Stress: coping and management skills

 Stress stress


a stressor is defined as a disruptive force acting within or on any system.


Reaction to a stressor (physical or psychological stress):

  1. Alarm phase (fight or flight)

  • increased blood glucose

  • increased levels of epinephrine

  • increased heart rate

  • increased level of alertness

  1. Adaptation

  • body stabilizes and restores homeostasis ( resting or normal hormone levels, heart rate)

  1. Recovery or Exhaustion

  • if stressor is still present and no adaptation has occurred individual enters exhaustion

  • exhaustion: energy levels to resist stress and maintain adaptation are depleted

  • body is no longer able to defend itself against the impact of the event (trauma, immunologic insult)


NOTE: prolonged stress can cause illness


  • increased levels of fight or flight hormones over long duration can change biological and physiological processes

  • coping mechanisms such as lack of sleep, increased caffeine intake, use of tobacco, alcohol have negative effects on metabolism and cellular processes

  • stress may cause an individual to neglect warning signs of oncoming illness and exhaustion or forget or ignore prescribed medications or other treatments.


Psychological Stress Reaction

  1. Primary appraisal

  • the individual evaluates the event

  • event or circumstance classified as:

  • harm

  • loss

  • threat

  • challenge


  1. Secondary appraisal

  • individual focuses on possible coping mechanisms

  • Crisis Theory states reappraisal of original situation classification

  • result: coping behaviors constantly change as new information is gained


  1. Copingcoping

  • the individual’s efforts to manage psychological stress

  • effectiveness of strategies depend on individual’s needs

  • therefore, coping mechanisms may vary for individuals as well as for different stresses

  • stress type, personal beliefs, goals, support networks and resources influence a person’s ability to cope with stress


  1. Ego-defense mechanisms

  • psychological adaptive behaviors to cope with the stress

  • mechanisms may be task oriented, involoving direct problem solving to cope with threat(s)


Stress management techniquesrelaxation

  • regular physical excercise

  • support systems such as family and friends

  • time management

  • guided imagery or visulization techniques

  • meditation

  • progressive muscle relaxation (such as massage)

  • assertiveness training

  • journal writing


Perry, A, G, Potter, P, A, Ross-Kerr, J, C and Wood, M, J. 2006. Canadian fundamentals of nursing. 3rded. Toronto: Elselvier.


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