A Critical Evaluation Of Physiological And Environmental Explanations Of Stress Among Nurses

The Physiological Explanations of Stress

Definitions and approaches to stress

Follow the guidelines notes, explain the questions and base it on someone,for example how it affects nurses. Strictly follow,define , explain and say what the definition means to you.

This essay aims to distinguish between and outline the different definitions/approaches to ‘Stress’. It will critically evaluate the physiological explanations of stress. In psychology, stress refers to the feeling of strain and anxiety. It has been categorized as a stimulus, a response or consequence, and as an interaction. It is not inherently harmful. The cognitive perceptions, interpretations and appraisals of individuals give an implication to the events and establish whether the events are observed as positive or intimidating. The traits of personality also influence the equation of stress because what may be overburdening to one individual may be exciting to another. This essay will revolve around the settings involving the ‘Nurses in the Hospitals’. The potential stressors identified among nurses encompass decision making, patient care, change and taking responsibility (Hulbertâ€ÂWilliams et al. 2013). The role of a nurse has been regarded as a job which is full of stress in terms of working hours, physical labor, staffing, interpersonal relationships and human suffering, all of these are central to the work of a nurse (Chida 2013).This essay will also critically evaluate the environmental explanations of stress and will discuss the role of individual differences in relation to stress with reference to psychological research.

According to Hans Selye, stress can be defined as “a state that is manifested by a syndrome which encompasses all the nonspecifically induced alterations in a biological system”.  These nonspecifically induced changes comprise of the stereotypical response pattern of systemic stress (Szabo et al. 2012.) On the other hand, a psychological view has been advocated by Lazarus, the definition of stress, from his point of view is- “stress involves a particular association between individuals and the surrounding which is evaluated by the individuals as exceeding their resources and jeopardizing their well-being (Lazarus 2013).” In my opinion, Selye’s definition of stress focuses on the changes which are induced nonspecifically in a biological system, but Lazarus definition of stress is entirely different, he has laid emphasis on the association of individuals and their environment which is evaluated by the individuals. Both of these definitions have their own perceptions, and both of them are significant in defining the state of stress in the individuals (Jan and Popescu 2014).

Stressors experienced by nurses in hospitals

The transactional model of stress proposed by Lazarus and Folksman involves a framework to evaluate the processes of dealing with the events of stress. Stressful experiences are interpreted as the communications of individuals and environment (Martin and Daniels 2014). These communications rely on the external stressor impact. Seyle’s theory of stress involves a stereotypical response pattern which is called as General Adaptation Syndrome’ (GAS), and it progresses in three stages (Jackson 2014). Holmes and Rahe have developed a Social Readjustment Rating Scale (SRRS), which is called as Holmes and Rahe stress scale. It is a tool which helps to evaluate the load of stress carried by the individuals and the ways to deal with the stress (Blasco-Fontecilla, et al. 2012). Daily hassles are concerned with the minor events that arise in our daily activities. They are used as a measure of stress. Kanner et al., Conducted a key study which investigated the relationship between daily hassles, stress symptoms, and uplifts (Hulbertâ€ÂWilliams et al. 2013).  A comparison of the outcome was also made by using the SRRS as a stress symptoms predictor (Larsson et al. 2016).  The Hardiness theory of Kobasa describes a personality pattern that distinguishes the executives and managers who remain healthy under the stress of life, in comparison to those who develop problems of health (Wiebe 2013).  In psychology, hardiness refers to cognitive hardiness or personality hardiness in the literature (Hanton et al. 2013). Friedman and Rosenman developed the theory of Type A Personality which is concerned with the reaction of the individuals towards stress, and it was based on the observing the patients having heart conditions (Šmigelskas et al. 2015). 

Seyle’s theory of stress involves a stereotypical pattern of response which is known as General Adaptation Syndrome’ (GAS), it progresses in three stages; the first one is the alarm response which encompasses an initial shock phase and a succeeding countershock phase. Automatic excitability, gastrointestinal ulcerations and increased discharge of adrenalin are exhibited by the shock phase. On the other hand, the first operation of the defense process is marked by the countershock phase and is distinguished by augmented adrenocortical activity. The second one involves the deleterious stimulation which continues in the organism when it enters the resistance stage. In this, the alarming symptoms vanish, which apparently point to the adaptation of the individual to the stressor (Chida 2013). Conversely, when the resistance to the deleterious stimulus increases, at the same time the resistance to other types of stressors decreases (Šmigelskas et al. 2015).  The third one relies on the condition that if aversive stimulation continues, then the stage of exhaustion is given by resistance. The capability of the organism to adapt to the stressor get exhausted and the symptoms of the first stage appear again, but there is no possibility of resistance (Martin and Daniels 2014). The damage of irreversible tissue appears, and if the stimulation continues, the death of the organism occurs (Kim et al.2012). Seyle, who is considered as the ‘father of stress research,’ has described the different stages of with respect to the general adaptation syndrome. Our body responses towards stress in three distinct stage namely, the alarm stage, the resistance stage, and the exhaustion stage. If the nurses are taken into consideration, these three stages revolve around their profession. In the first stage, the nurses recognize the risk and get prepared to deal with the risk. In the second stage, their mind and body adapt for resolving the threat. In the final stage, the stress continues for some time, and the process of adaptation gets over, and they get overloaded or burnout. The nurse’s experiences stress on a regular basis, when they are subjected to the care of the patients in the hospitals. They are given with the responsibilities to provide care to the patients. By keeping a constant vigil on the patients they become exhausted due to the effect of stress that makes them susceptible to get burn out or overloaded with the stress that arises due to the work pressure (Sudhir and Taksal 2013). For nurses, stress can have extreme consequences for the nurses and due to this reason the management of stress is important. The stress related to occupation has been found to be one of the major health problems that are related to the work (Šmigelskas et al. 2015). 

Physiological explanations of stress

Stressors are the events as well as stimuli that lead the individuals top experience stress psychologically (Beehr 2014).  Psychological stressors include emotional stressors (frustration, anger, and fears), perceptual stressors (attitudes, beliefs, world view, roles) and cognitive stressors (worry, anxiety, shame, attachments, jealousy, and self-criticism). Holmes and Rahe SSR scale involve a list of stressful life events which are 43 in number. These events can contribute to disease illness. In the year, 1967, the examination of the medical records of more than 5,000 patients has been carried out by Holmes and Rahe to find out whether the events of stress might lead to illnesses. The association between stress and illness has been supported by subsequent validation. Daily hassles are concerned with the minor events that arise in our daily activities. They are used as a measure of stress (Jameson 2014). Kanner et al. conducted a key study which investigated the relationship between daily hassles, stress symptoms, and uplifts (Martin and Daniels 2014).  A comparison of the outcome was also made by using the SRRS as a stress symptoms predictor (Blasco-Fontecilla et al. 2012). According to the findings, daily hassles were linked positively with the psychological symptoms that were associated with stress and there occurs a negative association between stress symptoms and uplifts. These two theories can be applied on the nurses who experience the symptoms of stress on a regular basis. Due to the effect of stress, they get frustrated and are not able to focus on their work. The role of a nurse has been regarded as a job which is full of stress in terms of working hours, physical labor, staffing, interpersonal relationships as well as human suffering, all of these are central to the work of a nurse (Wilkinson 2014). Stress can have a noteworthy impact on individual nurses and their capability to accomplish tasks and more purposely, poor decision making, lack of concentration, indifference, decreased enthusiasm and anxiety may harm job performance creating unexpected errors (Jameson 2014).

Friedman and Rosenman developed the theory of Type A Personality which is concerned with the reaction of the individuals towards stress, and it was based on the observing the patients having heart conditions in the waiting room. Both of them have conducted this research to demonstrate that individuals with type A personality possess a higher risk of developing heart diseases along with high blood pressure than the individuals with type B personality. The nurses can effectively take benefit from this theory because they would be able to identify the individuals who are at risk of developing heart diseases and high blood pressure by observing the behavior of the patients. They might be able to prevent the probable diseases in the individuals and can help the community to get alert regarding the disease which can occur in future. Stressful experiences are interpreted as the communications of nurses and the individuals (Chida 2013).

Environmental explanations of stress

In the end, it can be concluded that different theorists have different perspectives for stress in the mind of individuals. Stress has been categorized as a stimulus, a response or consequence, and as an interaction. The theorists of psychology reached to their conclusions by observing the outcomes of the methods or procedures which they have involved in their studies to assess the symptoms of stress in the individuals.  The role of a nurse has been regarded as a job which is full of stress in terms of working hours, physical labor, staffing, interpersonal relationships and human suffering, all of these are central to the work of a nurse. According to me, stress is something which cannot be avoided, but we can restrict the impact of stressful events in our life by staying healthy and managing our time. Stress can be overwhelming, and almost impossible to get through life with experiencing it.  Hence, we should learn to identify the situations in which we can do something to manage our stress and by being organized in our lives in an efficient manner.

References

Beehr, T.A., 2014. Psychological stress in the workplace (Psychology revivals). Routledge.

Blasco-Fontecilla, H., Delgado-Gomez, D., Legido-Gil, T., De Leon, J., Perez-Rodriguez, M.M. and Baca-Garcia, E., 2012. Can the Holmes-Rahe Social Readjustment Rating Scale (SRRS) be used as a suicide risk scale? An exploratory study. Archives of Suicide Research, 16(1), pp.13-28.

Chida, Y., 2013. Heart Disease and Type A Behavior. In Encyclopedia of Behavioral Medicine (pp. 948-950). Springer New York.

Hanton, S., Neil, R. and Evans, L., 2013. Hardiness and anxiety interpretation: An investigation into coping usage and effectiveness.European Journal of Sport Science, 13(1), pp.96-104.

Hulbertâ€ÂWilliams, N.J., Morrison, V., Wilkinson, C. and Neal, R.D., 2013. Investigating the cognitive precursors of emotional response to cancer stress: Reâ€Âtesting Lazarus’s transactional model. British journal of health psychology, 18(1), pp.97-121.

Jackson, M., 2014. Evaluating the Role of Hans Selye in the Modern History of Stress.

Jameson, P.R., 2014. The effects of a hardiness educational intervention on hardiness and perceived stress of junior baccalaureate nursing students.Nurse education today, 34(4), pp.603-607.

Jan, L.K. and Popescu, L., 2014. Israel’s Nursing Students’ Stress Sources and Coping Strategies During Their First Clinical Experience in Hospital Wards-A Qualitative Research. Revista de Asistenta Sociala, (4), p.163.

Kim, S., Guy, S.J., Manocha, D. and Lin, M.C., 2012, March. Interactive simulation of dynamic crowd behaviors using general adaptation syndrome theory. In Proceedings of the ACM SIGGRAPH Symposium on Interactive 3D Graphics and Games (pp. 55-62). ACM.

Larsson, G., Berglund, A.K. and Ohlsson, A., 2016. Daily hassles, their antecedents and outcomes among professional first responders: A systematic literature review. Scandinavian journal of psychology.

Lazarus, R.S., 2013. Fifty years of the research and theory of RS Lazarus: An analysis of historical and perennial issues. Psychology Press.

Martin, P.D. and Daniels, F.M., 2014. Application of Lazarus’s cognitive transactional model of stress-appraisal-coping in an undergraduate mental health nursing programme in the Western Cape, South Africa.

Selye, H., 2014. Occupational Stress. Mental Illness in the Workplace: Psychological Disability Management, p.131.

Šmigelskas, K., ŽemaitienÄ—, N., Julkunen, J. and Kauhanen, J., 2015. Type A behavior pattern is not a predictor of premature mortality. International journal of behavioral medicine, 22(2), pp.161-169.

Sudhir, P. and Taksal, A., 2013. Coping with Stress. Stress and Work: Perspectives on Understanding and Managing Stress, p.211.

Szabo, S., Tache, Y. and Somogyi, A., 2012. The legacy of Hans Selye and the origins of stress research: a retrospective 75 years after his landmark brief “letter” to the editor# of nature. Stress, 15(5), pp.472-478.

Wiebe, D.J., 2013. Hardiness and Health. In Encyclopedia of Behavioral Medicine (pp. 893-895). Springer New York.

Wilkinson, S.A., 2014. Nurses caring for children and families: stress, hardiness and burnout (Doctoral dissertation, University of British Columbia).