STRESS AND ADAPTATION


Every person has something called stress throughout life in this case a stress is positive and even necessary, however, too much stress can lead to poor adjustment, physical illness and inability to cope with coping with the problem. Hasn Selye developed a model of the biochemistry of stress known as the general adaptation syndrome (general adaptation syndrome (GAG). Which describes the physiological events during the stress response. Selye also introduced the concept of stressor that is internal or external stimuli that cause stress.
 The concept of stress
Stress and stressors
Stress is any situation where non-specific demands require an individual to respond or take action. Response or action, including physiological and psychological responses. Stress can cause negative feelings or the opposite of what is desired or threaten the emotional well-being. Stress can disrupt the way of thinking in general and the related person and a sense of belonging, other than that stress can impair a person's general outlook on life, brush aimed at loved ones and health status.
Perception or experience of the individual against big changes can cause stress. Stimuli that initiate or trigger the change is called a stressor. Stressors showed an unmet need and the needs of the bias are physiological needs, psychological, social development environment, spiritual or cultural needs. Stressors can generally be classified as internal or external. Internal stressors in a person comes from eg fever, conditions such as pregnancy or menopause or kejadaan emotions such as guilt. External stressors from outside oneself (eg, significant changes in ambient temperature, changes in family or social role or pressure from a partner.

 Stress
The term stress is often used incorrectly, used to designate the phenomenon of "side, not insane" in fact stress is a very neutral term, emunjuk the things that always experienced by humans in daily life. Simply put stress can be defined as a situation where individuals impaired balance. Stress is the result of external or internal situation which led to disruption and demand for adaptive berepson.
Stress is something inseparable from human life, even stress as a part of life itself. Every day we have to hurry up, pick up homework, forgot or did not get breakfast, ran after public transport, schools or through the activity, conflict with friends or anyone else, but ran out of money to buy daily necessities and so on. All of that led to stress.
Although quite often annoying, stress need not always be seen as a negative thing. In certain respects, stress has positive implications. Esutress is "stress in a positive sense". Which state that can motivate, had a beneficial impact. For example, there are people who when it is pressed for time, will suddenly awakened creativity. Some are feeling left behind, self-motivated and able to perform brilliantly.
Stress shows itself through various symptoms, such as increased anxiety, tension and anxiety, dihayatinya physical pain (headache, heartburn, hives, diarrhea), the kelelahyan, muscle tension, sleep disturbances, or increased blood pressure and heart rate. Stress can also appear in perubahgan on behavior: individual so impatient, more irritable, withdrawn or displaying dietary changes. Some individuals feel frustrated, helpless, become lethargic and have a judgment.

Models of stress
Nurses use the model to help clients overcome stress response that is not healthy, non-productive. With modifications, this model can help nurses respond in a way that shows care for the individualization of the client.

Model-based response
Models based on the response or responses associated circuitry specialize in a particular response that might indicate a stressor. Stress model of Selye (1976) is based on a model which defines the stress response as non-specific response of the body against any claim that was inflicted on him. Stress is indicated by a specific physiological reactions, GAG, so that one's response to physiological stress completely and never be modified to allow the influence of cognitive (MC Nett, 1989).

Models based on stimulation
The model focuses on the characteristics of stimulation by an annoying or disruptive in the environment. The model is based on stimulation of focusing on the following assumptions (Mc Nett. 1989).
1. Changes in life events is normal. And the change requires the type and duration of the same adjustment
2. Individuals are passive resipen of stress and their perceptions of events are not relevant
3. All people have the same stimulus amjbang and disease can occur at a point after the threshold is seetiap.
Nurses may experience difficulties when trying to use this model in the management of stress due to lack of keleluasannya for individual adaptation.

Models based on individual
Models based on looking at individual transactions in relation to environmental da dynamic, reciprocal and interactive (and Floknenan Lazarus, 1984). The model developed by lazarus and flokman, viewed as a stressor individual perceptual responses that stem from psychological and cognitive processes. Stress comes from relationships between individuals and the environment.

 The response to stress
When there is stress, a person using physiological and psychological energy to respond and adapt. Stress response is adaptive and prosektif, and the characteristics of this response is the result of integrated endocrine response of the neuron. Below will be explained more clearly in response to stress there are two, namely:
► physiological response
Classic research conducted by Selye (1946, 1976) has identified two physiological responses to stress: Okal adaptation syndrome (LAS) and the general adaptation syndrome (GAS), LAS is the response of tissues, organs or body parts to stress kjarena trauma, illness or change other physiological. GAS is the response of the whole body's defenses against stress.
LAS 
All forms of LAS has the following characteristics:
1. There is a local response, this response does not involve the whole body system
2. Adaptive response, meaning that the stressor is needed to stimulate.
3. Response is short term, there is a continuous response
4. Response is restorative, meaning that the LAS assist in restoring the homeostatic region / body part
As an example of the reflex response LAS pain and inflammatory responses. Reflection response of pain
Pain response is a reflection of the local response of the central nervous system to pain. This response is adaptive responses and protect tissues from further damage lanjuut
The inflammatory response
Distimuli inflammatory response to trauma or infection. Inflammatory response to this market, thereby inhibiting the spread of inflammation and promote healing. The inflammatory response includes the three phases.
• The first phase includes changes in the cells and the circulatory system
• The second phase is marked by the release of exudates from the wound
• Fffase last / third is the repair or regeneration of tissues by the formation of lung tissue.
 GAS
GAS is the physiological response of the whole body to stress. GAS consists flow peringata reaction, visislens stage, and stages of labor kenalisan. The following explanation:
 alarm reaction
Alarm reaction involves directing the defense mechanism of body and mind to face the stressor. During the alarm reaction of individuals exposed to specific stressors.
 Stage resistant
In the back of the body resistant stable stage, hormone levels, blood pressure, heart rate and cardiac output increased again to normal.

 Stage of exhaustion
Stage of exhaustion occurs when the body can no longer resist the stress and when the energy required to maintain the adaptation that has been thinned.
► Psychological Response
Psychologically adaptive behavior can be constructive or destructive. Constructive behavior helps individuals to accept the challenge to resolve the conflict. Even anxiety can be constructive: for example, anxiety may be a sign that there is a threat that someone can take action to reduce its severity. Adaptive behavior is also referred to as a psychological coping mechanism.
o Treatment of task-oriented
Task-oriented behaviors include the use of cognitive ability to reduce stress, solve problems, resolve conflicts and meet the needs. (Stuart and Sundeen).
o Defense mechanisms
Ego defense mechanisms whose purpose is to regulate the emotional distress and thus provide individual protection te4rhadap anxiety and stress. Ego defense mechanisms is a method of coping with stress are not unfamiliar.

NURSING PROCESS AND ADAPTATION TO STRESS
One's perception of the stressor is based on the beliefs and norms, experience and lifestyle, environmental factors, family structure and function, developmental stage, past experience with stress and coping mechanisms.
 Physiological Indicator
Physiological indicators of stress is the objective, is more easily identified and can generally be observed or measured. The relationship between psychological stress and disease is often called the mind body interactions. Research has shown that stress can affect patterns of disease and illness. Stressful situations can be divided into 3 sections:
 mild stress situation is a stressor that everyone faces on a regular basis, such as too much sleep, traffic congestion, criticism from superiors.
 ongoing stressful situation much longer, from several hours to several days
 The situation is a situation of chronic stress that can take several weeks to several years. Such as marital discord continuous, trouble finansional prolonged and long-term physical pendyakit.

 Indicator development
Prolonged stress can affect the ability to complete development tasks. Prolonged stress can interfere with or impede the smooth finish that stage of development. In the form of existential, prolonged stress can lead to a crisis of maturity.
 baby or small child in the home generally face the stressor
 school-age children typically develop a sense of adequacy
 Teens usually develop a strong sense of identity but at the same time need to be accepted by their peers.
 Young adults in transition from adolescence to the experience of adult responsibilities
 middle age are usually involved in building a family, creating a stable career and the possibility of caring for their parents.
Age  elderly generally face change adaptation in the family and the possibility of the death of a spouse or a friend of his life.


 Indicator emotional behavior
Individual personalities include complex relationships diatara many factors, it is a reaction to prolonged stress determined by examining the client's lifestyle and the last stressor, previous experience with the stressor, coping mechanisms that work in the past, the role function, self-concept and fortitude that is a combination of three personality characteristics are thought to be the media to stress

 Indicator intellectual
Prolonged stress can manifest in the intellectual dimension and has indicator that can be observed

 Social Indicator
Assess stressors and coping resources in the social dimension covers the court with clients on the size, type and quality of social interactions that exist. Family stressors can sign menimbuilkan effect. Dysfunction affecting the client or the overall keluiarga (Reis and Heppner, 1993).

 spiritual Indicator
People using spiritual resources to adapt to stress in many ways, but stress can also manifest in the spiritual dimension

 Improving health
The nurse must first establish a severe help, create mutual trust comfortable environment serves as the basis for any changes in behavior. When helping clients reduce stress, nurses reduce stressful situations, reduce the physiological response to stress and improve emotional and behavioral responses to stress.

► Reduce stressful situations
Nurses can reduce some stressors and thereby giving the client a greater sense of control. There are several methods that help in reducing stress.
 Structure
 Management of time
 environmental modification
► Reduce the physiological response to stress
In general, stress management techniques include the usual health promotion can reduce the impact of stress on physical and mental health. General requirement for penalataksanaan stress including
Exercise regularly 
 Humor
 Nutrition and diet
 Rest
 relaxation techniques
 Spirituality
► Improved behavioral and emotional responses to stress
Behavioral and emotional responses to stress can be bridged by using a system support, crisis intervention and improved self-esteem.
 System supporters
 crisis intervention
Is a therapeutic crisis intervention techniques to help clients solve specific problems due to stress that just happened. There are crisis intervention, namely:
1) Crisis
2) The crisis situation
3) the development crisis
 Increase self-esteem

► Improve stress management for care
Most of the nurses experienced stress in their work environment is stressful jobs often lead to a condition called fatigue

CORE CONCEPT
- The mechanism is controlled by physiological adaptis through oblongata, and reticular formation of the pituitary gland
- Prolonged Stress lowers the body's adaptive capacity
- Stress is a physiological or psychological stress that can affect any or all of the human dimension
- A person may encounter environmental stressors in the internal / external
- Stressors require changes / adaptations so that the state can be maintained akuilibriuym
- A person's response to stress is influenced by the intensity, duration and scope of the stressor and the magnitude of stressors that occur at specific times
- A man facing stresdengan using sources in the physical and developmental, emotional, intellectual, social and spiritual
- Ekedua form of physiological response to stress is the local adaptation syndrome and the general adaptation syndrome
- Sinmdrom common adaptations include physiological responses, to stress mulktisistem
- The three stages of the syndrome is common adaptasdi warning reaction, resistance phase and exhaustion stages
- Psychological Response to strestermasuk firmly oriented behavior and mechanisms of ego resilience
- Ego defense mechanisms are unconscious behavior that gives a person protection from stressful feelings or events that
- Stress has an impact on the onset, travel and outcome of disease.
- Prolonged stress lose the ability to adapt to stress and have someone in keldima dimension
- People generally learn to use a strategy of short-term and long term to cope with stress.
- Stress management techniques include peningkatn habit habits health crisis intervention
- And the improvement of health, crisis intervention and methods of work stress reduction.

In individuals, the source of the stressor can be:
1. Environment
1. Environmental attitudes: The form of the demand, positive and negative views on the success of acceptable work
b. Kelduarga demands and attitudes, for example, must get a job, the desire for parental choice to work
c. Ppperkembangan science and technology (Science and Technology), the more quickly obtain information and future trend if it works for something to be desired
2. Yourself
1. Psychological needs of the lust that must be achieved against the cool them.
b. Internalization process itself, namely the absorption of the continually desired in accordance with its development
3. Mind
1. Associated with an individual assessment of the environmental and pendgaruhnya on perceptions of self and the environment
b. Related to the way self-assessment on how the adjustment can be done by the individual concerned.

Negative assessment of the individual mind both current and foreseeable future to give a more severe effect. For example:
- Anxiety entrance exams work
- Fear not pass the entrance exams work
- In doubt follow from work

STRESS IN DAILY LIFE
The onset of stress and personality factors
In action and alert yourself to face a danger, the individual often can not distinguish whether the danger tersebuit concrete / real or merely the perception / anticipation mere shadow, depending on the individual unconscious attitudes toward the stressor. Anticipation of negative emotional reactions may aggravate or extend more and reasonable. Also can arise in reaction to something that actually never happened. Psychological stress can accumulate and affect health.
Personality and behavior patterns of individuals to determine the pattern of reaction to a situation or event. Attitudes, and habits that kuranglugas tatanilai and anticipatory fear of going to things that are not yet known, impatient, angry, anxious and so can lead to nerve stimulation and the same biochemical reactions in the face of stressors such as concrete and cause unnecessary stress.
Two cardiologists, M. Friedman and R. Rosenman developed the following classification: type A personalities who tend to be excited: very conscious of time, impatience, stress.

Changes in lifestyle
Lifestyle changes can be a challenge that brings stresoir nTo take risks and adapt. The better the health status of a person going the better the ability to cope with these changes. TH Holmes and RH Rahe created a scale of social adjustment by making the weighting score required by the person to change or adjust to the changing situation perbagai life: More than 300 in one year means that the risk of falling ill in 80% of individuals: 150 299 30% reduced risk ; and less than 150 means that the risk lightly.
Other experts argue that external events are not enough to cause interference, but the combination of experience and genetic factors must exist for the sick. Personality and ability to cope with life changes that determine how well the reaction in such a life change.

Achievement demands
We are making progress with challenges and stress of physical feats and skills. This is a healthy thing as long as we remain confident, and able to use the energy and tension arising from these additional demands. Certain emotional states can also be a secondary stressor; boredom with the lack of stimulation or interest in the work, unemployed or retired may cause derpesi, apathy and stress. Doubts about whether it was needed or appreciated may lead to poor self-image and sense of alienation often.
Grief or loss of a spouse with divorce, separation or death can influence the prolonged menimbulakn. And if it does not resolve your grief can trigger mental or physical illness.
WHAT STRESS ON OUR BODIES
Stress is a natural response of our body and soul when subjected to environmental stresses. The impact of diverse strespun, can affect mental and physical health but also have a positive impact (eustress). Here are the effects of stress that you know sebainya
The positive impact of waged spirit!
Effects of stress on this one it is very important to balance the body. Eustress is a positive impact of stress that makes you become discouraged when faced with a case or issue a challenge. Your creativity can testimuylasi. For example, when deswainer must complete a rancangtan already approaching deadline, he will devote all its capabilities and creativity to design the perfect finish.

Chronic stress triggers extreme measures
Prolonged stress will lead to tensions and worries constantly. According to the psychological term, prolonged stress is called chronic stress. Nature of chronic stress undermines and destroys the body, and the whole life of his suffering pikir5an slowly. As a result, the patient will continue to feel depressed and lose hope.
No wonder people with chronic stress eventually took the decision to commit suicide or die of a heart attack, stroke, cancer or high blood pressure. So observe yourself, if you include people who like to let the matter without a positive way out? Be careful of the consequences that you will face!

The stress is more sensitive
People who are stressed will be more sensitive than people who are not in conditions of stress. Therefore, someone who stressed esring misrepresenting what happened to him. Could be one of perception, one read and interpret a situation, opinion or judgment, criticism, advice, and even the behavior of others.
In addition, the stress tends to associate everything with him. As a result he has more to withdraw from the environment, no longer follow the usual activities and easy emotion. No wonder the result of this attitude they are shunned by her friends. Negative response will further add to the burden that he suffered because of the perception that during the time he thought was right.

Influence to health
• Triggering heart disease
In the long term, uncontrolled stress would trigger a rise in blood pressure so that the risk of heart attack meningkatl. Stress can also raise blood cholesterol levels. These conditions are made so that the clogged arteries of patients susceptible to heart attack or stroke are familiar with our usual
• Causes the body easily tired and limp
This is because the hormones serotonin and melatonin is disrupted when the body is stressed. Need and know, both these hormones play a major role to help us sleep well. Sleeping conditions will trigger a rise in cortisol hormone in the body. As a result, eye brows screwed hard imsomnia
• Cause gastric disorders like heartburn
Heartburn arises because the production of excess stomach acid. Well, when you are stressed, your body will produce gastric acids in amounts higher than normal and also erode the stomach lining, or mucosa, which in turn cause the pain that we know as heartburn.

As for how DEALING WITH STRESS
First you must learn to recognize stress. Gejkala-stress symptoms include mental, social and physical. These include fatigue, loss of or increase in appetite, headaches, crying, sleeplessness, and oversleeping, break away from alcohol, drugs or other compulsive behavior are often indications of feelings of stress symptoms of anxiety, frustration or kelelusan can accompany stress.
What can you do to manage your stress? What strategies are there?
1. Consider the environment around you might see something that you really can you change or control in such situations.
2. keep yourself from stressful situations, your situation, give yourself a chance to rest
3. learn the best way to relax yourself and, meditation and breathing exercises have been proven effective in controlling stress. Practice to clear your mind of disturbing thoughts.
4. Determine realistic goals for yourself. By reducing the number of events that happen in your life, you will be able to reduce the burden of excessive
5. Do not be concerned about trivial things, try to prioritize a few things that really matter and let the others follow
6. Do not overload yourself with too much you are complaining about your entire workload. Handle each task as where it should, or deal selectively with respect to some priority.
7. Get enough sleep, lack of rest just aggravates stress. Use a good weekends, particularly for self memajatkan and out of the daily routine
8. Open, not buried our problems alone. With a variety of stories to people who we believe we will force the load is lighter and does not settle in the mind.
9. Levels of sense of humor, humor can be used clinically to relieve stress. Humor is needed so that nerves are not too tight and the body can relax.
As with individuals, family groups may be beradaptsi to stressors. Aedalah family adaptation process in which the family maintains a balance so that families can meet the goals and tasks to cope with stress and enhance the growth of individual members.

ADAPTATION
Adaptation is the outcome of coping efforts, adapting response characteristics are:
- Able to maintain a balance
- Adaptation takes time
- The ability of adaptation is different for each individual
- Adaptation to the laborious and need help from others.

ADAPTATION to stressors
Adaptation is the process by which the physiological and psychosocial dimensions of change in responding to stress. An adaptive process occurs when the stimulus of internal and external environment causes deviations balance of organisms. With dmeikian adaptation is an attempt to maintain optimal function. Melibgatkan adaptation reflex, an automatic mechanism for the protection of coping mechanisms, and may lead to adjustments idelany1., Mastery of the situation (Selye, 1976). Mosen. Floyd and Brookman 1992). Short term such as fever, long term, such as paralysis of the limbs of the body.
In order to function optimally, one must be able to respond to and adapt to the demands stresir or needed changes, adaptation requires an active response from all individuals.

ADAPTATION
Physiological adaptation to stress is the body's ability to maintain a state of relative balance. This adaptive capability is a form of dynamic equilibrium of the body's internal environment. Internal environment is constantly changing and adaptive mechanisms of the body is continuously working to adapt to these changes and to maintain equilibrium or homeostasis.
Homeostasis is maintained by a physiological mechanism that controls body functions and organs of the body to monitor most of these mechanisms are controlled by the nervous and endocrine system and do not include the behavior of the body sasdar make adjustments in heart rate. Frekeunsi breathing, blood pressure, body temperature, fluid balance and elektrolis, hormone secretion and levels of consciousness are all shown to maintain adaptation.

Physiological ADAPTATION MECHANISM
Physiological mechanisms of adaptation to function through a negative feedback mechanism is a process by which a state of abnormal control feel like a drop in body temperature and makes an adaptive response, such as starts to shiver to generate body heat
Medulla oblongata, medulla oblongata is a vital control functions needed to maintain these functions including heart rate, blood pressure and respiration.
Reticular formation is a small group of neurons in the spinal cord and batng optak. This group also controls the vital functions and continuously monitor the physiological status of the body via connections with sensory and motoriks tract. For example, certain cells in the reticular formation can cause a sleeping person awake or increase awareness tingkt when the need arises.

MODEL ADAPTATION
Ability to adapt, stress, the first factor usually depends on one's experience with similar stressors. System support and overall perceptions, the second factor relating to the practice of individual and peer group norms. These responses can help clients adapt to stress or respond to simple circuitry to adjust to the behavior of a group of peers.
The third factor is the impact of social environment in helping an individual to adapt to the stressor. Last factor includes resources that can be used to cope with the stressor.

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