Stress and Stress Management

KEY POINTS

DEFINITION OF STRESS
Stress is the inability to cope with perceived (real or imagined) demands or threats
to ones mental, emotional, and spiritual well-being.
Stress occurs as a response to demands placed on ones body and/or mind.
Because demands are perceived differently based on the person and/or situation, what is
considered stressful varies.
Many different events or factors can be stressors. A stressor can be physical or
emotional/psychologic and positive or negative.
The common aspect is that stressors require an individual to adapt. Adaptation is
affected by the duration of the stressor (acute or chronic) and its intensity (mild,
moderate, or severe).

FACTORS AFFECTING RESPONSE TO STRESS

Great variability exists among the individual response to the same stressor.
Key personal characteristics, such as resilience and attitude, buffer the impact of
stress. Attitude and optimism also influence the way stress affects the person.
External factors, including positive support from ones social support system, play
a role in ones ability to cope with stress.

PHYSIOLOGIC RESPONSE TO STRESS

The physiologic response of the person to stress is reflected in the
interrelationship of the nervous, endocrine, and immune systems.
Stress activation of these systems affects other systems, such as the
cardiovascular, respiratory, gastrointestinal, renal, and reproductive systems.

MIND, BODY, AND SPIRIT CONNECTION

A person is made of three parts: mind, body, and spirit. All three parts are
important in your life and determining who you are.
What goes on in your mind influences every part of the body. Your body and your
mind are affected by how connected you feel to your spirit (soul). Your spirit is the life
force within you that gives life, energy, and power.
You are not just a person with a body. You are a spiritual being with a mind that
affects every aspect of your body.

EFFECTS OF STRESS ON HEALTH

Stress can have effects on cognitive function, including poor concentration,
memory problems, distressing dreams, sleep disturbances, and impaired decision making.
Long-term stress may increase the risk of cardiovascular diseases, such as
arteriosclerosis and hypertension. Other conditions are either precipitated or aggravated
 by stress, including migraine headaches, irritable bowel syndrome, and peptic ulcers.

COPING STRATEGIES
Coping is a persons efforts to manage stressors.
External factors, including positive support from ones social support system, play
a role in ones ability to cope with stress.
Coping can be either positive or negative. Positive coping includes activities such
as exercise and use of social support. Negative coping may include substance abuse and
denial.
Coping strategies can be divided into two broad categories: emotion-focused
coping and problem-focused coping.
Emotion-focused coping involves managing the emotions that an
individual feels when a stressful event occurs.
Problem-focused coping attempts to find solutions to resolve the problems
causing the stress.

RELAXATION STRATEGIES
Relaxation strategies can be used to cope with stressful circumstances and elicit
the relaxation response.
The relaxation response is state of physiologic and psychologic rest. It is the
opposite of the stress response and is characterized by decreased sympathetic nervous
system activity, which leads to decreased heart and respiratory rate, decreased BP,
decreased muscle tension, decreased brain activity, and increased skin temperature.
Regular elicitation of the relaxation response has been proven to be an effective
treatment for a wide range of stress-related disorders, including chronic pain, insomnia,
and hypertension. This can be achieved through relaxation breathing, meditation,
imagery, music, and massage.
One of the simplest and most effective ways to stop the stress response is
to practice relaxation or abdominal breathing.
Meditation is a practice of concentrated focus on a sound, object,
visualization, the breath, or movement. The purpose of meditation is to increase
awareness, reduce stress, promote relaxation, and enhance personal and spiritual
growth.
Imagery is the use of ones mind to generate images that have a calming
effect on the body.

NURSING MANAGEMENT: STRESS

As a nurse, you are in a key position to assess stress in patients and families, assist
them to identify high-risk periods for stress, and implement stress management strategies
that can prevent the negative consequences of stress on their health.
There are many stress management strategies within the scope of nursing practice,
including relaxation breathing, imagery, music, exercise, massage, meditation, art
therapy, and journaling.
 Before teaching stress management strategies to patients, you need to become
personally familiar with them.