Sympathetic Nervous System and Stress Primary Appraisal

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Assignment Title: Explore how a knowledge of models of stress might enable the nurse to provide effective nursing care. -------------------------------------------------
Exact Word Count: 2058

This essay will explore how the knowledge of stress might enable the nurse to provide effective nursing care. A definition of stress fall’s into three categories, stress as a stimulus, stress as a response, stress as interaction between an organism and its environment (Bartlett 1998). These classifications correspond very closely to three models of stress identified by Cox (1978). The engineering model the physiological model and the transactional model. The term stress means many different things to people; a lay person may explain stress in terms of pressure, unpleasant external forces, or an emotional response. The author will identify three models of stress and then go on to research ways in which a nurse can provide effective nursing care whilst battling stress before drawing to a final conclusion of the findings. The stimulus model is derived to some extent from the engineering approach, where stress refers to the load applied to a structure. Damage results when the strain exceeds the structures elastic limit. Individuals also have a certain tolerance to stressful life events but become psychologically disturbed or physically ill when their tolerance is exceeded. Several methods have been used to study the relationship between stress and physical illness. An example of measures of stress is the Holme and Rahe (1967) social readjustment rating scale (SRRS) and the life events and difficulties schedule (Gross 2009). Psychiatrists Holme and Rahe (1967) decided to study whether or not stress contributes to illness. They examined 5000 patients and asked them to say whether they had experienced any of a series of 43 life events in the past two years. Each event is called a life change unit (LCU) and had different scores for stress. The more events the patient had the higher the score. The higher the score and the larger the stress of each event, the more likely the patient was to become ill. Out of this grew the social readjustment rating scale, several studies have shown that people who experience many significant life changes score over 300 life change units and are more susceptible to physical and mental illness than those with lower scores. The different health problems include sudden heart attacks, TB, diabetes, leukaemia, accidents and athletics injuries (Gross & Kinnison 2007). One of the weaknesses of the Holmes and Rahe social readjustment scale is that it doesn’t take into account the individual’s personality nor does it take into account how long the stressor continues for the scale just gives a single number for each stressor. However it is known that the longer a stressor continues then the more likely it will cause stress to the person. Life changes may be stressful only if they are unexpected and in this sense uncontrollable therefore acutely ill patients who cannot control events might find a sensation of helplessness more stressful (Ogden 2004).

Response models concentrate on the psychophysiology of stress. Han’s Selye’s (1956) general adaptation syndrome (GAS) proposes that the body undergoes three stages of defence reactions when it is exposed to stimulus, alarm, resistance and exhaustion (Niven 1993). Selye’s discovery of the stress response was and accident he was doing research on the effects of hormone injections in rats. He first thought he had detected a harmful effect from the hormones, because many of the rats became sick after receiving the injections. When Selye used a controlled group of rats by injecting a solution containing no hormones he observed that they became sick too. It turned out...
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