Stress and Coping

Stress and coping

• Risk factors for altered stress and coping

  • Problems with interpersonal relationships

  • Strained family relationships

  • Financial stress

  • Occupational stress

  • Food insecurity

  • Significant injury or illness

• Recognizing patient stress or maladaptive coping

  • Sympathetic nervous system response

    • Fight or flight responses

    • All resources sent to musculoskeletal system

    • Digestion, immune, etc. put on back burner

  • Positive stress responses/coping

    • Art therapy

    • Counseling

    • Distraction

    • Education

    • Massage

    • Meditation

    • Praying

    • Relaxation techniques

    • Music theory

    • Physical activity

    • Social support

    • Spiritual resources

    • Yoga

  • maladaptive coping

    • Avoidance

    • Attaching

    • Compartmentalization

    • Denial

    • Dependency

    • Displacement

    • Dissociation

    • Emotional outbursts

    • Excessive eating

    • Regression

    • Rationalization

    • Self harm

    • Sensitization

    • Social isolation

    • Substance use

    • Violence

• Appropriate nursing and collaborative interventions to enable stress management and optimize the coping response

  • Primary prevention strategies

    • Promote effective coping, health and wellbeing

    • Maintaining health and proper nutrition

    • Regular exercise

    • Positive personal relationships and social supports

    • Preserving positive self esteem

    • Learning effective preventative coping strategies

  • Secondary prevention strategies

    • Screening

      • Behavioral (Miller)

      • Coping ( Mainz, BCI, Billings and Moo, WCQ)

  • Therapeutic communication 

    • Communicating with the patient to figure out what helps them with their stress, what has worked in the past, what doesn’t work, etc.

  • Meditation

    • Concentrated focus on

      • A sound, object, visualization, breath, movement

    • Purpose

      • To increase awareness, reduce stress, promote relaxation, and enhance personal and spiritual growth

  • Imagery 

    • Generates images that produce a calming effect on the body

      • Requires a focused mind

      • Guided imagery - suggest imagery external to the patient

  • Emotion focused coping

    • Managing emotions that one feels when a stressful event occurs

      • Unchangeable/uncontrollable situation

    • Purpose is to decrease negative emotions and help create a feeling of wellbeing

  • Problem focused coping

    • Finding solutions to resolve problems causing stress

      • controllable/changeable situation

    • Purpose is to allow one to look at a challenge objectively and take action to address the problem and reduce stress

  • Meaning focused coping

    • finding meaning in the stress you are experiencing can help lessen the impact