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NURS 509A
Stress, Adaptation, Psychosocial Health
| Question | Answer |
|---|---|
| The biopsychosocial model of health and illness is a venn diagram that intersects by way of these factors | psychological---sociological---biological |
| Psychosocial health largely depends on self-concept . . . .what is a simple definition of self-concept | how one thinks/feels about oneself----it is a complex, life-long & multifactorial process |
| Self-concept has 4 dimensions . . .they are | identity---body image---self estem---role performance |
| Self concept: body image | the sum of attitudes that a person has toward their body---depends only partly on the reality of the body |
| Self-concept: role performance | the ways in which we perceive our ability to carry out significan roles such as care-taker, parent, friend, etc. |
| self-concept: identity | the constructs by which we perceive ourselves---age/race/culture/sexuality/occupation/beliefs/personality/character------in short, what distinguishes self from non-self |
| self-concept: self-esteem | overall judgement of one's own worth or value----expressed as a venn diagram intersecting between ideal self and real self |
| What are some factors that effect self-concept | history of success/failure---family/peer relations----developmental level---locus of control |
| other factors that affect self-concept | SES---illness---sexual dysfunction---abuse (past/present) |
| Nursing interventions to promote self-esteem/self-concept include | encouraging pt to be as independent as possible---realistic pt goals---positive words---pt use positive self-talk---ackowledge pt positive health behaviors |
| Most commonaly accepted definition of stress-Dr. Richard S. Lazarus (paraphrased) | feeling when a person perceives that demands exceed resources |
| Work stress is becoming more widely viewed as a major cause of poor health that must be addressed. What causes stress? | It is different for each of us - it depends upon the individual |
| distress | can threaten health (financial worries) |
| eustress | good stress (winning a prize) |
| developmental stress | associated with life stages (graduation) |
| situational stress | associated with random, unpredictable events (hurricane) |
| physiological stress | affects structure/function of body (motility problems, disease states) |
| psychological stress | arise from life events (work pressure) |
| common responses to stress include body---mind---emotions---behavior. Give an example of each | body (muscle tension)---mind (impaired judgement)---behavior (insomnia) ---emotions (anxiety) |
| coping strategies can either be adaptive or maladaptive. give an example of each | adaptive (lifestyle choice)-----maladaptive (overeating) |
| psychological defense mechanisms include the following | include the following definitions for psychological defense mechanisms |
| avoidance | staying away from (I'm too tired to go) |
| compensation | making up for perceived inadequacy (being a musician when you'd rather be a football player) |
| conversion | emotional conflict changed to physical symptom (developing nausea causing you to miss exam) |
| denial | unconsciously refusing to acknowledge reality (I can quit smoking any time I want to) |
| displacement | transferring emotions from original object to perceived less powerful one (mad at the boss, kick your dog) |
| dissociation | painful events separated from conscious mind (sexually abused child describes as though it happened to sibling) |
| identification | taking on ideas of another (child who plays policeman) |
| intellectualizaiton | cognitive reasoning used to block/avoid painful incident (husband dies, wife says it's better because he is in a better place now) |
| minimization | making one's part less important (it doesn't matter how much I drink because I'm not driving) |
| projection | blaming others (I can't do it right because you make me nervous) |
| rationalization | logical sounding excuses---(it was God's will that this happened to me) |
| What happens when stress occurs | it produces voluntary/involuntary coping responses to restore equilibrium |
| Name 3 general approaches for coping | alter the stressor---avoid the stressor---adapt to the stressor |
| Hans Selye - the father of stress research - defined stress in 2 ways (1936 & 1950) | 1936- non-specific response of the body to any demand for change-----1950 the rate of wear & tear on the body |
| Hans Selye- definition of a stressor | stimulus perceived as a challenge/threat---it disturbs equalibrium---initiates physical/emotional response |
| slide 24 depicts Selye's schematic of stress, the point emphasized in lecture relating to this slide is | that it is the HPA axis that gets activated (hypothalmus---pituitary---adrenal) with the resultant release of cortisol, which is also known as the 'stress hormone' |
| Selye's model for stress is called "General Adaptation Syndrome" = GAS, which has 3 stages | Alarm Stage---Resistance or Adaptation---Exhaustion or Recovery |
| What happens in GAS-Stage 1: Alarm stage | Fight or flight by endocrine system --> SNS (sympathetic NS) --> activates CV, Resp, metabolic, GU, Musculoskeletal (MS). Take home message = it is a SNS response |
| What happens in GAS-Stage 2: | Compensatory mechanisms for coping/protection. PSNS (parasymathetic) balances out SNS and hormones return to normal if adapting. |
| GAS stage 2 adaptation is the desired outcome of stress---involves adusting to stress/stressor and allows for normal growth/devel----But the ability to adapt depends on these 3 factors | intensity of the stressor---effectiveness of coping skilss---personal factors (realistic understanding of stressor, previous adaptations successful? overall health status) |
| What is a HUGE personal factor as relates to stress | PERCEPTION - high, high degree of variability |
| Other factors that influence adaptation | suport system (the stronger the better)---age, developmental level, life experiences |
| Slide 30 of ppt depicts the equalibrium of adaptation and homeostasis as being balanced by these factors | available supports/coping abilities & experiences-----#, duration, strength of stressors + unrealistic perception of stressor |
| GAS: Stage 3 has two possible outcomes, which are | exhaustion (if adaptive mechanisms ineffective)---recovery (if adaptive mechanisms effective) |
| Long term exhaustion can contribute to stress-related illnesses including | CV disease, metabolic (CVD, DM, Syndrdome X)---Central sensitization syndroms (IBS, fibromyalgia, pelvic DOs)---cancer, pschiatric/mental health DOs |
| Stress management tools | change perception of stressor---use support systems---spiritual support---crisis intervention---appropriate referrals (anger mgt, addiction counseling, etc) |
| What is the BEST health promoting activity for stress mgmt | exercise |
| Can over-use of adaptive coping mechanisms become mal-adaptive? | Yes, behaviors such as ETOH, caffeine, sweets, smoking, etc become maladaptive if used long term |
| Other important health promotion activities for stress management | nutrition---7-8 hours of sleep---leisure activites---time/responsibility management |
| Stress management techniques | relaxation, imagery, humor, mediation and a host of common-sense others on slide |
| Does the CDC have tips for self care? | Yes - which essentially restates material covered in previous slides |
| Take home message from Seyle when he dedicated his book | That he could not be CURED of his stress, merely taught to ENJOY it . . .in other words, acceptance and adapting are the ways out of hell :-) |
| Note included in this study stack: | slides she tacked onto end of lecture and stated would not be on exam |
Created by:
MEPN 2013
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