Concept 30 Stress and Coping PDF

Concept 30 Stress and Coping Concepts for Nursing Practice, 3rd edition Copyright © 2021, Elsevier Inc. All rights reserved.  Lesson 30.1 Stress and Coping 1. Define and describe the concepts of stress and coping. 2. Notice risk factors f...

Concept 30 Stress and Coping Concepts for Nursing Practice, 3rd edition Copyright © 2021, Elsevier Inc. All rights reserved.  Lesson 30.1 Stress and Coping 1. Define and describe the concepts of stress and coping. 2. Notice risk factors for altered coping and stress. 3. Recognize when an individual is stressed or has maladaptive coping responses. 4. Provide appropriate nursing and collaborative interventions to enable stress management and optimize the coping response. Copyright © 2021, Elsevier Inc. All rights reserved. 2  Definition  Stress and coping is a continual process that starts with an event that is experienced by the individual, perceived through intact information processing channels, appraised for scope and meaning, assessed as neutral, manageable, or threatening within current capacity of coping skills, resources and abilities, ending ideally in a positive outcome of homeostasis and feeling of well-being. Copyright © 2021, Elsevier Inc. All rights reserved. 3  Scope  Continuum of stress  Neutral  Challenge/manageable  Not manageable Copyright © 2021, Elsevier Inc. All rights reserved. 4  Normal Physiological Process  Review of anatomy and physiology related to the stress response  Central nervous system  Sympathetic nervous system  Endocrine system  Immune system  Neuro-endocrine response  Age-related differences Copyright © 2021, Elsevier Inc. All rights reserved. 5  Variations and Context  Sources of stress  Psychological/emotional stressors  Types of stress  Cognitive appraisal  Age  Developmental level  Maturation  Environment  Life experiences  General mental and physical health status Copyright © 2021, Elsevier Inc. All rights reserved. 6  Consequences  Chronic stress produces negative outcomes across multiple body systems:  Central nervous system  Cardiovascular system  Immune system  Musculoskeletal system  Gastrointestinal system  Integumentary system  Sexuality and reproduction system Copyright © 2021, Elsevier Inc. All rights reserved. 7  Risk Factors  Populations at risk  Infants and children  Adolescents  Older adults Copyright © 2021, Elsevier Inc. All rights reserved. 8  Individual Risk Factors  Individual risk factors  Risk for psychological stress Problems with interpersonal relationships Strained family relationships Financial strain Occupational stress Food insecurity  Risk for physiologic stress Significant injury or illness Copyright © 2021, Elsevier Inc. All rights reserved. 9  Assessment  History  Certain conditions can be associated with stress  Clues can also be within the psychosocial component of the history  Examination  Usually consistent with sympathetic nervous system activation  Findings consistent with poor coping behavior include anger, anxiousness, sadness, or hopelessness Copyright © 2021, Elsevier Inc. All rights reserved. 10  Clinical Management: Primary Prevention  Promote effective coping, health and well-being  Maintaining good health and proper nutrition  Regular exercise  Positive personal relationships and social support networks  Preserving positive self-esteem  Learning effective preventative coping strategies Copyright © 2021, Elsevier Inc. All rights reserved. 11  Clinical Management: Secondary Prevention (Screening)  Stress screening tools available  No national recommendations on general stress screening  Recommendations for screening in situations related to mental health that are linked to ineffective or maladaptive coping  Substance abuse  Depression Copyright © 2021, Elsevier Inc. All rights reserved. 12  Collaborative Interventions  Geared toward reducing actual or perceived threats  Reinforcement of perceived control by adopting positive coping strategies Copyright © 2021, Elsevier Inc. All rights reserved. 13 Categories of Coping Strategies  Problem-focused coping  Emotion-focused coping  Meaning-focused coping Copyright © 2021, Elsevier Inc. All rights reserved. 14  Coping Responses (1 of 2)  Common positive coping strategies  Education  Social support  Exercise  Therapeutic lifestyle change  Music therapy  Relaxation strategies  Alternative therapies Copyright © 2021, Elsevier Inc. All rights reserved. 15  Coping Responses (2 of 2)  Ineffective and maladaptive coping responses  Appropriate but insufficient  Use or abuse of alcohol or other substances  Smoking  Overeating  Denial  Avoidance Copyright © 2021, Elsevier Inc. All rights reserved. 16  Pharmacologic Agents  Anxiolytics  Hypnotics  Antidepressants  Psychotherapeutics  Muscle relaxants  Antimigraine agents  Selective serotonin reuptake inhibitors (SSRIs) (older adults) Copyright © 2021, Elsevier Inc. All rights reserved. 17  Interrelated Concepts  Anxiety  Functional ability  Family dynamics  Cognition  Mood and Affect  Perfusion  Sexuality  Sleep  Immunity Copyright © 2021, Elsevier Inc. All rights reserved. 18  Featured Exemplars  Anxiety disorders  Tension headache  Hypertension  Irritable bowel syndrome  Eczema Copyright © 2021, Elsevier Inc. All rights reserved. 19  Question 1 What powerful tool will increase self- efficacy and control for a person who is stressed? 1. Self-perception 2. Denial 3. Education 4. Maladaptive coping Copyright © 2021, Elsevier Inc. All rights reserved. 20  Question 1 Answer  3: Education  Rationale: Education regarding the situation and alternative coping measures is a powerful tool to increase self-efficacy and control. Copyright © 2021, Elsevier Inc. All rights reserved. 21  Question 2 What factors may cause an individual to be at risk for negative outcomes from stress? 1. Supportive family 2. Age 3. Performance of daily relaxation training 4. Optimism Copyright © 2021, Elsevier Inc. All rights reserved. 22  Question 2 Answer  2: Age  Rationale: Individuals who are very young may not have developed adequate coping strategies, adolescents are still developing and are at high risk to choose ineffective coping strategies in times of stress. Older adults may have lost mobility and may have a reduced social structure for support in times of stress. Copyright © 2021, Elsevier Inc. All rights reserved. 23  Question 3 Which of the following is a body system that is associated with negative outcomes due to stress? 1. Immune system 2. Gastrointestinal system 3. Cardiovascular system 4. All of the above Copyright © 2021, Elsevier Inc. All rights reserved. 24  Question 3 Answer  4: All of the above  Rationale: Stress can cause negative outcomes throughout many body systems including the central nervous system, the cardiovascular system, the immune system, the musculoskeletal system, the gastrointestinal system, the integumentary system, and the reproductive system. Copyright © 2021, Elsevier Inc. All rights reserved. 25