Chapter 13. Coping and Stress

Transcription

1 Chapter 13 Coping and Stress

2 Objectives Explain the concepts of stress and coping. Compare the physical, emotional, and behavioral signs of stress. 2

3 Physical Signs of Stress Cardiovascular signs The heart rate and amount of blood ejected from the heart during each contraction increase. Respiratory signs Respiratory rate increases and bronchial passages dilate during stress to allow increased oxygen exchange. Musculoskeletal signs Muscle tension in the back, neck, and head increases with stress. 3

4 Physical Signs of Stress Gastrointestinal signs (Cont.) Peristalsis decreases with stress, as does the production of digestive enzymes. Urinary signs Decreased urine production but increased urinary frequency Cognitive signs Mild stress results in increased state of alertness. Severe stress affects problem-solving ability. 4

5 Physical Signs of Stress Emotional signs (Cont.) Fatigue, tension, and anxiety When stress becomes severe, people may experience signs of clinical depression or even verbalize suicidal thoughts. Behavioral signs Some avoid all interactions or tasks that might increase their stress level, but others take on additional duties in an attempt to block out the source of their distress. 5

6 Symptoms of Depression Changes in appetite and weight Disturbed sleep Motor agitation or retardation Fatigue and loss of energy Depressed or irritable mood Loss of interest or pleasure in usual activities Feelings of worthlessness, self-reproach, guilt Suicidal thinking or attempts Difficulty with thinking or concentration 6

7 Goals of Treatment for Decreased symptoms of depression Reduced risk for relapse and recurrence Improved quality of life Depression Improved medical health status 7

8 Audience Response Question 1 Job pressures or changeable social relationships are all types of A. external physical threats. B. psychological threats. C. internal threats. D. external social threats. System 8

9 Objectives Describe methods for reducing stress. Discuss changes in stress and coping that occur with aging. Identify older adults who are most at risk for experiencing stress-related problems. 9

10 Stress and Illness Research has shown that both mental and physical illness result in stress and that stress increases the risk for both mental and physical illness. Decreasing the number of stressors or the level of stress can prevent illness or improve a person s ability to cope with existing illnesses. Stress has been shown to have negative effects on many body systems. 10

11 Stress and Illness (Cont.) Coping mechanisms are neither good nor bad; they become dysfunctional only when used excessively or inappropriately as a way of avoiding dealing with the stressors. Many different coping or defense mechanisms are used as part of day-to-day living. 11

12 Common Coping or Defense Mechanisms Repression Denial Rationalization Intellectualization Displacement Suppression Projection Sublimation Substitution 12

13 Stress and Life Events Although stress can cause physical illness, physical illness also increases stress. Stress can increase as a result of loss the loss of friends, family members, and particularly a spouse can be highly stressful. Other life events, such as a change in residence or financial worries, can also contribute to stress. 13

14 Stress Reduction and Coping Strategies Problem-focused coping strategies Attempt to change or eliminate the stressful event or threat. Emotion-focused strategies Attempt to change the person s response to the stressful event or threat. One effective way of reducing stress is to avoid or escape the stressor(s). 14

15 Stress Reduction and Coping Strategies (Cont.) When stressors cannot be avoided, when their personal significance is high, or when the person believes he or she can affect the outcome, other methods can be used. Confrontational methods Cognitive methods Problem-solving methods 15

16 Audience Response Question 2 Those who have learned good coping strategies and have used them throughout a lifetime will continue to do so into old age. A. True B. False System 16

17 Assessment Does the person verbalize feelings of tension, stress, frustration, or depression? Does the person complain of changes in eating habits? Does the person complain of changes in bladder or bowel elimination patterns? Is the person experiencing changes in sleep patterns? 17

18 Assessment (Cont.) Does the person have difficulty making decisions or solving problems? Does the person appear agitated, aggressive, angry, or hostile? Is the person depressed or withdrawn? Does the person smoke or consume alcohol excessively? Has the person experienced an increased frequency of illness or accidents? 18

19 Nursing Diagnosis Ineffective coping 19

20 Nursing Goals/Outcomes Communicate feelings of stress. Identify personal strengths and effective methods of coping. Participate in decision making. 20

21 Nursing Interventions Maintain continuity of care to develop a stable, trusting relationship. Encourage older adults to verbalize their feelings. Ensure that older adults receive adequate nutrition, rest, and pain relief. Assist older adults in identifying personal strengths and previously successful coping strategies. 21

22 Nursing Interventions (Cont.) Explain a variety of stress-reduction techniques. Encourage older adults to participate in activities. Consult with mental health specialists, ministers, or counselors. 22

23 Audience Response Question 3 Older persons who are having problems coping often appear to be A. very happy. B. unemotional. C. agitated. D. relaxed. System 23

24 Nursing Diagnosis Relocation stress syndrome 24

25 Nursing Goals/Outcomes Recognize the reasons for the move or change. Identify ways to maintain control and decisionmaking powers in the new environment. Verbalize concerns about new living arrangements. Identify methods for coping with change. 25

26 Nursing Interventions Encourage verbalization of feelings, fears, and concerns about the move or change. Discuss the reasons for the move or change. Include older adults in care planning. Encourage a positive attitude. Maintain continuity of care to enhance feelings of trust. Reference familiar objects and belongings. 26

27 Audience Response Question 4 The changes experienced by the older adult with relocation syndrome are only emotional. A. True B. False System 27