STRESS AND ITS
MANAGEMENT
Presented By: Hashmat Amin
INTRODUCTION
• Stress is a normal psychological and physical
reaction to the threatening demands on individuals.
• It is a immediate effect to the threat or danger.
• It enables the body to resist the stressor in the best
possible way.
CONCEPT OF STRESS
Stress is a physical and emotional state always
present in the person as a result of living.
Stress reactions are purposeful and initially
protective
Stress on positive side helps to maintain equilibrium
Stress on negative side is noxious, unpleasent,or
damaging.
Complete freedom from stress is death or non
existent state.
DEFINITION
Stress is the non specific response of the
body to any kind of demand made upon it.
(Selye 1956)
Stress is the arousal of mind and body in
response to demands made upon by them.
(Shafer -2000)
TYPES OF STRESS
Acute stress
Episodic Stress
Chronic stress
ACUTE STRESS
Stress caused by daily demands and pressure. It
occurs only at a very short period of time.
Symptoms of acute stress includes:
Emotional distress
Physical problem
EPISODIC STRESS:
The acute stress which is suffered too frequently
is termed as episodic stress.
The symptoms of episodic stress include:
Ceaseless worrying .
Longer periods of intermitted depression ,
anxiety disorders and emotional distress.
Persistent physical symptoms similar to those
found in acute stress.
CHRONIC STRESS
A sustained state of psychological and
physiological tension resulting from prolonged
exposure to stressors, which may lead to
significant impairments in daily functioning and
increase vulnerability to mental health disorders.
Chronic stress is dangerous and unhealthy.
It is caused by long term exposure to stressors .
SIGNS AND SYMPTOMS
Physical Signs And Symptoms Mental Signs and Symptoms
Dry mouth Sudden irritability
Difficulty in breathing Tension
Pounding heart Problems with concentration
Stomach ache Difficulty in sleeping
Headache Narrowed perception
Diaphoresis Frequent feelings of fatigue
Frequent urination
Tightening of muscles
TYPES OF STRESS
Distress
Eustress
Neutral stress
SOURCES OF STRESS
Environmental stressors
Physiological stressors.
Social stressors.
Any change.
Individual personality.
Interpersonal issue.
System issues.
STRESSOR AND ITS TYPES
Stressor: A biological, psychological,
social or chemical factor that cause
physical or emotional tension and may
contribute to the development of certain
illnesses.
ACUTE STRESSORS
An acute stressor refers to a short term
event or situation that triggers a stress
response in an individual. These stressors
are usually sudden , intense and
temporary, causing immediate
physiological or psychological reactions .
CHRONIC STRESSORS
Continuous or persistent stress – inducing
circumstances that individuals experience over
an extended period. According to McLean and
Link chronic stressors are of five types.
1. Persistent life difficulties.
2. Role strain
3. Social groups
4. Community wide strains
5. Daily haste
EFFECTS AND RESPONSES OF
STRESS
Effects and response to the stressor depend on :
Individuals perception of intensity of the stressor
Cumulative effect of simultaneous stressor.
Sequence of stressors.
Individual previous experience with stressors.
Amount of social support.
Use of coping mechanism.
STRESS RESPONSES
Stress responses are broadly categorized into two:
Positive Stress Responses
1. Problem solving
2. Using social support
3. Reframing
Negative Stress Responses
4. Avoidance
5. Self blame
6. wishful thinking
STRESS AS A BIOLOGICAL
RESPONSE
It is a chain or pattern of physiological events.
Hans selye, a pioneering stress theorist
developed general adaptation syndrome model
that suggests that a person’s response to stress
consists of three stages.
1. Alarm Reaction Or Fight Or Flight Response.
2. Stage Of Resistance.
3. Stage Of Exhaustion.
Alarm reaction or fight or
flight response
it is a body’s initial reaction to a stressor.
it is a set of reactions initiated when the
hypothalamus stimulates the sympathetic
division of Autonomic nervous system and the
adrenal medulla.
The alarm reaction is meant to counteract a
danger by mobilizing the body’s resources for
immediate physical activity.
Changes in cardiovascular system:
Cardiovascular system:
Force of cardiac contraction :increases
Heart rate: increases
Cardiac output: increases
Blood pressure: increases
Blood vessels supplying to the skin and
viscera(except heart and lungs)constrict.
Vessels supplying to the skeletal muscles and brain
dilate.
Changes In Respiratory System
Rate of breathing increases.
Bronchioles dilate.
Respiratory passage widen.(this enable the body to
acquire more oxygen)
Changes In Gi System
Gastric and intestinal motility decreases
Secretions decreases
Sphincters contract
Production of saliva and digestive enzymes reduces.
Glycogenolysis and gluconeogenesis increases
Glycogen syntheses decreases.
Changes In Urinary System
Increased ureter motility
Bladder muscles contracts
Sphincter relaxes
Others:
Eyes :pupils dilate
Lacrimal glands :secretions increase
Sweat glands :secretions increases
Fat cells: lipolysis
Stage of resistance
Also called resistance reaction
It is second stage in the stress response
It is a long term reaction
It is initiated by regulating hormones secreted by the
hypothalamus
STRESSOR
HYPOTHALMUS
CRH,GHRH,TRH
ANTERIOR PITUATARY
GO
NA
ACT HG AD DO
TSH
H H H TR
OPI
NS
ACTH
ADRENAL CORTEX
GLUCOCORTICOIDS MINERALOCORTICOIDS
RETENTION OF
GLUCONEOGENES
SODIUM AND
IS
WATER
HGH
LIVER
SUPPLIES ENERGY THROUGH
GLUCONEOGENESIS
TSH
THYROID GLAND
INCREASES BSR
ADH
INCREASES BLOOD PRESSURE
INCREASES FLUID RETENTION
GONADOTROPINS
DECREASES SECRETION OF SEX HARMONES
DECREASES LIBIDO IMPOTANCE
STAGE OF EXHAUSATION
This stage occurs when the body responds to
prolonged exposure to a stressor.
At this stage the cells start to die and the organs
weaken .
A long term resistance reaction puts heavy demand
on the body particularly on the heart, blood vessels
and adrenal cortex, which may suddenly fail under
the strain .
Diseases of adaptation or death may occur.
Stress As An Environmental
Event
This concept defines stress as an event that triggers
an individuals adaptive psychological and
physiological responses.
The event creates changes in life patterns of the
individual: requires significant adjustment in life style
and taxes available personal resources.
The changes can either be positive or negative.
Cont…
[Link] as an event:
Viewed as an external occurrences
Acts as a trigger for an individuals adaptive
response.
[Link] of the event
Creates change in the individuals life pattern
Requires substantial adjustment in lifestyle.
Cont…
[Link] on the individual
Taxes available personal resources
Can be positive ( eg personal achievement)or
negative(job loss)
4. Focus on change
Emphasis on deviation from the existing steady state
of the individuals life.
[Link] response
Psychological and physiological adaptations are
esssential for coping.
Stress as the transaction between the
individual and the environment
The concept of stress as a transaction between the
individual and the environment emphasizes the
relationship between the internal variables(within an
individual) and the external variable (within the
environment)
This concept parallels the concept of modern
etiology.
Cont..
Transactional theories of stress are based on the
work of lazarus(1966).
The Lazarus transitional stress theory encompasses
a set of cognitive, adaptive coping and affective
responses that arises out of person environment
transactions.
The person and environment are inseprerable each
affects and is affected by the others.
Cont..
He emphasizes that each individual differ in their
sensitivity,valnerubility and perception of stressor
and response to stressor.
The model emphasizes that stress is not solely by
external events but heavily influenced by an
individuals interpretation and perception of these
events.
Additionally it highlights the role of coping strategies
in managing stress.
APPRAISAL
Appraisal in Lazarus and Folk man's model refers to
the cognitive process through which individuals
evaluate and interpret a situation in terms of its
potential significance for their well being.
The individuals appraisal consists of
1. Primary appraisal
2. Secondary appraisal
PRIMARY APPRAISAL
Primary appraisal is the initial assessment individual
make when encountering a situation to determine its
significance for their well being.
In Lazarus and Folk man theory primary appraisal
involves evaluating whether the situation is
1. Irrelevant
2. Benign-positive
3. Stressful
4. Challenging
Cont..
1. Irrelevant: An event is judged irrelevant when the
outcome holds no significance for the individual.
2. Benign – positive: it is a category where
individuals evaluate a situation as being positive or
having a positive impact on their well being.
3. Stress Appraisal: This category involves
I. Harm or loss appraisal:refers to damage or loss
already experienced by the individual .
II. Appraisals of threatening nature: are perceived as
anticipated harms or losses
Cont…
Challenging appraisal: is classification within the
primary appraisal stage where individuals perceive a
situation as opportunity for growth, mastery or
development rather than as a threat or harm.
SECONDARY APPRAISALS
Secondary appraisal in L&F model of stress and
coping follows the primary appraisal and involves
further evaluation of the situation after its initial
categorization as irrelevant , benign positive
challenging or threatening.
The secondary appraisal is an assessment of skills
resources and knowledge that the person possess to
deal with the situation.
The Individual Evaluates By Considering The
Following
Evaluation of coping resources
Perceived control
Outcome expectancies
PREDISPOSING FACTORS
A variety of elements influence how an individual perceives and
responds to stressful situation.
TYPES
• Genetic influence
• Personality traits
• Past experience
• Cultural and social factors
• Health status
• Cognitive factors
• Environmental factors
STRESS MANAGEMENT
Stress management involves the use of coping
strategies in response to stressful situations
Coping strategies are adoptive when the protect
the individual from the harm strengthen the
individuals ability to meet challenging situations.
Coping strategies are maladaptive when the
conflict being experienced goes unresolved or
intensifies.
DEFINITION
Stress management is a set of techniques
and programs intended to help people deal
more effectively with stress in their lives by
analyzing the specific stressors and taking
positive actions to minimize their effects.
-Gale Encyclopedia of Medicine, 2008
Steps in stress management
UNDERSTAND STRESSS
IDENTIFY SOURCES OF STRESSS
LEARN TO RECOGNISE STRESS SIGNALS
RECOGNISE STRESS STATEGIES
IMPLEMENT HEALTHY STRESSS MANAGEMENT STRATEGIES
MAKE SELF CARE A PRIORITY
ASK FOR SUPPORT WHEN NEEDED
UNDERSTAND STRESSS
IDENTIFY SOURCES OF STRESSS
LEARN TO RECOGNISE STRESS SIGNALS
RECOGNISE STRESS STATEGIES
IMPLEMENT HEALTHY STRESSS MANAGEMENT
STRATEGIES
MAKE SELF CARE A PRIORITY
ASK FOR SUPPORT WHEN NEEDED
STEPS IN STRESS MANAGEMENT
Given by American Psychological Association
Stress Management
Techniques And Strategies
The techniques of stress management can be
categorized into three groups
Action Oriented Approaches
Be assertive
Maintain calm environment
Time management
Creating boundaries
Distract yourself
Emotion Oriented Approach
Affirmations and imagery
Cognitive restructuring
Acceptance oriented Approach
Diet and exercise
Meditation and physical exercise
Build resilience
Talk it out
Sleep
OTHER TECHNIQUES
Autogenic training
Cognitive therapy
Conflict resolution
Physical exercise
Hobbies
Meditation
Breathing techniques
Memory enhancers
Cont..
Creativity
Fractional relaxation
Progressive muscle relaxation
The term spa
A stress ball
The term alternative medicine
Time management
Listening to certain types of relaxing music
ROLE OF NURSE IN STRESS
MANAGEMENT
Assessment
Education
Support
Collaboration
Holistic Care
Advocacy
Utilizing community resources
Summary
Stress (introduction concept and definition)
Types, signs symptoms and sources of stress
Stressor and types
Effects and response of stress.
Models of stress
Management of stress
Steps in stress management
Stress management techniques and strategies
Role of nurse in stress management.
CONCLUSION
Understanding stress is crucial as it affects both
mental and physical health. By acknowledging
stressors and implementing proactive coping
strategies, individual can foster resilience and
maintain overall wellbeing
