vibha stress.pptx psychiatric topic stress

introduction definition. type, factor , psychological adaptation to stress , stress as a biological response stress as an environment stress. stress as a transaction between individual and the environment, stress management

1. STRESS AND ITS MANAGEMENT Vibha Chaudhary M Sc Nursing GSVM

2. CONTENT Introduction Definition Types, factors Stressor and its types Psychological adaptation to stress Stress as a biological response Stress as an environmental event Stress as a transaction between the individual and the environment Stress management

3. INTRODUCTION Stress is an universal experience. Stress is part of being alive. Right from the time of birth till the last breathe drawn, an individual is invariably exposed to various stressful situations. Stress may be physical, mental or emotional. Stress has become a serious concern in present age. Its effects on the health is resulting into various physiological and psychological disorders in body. It leads to various health problems like blood pressure, heart attack, diabetes, migraine.

4. DEFINITION According to Selye “Stress as excessive burning of energy resources”. According to Woodworth “A state of strain, whether physical and psychological”. Stress is a non-specific response of the body to any positive and negative demand placed on it and the potential of illness. BASIC CONCEPT OF STRESS Stress is a non-specific response to an internal or external environment. Stress reactions are purposeful and intially protective.

5. Stress, on positive side helps to maintain equilibrium, to increase motivation, learning, creativity, development and motivation. On negative side stress is noxious, unpleasant and damaging. Complete freedom from stress is death. TYPES OF STRESS Distress : It is arise due to an excess of adaptive demands. The demands are so great that they lead to bodily and mentally damage. E.g : death of loved one. Eustress : It is an optimal amount of stress which helps to promote health and growth. E.g : praise from a teacher for a well written assignment. Neutral stress : Here, the subject neither feels good nor bad to the stress. Equilibrium and homeostasis is maintained.

6. PREDISPOSING FACTORS Biological factors : It includes genetic background, nutritional status, biological sensitivities. Psychological factors : It includes intelligence verbal skills, personality, past experience etc. Socio cultural factors : It includes age, gender, education, income, occupation, social position etc. Precipitating factors : It includes fear, anxiety, pain, traumatic experience etc.

7. STRESSOR A biological, psychological, social or chemical factor that causes physical emotional tension. A stressor is a stimuli that proceeding a change. Types of stressor :

8. Acute stressor : Changes of any kind that required some adjustment in behavior or lifestyle could cause stress. Chronic stressor : It is of 5 types; Persistent life difficulties Role strain Social group Community-wide strains Daily haste Positive situations : Include marriage, pregnancy, child birth, etc. Negative situations : Includes frustration, conflicts, and pressure.

9. Conti… 1. Frustration Any blockage in the achievement of goal is called frustration. E.g : A student wanted to be doctor and makes all efforts to clear the PMT but unable. Frustration is of two types: External and Internal External frustration : E.g, A student wanted to go for higher studies but poor financial position does not permit him. Internal frustration : E.g, A student wanted to achieve higher grades but lower intelligence level serve as internal blockage.

10. Conti.. 2. Conflict It is most serious type of stress. It is a condition when two or more than two goals come into competition with each other in such a way that achievement of one goal is blocked by other. Types of conflict :

11. Conti.. 3. Pressure Pressure is an excessive stressful demands from an individual. E.g : A student is already working very hard with his best efforts but if parents unnecessarily put pressure to work hard, then it is called a serious stress. External pressure : E.g, parents and teachers continuously demand from children to get high grades even when they are getting good marks according to his/her ability. Internal pressure : E.g, a student want to join an IAS services and feel internal pressure to work hard to be successful in competitive exam.

12. SOURCES OF STRESS Environmental stressor Physiological stressor Social stressor Change of any kind can induce stress Individual personality that can induce stress Interpersonal issues they can induce stress System (family, job, school, organization issues that can induce stress)

13. PSYCHOLOGICAL ADAPTATION TO STRESS Individual response to stressful situation was influenced by his or her personal perception or event. Anxiety and grief have been described as two major primary psychological response patterns to stress.

14. DIFFERENCE POSITIVE STRESS RESPONSE NEGATIVE STRESS RESPONSE Problem solving Using social support Reframing : Redifining the situation (to see positive as well as negative sides of problem), how to solve. Avoidance Self-blame Wishful thinking : It involves thinking that will resolve by themselves e.g, “everything will be fine”.

15. 1. Anxiety Anxiety drives from the Greek root “to press right”. Anxious is related to Latin word angor, which means “to distress”. Anxiety involves one’s body, perception of self, and relationships with others. Characteristics of anxiety : It is an emotional and subjective experience of an individual. It is provoked by the unknown and precedes all new experiences such as entering school, starting a new job or giving child birth. Anxiety is communicated interpersonally Culture is related to anxiety

16. Levels of anxiety

17. Defense mechanism Defense mechanism is firstly used by Sigmund freud. It is a technique to reduce the anxiety. Adjustment is the process by which an individual maintains a balance between his needs and circumstances.

18. Classification of defense mechanism Successful unsuccessful Repression Rationalization Intellectualization Compensation Substitution Sublimation Suppression Reaction formation Displacement Denial Isolation Projection Regression Conversion Fixation Fantasy

19. Conti.. Repression : (Motivated forgetting) expelling an idea from conscious awareness. E.g : a mother shows seems unaware of the date or events surrounding her child’s death. Rationalization : Making excuses for behaviour in which we failed. E.g : when a fox faces failure to reach the grapes then she said, the grapes are sour. Intellectualization/isolation of affect : Seperation of feelings from ideas and events. E.g : a child who has beaten, discusses the beatings without any display of emotion. Compensation : Develop positive traits and distract attention attention from the weaknesses. Substitution : Replacing unachievable goal with achievable goal.

20. Conti.. Sublimation : Transfer unacceptable feelings or impulse into socially accepted behaviour. E.g : sublimating aggressive impulses toward a career as a boxer. Suppression : Pushing into the unconscious. E.g : trying to forget something that causes your anxiety. Reaction formation : Taking the opposite belief because the true belief causes anxiety. E.g : women who actually dislike her mother in law, hide her feelings by being always nice to her. Displacement : transfer an idea from more threatning object to less threatning object. E.g : yelling out your partner after argument with your boss.

21. Conti.. Denial : Any individual refuses to face the reality. E.g : parents of the ill child will deny the serious kind of illness. Projection : Placing blame for own difficulties upon others. E.g : a student placing blame on her teacher because of fail in exam. Regression : (flight to childhood) a nurse makes an error in giving medication and starts crying. Somatization or Conversion : Converting psychic derivatives into somatic manifestation. E.g : getting a headache while giving an exam. Fixation : It refers to the point in which an individual’s development at which certain aspects of the emotional development do not advance. E.g: thumb sucking continuously till adult age. Fantasy : (day-dreaming) It is an imaging and wishful thinking. E.g : a boy is punished by the teacher he creates fantasy of shooting the teacher.

22. 2. Grief Grief is defined as the emotional process of coping with a loss. These responses include helplessness, loneliness, hopelessness, sadness, guilt and anger. Theories of grief Engel’s theory(1964) : It has three phases; 1. Shock and disbelief – individual denies the reality and physical reactions appears. 2. Develop awareness – feeling of desperation and it includes anger, depression, frustration etc. 3. Reorganization and restitution – begins to reorganize life and new self awareness also developed.

23. Conti.. Kubler – Ross (1969) stages of dying I has five stages of grief : Denial Anger Bargaining Depression Acceptance Martocchio’s phases (1985) Martocchio describes 5 phases of grief. Intense reaction usually subside within 6-12 months. Active mourning may continue for 3-5 years. Shock and disbelief Yearning and protest Anguish, disorganization & despair Identification in breavement Reorganization and restitution

24. Nursing intervention Provide an open accepting environment. Encourage ventilation of feelings and listen actively Provide various diversional activities Provide teaching about common symptoms of grief Reinforce goal-directed activities

25. STRESS AS BIOLOGICAL RESPONSE Stress adaptation model(General Adaptation Syndrome) - (GAS) Alarm reaction : In the face of excessive stress, all biological defense mechanisms are alarmed by the activation of ANS. This first stage is called alarm reaction . Stage of resistance : All biological resources are activated and physiological changes will takes place like rise BP, sugar level, hormone level, heart rate. Stage of exhaustion : If stress continuous, then resources starts to deplete and the person losses its ability to resist stress. This may lead to weakness and death.

26. Stress as an environmental event This concept defines, stress the “thing” or “event” that triggers the adoptive physiological and psychological responses in an individual. The changes can be either negative and positive.

27. Stress as a transaction between the individual and the environment Precipitating event : A stimulus arising from the internal or external environment and perceived by the individual in a specific manner. Individual’s perception : Primary appraisal – a judgment about the situation : Irrelevant Benign positive Stress appraisal

28. Conti.. Secondary appraisal : An assessment of skills, resources, and knowledge that the person possesses to deal with the situation. Predisposing factors Genetic influences Past experiences Existing conditions

29. Stress management Awareness Relaxation Meditation Interpersonal communication with a caring others Problem solving Pets Music Manage time Monitor your physical comfort

30. Conti.. 10. Take care of your body 11. Laugh 12. Know your limits 13. Think positively 14. Compromise 15. Have a good cry 16. Avoid self medication

31. Techniques of stress management Autogenic training Cognitive therapy conflict resolution Physical exercise Hobbies Meditation Deep breathing exercise Creativity A stress ball The term spa

32. Nursing care plan in stress Assessment Nursing diagnosis Goals and interventions Evaluation

33. Summarization Introduction Definition Types Factors Psychological adaptation to stress Stress as a biological response Stress as an environmental event Stress as transaction between the individual and the environment Stress management, techniques of stress management, nursing management

34. Recaptulization Define stress? Enlist the types of stress? Write the factors of stress? Define stressor? Explain the types of stress? Explain about the stress adaptation model? What is defense mechanism? Enlist the types of defense mechanism? Define projection? Give its example Explain the techniques of stress management?

35. Bibliography Bhaskara Raj Elakkuvana D. a textbook of Mental Health (Psychiatric) Nursing. edition 1 st Bangalore: EMMESS publisher : Pp (82-94). Sreevani R. a textbook of A Guide To Mental Health & Psychiatric Nursing. Edition 4 th New Delhi: Jaypee publishers : Pp (328-331). Mann Gulshan, Kumar Harish Sharma. a textbook of Psychology for nurses. edition 5 th Jalandhar: Lotus publishers : Pp (179-194)

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