1.Omero G. MwaleMsc . Mental Health Nursingreactions to socio-environmental stress.omero.Mscmental health

2. Learning outcomes Upon completion of this topic participants should beable to; Define the following terms: stress Stressor Adaptation response maladaptationreactions to socio-environmental stress.omero.Mscmental health 3. Objec,cont Identify the physiological responses to stress Explain the relationship between stress and diseases ofadaptation Describe the concept of stress as an environmental event. Explain the concept of stress as a transaction between theindividual and the environment Discuss adaptive coping strategies in management of stressreactions to socio-environmental stress.omero.Mscmental health 4. Definitions Stress may be viewed as an individuals reaction toany change that requires an adjustment orresponse, which can be physical mental oremotional. Stressor-a biological , physiological, social orchemical factor that causes physical or emotionaltension and may be a factor in the etiology of certainillnessreactions to socio-environmental stress.omero.Mscmental health 5. Defin,cont adaptation- is viewed as positive and is correlatedwith a healthy response. When behavior disrupts the integrity of the individualit is perceived as maladaptive (negative orunhealthy)reactions to socio-environmental stress.omero.Mscmental health 6. Physiological response to stress Selye, 1976, called this as state manifestated by aspecific syndrome which consists of all thenonspecifically induced changes within a biologicalsystem. Syndrome of symptoms is known as fight or flightsyndrome Called this general reaction of the bodyreactions to socio-environmental stress.omero.Mscmental health 7. Cont,to stress the general adaptation syndrome. Has three phasesreactions to socio-environmental stress.omero.Mscmental health 8. 1.Alarm reaction phase Fight or flight syndrome are initiated The body prepares to fight or adjust to the stressorby increasing ; heart rate blood sugar respiration and muscle tensionreactions to socio-environmental stress.omero.Mscmental health 9. 2.Resistance stage The individual uses the physiological responses ofthe first stage as a defense in the attempt to adapt tothe stressor. If adaptation takes place the third stage is preventedor can be delayed. Physiological symptoms may disappear.reactions to socio-environmental stress.omero.Mscmental health 10. 3.Exhaustion stage It takes place when there is a prolonged exposure tothe stressor to which the body has become adjusted The adaptive energy is depleted Diseases of adaptation may occur Such as headaches, ulcers, coronary heartdisease, mental disorders Without intervention, this may result into death.reactions to socio-environmental stress.omero.Mscmental health 11. general adaptation syndrome(diagrammatically)AlarmreactionstageIncreasedblood sugarRespirationsincreaseBloodpressureincreaseResistancestagePhysiologicalresponses areusedExhaustionstageEnergy isdepletedDeath canoccur withoutinterventionsreactions to socio-environmental stress.omero.Mscmental health 12. Stress as an environmentalevent The event creates change in the life pattern of theindividual , requires significant adjustment in lifestyleand taxes available personal resources. The change can be either positive, such asoutstanding personal achievement, or negative suchas being fired from job. What is important is the change from thereactions to socio-environmental stress.omero.Mscmental health 13. contexisting steady state of the individuals life pattern Miller and Rahe found that women react to life stressevents at higher levels than men, And unmarried people gave higher scores thanmarried people for most of the events. They used a rating scale with numerical values. Table 1-1 (Townsend 2012)reactions to socio-environmental stress.omero.Mscmental health 14. Cont, Younger subjects rated more events at a higherstress level than older subjects A higher score on the recent life changesquestionnaire( RLCQ) puts the individual at greatersusceptibility to physical or physiological illness The questionnaire may be completed considering lifestressors within a 6 months or 1-year period.reactions to socio-environmental stress.omero.Mscmental health 15. Cont, Six months totals equal to or greater than 300 life changeunits(LCUs) or 1 year totals equals to or greater than 500 (LCU) areconsidered indicative of a high level of recent life stress, Thereby increasing the risk of illness for the individual. It is not known whether stress overloadreactions to socio-environmental stress.omero.Mscmental health 16. contMerely predisposes a person to illness or actuallyprecipitates it but there does appear to be a causallink( Pellelier 1992 cited in Townsend 2012) The drawback to life changes questionnaire is that itdoes not consider the individuals perception of theevent. Individuals differ in their reaction to life eventsreactions to socio-environmental stress.omero.Mscmental health 17. Cont, And these variations are related to the degree towhich the change is perceived as stressful. The same instruments fail to account for theindividuals coping strategies and available supportsystems at the time when the life change occurs. Positive coping mechanisms and strongreactions to socio-environmental stress.omero.Mscmental health 18. Cont, Social or familial support can reduce the intensity ofthe stressful life changes and promote a moreadaptive response.reactions to socio-environmental stress.omero.Mscmental health 19. Stress as a transaction betweenthe individual and theenvironment The emphasis is the relationship between the individualand the environment. Personal characteristics and the nature of theenvironmental event are important. This differs with the modern explanation of the etiology ofdisease No longer is causation viewed solely as an external entityreactions to socio-environmental stress.omero.Mscmental health 20. Cont, Whether or not illness takes place depends also onthe affected organism susceptibility. Similarly, to predict psychological stress as areaction, the properties of the person in relation tothe environment must be considered.reactions to socio-environmental stress.omero.Mscmental health 21. Precipitating event Is a stimulus arising from the internal or externalenvironment and is perceived by the individual in aspecific manner. The determination that a particular person-environmentrelationship is stressful depends on the individualscognitive appraisal of the situation. Cognitive appraisal is an individual evaluation of thepersonal significance of the event orreactions to socio-environmental stress.omero.Mscmental health 22. Cont, Or occurrence. The event precipitates a response on the part of theindividual, and the response is influenced by theindividuals perception of the event. The cognitive response consists of a primaryappraisal and secondary appraisal.reactions to socio-environmental stress.omero.Mscmental health 23. Individuals perception of theevent 1. primary appraisal Lazarus and Folkman 1984 cited in (Townsend2012), identified three types of primary appraisal. 1.Irrelevant 2.Benign-positive 3.stressfulreactions to socio-environmental stress.omero.Mscmental health 24. 1.Irrelevant An event is judged irrelevant when the outcomeholds no significance for the individual.reactions to socio-environmental stress.omero.Mscmental health 25. 2.A benign-positive outcome Is one that is perceived as producing a pleasure for theindividual Stress appraisal include harm/loss, threat and challenge. Harm/loss appraisals refers to damage or loss alreadyexperienced by the individual. Appraisals of a threatening nature are perceived asanticipated harm/losesreactions to socio-environmental stress.omero.Mscmental health 26. Cont, When an event is appraised as challenging, theindividuals focuses on potential for gain orgrowth, rather than a risks associated with the event. Challenge produces stress even though theemotions associated with it (eagerness andexcitement) are viewed as positive and copingmechanisms must be calledreactions to socio-environmental stress.omero.Mscmental health 27. contto face the new encounter. Challenge and threat may occur together when anindividual experiences these positive emotions along withfear or anxiety over possible risks associated withchallenging event. 3.When stress is produced in response toharm/loss, threat or challenge , a secondary appraisal ismade by the person.reactions to socio-environmental stress.omero.Mscmental health 28. Secondary appraisal This is an assessment of the skills, resources, andknowledge that the person posses to deal with thesituation. The individual evaluates by considering the following; Do I have the resources to deal effectively with this challengeor stressor? Which coping strategies are available to me?reactions to socio-environmental stress.omero.Mscmental health 29. Secondary app..Cont, Will the option I choose be effective in this situation Do I have the ability to use that strategy in aneffective manner The interaction between the primary appraisal of theevent that has occurred and the secondary appraisalavailable coping strategies determines the quality ofreactions to socio-environmental stress.omero.Mscmental health 30. Cont, the individuals adaptation response to stress.reactions to socio-environmental stress.omero.Mscmental health 31. Predisposing factors A variety of elements influence how an individualperceives and responds to a stressful event. These predisposing factors strongly influencewhether the response is adaptive or maladaptive. Types of predisposing factors include geneticinfluences, past experiences andreactions to socio-environmental stress.omero.Mscmental health 32. Cont, Existing conditions Genetic influences are those circumstances of anindividuals life that are acquired through heredity. Examples include family history or physical andphysiological conditions( strengths and weaknesses) And temperament ( behavioral characteristicspresent at birthreactions to socio-environmental stress.omero.Mscmental health 33. Cont,that evolve with development). Past experiences are occurrence that result inlearned patterns that can influence an individualsadaptation response They include previous exposure to the stressor orthe other stressors, learned coping responses anddegree of adaptation to previous stressors.reactions to socio-environmental stress.omero.Mscmental health 34. Cont. Existing conditions incorporate vulnerabilities thatinfluence the adequacy of the individualsphysical, psychological and social resources fordealing with adaptive demands. Examples include current healthstatus, motivation, developmental maturity, severityand duration of the stressor,reactions to socio-environmental stress.omero.Mscmental health 35. Cont, Financial and educational resources ,age, existingcoping strategies and a support system of caringothers.reactions to socio-environmental stress.omero.Mscmental health 36. Transactional model ofstress/adaptationreactions to socio-environmental stress.omero.Mscmental health 37. Stress management It involves the use of coping strategies in responseto stressful situations. Coping strategies are adaptive when they protect theindividual from harm ( or additional harm ) orstrengthen the individuals ability to meet challengingsituations. Adaptive responses help restore homeostasisreactions to socio-environmental stress.omero.Mscmental health 38. Cont, To the body and impede the development of diseases ofadaptation. Coping strategies are considered maladaptive when theconflict being experienced goes unresolved or intensifies Energy resources become depleted as the bodystruggles to compensate for the chronic physiological andpsychologicalreactions to socio-environmental stress.omero.Mscmental health 39. Cont,arousal being experienced. The effect is a significant vulnerability to physical orpsychological illness.reactions to socio-environmental stress.omero.Mscmental health 40. Adaptive coping strategies Awareness to become aware of the factors thatcreate stress and feelings associated with a stressfulresponse Stress can be controlled only when one recognizesthat it is being experienced. As one becomes aware of stress he or she can omit,avoid or accept them.reactions to socio-environmental stress.omero.Mscmental health 41. Relaxation Individuals experience relaxation in different ways. Exercise that require strong energy Use of breathing exercises and progressiverelaxation relieve stressreactions to socio-environmental stress.omero.Mscmental health 42. Meditation Involves assuming a comfortable position, closingthe eyes, casting off all other thoughts andconcentrating on a single word, sound or phrase thathas a positive meaning to the individual. Practiced 20 minutes once or twice daily , has shownto produce a lasting reduction in blood pressure andother stress related symptoms.reactions to socio-environmental stress.omero.Mscmental health 43. Interpersonal communicationwith others Talking the problem out with an individual who isempathetic is sufficient to interrupt escalation of thestress response. Writing about ones feeling in a journal or daily canalso be therapeutic.reactions to socio-environmental stress.omero.Mscmental health 44. Problem solving Done objectively by looking at a situation. After an objective assessment of the situation, theproblem solving /decision making model can be put inplace. Assess the facts of the situation Formulate goals for resolution of the stressful situation Study the alternatives for dealing with the situationreactions to socio-environmental stress.omero.Mscmental health 45. Cont, Determine the risks and benefits of each alternative Implement the alternative selected Evaluate the outcome of the alternative implemented If the first choice is ineffective select and implementa second optionreactions to socio-environmental stress.omero.Mscmental health 46. Pets Studies have shown that people who care for petsespecially dogs and cats are better able to cope withstressors of life (Allen, Blascovich &Mendes, 2002, Barker Knisely, Mccain &Best 2005cited in Townsend 2012). The physical act of stroking or petting a dog or catcan be therapeuticreactions to socio-environmental stress.omero.Mscmental health 47. Cont, It gives the animal an intuitive sense of being cared forand at the same time gives the individual the calmingfeeling of warmth, affection and interdependence with areliable trusting being. One study revealed evidence that individualsexperienced a statistically significant drop in bloodpressure in response to petting a dog or cat(whitaker2000 cited in townsend 2012.reactions to socio-environmental stress.omero.Mscmental health 48. Music Creating and listening to music stimulatemotivation, enjoyment and relaxation. Music can reduce depression and bring aboutmeasurable changes in mood and generalactivity.(classical or spiritual music)reactions to socio-environmental stress.omero.Mscmental health 49. Ethical Issues AboutStress in Organizations Organizational change: do managers have an ethical duty toprepare employees for change? Physical work environment: is it unethical for managers toknowingly expose workers to hazards? Person-environment fit: is it unethical for an organization todistort information about a job? Knowledge about work and nonwork stressors: shouldmanagers consider nonwork stressors when trying tounderstand the total stress effects on an employee?reactions to socio-environmental stress.omero.Mscmental health 50. OTHER ASPECTS -Cont, How would you know that your employees arestressed up as a manager? Physical symptoms. behavioral symptoms. How do you deal with stress in a work place ?reactions to socio-environmental stress.omero.Mscmental health 51. References Townsend M,C. (2012) Psychiatric Mental HealthNursing.Concepts of care in evidence basedpractice. 7th edition. Davis company;philadephia. Meyer s, Naude Nierkek (2005) .the unitmanager.comprehensive guide. JUTTA; SouthAfricareactions to socio-environmental stress.omero.Mscmental health