Stress in Nursing: Psychophysiological Adaptations

Instructor: Zona Taylor

Zona has taught Nursing and has a master's degree in Nursing Education and Maternal-Infant Nursing from University of Maryland Baltimore.

Stress is something everyone talks about in modern life, but what is it exactly? In this lesson, you will learn the levels of stress, the difference between a stressor and stress, and what the human physical as well as psychological responses to stress are.

While a complete definition of stress has eluded scientists and researchers since the term was coined by Hans Selye in 1953, a simple definition of stress is, ''the response of the body (and mind) to anything that requires a response.'' For example, if it is too cold, your body will respond by trying to warm up with forming goose bumps, shivering, or putting on a coat or adding a blanket. All of those are responses to being cold.


To understand stress, here are some terms you need to understand:

  • A stressor is the cause that requires the response. In the above example, the stressor would be the cold temperature.
  • Not all stress is bad. For instance, getting married is quite stressful, but it is a happy (or normal) kind of stress, which is known as Eustress.
  • Distress is the kind that most people refer to when using the word stress and is the kind that is associated with negative emotions and negative physical results.
  • Adaptation refers to a change by which an organism becomes better suited to its environment.
  • Acute refers to immediate, current, right now. Short-lived.
  • Chronic refers to long-term, over a long period of time. It may be intermittent or continuous.

Stress Continuum

Stress can be considered to be a continuum.

Eustress is a normal response, i.e. fight or flight response, like the sensation after a near-miss with another car. Distress occurs when the elevated blood pressure does not return to normal in between stressors, i.e. stressors that come one after the other all day at work. Severe Distress shows up as burnout, obesity, clinical hypertension after prolonged distress without adequate recovery time such as single parenting or working for a jerk or with malicious co-workers.
stress continuum

The following table shows the physical and psychological adaptations to the various levels of stress on the continuum.

Type of Response Eustress Distress Severe Distress
Psychological Fear Unease Burnout
Excitement Apprehension Emotional exhaustion
Increased problem solving Sadness Depersonalization
Increased mental alertness Depression Disengagement
Pessimism Decreased personal accomplishment
Listlessness Psychosis
Lack of self-esteem
Negative attitudes
Short temper
Poor sleep
Increased smoking/alcohol consumption
Physical Increased blood pressure Persistently high blood pressure Clinical hypertension
Increased heart rate Indigestion Coronary heart disease
Quicker reaction times Constipation or diarrhea Gastric disorders
Increased metabolic rate Weight gain or loss Menstrual problems in women
Increased blood glucose levels Increased asthma in sufferers
Increased serum lipid levels Diabetes
Increased serum amino acid levels Obesity
Impact on the individual Increased alertness Variable from one person to another, but usually a combination of the above Variable from one person to another, but may be life-threatening, a combination of the above.
Attention focused on the situation
More responsive to changing situations
Fear-> fight or flight response

The 'Fight or Flight' Response - General Adaptation Syndrome (also coined by Hans Selye)

The 'Fight or Flight Response' refers to the reaction of the body and mind in a harmful situation. For example if a caveman was walking in the jungle and encountered a wooly mammoth, he had to two choices: he could stand and fight or he could run away. Either choice would require increases in his abilities to fight hard or run fast. Research revealed that the physical changes that occur during an acute stress situation provide the additional strength and energy to deal with the immediate threat, and it normally take about 45 minutes for the body to return to its non-stressed state.

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