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Stress, Anxiety, and Coping

Stress, Anxiety, and Coping. Spring 2011. Stress. A broad class of experiences in which a demanding situation taxes a person’s resources, or coping capabilities, causing a negative effect. Conflict Sources. Unconscious needs Everyday and family life Social Issues Ethical Issues.

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Stress, Anxiety, and Coping

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  1. Stress, Anxiety, and Coping Spring 2011

  2. Stress • A broad class of experiences in which a demanding situation taxes a person’s resources, or coping capabilities, causing a negative effect

  3. Conflict Sources • Unconscious needs • Everyday and family life • Social Issues • Ethical Issues

  4. Types of Conflict • Approach-Avoidance • Avoidance-Avoidance • Vacillation

  5. Biopsychosocial Theories • Fight or Flight • Maladaptive • Physiologic stress

  6. Life Change Theory of Stress • Life change units (LCU) • Holmes and Rahe Scale • Assumptions/cautions when applying the theory to mental health

  7. Assumptions/ Cautions • Same response to stress • Common threshold for stress effect • Same event = same stress • Same amount of adaptation required • Stress = change • Some life events irrelevant to some people

  8. Stress as a Transaction • Primary appraisal • Secondary appraisal • Coping • Reappraisal

  9. Psychoneuroimmunology Framework • Self-healing personalities • Hardiness and health • Disease-prone personalities

  10. Stress and the Immune System

  11. Stress and the Immune System

  12. Neurobiological basis Measurable Assessment Emotional/behavioral Physiological Cognitive Anxiety

  13. Levels of Anxiety Mild Moderate Severe Panic Anxiety - continued

  14. Coping • Task-oriented • Problem solving • Defense-oriented • Protective

  15. Coping Strategies • Seeking comfort • Relying on self-discipline • Intense expression of feeling • Avoidance and withdrawal

  16. Coping Strategies - continued • Talking it out • Privately thinking it through • Working it off • Engaging in self-healing and mind/body practices

  17. Coping Strategies - continued • Spirituality and prayerfulness • Symbolic substitutes • Somatizing

  18. Coping Resources • Sense of Coherence -Comprehensible -Manageable -Meaningful • GRRs

  19. Repression Suppression Dissociation Identification Introjection Projection Defensive Coping

  20. Denial Fantasy Rationalization Reaction formation Displacement Intellectualization Defensive Coping - continued

  21. Intervention Strategies • Repression/suppression – support, protect, and help client develop objectivity • Dissociation – help client recall and resolve past conflicts • Identification/introjection – clarify roles, assist with client self-care plan and self-awareness

  22. Intervention Strategies - continued • Projection – respect, separate feelings from facts • Denial – discern protective function, then either support denial or focus on reality • Fantasy – focus on realistic plans and expectations

  23. Intervention Strategies - continued • Rationalization – focus on strengths and past success • Reaction formation – respect and support, provide security • Displacement – focus on reason for anger • Intellectualization – explore emotional reactions

  24. Influence on Stress Altered Course or Treatment • Psychiatric disorder • Symptom • Personality trait • Coping style • Maladaptive health behavior • Stress related physiologic response

  25. Conditions with Psychological Components • Cardiovascular • Gastrointestinal • Hormonal • Immune • Integumentary • Neuromuscular and Skeletal • Respiratory

  26. The Challenge • As nurses work with individuals to increase their awareness of stress and improve health-promoting behaviors, they will find that these tasks are not always easy, nor do they always result in change.

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