Islamic University of Gaza Faculty of nursing

1. Islamic University of Gaza Faculty of nursing Community Mental Health Nursing Prepared by : Mohammed Zaki Abu Rokba Supervised by : Dr. Ashraf El-Jedi

2. الضغوط النفسيةStress يقول الله تعالى في محكم التنزيل: { لَقَدْ خَلَقْنَا الْإِنسَانَ فِي كَبَدٍ } سورة البلد(4)

3. Stress and Mental Illness • The acceptance of stress as a topic worthy of study has developed rapidly during the 1980s largely as a matter of necessity resulting from many people requiring care or treatment. • However, stress has been the subject of much study throughout from the viewpoint of whether external events or mental trauma could be seen as responsible for producing definite ill-health. • Stress has clearly always been a normal part of everyday living, only in certain periods in history have almost all of their important variables changed together. We can identify these important variables as economic, political, religious and social relationship and work practices.

4. Definition of stress • Stress as a generic term for the whole area of problems that includes the stimuli producing stress reactions, • the reactions themselves and the various intervening processes. It defines a large, complex, amorphous, interdisciplinary area of interest and study. (Lazarus, 1966) Stress is defined as a non-specific response of the body to a demand (Kopolow 1977:1(

5. Stages of Stress (Wilder and Plutchik 1985:1198) • Stress Response Pattern Alarm Resistance Exhaustion “Fight or Flight” activation of the autonomic nervous system (e.g., heart rate, blood pressure, cortisol, etc.) Immune suppression reaction, release of endorphins and growth hormone Exhaustion phase contributing towards stress related illness and exacerbation of medical conditions

6. الضغوط النفسيةStress دورة الضغط النفسي: الأداء حد القدرة شعور بالملل أو التعب تأثير جسدي واضح تأثير جسدي واضح انهيار نفسي او جسدي تام الضغط النفسيStress

7. (Wilder and Plutchik 1985:1198)have summarized Style's views on stress as follows : • Stress is non-specific, although each stressor has both specific effects (sweating during heart) and non-specific effects (adrenal enlargement, thymus involution, and development of ulcer). • A stressor is whatever produces these non-specific effects. • Psychological events can produce the same stress response as physical stressor. • Some stressors produce good stress, or eustress, and produce bad stress. • Stress is always a matter of degree. • Stress in humans can be moderated by various treatment techniques.

8. People at risk of stress disorder • Whilst it is true that nearly everyone would break down under extreme condition of stress, for example the effects of systematic torture, such conditions are mercifully rare. Only a small segment of the population are likely to be referred for professional assessment and assistance at any given time. • However, we have to note that at the current time the increasing numbers of people experiencing stress gives rise to the need for a wider approach to the problem. • The social circumstances that surround people will also affect markedly the response to a stressful situation. For example, a wealthy individual will not respond to an ordinary stressor with such cancer, • Beside these psychological factors that give rise to vulnerability to stress there is the aspect of what type of psychiatric disorder the stressful incident may lead to. According to a recent researcher (McFarlan 1991:308) the commonest disorder was depression followed by PTSD and generalized anxiety disorder.

9. An expanded vulnerability modelof the relation between stressful life events health outcome ( from cotton 1990 , P . 35 )

10. The stress problems that clients may present. Clarc(1988:122) has produce a list that assists clients in understanding their particular situation: 1. identify sources of stress for you. List changes in the following areas that are affecting you now. • School • Close relationships with friends, family, and significant other people are pets: • Work • Life style (include nutrition, fitness, ect.) • Living arrangements or place of residence • Finances • Amount of worry about the future • Sudden challenges 2. Identify which changes seem to be negative (stressful) by placing a minus sign (-) in front of them and which seem to be positive (helpful or neutral) by placing a plus sign (+) in front of them. 3. Identify the negative (-) changes and decide on a procedure for limiting the effects of stress.

11. شكراً جزيلاً