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Chapter 20
Communicating with Clients in Stressful Situations
17
Nursing
Undergraduate 3
11/23/2013

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Term
Stress
Definition
natural physiologic, psychological and spiritual response to the presence of a stressor
Term
stressor
Definition
a demand, situation, internal stimulus or circumstances that threatens a person security or self-integrity.
catastrophic related to
related to life change
experience as a minor hassle
Term
intense stress response stressor
Definition
that a person has limited control over
Ambiguous situations
Current situations
intensity and duration of stress varies according to the circumstance, social support, emotional state of the person
Term
eustress
Definition
short mild level of stress.
-positive stress response w/ protective and adaptive functions
-Perceived as within the person’s ability to manage
Term
Distress
Definition
negative stress that causes a higher level of anxiety.
-being unpleasant and diminishes performance
-includes fight or flight patterns or tend and befriend.
Term
Mild stress
Definition
-Can be beneficial as helps people stay focused and alert.
-Serves as a motivator
Term
Moderate Stress
Definition
-Chronic stress exacerbated in health illnesses
-when people experience frustration/conflict over inability to change a desired outcome through own efforts
Term
High Stress levels
Definition
Interferes with a person’s ability to function because reduces person’s objectivity
Term
Physiologic response models of Stress
(Walter Cannon, 1932)
Definition
- people feel well in all areas = state of Homeostasis
-Stress Disturbs homeostasis- a
physiological sympathetic-adrenal medulla system in the brain sets into motion and immediate hormonal cascade to mobilize the body’s energy resources.
Fight or flight response
Term
General adaptation syndrome
(Hans Selye, 1950)
Definition
-described responses to longer term stress exposure
-3 stage progressive pattern of non specific physiologic responses
Alarm- characterized by increased activity in the hypothalamic-pituitary adrenal(HPA) axis
Resistance- the body tries to accommodate for the stressor by adaptation
Exhaustion-the body fails to adapt
People in this response are high risk for stress related illness or mental disorders
Term
Allostasis
Definition
how an organism achieves homeostasis through adaptation (stability through change)
The interaction between stressor and physical responses is ongoing and the person becomes less or more susceptible to the negative consequences of stress over time.

The brain serves as primary mediator between the stress exposure and internal regulation of bodily processes and health outcomes

The brain attempts to find a new homeostasis that better fits the requirements of the environmental stressors by adaptation
Term
Stimulus Stress Model
(Thomas Holmes and Richard Rahe, 1967)
Definition
-transitional model of stress
- scale gave each individual life event; weighted numerical score reflecting its stress impact on a person.

stressful life events as s stimuli that threatens of disrupts homeostasis.
Term
Transactional model of stress
(Lazarus and Folkman's, 1984)
Definition
- most widely used to explain stress responses
-Based on premise of stressful experience is the result of a transaction between a situation or circumstance in the environment and the individual experiencing the stressor
- appraisal of stressors and coping strategies as primary emphasis
Term
Primary Appraisal
Definition
- evaluates the magnitude of stressor
- focuses on the stressor or stressful event itself
Content and strength as a personal threat
A person determines if and event is stressful and draws one of three conclusion
It is not stressful
It is relatively benign
It poses a significant threat to self-integrity
Term
secondary appraisal
Definition
involves a person’s perception or personal coping skills and available resources in the environment to aid in reducing stress impact
Term
Coping with Stress
(pearlin and schooler
Definition
-Knowledge of coping is essential to understanding how a stressor affect people
-Coping can reduce effects of stressors and the development of stress
-Any response to external life stains that serves to prevent, avoid or control emotional distress.
Term
Purpose of coping
(Pearlin and schooler )
Definition
-To change the stressful situation
-To change the meaning of the stressor
-To help the person relax enough to take the stress in stride
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