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Stressors and reaction related to disease process
The document discusses various stressors and their effects on physical and mental health, defining stress and outlining models of the stress response. It also examines the nurse's role in assessing a patient's stressors, coping mechanisms, and diagnosing conditions related to maladaptive stress responses such as anxiety or impaired adjustment. Crisis intervention is also addressed, with summaries of several common models for responding to crises.
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Stressors and reaction related to disease process
- 1. Stressors and reactionrelated to disease process Submitted to : Mr. Imran khan (asst. professor)
- 3. Definitions • The non-specificresponse of the body to any demand placed upon it. (Hans Selye) • Stress should be restricted to conditions where an environmental demand exceeds the natural regulatory capacity of an organism.(Bruce McEwen and Jaap Koolhas) • Relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well- being.(Lazarus and Folkman , 19
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- 5. Definitions • A stressoris any event or stimulus that causes an individual to experience stress. • An internal or external event or situation that creates the potential for physiological, emotional, cognitive or behavioral changes. • When a person faces stressors, responses are referred to as coping strategies, coping responses or coping mechanisms.
- 6. Sources of stress Internalstressors • Originate within the person e.g., Infection or feeling of depression External stressors • Originate outside the individual e.g., to move to another city, • death in the family or pressure from peers.
- 7. Cont… Developmental stressors • Occurat predictable time throughout an individual’s life Situational stressors • Are unpredictable and may occur at any time during life. • It can be either positive or negative . e.g., -death of the family member -marriage or divorce -birth of child -illness
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- 9. Cont… Common effects ofstress on your body • Headache • Muscle tension or pain • Chest pain • Fatigue • Change in sex drive • Stomach upset • Sleep problems
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- 11. Cont.. Common effects ofstress on your mood • Anxiety • Restlessness • Lack of motivation or focus • Feeling overwhelmed • Irritability or anger • Sadness or depression
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- 13. Cont… Common effects ofstress on your behavior • Overeating or under eating • Angry outbursts • Drug or alcohol abuse • Tobacco use • Social withdrawal • Exercising less often
- 15. Physical stressors • Cold •Heat • Chemical agents • Lack of rest and sleep • Excessive drinking • Isolation or crowding
- 16. Physiological stressors • Pain •fatigue • illness injuries • inadequate sleep or nutrition • hormonal fluctuations etc.,
- 17. Psychosocial stressors • Fear •anxiety • phobia • losing a loved one • financial problems etc.
- 18. Environmental stressors • noise •pollution • traffic • weather • crowd etc.
- 19. Relation between Stressand disease
- 20. Cont.. • Relating lifeevents to illness has been a major focus of psychosocial studies. Researchers suggest that people under constant stress have a high incidence of psychosomatic disease.
- 21. Psychological responses tostress • After recognizing a stressor, a person consciously or unconsciously reacts to manage the situation. This is term as the mediating process .a theory developed Lazarus emphasize cognitive appraisal and coping as imp. Mediators of stress.
- 22. Physiologic response tostress • A physiology response to a stressors whether it’s is physical, psychological, or psychosocial, is a protective and adaptive mechanism to maintain the body’s homeostatic balance
- 24. Stimulus based model •Acc. To this model stress is defined a s a stimulus, a life event, or a set of circumstances that arouses physiological and psychological reactions that may increase the individuals vulnerability to illness. • Holmes and Rahe develop the social readjustments rating scale • (SRRS) consisting of 43 life changes or events which are both positive and negative in nature and considered stressful.
- 25. Cont… • The SRRSprovides the general impressions of stressors in the person life. • The more stressors a person experiences in a short period (1 to 2 years) the more likely that physical illness, mental disorders or other stress responses will follow . • This theory also explain that many people with high scores on the SRRS • Do not subsequently experience serious problem. In addition , low scores do not guarantee a life free of danger of stress
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- 27. Response based model •Selyes stress response is characterized by a chain or pattern of physiologic events called the general adaption syndrome.
- 28. General adaption syndrome Alarmreaction • Heart rate and strength of cardiac muscle contraction increases • Blood vessels supplying to the skin and viscera constrict; at the same time blood vessels supplying to skeletal muscles and brain dilate; thus decreasing blood supply to organs which do immediate active response
- 29. Cont… • RBC productionis increased leading to an increase in the ability of the blood to clot. This helps to control bleeding • Liver converts glycogen into glucose and releases it into the blood stream; this provides energy needed to fight the stressor. • The rate of breathing increases and respiratory passage widen to accommodate more air.
- 30. Resistance Reaction • Itis initiated by regulating hormones secreted by hypothalamus. • It is a long-term reaction. • Regulating hormones are • Corticotrophin Releasing Hormone (CRH) • Growth Hormone Releasing Hormone (GHRH) • Thyrotrophic Releasing Hormone(TRH)
- 31. Cont… • CRH stimulatesthe anterior pituitary to increase its secretion of adrenocorticotrophic hormone(ACTH). The action of these hormones helps to control bleeding, maintain blood pressure etc. • GHRH stimulates anterior pituitary to secrete human growth hormone(HGH). • TRH causes the anterior pituitary to secrete thyroid stimulating hormone (TSH). The combined action of HGH and TSH help to supply additional energy to the body
- 32. Exhaustion stage • Atthis stage, cells start to die, and the organs weaken. • A long – term resistance reaction put heavy demand on the body, particularly on the heart, blood vessels, and adrenal cortex, which may suddenly fail under strain. • Immune system is exhausted and function is impaired resulting in decomposition. • The result can manifest itself in obvious illnesses such as ulcers, depression, diabetes, trouble with the digestive system or even cardiovascular problems, along with other mental illnesses.
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- 34. Transaction - basedmodel • Transactional theories of stress are based on the work of LAZARUS (1966). The Lazarus transactional stress theory encompasses a set of cognitive affective and adaptive (coping) responses that arise out of person – environment are inseparable, each affects and is affected by the other. • Lazarus recognizes that certain environmental demands and pressure produce stress in substantial number of people.
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- 36. Reaction related diseaseprocess
- 37. Physical and mentalreactions • Violent • Major depression • Mania • Schizophrenia • Personality disorder • Panic attack • Catatonic stupor • Hysterical attacks
- 38. Behavioral reactions • Delusions •Hallucinations • Agitation • Dysphoria • Anxiety • Euphoria • Sleep and nighttime behavior
- 40. Cont… • The termcoping is used to refer to the process by which a person attempt to mange stressful demands. It takes two major forms. A person can focus on the specific problem or situation that has arisen, trying to find some way of changing it or avoiding it in the future, this is called problem focused coping. problem focused coping strategy helps to resolve or change a person’s behavior or situation or manage life stressors. These are- - Learning problem solving methods - Applying the process to identify problems - Role play interactions with others
- 42. Cont… Adaptive • When theproblem is solved in a rational or a productive way and the anxiety is reduced. Palliative • If the solution temporarily reduces the anxiety but the problem still exist and must be dealt with again at a later time.
- 43. Cont… Maladaptive • If successfulattempt are made to decrease the anxiety without attempting to solve the problem coping strategies Dysfunctional • The individual who does not attempt to reduce the anxiety or solve the problem is considered to have dysfunctional management of the stressor and emotional response
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- 45. Defense mechanism • Defensemechanism are methods of attempting to protect self and cope with basic drives or emotionally painful thoughts, feelings or events • Relevance to nursing practice: the nurse must recognize and understand maladaptive defense mechanism that patient use. The nurse has to carefully point out these mechanisms and work with patients to encourage such behaviors and discourage adaptive ones
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- 48. ASSESSMENT: ♦On the scaleof 1 to 10, where 1 is very minor and 10 is extreme, how would you rate the stress you are experiencing in the following areas? • Home • Work or school • Finance • Recent illness or loss of loved one • Your health • Family responsibilities • Relationships with friends/parents/partner • Recent hospitalization • Other(specify)
- 49. Cont… ♦how long haveyou been dealing with these stressors? ♦how do you usually handle stressful situations? if the client does not adequately describe, prompt with the following: • Cry • Get angry • Talk to someone(who) • Withdraw from the situation • Control others or situation • Go for a walk or perform physical exercise • Try to arrive at a solution
- 50. Cont… • Pray • Laughjoke or use some other expression of humor • Mediate or use some other relaxation technique such as yoga ♦how do well does your usual coping strategy work?
- 51. Diagnosis • Anxiety • Compromisedfamily coping • Decisional conflict • Defensive coping • Disabled family coping • Fear • Impaired adjustment • Ineffective coping • Ineffective denial • Relocation stress syndrome
- 53. Crisis • A crisisis an overwhelming reaction to a threatening situation in which a person’s usual problem solving strategies fail to resolve the situation resulting in a state of disequilibrium.
- 54. TYPES OF CRISIS •Developmental (Maturational) Crisis • Situational Crisis • Adventitious Crisis
- 56. Models • Triage assessmentsystem • Gilliland’s six step model • Seven-stage model of crisis intervention • ABC model of crisis intervention
- 57. Triage assessment system •It was developed by Myer (2001), who posts that it is necessary to assess crisis reactions in three domains: affective(emotional) cognitive(thinking) behavioral(actions)
- 58. Gilliland’s six stepmodel
- 59. Seven-stage model ofcrisis intervention
- 60. ABC model ofcrisis intervention
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