Coping and Stress Management

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Coping and Stress Management

• George Ann Daniels,MS, RN

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Terms

• Stress
• Complex phenomenon that is inherent to life
• Human response
• Coping
• Process used to manage events that he/she
  encounters, perceives, or interprets as stressful
• Adaptation
• A persons capacity to survive and to flourish
• Outcome of coping, adjustments, change
• Homeostatis

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Characteristics of stress, coping and adaptation

• Stress as a stimulus
• Stressor
• Event that causes a response
• Triggers associated with work, relationships,
  disasters, trauma, injuries, illness, divorce,
  death, loss of job.
• Stress as a response
• Nonspecific response of the body to any demand
  upon it
• Change or adaptation
• Negative/positive stressors

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Physiologic response to stress

• Nervous system
• Central cortex ( thinking part of the brain)
  processes the stressful stimuli and relays this
  information via the limbic system to the
  hypothalamusemotional response
• Activation of sympathetic nervous system
• Fight or flight response
• Endocrine/autonomic nervous system
• Activation of these systems may alter the immune
  function

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Psychologic response to stress

• Anxiety
• Fear
• Anger
• Depression

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Cognitive manifestations

• Thinking response
• Problem solving
• Structuring
• Self-control
• Suppression
• Fantasy or day dreaming
• Prayer

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Verbal and motor manifestation

• Crying
• Verbal abuse
• Screaming
• Hitting, kicking
• Holding, touching
• Laughing

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Normal coping patterns

• Manage change, demands, and challenges
• Adaptations
• Coping mechanisms
• Activities or measures for managing stress
• Long term coping
• Short term coping
• Defense mechanisms table 48-1
• Personalities
• A or B

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Lifespan

• Newborns/ infants
• Reflex responses and associated stressors
• Hungry infants will cry and the parents will
  response to stimuli and fed the infant
• Totally dependent on the caregivers
• Toddler and Preschooler
• Learning coping strategies for simple stressors
• Not getting exactly what they want
• Still dependent on caregivers for safety and
  limits (boundaries)

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• Child
• Experience stress outside the home
• Classroom, interaction with other children and
  adults
• Can identify stressors and reason with parents
  about how to cope.
• Draw from past experiences
• Adolescents
• Stressors
• Achieving emotional independence from parents,
  developing sexual identity, learning values and
  social responsibility
• Develop new coping skills

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• Adulthood
• Daily stressors
• Draw on coping skills developed though life and
  learn new ones
• Previous exposure to stressful situations may
  help
• Older adults
• As a person ages, stress does not decrease.
• Retirement, decline in physical energy, decrease
  in income, loss of family and friends, loss in
  functioning ability

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Factors affecting coping patterns

• Diet
• Poorly nourished person unprepared to handle
  stress
• Activity/exercise
• Benefits of exercise on stress reduction
• Sleep/rest
• Safety/security

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Manifestations of altered coping

• Addictive behaviors
• Physical illness
• Overhead
• Anxiety/ depression
• Violent behavior

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Assessment

• Subjective
• Assess
• Physiologic stress
• Psychological stress
• Environmental stress
• Sociocultural stress
• Risk identification
• Objective
• Cardiovascular, respiratory, GI, MS,
  integumentary

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NDX

• Ineffective individual coping
• Goal
• The client will identify sources of stress in
  his/her life.
• The client will list effective coping mechanisms
  for stressful situations.

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Interventions

• Health promotion
• Reducing stress
• Addressing perfection
• Supportive internal messages
• Assertiveness
• Act in their best interest
• Lifestyle change
• Exercise
• Relaxation techniques
• Modifying the environment

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Crisis

• A state of psychological emergency rendering
  ones usually effective problem solving skills
  useless or greatly diminished.
• Crisis interventions
• Systematic application of problem-solving
  techniques, designed to help the client in crisis
  move through the crisis process swiftly and
  painlessly as possible and achieving at least the
  same level prior to crisis

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