Nursing Theory

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Unit 10: Stress Theory; Selyle/Psychoneuroimmunology
By Jessica Cronin RN, Teri Lieser RN
Unit Summary
Unit 10 examines stress, the stress response as described by Dr. Hans Selye in addition to clinical situations and research involving Stress Theory, a borrowed theory used in nursing practice. Unit Objectives

1. Describe the background, development and concepts of Stress Theory 2. Identify the relationship among Stress Theory concepts 3. Outline the phenomena, populations and clinical situations Stress Theory explains Assigned Readings

Clancy, J. & McVicar, A. (1993). Subjectivity of stress. British Journal of Nursing, 2(8), 410-
Hays, M., All, A., Mannahan, C., Cuaderes, E., & Wallace, D. (2006). Reported stressors and
ways of coping utilized by intensive care nurses. Dimensions of Critical Care Nursing, 25(4),
McEwen, M. & Wills, E.M. (2007). Theoretical Basis for Nursing. Chapter 13 (314-317, 323),
Chapter 14 (338-340).
Unit 10 Key Points
Background, development and concepts of Stress Theory
Relationship among Stress Theory concepts
Phenomena, populations and clinical situations explained by Stress Theory

Find the definitions of the following terminology of Stress Theory
Stress, Distress, Eustress
General Adaptation Syndrome

Overview of Stress Theory
The patient is a 27 year old female, vital signs are normal, lab values are WNL. Normal is a very subjective term. It can have many different meanings to many different people. In nursing, normal can often be described in terms of homeostasis. Homeostasis is a concept that was first conceived by Claude Bernard, a 20th century physiologist. Walter Canon, a physician in the 20th century expounded upon this concept, using feedback mechanisms to explain Bernard’s concept’s regulation. These men discussed the body’s physiologic processes, and acknowledged that they have the ability to adapt to environmental changes.

Hans Selye came along a little later in the picture. He was a Doctor of Medicine and Chemistry, originally studying in Prague and moving on to Johns Hopkins. He began to research the concept of stress in 1926 at McGill University in Canada. His initial inspiration for general adaptation syndrome (GAS, a theory of stress) came from an endocrinological experiment, in which he injected mice with extracts of various organs. At first, he believed he had discovered a new hormone, but was proved wrong when every irritating substance he injected produced the same symptoms (swelling of the adrenal cortex, atrophy of the thymus, gastric and duodenal ulcers). This, paired with his observation that people with different diseases exhibit similar symptoms, led to his description of the effects of "noxious agents" as he at first called it. While caring for people who were ill, Selye noted that the recurring clinical manifestations were loss of appetite, weight loss, feeling and looking ill, and generalized muscle aching and pain. He later coined the term "stress," which has been accepted into the lexicon of various other languages.

We chose Stress Theory, because it is applicable in so many different settings. We all experience stress in our lives, as do our patients. By understanding the predictable physiologic response to stress, we can focus our nursing care to note when patients are experiencing “noxious stimuli,” as well as prevent complications from occurring. Selye’s work is proof that nursing theory is applicable to our daily practice, and can often withstand the test of time. Description and Analysis of the Theory and Components

Dr. Hans Selye (1930’s-1970’s) defined stress (whether positive or negative stress) as “wear and tear on the body” and developed the General Adaptation Syndrome (GAS), which explains the physiologic response to stress. Selye described...
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