Nursing Theory and the Role of Stress
- Callista Roy’s Adaptation Model describes how an individual can
effectively respond to stressors in the environment. According to Roy’s
theory, a person has the ability to modify external stimuli to allow
adaptation to occur. A nurse assists an individual with modifying and
regulating peripheral stimuli to promote a supportive healing
environment. On the other hand, - Pender’s Health Promotion Model focuses on promoting health and managing stress. In this
model people are capable of assessing their own abilities and assets and want to live in ways that enable them to be as healthy as possible. Interventions such as increasing physical activity, improving diet and nutrition, and using stress-management strategies help the individual become and remain healthy. - Systems approach model - Betty Neuman - every person develops defines to stress- helps maintain health and wellness. Events are multidimensional and not caused or affected by only one thing. Every person develops a set of responses to stress that constitute the “normal line of defense”. This line of defense maintains
health and wellness. Physiological, psychological, sociocultural, developmental, or spiritual influences buffer stress. The Neuman Systems Model of nursing views a patient, family, or community as constantly changing in response to the environment and stressors. 3 levels of prevention: primary - measures taken before symptoms e.g. vaccination. Secondary - investigation and treatments after symptoms occur. Tertiary - recovery from irreversible damage e.g. rehabilitation from a disabled person.
Factors Influencing Stress and Coping
Situational Factors- EVERYDAY STRESS
Situational stressors in the workplace that affect nurses and other health
care professionals include high-acuity patient load, job environment,
constant distractions, responsibility, conflicting priorities, and intensity of
care (e.g., trauma, emergency, or critical care areas). In addition, changing shifts increases fatigue and workrelated stress.
Maturational Factors- PREDICTABLE STAGES OF DEVELOPMENT
Stressors vary with life stage. Children
who are in the stage of initiative versus guilt identify stressors related to
physical appearance, families, friends, and school. Preadolescents experience stress related to self-esteem issues, changing
family structure as a result of divorce or death of a parent, or hospitalizations. Erikson asserts that during this stage, they can develop a
sense of inferiority without proper support for learning new skills. As
adolescents search for identity with peer groups and separate from their
families, they also experience stress. In addition, they face stressful
questions about sex, jobs, school, career choices, and using mind-altering substances. During this stage of development, stress can occur because of preoccupation with appearance and body image. Stress for adults centers around major changes in life circumstances.
These include the many milestones of beginning a family and a career,
losing parents, seeing children leave home, and accepting physical aging. In old age stressors
include the loss of autonomy and mastery resulting from general frailty or health problems that limit stamina, strength, and cognition
Sociocultural Factors- lead to developmental problems e.g. prolonged poverty and physical disability. Cultural variations particularly if personal values disrupted by culture e.g. migrating to another country.
Second Victim Syndrome
Environmental and social stressors often lead to developmental problems.
Potential stressors that affect any age-group but that are especially
stressful for young people include prolonged poverty and physical
disability. Children become vulnerable when they lose parents and
caregivers through divorce, imprisonment, or death or when parents have
mental illness or substance-abuse disorders. Living under conditions of
continuing violence, disintegrated neighborhoods, or homelessness affects
people of any age, especially young people (Murdaugh, et al., 2015).
A person’s culture also influences stress and coping. Cultural variations
produce stress, particularly if a person’s values differ from the dominant
culture in aspects of gender roles, family relationships, and religious
beliefs (Giger, 2017, Shavi et al., 2016). Other aspects of cultural
variations begin with language difference, geographical location, family
relationships, time orientation, access to health care programs, and
disparities in health care
Compassion Fatigue
Compassion fatigue is a term used to describe a state of burnout and
secondary traumatic stress. Secondary traumatic stress is the stress that health care providers experience when witnessing and caring for others
who are suffering.
Second Victim Syndrome
Second victim syndrome affects health care providers when a medical
error that results in significant harm to a patient and the patient’s family
occurs.
