华盛顿大学压力管理课件

StressManagementAllanSanders,MN,ARNPObjectivesExplorethebiological,psychological,andsocialaspectsofthehumanstressresponse.Describethedifferencebetweenadaptiveandmaladaptivecopingstrategies.Understandcopingstrategiesthatincreaseresiliencetopromoteproductivelivingandhealthyaging.CommonStressAssociatedDiseasesDiminishedImmunityHeadacheFatigueWeightgainDyslipidemiaHypertensionHeartDiseasePsoriasis/EczemaDigestiveproblemsAnxietyDepressionAlcoholismSubstanceabuseInsomniaIrritablebowelsyndromeFibromyalgiaDecreasedsexdriveStressEustressManageableStresscanleadtogrowthandenhancedcompetenceDistressUncontrollable,prolonged,oroverwhelmingstressisdestructive.AcuteStressImmediateresponsetoathreatorchallengeChronicStressOngoingexposuretostress,mayseemunrelentingCausesofStressExternalcausesFamily,work,economics,work,school,majorlifechanges,unforeseenevents,etc.InternalcausesWorry,uncertainty,fear,attitudes,unrealisticexpectations,etc.SourcesofClinicalStressForpatientsUncertaintyFearPainCostLackofknowledgeRiskforharmUnknownresourcesFornursesPoorpatientoutcomesRiskofmakinganerrorUnfamiliarsituationsExcessiveworkloadInadequateresourcesALARM:ActivationofHypothalamicPituitaryAdrenalAxis

CatecholaminesIncreasescardiacoutputDilatesairwaysDilatespupilsMobilizesglucoseCausesvasomotorchangesDecreasesdigestionEnhancescoagulationCorticalSteroidsElevatesglucoseIncreasesaminoacidsIncreasesNAresorptionIncreasesextracellularfluidvolumeInhibitshistamineandbradykininSuppressestheimmuneresponseResistanceAdaptationoccursActivationofthehypothalamicpituitaryadrenalaxiscontinuesThestressormayberesolvedThebodyreturnstohomeostasisMayprogresstoexhaustionStresscontinuesasresourcesaredepletedExhaustion

Occurswhenthedemandsofthestressexceedsthepersonsabilitytoadapt.FunctioningdeclinesMayresultinhealthproblemsPhysicalsymptomsMentalsymptomsGenetics&DevelopmentGeneticsGenescontrolthestressresponseIndividualshavedifferentresponsestostressThereisageneticcomponentto:fearfulbehavioranxietydisordersNeurobiologicalresponseDevelopmentLifeexperiencescanaffectaperson'sstressresponseSocialsupportStrongsupportisprotectiveEarlylifestressIncreasesstressreactivityasanadultCoping&ResilienceCopingAbilitytocontrolemotionsAbilitytoperceiverealityAbilitytothinkrationallyAbilitytoproblemsolveCulturallydefinedResilienceTheabilitytobouncebackThepositivecapacitytocopewithstressProvidesresistancetonegativeeventsHardiness,ResourcefulnessCopingAdaptiveCopingContributetoresolutionofthestressresponseMaladaptiveCopingStrategiesthatcausefurtherproblemsActiveCopingActivelyseekingresolutiontothestressPromoteAdaptiveCopingTrainingPreparesforstressfuleventsNutritionEathealthy,avoidskippingmealsExerciseIncluderegularexerciseSleepGetadequatesleep—avoidfatigueAvoidMaladaptiveCopingBlurringofboundariesAvoidance/withdrawalNegativeattitudeAngeroutburstsAlcohol/DrugsHopelessnessNegativeself-talkResentmentViolencePromoteResilienceFactorsPositiveRoleModelsOptimismHumorMoralCompassAltruismReligion&SpiritualitySocialSupportOptimismPositiveBeliefsAssociatedwithwellbeingCognitivereframingPositivethinkingRefutethenegativethinkingBelieveinameaningfulcauseItisimportanttoacknowledgerelevantnegativefactorsHumorHighlyeffectiveMaturecopingmechanism

“Anotherofthesouls’weaponsforthefightforself-preservation,itiswellknownthathumor,morethenanythingelseinthehumanmakeup,canprovideanaloofnessandtheabilitytoriseaboveanysituation,evenforafewseconds.”

ViktorFranklMoralCompassConductamoralinventory“Looknotforanygreaterharmthenthis,destroyingthetrustworthy,self-respecting,well-behavedmanwithinyou.”

Epicetus

Maintainyourintegrity“Betweenstimulusandresponsethereisaspace.Inthatspaceisourpowertochooseourresponse.Inourresponseliesourgrowthandourfreedom.”

ViktorFranklReligion&SpiritualityAssociatedwithpsychologicalandphysicalwellbeingGuardsagainstdespairProvidessocialsupportProvidespositiverolemodelsProvidesapositivemissionSocialSupportSocialsupporthasaprofoundeffectonlifeexpectancyPatientshavebetteroutcomeswithstrongsocialsupportIsolationandpoorsocialsupportareassociatedwithapoorstressresponseFewhardyindividuals“goitalone”Review:PracticalTipsSetrealisticexpectationsExerciseregularlyEathealthyGetadequatesleepMaintainawork-leisurebalancePositiveReframing&optimismEnhancesocialsupportInternetResourcesBuildingresilience:Diet,exercise,stressandtheimmunesystem:Exercise:Revupyourroutinetoreducestress:Positivethinking:Reducestress,enjoylifemore:Stressmanagementforpatientandphysician:

Stressmanagement:Understandyoursourcesofstress:Stressreductiontechniques:Amustforahealthylifestyle:

LearningExerciseListyourcurrentsourcesofstress.Conductaninventoryofcopingstrategiesthatyouuseorhaveusedinthepast.IncludemaladaptivestrategiesListyoursignaturestrengthsandfactorsthatmayenhanceyourresilience.Whileconsideringtheabove,developapersonalizedstressmanagementplantoenhanceyourcopingandresilience.References

Ahern,N.,Ark,P.,Byers,J.(2001).Resilienceandcopingstrategiesinadolescents.PaediatricNursing.28(10).Beckmann-Murray,R.,Proctor-Zentner,J.,&Yakimo,R.(2009).Healthpromotionstrategiesthroughthelifespan.NewJersey:PrenticeHallBhui,K.,King,M.,Dein,S.,&O’Conor,(2008).Ethnicityandreligiouscopingwithmentaldistress.JournalofMentalHealth.12(2).Copstead,L.C.&Banasik,J.L.(2010).Pathophysiology:Biologicalandbehavioralperspectives(2ndED.)USA:W.B.SaundersCompanyFielding,R(Undated)RetrievedSeptember25,2007from:Hildon,Z.,Smith,F.,Netuveli,G.&Blane,D.(2008).Underst