stress, coping, and spirituality in families and communities

acute stress

• fight or flight

• short

• ex: late for work and lost your keys, then stuck in traffic

episodic acute stress

• live in state of tension due to recurring stress

• ex: work on a poorly managed floor and everyday there

  is a new crisis

chronic stress

• stress over years

• poverty, war, continual worry/anxiety

stressor

an event that creates tension and anxiety

appraisal

how the person interprets the impact of the stressor

stress leading to personal growth is known as ___ while stress leading to illness is ___

eustress, destress

general adaptive syndrome (GAS)

1. alarm: CNS aroused, increased blood flow, HR, RR, BP

2. resistance: body stabilizes and responds in an attempt

   to compensate for changes

3. exhaustion: prolonged stress causes breakdown of

   coping mechanisms and illness

4. immune response

psychological response

• cognitive and behavioral efforts to manage stress

• adaptive: exercising, studying

• maladaptive: drinking, drugs, eating

post traumatic stress disorder (PTSD)

• develops when a person experiences a traumatic event

  resulting in intense fear/helplessness

• commonly associated w/: anxiety, flashbacks, depression

neuman systems model

• uses systems approach

• based on the concepts of stress and reaction to it

roy’s adaptation model

a person has the ability to modify external stimuli to allow adaptation to occur

pender’s health promotion model

promoting health and managing stress

situational factors influencing stress/coping

• personal changes (job, finances)

• family changes (death, divorce)

maturation factors influencing stress/coping

• vary across lifespan

sociocultural factors influencing stress/coping

• environmental, social, cultural stressors

• ex: acceptance of cultural expression

nursing stressors include…

• patient load

• charting

• acuity of care

• lack of training

• ethical/moral dilemmas

• prolonged stress at work can lead to burnout

nursing burnout

• a state of emotional exhaustion that results from the

  accumulative stress of an individual’s life

• risk factors: idealistic, perfectionistic, Type A

• early stages: bad behavior towards coworkers/patients,

  alcohol, absenteeism

• later stages: medication/treatment errors, increased

  infection rates

• prevention: self care, time/stress management, goal

  setting, identifying underlying problems, realizing early

ADPIE (assessment) stress

• gather information

• subjective perception of stressor (interview/history)

• objective perception of stressor (elevated vitals)

ADPIE (diagnosis) stress

• anxiety

• fear

• ineffective coping

• powerlessness

• risk for PTSD

• stress overload

ADPIE (planning) stress

• smart goals

• pharmalogical (SSRI’s) and non-pharmalogical (deep breahing, meditation) interventions

ADPIE (implementation) stress

• health promotion

• stress management techniques

ADPIE (evaluation) stress

• did patient accomplish goals developed during

  planning phase?

• does the plan of care need changed/discontinued?

cognitive behavioral therapy (CBT)

• how we THINK affects how we FEEL which affects how

  we BEHAVE

• E+R=O

spirituality

an awareness of one’s inner self and a sense of connection to a higher being, nature, or some purpose greater than oneself

self-transcendence

• connecting to one’s inner self

• ex: holding a new baby

connectedness

intrapersonally connected to oneself, interpersonally connected to others, and transpersonally connected to higher power

faith

belief in something w/o physical evidence

hope

energizing source that encourages future outcomes and goals

religious care

helping patients maintain faithfulness to their belief system and worship practices

spiritual care

helps patients to identify meaning and purpose in life

spiritual distress

• state of suffering due to impaired ability to integrate meaning and purpose in life through connectedness

• caused by stress and near death experiences

ADPIE (assessment) spirituality

• gather data regarding patient's faith history to reveal their beliefs about life, health, and a supreme being

• listening, direct questions, spiritual well-being scale

ADPIE (diagnosis) spirituality

• anxiety

• ineffective coping

• complicated grieving

• (risk for) spiritual distress

• readiness for enhanced spiritual well being

ADPIE (planning) spirituality

• smart goals

• encourage patient to initiate social interaction with family and friends

ADPIE (implementation) spirituality

• help patient use resources

• mobilize hope

ADPIE (evaluation) spirituality

• are they interacting w/ members of their support system?

• do they express hope regarding their situation?