Title: STRESS MANAGEMENT
1STRESS MANAGEMENT
- Waris Qidwai
- Professor and Chairman
- Department of Family Medicine
- The Aga Khan University
- Karachi - Pakistan
2Rabindranath Tagore
Man's abiding happiness is not in getting
anythingbut in giving himself up to what is
greater than himself,to ideas which are larger
than his individual life,the idea of his
country, of humanity, of God
3History
Hans Selye
- Walter Cannon and Hans Selye used animal studies
to establish the earliest scientific basis for
the study of stress. - They measured the physiological responses of
animals to external pressures, such as heat and
cold, prolonged restraint, and surgical
procedures, then extrapolated from these studies
to human beings.
4History
Hans Selye (1907-1982)
Stress is the spice of life
5DEFINITION OF STRESS
- An external demand made upon the adaptive
capacities of the mind and body. - If these capacities handle the demand and
enjoy the stimulation involved, then stress is
welcome and helpful. - If the capacities cannot handle the demand,
then stress is unwelcome and unhelpful.
6DEFINITION OF STRESS
- Stress results when pressure exceeds one's
perceived ability to cope - This concept about stress forms the basis for
it being Controllable
7DEFINITION OF STRESS
- Stress does not necessarily follow the
presence of a potential stressor - It is ultimately a person's thought processes
that determine the response to potentially
stressful external
8STRESS AS A STIMULUS
- Too many positive or negative changes (such as
marriage and divorce) occurring in a very short
period, can tax the adaptive capacity of the
individual and lead to increased susceptibility
to mental and physical illness
9STRESS AS A RESPONSE
- Stress results in a certain pattern of
physiological changes such as gastrointestinal,
glandular and cardiovascular disorders. - Moreover, it affects the entire body, not just a
single part. - There are large differences in response within
and between individuals.
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11Quotation
-
- Adopting the right attitude can convert a
negative STRESS into a positive one - Hans Selye
12THREE STAGES OF ADAPTASION IN STRESS
- Alarm reaction
- When a person is exposed to an unadapted
stimulus there is an initial shock (in which
resistance is lowered) followed by a rebound
reaction (counter shock phase) during which the
organisms defence mechanisms become active. - Stage of resistance During this stage the
persons full adaptation may lead to - successful return to equilibrium.
- 3. Stage of exhaustion In case of failure of
adaptability the organism becomes exhausted.
13HUMAN FUNCTION CURVE
Intended Performance
PERFORMANCE
Exhaustion
III Health
Fatigue
Actual Performance
P
Healthy Tension
Breakdown
AROUSAL
P The point at which minimum arousal may bring
on a breakdown
14STRESSORS
- Environmental
- Work related
- Interpersonal
- Life events
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16Quotation
- The human body has been designed to resist an
infinite number of changes and attacks brought
about by its environment. The secret of good
health lies in successful adjustment to changing
Stresses on the body - Harry J. Johnson
17PHYSICAL SYMPTOMS AND SIGNS
- Back Pain
- Constipation
- Diarrhoea
- Dizziness
- Dry Mouth
- Excess Perspiration
- Excessive Hunger
- Exhaustion
- Headaches
- Heart Burn
- Insomnia
- Muscle Spasms
- Nausea
- No Appetite
- Pounding Heart
- Shortness of Breath
- Skin Rashes
- Upset Stomach
18PSYCHOLOGICAL SYMPTOMSAND SIGNS
- Anger
- Anxiety
- Apathy
- Boredom
- Depression
- Fatigue
- Fear of Death
- Frustration
- Guilt
- Hopelessness
- Hostility
- Impatience
- Inability to Concentrate
- Irritability
- Rejection
- Restlessness
19BEHAVIOURAL SYMPTOMSAND SIGNS
- Overreacting
- Stuttering
- Swearing
- Touching Hair, Ears, or Nose
- Trembling Hands
- Biting Lips
- Foot Tapping
- Grinding Teeth
- Impulsive Actions
- Moving in Tense, Jerky ways
- Nervous Tics
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21STRESS AND HEALTH
- Accidents
- Accidents at home, on the roads, and at work
are more likely to occur when individuals are
under stress. - People are more easily distracted when
abnormally anxious.
22INFECTIONS AND IMMUNESYSTEM
- Stress impairs the workings of the immune
system, which may lead to greater susceptibility
from infections. - Stress is significantly associated with
subsequent infections, in particular those of
the respiratory tract.
23HIGH BLOOD PRESSURE STROKES
- It was demonstrated that the incidence of raised
blood pressure and strokes was three to four
times greater in the Air Traffic Controllers than
in comparable workers in other occupations
24HEART DISEASE
- In the 1960s Friedman and Rosenman, found that
heart disease patients under study behaved
similarly-- they were aggressive, striving for
achievement. - These individuals were described as type A
personalities, as opposed to more relaxed type B
personalities.
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27CANCERS
- Those who respond to stress by smoking or
drinking more heavily will increase their risk of
developing cancers of the esophagus, larynx, and
lung. - It is also possible that some cancers might be
produced as a result of an immune response within
the body.
28WHAT IS BURNOUT ?
- Three stages of burnout are recognised
- 1. Job stress -- working excessive hours,
foregoing holidays, a tendency towards hurried
and skipped meals and giving little time to the
family. - 2. Mental or emotional exhaustion -- tiredness,
lethargy, hypochondria, irritability, anxiety,
depression, insomnia or possibly uncontrolled
alcohol consumption. - 3. Inability to feel sympathy for others. This
is accompanied by a deterioration in
communication skills and tardiness.
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31A model of occupational psychosocial stress
Source of stress
The Individual
Outcomes
Intrinsic Stress
Job dissatisfaction Excessive drinking Excessive
smoking Drug use Anxiety Depression Coronary
heart disease Marital disharmony
Work Overload
Demographic factors
Role in the Organisation
Stress coping ability
Self
Organisational structure climate Security
Home/work interface
32PROFESSION Sources of Stress
- Intrinsic Stress
- We experience stress almost everyday as an
- intrinsic part of our profession and this is
- unavoidable.
- Dealing with unsatisfied clients
- Problem clients
- Uncertainty
- Interpersonal Issues with colleagues and peers
33WORK OVERLOAD AND TIME PRESSURE
- Both qualitative (too difficult) and quantitative
(too much to do). - Not having personal free time and carrying a
heavy workload - Time factors are a major source of dissatisfaction
34Role in the Organization
- Clarity in the role/job description
- Career progression
- Responsibility Vs Authority
- Vision and Mission
- Ownership
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37ORGANIZATIONAL STRUCTURE AND CLIMATE
- Source of stress for the employee arises from
the organizational structure and climate - gtParticipation in the decision making process
- gtEffective communication
- gtRestrictions in behavior
38EMPLOYEES AND THEIR FAMILIES
- Although stress is predominantly work-related,
sufferers get caught in a vicious circle of
neglecting the family life. - Excessive involvement of husbands and wives in
demanding occupational roles, can have an adverse
effect on the family
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40EMPLOYEE and SPOUSE
- Professional spouse are more likely to suffer
from Psychiatric problems and suicides - When there is a marital problem, denial may take
the form of - (a) withdrawal into longer hours at the
office, or - (b) passive and condescending tolerance of
her angry outbursts
41WOMEN PROFESSIONALS
- Despite working full-time, women are often
expected to meet domestic commitments. - Married women are either divorcing, limiting
their family size, or coping with both worlds at
the expense of their physical and psychological
health. - The ratio of divorces for female doctors compared
with male doctors is 3 to 2. - More female doctors are single than male doctors.
The percentage for female doctors is 31 and for
male doctors 8 (UK study)
42PERSONALITY
- High achievers are described as competitors and
achievement oriented. - This trait may increase in intensity as one
climbs the career ladder. - Takes pride in over-production and often has a
pathologically overdeveloped ability to postpone
pleasure.
43PERSONALITY
- Feelings of doubt, guilt feelings, and an
exaggerated sense of responsibility. - Excessive conscientiousness is a character trait
that is socially valuable but personally expensive
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45Measuring stress
- Holmes and Rahe stress scale
- In 1967, psychiatrists Thomas Holmes and
Richard Rahe developed the scale, based on data
of 5000 patients - A list of 41 stressful life events that can
contribute to illness was developed and scaled
46Measuring stress
- Holmes and Rahe stress scale
- Rahe carried out a study in 1970 testing the
reliability of the stress scale as a predictor of
illness. - The scale was given to 2,500 US sailors and they
were asked to rate scores of 'life events' over
the previous six months. Over the next six
months, detailed records were kept of the
sailors' health. - There was a positive correlation between stress
scale scores and illness.
47Measuring stress
- Holmes and Rahe stress scale
- Life event Life change units
- Death of a spouse 100
- Divorce 73
- Marital separation 65
- Imprisonment 63
- Death of a close family member 63
48Measuring stress
- Holmes and Rahe stress scale
- Life event Life change units
- Change in number of family reunions 15
- Change in eating habits 15
- Vacation 13
- Christmas 12
- Minor violation of law 11
49Measuring stress
- Holmes and Rahe stress scale
- Score of 300
- At risk of illness
- Score of 150-299
- Risk of illness is moderate (reduced by 30 from
the above risk) - Score 150 or less
- Only have a slight risk of illness
50A STRESS DIARY
- It is important to be able to identify precisely
those individual or series of related events that
may be causing stress or tension. - One way of doing this is to maintain a stress
diary for a few weeks, noting all activities and
using a simple code to indicate the strain
involved - An awareness of this should help the to develop
an action plan to minimize or eliminate the
stressors
51TIME MANAGEMENT
- Identify key areas where you need to spend most
of your time. - Work out an acceptable balance of work and
relaxation. - Try to have sometime from each day that is for
you. - Plan your time, prioritize your tasks and try to
build some flexibility. - Set yourself realistic achievable goals
52SIMPLE STRESS MANAGEMENT ADVICE
- To avoid stress
- Accept it is normal to be an imperfect person in
an imperfect world - Problems are analysed logically and plans made to
resolve them - Work out those situations and people which cause
you stress and why? - Change those things that actually can be changed
- Identify and respect your own good points
- Improve your shortcomings as much as possible and
then accept them as part of you
53SIMPLE STRESS MANAGEMENT ADVICE Contd
- 7. Dont compare yourself with others
- 8. Set realistic goals -- tackle big problems one
step at a time, expect to make mistakes,
apologise and then learn from them - 9. One may delegate tasks but one cannot delegate
responsibility - 10. Look at ways to delegate jobs that are urgent
but not important. - 11. Avoid interruptions, if possible.
- 12. Assertiveness training is particularly
helpful for people who have difficulty in saying
no
54PHYSICAL ACTIVITY
- Physical activity is a way of responding to
stress. and allows the discharge of the energy
the body is anticipating. - Physical activity can be taken in many ways,
including activities such as walking, jogging,
dancing, or sport.
55MEDITATION/SIMPLE RELAXATION
- Frequent and regular meditation, even if only for
a few minutes a day, does four things that are
helpful in a stress-reducing programme - 1. It trains the attention.
- 2. It increases control over thought processes.
- 3. It increases the ability to handle emotions.
- 4. It aids physical relaxation.
56OTHER FORMS OF RELAXATION
- Other forms of relaxation are similar to
meditation in that they lead to the same results
through somewhat different means. - Because muscles can be more easily trained to
respond to conscious control the technique of
progressive muscular relaxation can often be
used. - Hypnosis is a very effective medium for
relaxation and is widely practiced by the medical
profession all over the world.
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58Service At Corporate Field Sites
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- ENI, Pakistan
- OMV, Pakistan
- HUBCO
- British Petroleum, Pakistan
- BHP
- Tethyan Copper Company
- UCH Power Plant
- ROUCH Power Plant
- KAPCO Power Plant
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1
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59First Occupational Health Conference April 21,
2011
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64Tenderness and kindness are not signs of
weakness and despair but are manifestations of
strength and resolution
Gibran
Khalil
65THANK YOU VERY MUCH