PRESENTED BY : MRS.JANCY RACHAEL

1. STRESS AND COPING STRATEGIES PRESENTED BY : MRS.JANCY RACHAEL

2. AWARENESS OF STRESS AND COPING STRESS: stress is a relationship between person and the environment that is appraised by the person as exceeding or taxing the persons resources. STRESSORS : A biological, psychological,chemical or social factor that causes physical or emotional tension May be a etiology of certain illness

3. TYPE OF STRESSORS Dr. seyle called the causes of stress “stressors” or “triggers”. There are two kinds of stressors: EXTERNAL STRESSORS INTERNAL STRESSORS

4. EXTERNAL STRESSORS INCLUDE: • Physical environment : • Noise, bright lights, heat confined • spaces. • Social (interaction with people): • Rudeness, bossiness or aggressiveness • on the part of someone else. • Organizational: • Rules, regulations, “red tape,” deadlines. • Major life events: • Death of a relative, lost job, new baby. • Daily hassles: • Commuting, misplacing keys, mechanical • breakdowns.

5. INTERNAL STRESSORS INCLUDE Lifestyle choices: caffeine, not enough sleep, overloaded schedule. Negative self-talk: pessimistic thinking, self criticism, over- analyzing. Mind traps: Unrealistic expectations, taking things personally, all-or-nothing thinking, exaggerating, rigid thinking. Stressful personal traits: Type A, perfectionist, workaholic, pleaser.

6. It is important to note that most of the stress that most of us have is actually self-generated. Recognizing that we create most of our own upsets, however, is an important first step to dealing with them

7. EXAMPLE Susan was less stressed than Joanne was. Susan was tested, had studied and was interested in the content. Whereas Joanne was, sleep deprived and inadequately prepared. The critical factor is the risk involved. For Susan, a failed test meant a retake, Joanne failed test meant not returning to school.

8. LEVELS OF APPRAISAL PRIMARY APPRAISAL & SECONDARY APPRAISAL

9. primary appraisal : • In the above stated example, • Susan’s commitment to the goal of doing well on the test is consistent with her “valuing the content, which in turn motivated to her study regularly and prepare carefully for the exams. She believed the test would be difficult.” • Joanne had the commitment to pass the test but did “not value the content. However, Joanne believed that the test would be relatively easy”.

10. Secondary appraisal : “ The second level secondary appraisal involves making decision about blame or credit coping potential and future expectation.” In this example, • Susan nervous but took test. • Joanne’s secondary appraisal of test taking situation begun with the realization. She might not pass the test because the questions were different. She acted impulsively by blaming the teacher for giving the different examination and storming out of the room. She did not cope effectively with the situation.

11. GENERAL ADAPTATION SYNDROME • seyle called the general reaction of the body to stress as the general adaptation syndrome. ALARM REACTION STAGE STAGES OF RESISTANCE STAGES OF EXHAUSTION Stages of stress

12. ALARM STAGE During this stage, the physiological responses of the “fight or flight syndrome” are initiated. The individual uses the physiological responses of the first stage as a defense in the attempt to adapt to the stressor. If adaptation occurs, the third stage is prevented or delayed. Physiological symptoms may disappear. This stage occurs when there is a prolonged exposure to stressor to which the body has been adjusted the adaptive energy is depleted and the individual can no longer draw from the resources for adaptation. STAGES OF RESISTANCE STAGES OF EXHAUSTION

14. HYPOTHALAMUS STIMULATES SYMPATHETIC NERVOUS SYSTEM INNERVATES SWEAT GLANDS ADRENAL MEDULLA EYE LACRYMALGLANDS RESPIRATORY SYSTEM CVS GI LIVER URINARYSYSTEM FAT CELLS Pupils dilated Bronchioles dilated Respiration rate increased • Reduced gastro intestinal motility. • Reduced secretions. • Sphincters contract Lipolysis • Increased ureter Motility. Bladder muscle contract Sphincter relaxes. • Increased force of cardiac contraction. • Increased cardiac output. • Increased heart rate. • Increased blood pressure. • Increased glycogenolysis. • Reduced glycogen synthesis. Nor epinephrine and epinephrine released Increased secretion Secretion increased

15. COPING . . . “Coping” is a process whereby a person manages the demands and emotions that are generated by the appraisal.

16. 1. Problem focused coping In problem focused coping, the person attacks the source of stress by eliminating it or changing its effects. Eg: when noise from television interrupts a student from studying and causes the student to be stressed, the student turns off the television and eliminates the noise

17. 2. Emotion focused coping The person reinterprets the situation reducing the stress and the need for further coping without changing the actual personal environment relationship. Eg : a mother is afraid that her teen aged daughter has been in an accident because she didn’t come home after a party. Then the woman remembers that he gave her daughter permission to stay at a friend’s house. She immediately feels better.

19. Change the situation: Avoid the stressor. Alter the stressor. Change your reaction: Adapt to the stressor. Accept the stressor Dealing with Stressful Situations: The Four A’s

20. Pare down your to-do list – Analyze your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely. • Alter the situation • PROBLEM SOLVING AND DECISION MAKING : • If something or someone is bothering you, communicate your concerns in an open and respectful way. Try to solve the problems by taking right decisions

21. Adapt to the stressor Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts. This simple strategy can help you keep things in perspective Accept the things you can’t change Share your feelings. Talk to a trusted friend or make an appointment with a therapist. Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation

22. POSITIVE THINKING • Positive thinking helps with stress management and can even improve your health. Overcome negative self-talk by recognizing it and practicing with some examples provided • Positive thinking enhances focus on your job and can help to reduce the chance of accidents

23. Understanding positive thinking and self-talk • Self-talk is the endless stream of thoughts that run through your head every day. These automatic thoughts can be positive or negative. Some of your self-talk comes from logic and reason. Other self-talk may arise from misconceptions that you create because of lack of information. • If the thoughts that run through your head are mostly negative, your outlook on life is likely pessimistic. If your thoughts are mostly positive, you're likely an optimist — someone who practices positive thinking.

24. How positive thinking gives way to negative thinking • But what if your self-talk is mainly negative? That doesn't mean you're doomed to an unhappy life. Negative self-talk just means that your own misperceptions, lack of information and distorted ideas have overpowered your capacity for logic and reason.

25. Some common forms of negative and irrational self-talk includes • Personalizing. When something bad occurs, you automatically blame yourself. • Catastrophizing. You automatically anticipate the worst. • Polarizing. You see things only as either good or bad, black or white. • Filtering. You magnify the negative aspects of a situation and filter out all of the positive ones

26. You can learn positive thinking • Instead of giving in to these kinds of negative self-talk, weed out misconceptions and irrational thinking and then challenge them with rational, positive thoughts. When you do this, your self-talk will gradually become realistic and self-affirming — you engage in positive thinking.

27. Periodically during the day, stop and evaluate what you're thinking. If you find that your thoughts are mainly negative, try to find a way to put a positive spin on them. • Don't say anything to yourself that you wouldn't say to anyone else

28. REMEMBER • You owe it to yourself to react positively! • You owe it to yourself to work safely! • You owe it to yourself and your loved ones to avoid injuries!

29. AWARENESS The first step in the stress management is to increase the client’s awareness of the events, interpretations and self talk that trigger a stress response, along with awareness of individual response patterns, Control of self talk.

30. The model is an easy to use as A, B, C. • A=Activating event (what happened). An occurrence which triggers an emotional consequences. Eg: My bus came late and I am unable to reach my work place in time. • B=Belief (what you are thinking, self talk) An evaluation and judgment about the demands on yourself, demands about others and demands about the world or life conditions. These may be rational and realistic or irrational. Eg: People who look down on me for being late they will that I am stupid and unreliable. • C=Consequence (outcome). An emotional and/or physical consequence taken to a belief. Eg: anxiety.

31. EXERCISE Step1: Think of an activating event. Speaking in front of the audience Step2: Identify your feelings and reactions. Felt fearful. Mouth gets dry hands become clammy.

32. Step3: Identify beliefs that lead to negative outcomes I am incapable of doing the job Step4: Write down the same event. I felt fearful in speaking in front of the audience Step5: How would you like to feel and behave the next time the same situation arises? I prepared well and I will do a good job. I have the skill

33. TIME MANAGEMENT

34. One of the most common cause of stress is being disorganized at studies or at the living environment. Nothing is particularly hard if you divide it into small jobs.

35. According to Benjamin Franklin, • “Time is the stuff of which life is mad". So time is the essence of living and it is the scarcest resource.

36. What are the time wasters for you? • Interruptions such as telephone calls, drop in visitors. • Lack of clear cut goals, objectives, priorities • Lack of personal organization and self discipline • Waiting for others

37. DO YOU KNOW WHEN TO STUDY • TIME MANAGEMENT TECHNIQUES FOR STUDENTS • Study when: • Plan two study hours for every hour you • spend in the class. • Study difficult or boring subjects first. • Avoid scheduling marathon sessions. • Be aware of best time of the day. • Use a regular study area.

38. Do you know where to study? Study where: • Choose a place that minimizes visual and auditory distractions. • Use library or empty classrooms get out of as noisy room. • Do not get too comfortable. Sit (or even stand) so that you can remain awake and attentive.

39. DO YOU KNOW HOW TO STUDY You and the outside world: • Pay attention to your attention. • Agree with roommates about study time. • Avoid noisy distractions. • Notice how others misuse your time. • Get off the phone. • Learn to say “no”. • Hanging a “do not disturb” on your door. • Ask, “how did I waste time.

40. POINTS TO BE KEPT IN MIND BEFORE TIME PLANNING 1.Blocks of the study times and breaks 2.Dedicated study spaces 3. Weekly review 4 Prioritize your assignments 5.Achieve stage one-get something done

41. PROBLEM SOLVING AND DECISION MAKING

42. PROBLEM SOLVING AND DECISION MAKING Problem solving and decision making is vital abilities for nursing practice. It is a process, which not only involves managing and delivering effective care but also is also essential for engaging in planned change.

43. PROBLEM SOLVING…. Problem solving is a systematic process that focuses on analyzing a difficult. It is the process of taking coercive action in order to meet objectives. It is also a part of decision-making.

44. DECISION MAKING …. Decision-making is a purposeful and goal directed effort using a systematic process to choose among options. The hallmark of decision-making is the identification and selection of options.

45. Problem solving steps

46. Process of problem solving in nursing Define the problem: Problem identification is influenced by information available, by the values, attitudes and experience of the decision makers, and by the time factor. Sufficient time should be allowed for collection and organization of data.

47. Gather data The data gathered consist of objectives (facts) and subjective (feeling) information. Information gathered should be valid, accurate relevant to the issue and timely. Moreover, individuals involved in this process must have access to information and adequate resources in order to make cogent decisions.

48. Analyze the data Further refine the problem statement and identify possible solutions or options.

49. Develop alternatives The goal of generating option is to identify as many choices as possible being flexible, open minded and creative to being able to consider a range of possible options.

50. Select solutions The decision maker should the objectively weigh each option according to its possible risks and consequences as well as possible outcomes they may be derived. The solution selected should be the one that is more feasible and satisfactory and has the least undesirable consequences.