Psychology Chapter on Stress and Coping

### Stress and Coping

• Stress is a person’s general response to demands.
• Stress can lead to personal growth (eustress) or illness (distress).
• Coping strategies include:
  • Problem-focused coping
  • Emotion-focused coping
• Subjective and objective data can be used to identify signs of stress in patients:
  • Eye contact
  • Energy level
  • Concentration
  • Sleep disturbances
  • Altered food intake
  • Observed emotions
  • Verbal statements
• The body’s stress response is called the fight-or-flight response, which is controlled by the sympathetic nervous system.

The Sympathetic Nervous System

• The sympathetic nervous system prepares a person for action by increasing heart rate.
• Diverts blood from the intestines and skin.
• Increases blood to the brain and striated muscles.
• Increases blood pressure, respiratory rate, and blood sugar levels.

Neurological Responses to Stress

• The medulla oblongata controls heart rate, blood pressure, and respiration.
• The reticular formation continuously monitors the body’s physiological status through sensory and motor tracts.
• The pituitary gland produces adrenocorticotropic hormone (ACTH), which leads to the release of cortisol, resulting in raised blood sugar levels and inhibited inflammation.

General Adaptation Syndrome (GAS)

• The GAS is an immediate physiological response to stress that involves several body systems.
• It includes three stages:
  • Alarm reaction
  • Resistance stage
  • Exhaustion stage

The Alarm Reaction

• The alarm reaction causes an increase in:
  • Blood volume
  • Blood glucose levels
  • Epinephrine and norepinephrine levels
  • Heart rate
  • Blood flow to muscles
  • Oxygen intake
  • Mental alertness

The Resistance Stage

• The resistance stage stabilizes the body by returning hormone levels, heart rate, blood pressure, and cardiac output to normal.
• The body begins to repair damage.
• Chronic activation of the stress response can lead to chronic illness.

The Exhaustion Stage

• The exhaustion stage occurs when the body is no longer able to resist the effects of the stressor.
• The body is drained of energy, leading to death.

Types of Stress

• Chronic stress can lead to chronic illness.
• Acute stress can result from time-limited events and lead to acute illness.

Factors Influencing Stress and Coping

• Situational factors arise from job changes or being a caregiver.
• Maturational or Developmental factors vary with life stages.
• Sociocultural factors include environmental, social, and cultural stressors.
• Physical factors include health status, lifestyle, nutrition, and exercise.

Cultural Considerations

• Culture influences what is stressful and how people cope with stress.
• Some cultures value controlling emotions, while others encourage expressing them.

Coping with Stress: Older Adults

• Older adults may experience stress due to:
  • Loss of mobility, independence, or a spouse/friends.
• Life experiences often lead to stress management techniques.

Nursing Actions to Help Patients Cope with Stress

• Safety: Nurse should stay with the patient experiencing severe anxiety.
• Nurse-patient relationship: Build a foundation of trust.
• Regular exercise
• Guided imagery and visualization
• Meditation and grounding techniques
• Healthy nutrition
• Journal writing
• Support system

Implementing Coping Strategies

• Guided imagery: Creating a relaxed state through imagination using sensory words.
• Environmental factors: Limiting noise, dimming lights, assigning the same nurses, and ensuring cleanliness.
• Communication: Explain procedures briefly using short, clear sentences to comfort the patient.

Work-Life Balance and Self-Care

• Maintain a balance between work and personal life to prevent stress.
• Practice self-care to prevent burnout.