Coping+_23
Graduating Nursing
Presenter: Collin Colle
Program: 1000 Nurses Program
Focus: Strong Coping Strategies
Disclaimer
Presentation is the intellectual property of the Nursing Faculty at Collin College.
Prohibition on sharing/redistributing without written permission.
Definitions of Coping
Coping: An evolving process blending cognitive and behavioral strategies to manage stressors beyond individual resources (Giddens, 2013).
Changes in thoughts and behaviors are assessed in stressful situations (Folkman, n.d.)
Coping mechanisms adapt to various stressors like illness, disability, death, work changes, etc.
Antecedents of Coping
Individual perceptions
Insight and honesty
Establishing boundaries
Life experiences and anticipation
Utilizing positive defense mechanisms
Cognitive and emotional appraisal of stressors
Relationships and environmental factors
Attributes of Coping
Calm affect and demeanor
Positive coping mechanisms
Communication that is effective and age-appropriate
Ability to perform Activities of Daily Living (ADLs)
Engagement with available support systems
Key Terms
Stress: Any hazard affecting homeostasis.
Stressors: Physical, psychological, or social stimuli threatening balance.
Appraisal: Individual interpretation of stressor impact.
Key Points of Coping
Coping applies to individuals, families, or communities
Spectrum of coping from effective/adaptive to ineffective/maladaptive
Coping mechanisms are utilized by all people irrespective of identity
Outcomes vary, can lead to resolution or acceptance
Types of Stress
Chronic Stress: Long-term stress.
Acute Stress: Short-term stress.
PTSD: Post-traumatic stress disorder; includes flashbacks and can lead to secondary traumatic stress.
Developmental Stress: Stress associated with life stages.
Situational Stress: Contextual stressors.
Adventitious Stress: Unintentional stress due to disasters.
Nursing Knowledge Base
Factors Influencing Stress and Coping
Situational Factors
Maturational Factors
Sociocultural Factors
Selye’s General Adaptation Syndrome
Stages:
Alarm Stage: Initial reaction to stress.
Resistance Stage: Adaptation occurs; outward appearance may normalize.
Exhaustion Stage: Resources depleted; increased vulnerability to disease.
Fight-or-Flight Response
Body readiness for perceived threats.
Increased vital signs (heart rate, respiration).
Notable differences in stress response between genders.
Stress Continuum
Distress: Negative, draining energy resulting in negative feelings.
Eustress: Positive energy motivating individuals leading to positive outcomes.
Immune System Interactions
Interaction between nervous and immune systems during alarm phase negatively impacts health.
Links between stress and disease are evident.
Ego Defense Mechanisms
Include denial, regression, projection, and rationalization.
Serve to protect the individual from stress.
Risk Factors for Poor Coping
Impairments in cognition
Denial or avoidance of reality
Lack of control or resources
Age and chronic health effects
Mediators of Stress Response
Physiological and psychological stressors
Individual temperament
Social support systems
Cultural and spiritual influences
Adverse Childhood Experiences (ACEs)
Psychological, physical, and sexual abuse.
Living with substance use disorders or mentally ill individuals.
Patient Assessment
Evaluate patient’s perception and coping ability.
Personal experience aids in assessing stress impacts.
Nursing Knowledge Base - Special Concerns
Compassion Fatigue: State of burnout from caring for patients.
Second Victim Syndrome: Emotional distress after a medical error impact.
Nursing Process - Assessment
Understand patient’s perspective
Assess environmental and subjective findings.
Nursing Management of Stress Responses
Social Readjustment Rating Scale to measure stress level.
Recent Life Changes Questionnaire as a tool.
Comprehensive Assessment Areas
History of perception of threat
Coping patterns and family dynamics
General health and substance use
Assessment Tools
Various screening tools including anxiety inventories and coping strategy assessments.
Nursing Interventions
Primary Prevention
Teach stress reduction and coping skills.
Identify resources available.
Secondary Prevention
Use assessment and screening tools for monitoring.
Tertiary Prevention
Continuing counseling and resource referrals.
Nursing Process - Analysis
Identify nursing problems like anxiety, stress overload, and family coping issues.
Expected Outcomes
Patients exhibit effective and adaptive coping strategies.
Improvement in mood and normalized physiological parameters.
Nursing Process - Implementation
Employ health promotion strategies.
Manage acute care crises and long-term impacts.
Therapeutic Interventions
Assist with daily living activities in a safe environment.
Encourage expression of feelings and fears.
Identify present stressors directly related to health conditions.
Further Interventions
Modify or eliminate identified stressors.
Foster autonomy and decision-making when not under severe stress.
Critical Nursing Skills
Assessment and therapeutic communication
Collaboration with multidisciplinary teams for holistic care.
Relaxation Techniques
Physical exercise, cognitive reframing, humor.
Deep breathing and guided imagery for stress relief.
Evaluation
Determine effectiveness of stress management interventions.
Assess progress toward coping with stress.
Desired Coping Outcomes
Resolution or acceptance of stressors.
Culturally sensitive individual evaluation.
Consequences of Poor Coping
Maladaptive responses lead to physical and psychosocial issues.
Risks include health decline, functional impairment, and family relationship deterioration.
Reflective Exercise
Identify and evaluate personal stressors and coping skills.
Vulnerability and Resilience
Understanding the adaptive capacity and resilience in coping methods.
Therapeutic Communication
Techniques to aid individuals in coping with stress.