formation
• Pituitary Gland

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MODELS OF STRESS

• Selye
• Lazarus
• Holmes and Rahe

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Selye Adaptation Model GAS

• A defense response of the whole body to stress
• Alarm Reaction
• Resistance Stage
• Exhaustion Stage

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GAS

• Immediate response to stress
• ANS
• Endocrine system
• Prolonged state of stress can cause disease

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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

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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

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RESPONSE TO STRESS

• Physiological functioning
• Personality
• Behavioral characteristics
• Nature of the stressor
• Influenced by
• intensity, scope, duration
• and nature of other stressors
• predictability

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Types of Stressors

• Situational job changes, chronic illness
• Maturational stressors vary with life stage
• Sociocultural environmental and social

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ASSESSMENT

• Physiological indicators
• Psychological indicators
• Developmental indicators
• Emotional Behavioral indicators

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ASSESSMENT

• Intellectual indicators
• Family indicators
• Lifestyle indicators
• Sociocultural indicators
• Spiritual indicators

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NURSING DIAGNOSIS

• ineffective coping
• Requires the presence of appropriate defining
  characteristics
• Identify the probable etiology for the problem

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PLANNING

• Outcome effective coping
• Select nursing interventions to promote
  adaptation to stress
• Consult
• Involve client, family and peers
• Identify community resources

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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,

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EVALUATION

• Reassess presence of new or recurring stress
  related problems/symptoms
• Determine if change in care promoted the clients
  adaptation to stress
• Ask of the clients expectations are being met