Stress and coping assessment cab be challenging for a nurse as it involves an array of determinants some psychophysiological and others social that are difficult to identify and distinguish. Besides, stress assessment would be determined by the family and community willingness to share their experiences of the affected to enable a nurse to understand the relationships that exist among various factors. Besides, the family and community assessments are essential to a nurse as they give data on factors such as structural, functional developmental determinants of health. Therefore, family and community support is a determinant of the success of the nurse in performing this task.
Stress has also been associated with many health problems such as alcohol and drug abuse, venereal diseases, poverty, obesity among others, making the process of stressor identification process complicated as not all such conditions result from stress. Stress management involves a dynamic interaction between the spirit, mind and the body which requires reasoning critically to examine various factors that may contribute to stress, thus a nurse encounter challenges in studying the behaviors of the patient to understand the real cause of the changes.
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In the recent past, I encountered a situation where a man was depressed due to the death of his spouse who had breast cancer. Before the spouse succumbed to cancer, the family had exhausted all the savings and even sold almost all its assets to get the wife out of hospital well. The situation of this man deteriorated in all dimensions; physically, economically and psychologically. This situation made him very careless and irresponsible. He could no longer go to work, bathe or even attend to children who were also out of school. His health status weakens until we took him for a counseling session and inducted him to stress management program. We promptly reacted because we were aware of the cause of the behavior change. Hence it could not take us much time to go through a rigorous process of stressor identification.
According to Lazarus and Folkman (1984), primary appraisal in the process of coping with stress entails a description of the perceived programs for preventing stress before reaching the symptomatic stage. Therefore, enrolling the man to a stress management program was essential to reinstate him to his original state. The secondary appraisal concerns the identification of options to cope with the harm, challenge or a threat by individuals. Thus the secondary appraisal would assist this man to understand the damage that may result from such stress. Therefore stress and coping assessment are paramount in enhancing a sound management program plan for a patient.
