INTRODUCTION:

Different studies revealed that three out of four people experience stress at least twice a month. Further, it was also found that stress contributes to many health problems such as heart diseases, high blood pressure, stokes, alcoholism, obesity, drugs addiction, smoking, depression and other harmful behavior. Living stress free life helps to promote health. Hence, every one must be aware of stressors that contributes health hazards and stress management to maintain balance in their life.²

TYPE OF STRESSORS:

1. External stressors- The physical environment, social interaction, organizational issues, major life events and daily hassles.

2. Internal stressors- The life-style choice, negative self talk, mind traps and personality traits.³

TYPE OF STRESS:

There are four types of stress.

1) Eustress or positive stress

2) Distress or negative stress

3) Acute and chronic stress.

4) Hyper and hypo stress.⁴

CAUSES:

Financial, work place, personal space, health problems and irritants.

MANIFESTATIONS OF STRESS:

a) Physiological symptoms: Indigestion, increased blood pressure, decreased libido, poor memory, altered eating habits, constant ache and pains, obesity, diabetes, eczema, hair loss, ulcer etc.

b) Psychological symptoms: Anxiety, fear, anger, depression, mood swing, short temper, feeling over whelmed.

c) Cognitive Forgetfulness, unwanted or repetitive thoughts, fear of failure, self irritation, suppression and fantasy.

d) Verbal motor: Crying, verbal abuse, laughing, streaming, hitting and kicking, holding andtouching.

STRESS MANAGEMENT:

There are two types of stress management

1. Non-pharmacological

2. Pharmacological management.

NON-PHARMACOLOGICAL MANAGEMENT:

· Relaxation Techniques:

It is a method, process, procedure or activity that helps a person to relax, to attain a state of increase calmness or reduce levels of anxiety, stress or anger. Relaxation exercises reverse the negative response of stress on our body and mind. Examples are deep breathing exercise, asana, saying or mantras, hypnosis, hydrotherapy, massage, humor, hobbies, reflexology, acupuncture and bio feedback therapy.⁵

· Laughter Therapy:

It is a part of human behavior regulated by brain. It signals acceptance and positive interaction with others. Laughter is a physical reaction in humans consists of rhythmical often audible contraction of diaphragm and other part of the respiratory system. It is a response to the certain external or internal stimuli. Laughter helps to relax all muscles and increase blood flow thereby improve blood circulation and decreases the risk of forming clots, high blood pressure and heart disease, improves the lungs capacity and oxygen levels in the blood. It alleviates asthma and bronchitis. Hence laughter is considered as best aerobic exercise, best universal medicine, most effective wonder drug, without cost involvement. Undoubtedly, this therapy is most popular and being used all over the world.⁶

· Clay Therapy:

Pottery is a good hobby for self improvement. It is an easy way to connect with yourself by expanding mind and self discovery. Clay art fills with positive perspective in every situation thus improving quality of life.

In recent time in India, schools have initiated pottery in summer camps to improve creativity, motor skills, sensory development, self-esteem, discipline, pride, and confidence within students and corporate have started using pottery as clay play workshop for the employees to be ambidextrous, develop patience, learn to cope with crisis, get better at time management, understand and reciprocate with others and to put forward the best. In western countries, art therapy has set its mark but in India, it is slowly catching up.

· Yoga:

Literary means union. It unites the mind, body and breath. it is a system of exercise to attain mental control and well-being to path of liberation; yoga helps to manage stress, increases the amount of oxygen supply, promote sleep, boost metabolism, delay aging, improve concentration, promote boosts the immune system, relieved depression, control diabetes etc. Pranayam and surya namaskar are some of example of the yoga technique that help to prevents or treat various health problems such as asthma, respiratory infection, sinusitis, constipation, reducing cerebral tension, improving blood circulation, reducing blood pressure etc. Yoga is an ancient physical, mental and spiritual practice that originated in India but now, it is soaring world over.

PHARMACOLOGICAL MANAGEMENT:

Various drugs are used to treat anxiety, depression, nightmare, slle disturbance etc. that includes- prazocin, clonidine, propranolol, carmazepine, tolramate, zolpiderm, valproic acid, risperadone etc.

Stress Among Students:

The stressor among medical and nursing students are academic, inter personal, family and emotional stress. The challenges for all students are long academic courses, unstructured time, being on your own in a new environments, changing relation with family etc. The total theory and clinical hours for nursing as well as medical students with changing academic curriculum which are often quite vast course and challenging one.

Exam Stress for Students:

The students have an increased sense of panic or anxiety in the days, weeks or months before, during or after any assessment or test. Causes of exam stress are lack of preparation and planning, the high expectation from others, low motivation levels, competition from peer, internal pressure, low confidence and comparison with others; Manifestation of exam are forgetfulness, poor appetite or over eating, dizziness, blurred vision, inability to sleep, concentrate and relax, fear, anxiety, worry, migraines or head ache, stomach ache, nail biting, increased hear rate, vomiting, depression, nervousness and low or no communication.

Management of academic stress in students:

Plan for studying today’s date, day remaining for exam, plan for 24 hours, scheduled the subject-prime, study prime i.e.-morning 3 hrs, afternoon 3 hrs, evening 3 hrs, night 3hrs; reading plan, writing plan, revision plan; take the disciplined action-act on the plan, follow the schedule, review the progress; do the exercise to improve concentration-deep breathing, palming, rubs the palms and cover the eyes, listen to music, making vision boards for formulae, charts and graphics; Be away from rebuttal people-avoid listening and talking advice from friends who are hyper and keep pestering, talk to them openly and do not get carried away by their negative emotions; Start most difficulty subject first, avoid postponing the unpleasant task, ask help from expert teachers and friends, refer to the additional references other than your notes; Avoid distractions at home, neighborhood, cricket matches, mobile/ internet chats; minimize with T.V and phone calls; Take the right amount of food, rest and sleep every day.

Unwind yourself-take a break; relax your mind; smile and make some one smile, talk to some one; Focus on health, drinks lot of water, take proper diet, eat wholesome meal; have fresh and dry fruits, a glass of milk, eats healthy snacks, avoid junk or fast food; Have a positive attitude- think and feel good about self- talk like “I can and I will”, “I trust and believe in myself”. Be confident, talk with parents and teachers, share your aspirations and goals, communicate and clarify; Make a commitment today- take ownership and responsibility of yourself, exams, career and your life; crosscheck, avoid useless discussion and manage time.

STRESS AMONG NURSES AND DOCTORS:

Health professionals working in healthcare setting develop a lot of stress during duty period. Normal reasons are:

CAUSES OF STRESS:

Job design; inter persons relationship at work, patients and heir families; poor prime management, teaching aspects; Dealing with death and dying, ambiguity personal reasons; lack of resources such as manpower and material; consumer demand, less pay, delay in promotion etc.

INTERVENTIONS:

Plan for the day’s work; Maintain interpersonal relationship with patients, family members, team members etc; Orientation and training, in-service training; continuous monitoring and supervision. Make arrangement for recreation activities, grievance redresses, adjustment of break timings; Motivated by giving credits, rewards, and awards for best service; arrange for resources such as manpower, material, provide extra pay for extra work/over time and quality care to patients. ⁷

CONCLUSION:

Stress is common problem that affects all most all of us at some point in our lives. we must identify when we are under stress, what is stressing us and how to cope with stress so that we can greatly improve our mental and physical wellbeing. By taking control of our thoughts, emotions and environment we can control our lives instead of letting stress control us. It's not the stress itself that is detrimental; it's our reaction on the stress that creates changes in our bodies. So, let’s switch off stress mode and change our reaction for a good life.

REFERENCE:

1. Lalitha K. Mental Health and Psychiatric Nursing: An Indian Perspective. VGM Book House. 2010. P – 588-94.

2. Sruvani R.A Guide to Mental Health and Psychiatric Nursing 3^rd edition, India, Jaypee Brothers, 2010, P-259.

3. Kozier and Erb’s, Fundamental of Nursing, 8^th edition, India Dorling and Kindersley India Pvt.Ltd.2009, P-1061- 77.

4. Ruth F craven, constance J Hirrle. Fundamental of Nursing, 6^th edition. USA. Luppincot: Wiliams and Wilkins, 2009, P-232.

5. Sakhardande et al Effectiveness of selected interventions on stress level among Nursing Students.

6. https://www.artofleveng-org/yogo.

7. https://study.com/stress-adoption-effects-defence-mechanisms-coping-strategies.

Received on 06.01.2020 Modified on 31.01.2020

Int. J. of Advances in Nur. Management. 2020; 8(2):162-164.

DOI: 10.5958/2454-2652.2020.00038.4