Stress management training

Editor's Notes

• #3: It may seem like the definition would be obvious since we all know what stress is like – and we have all experienced it. However, there are several definitions of stress and the exact definition is still being debated. Let’s begin by reviewing some of the main definitions of stress. Since this time, stress thinking and research has transitioned into being seen as more of a “bad thing,” with harmful biochemical and long term effects. Although today we will focus most of our time on the negative aspects of stress (as noted in the second definition, above) and ways to mitigate it, it is helpful to first briefly take a broad look at both (positive and negative) sides of stress:
• #4: Can you think of times when stress has a positive effect? List the participant’s responses about positive stress on a flip chart page. Mention these examples (if not already mentioned by participants):  Having a set deadline, which helps you accomplish a project (otherwise you might procrastinate)  Getting married  Getting a new/better job  Anticipation of a sports competition that helps you perform better or faster Stress is caused by various factors, some are external (such as where we live and work), and internal (such as physical ailments, worrying). The truth is, some factors we can control and others we cannot. Environmental Stressors  Reminders of war  Poor housing conditions  Pollution and noise  Political conflict in the community Family-related stressors  Family separations (due to work relocations or other reason)  Marital conflict  Illness or death of a family member  Parenting or child care challenges Workplace Stressors  Conflict among co-workers  Unexpected/unwanted transfer of work location  Lack of mobility/transport for high risk patients at the health facility  Poor communication with co-workers or patients  Lack of support from supervisor  No forum to express work concerns and issues  Lack of resources to support the provision of care Physical Stressors  Illness such as malaria  Physical injury such as strained back  Headaches, fatigue, indigestion
• #5: Now that we have discussed the definition of stress, let’s look a little deeper into some of the sources of stress in our lives. We all are under stress of some kind, but since each person here has unique experiences, we are going to do an individual exercise to get a sense of what our individual stress level is like right now. Appendix 1. -Personal Life Events Analysis the process of doing this self-assessment:   Personal Life Events Analysis Completing form - You should circle the numbers on the right beside various events that may have occurred in the past 12 months (if something has occurred more than once, you will be circling that number however many times you experienced it. For example, if you moved twice, note that you circle the value twice). Scoring the results - When you are finished circling the life event’s associated numbers on the right side of the form, add up the total of all the numbers you circled. Analyzing the results - When done adding your score, note that the higher your number, the higher your stress. If your results are over 150, your stress is considered on the high end and it will be important for you to figure out ways to manage your stress to prevent physical illness
• #6: – Some of you probably noted employment-related stressors when you completed the self-assessment exercise. We spend a lot of our time and energy in our work, and some jobs are intrinsically stressful. Share observation – Work-related stress is very common, as it is for many health workers here in Kono. Conditions can be difficult when resources are limited (human resources, medications/supplies, transport, etc.) and you may feel stretched to meet the demands of the patients in your health facilities. In the mind  Feeling anxious, overwhelmed, irritable, angry, upset, sad/depressed, “jumpy”/hyper vigilant, fearful  Having nightmares, obsessive thinking, emotional or angry outbursts  Noting poor concentration/memory, poor problem solving or decision making, etc. In behavior  Withdrawing from co-workers, difficulty taking breaks/resting, talking too much  Angry outbursts (with co-workers or patients), loss or increase of appetite, jumping from one activity to another (unfocused)  Increased alcohol consumption or smoking, change in normal communications, etc. In the body  Fatigue, headaches, dizziness, weakness, nausea, muscle tightness (neck, shoulders, jaw)  Sweating, shallow breathing, rapid heart rate, teeth grinding, etc. Spiritually  Feelings of loss or direction and purpose, emptiness  Feeling punished, apathy, crisis of faith, etc. In the workplace  Low morale, apathy, silence, impaired communication, isolation, lack of teamwork and team spirit  Low productivity, aggressive or confrontational behavior, high rates of absenteeism due to stress and illness, drug and alcohol abuse, etc.
• #7: – On the brighter side, we also know that there are some positive or healthier ways we can cope with our work-related stressors. Positive responses may include (add as appropriate):  Relaxation techniques  Religious practices  Meditation  Working on self-awareness – “check yourself”
• #8: It is helpful for everyone to find ways to integrate stress management techniques into our daily lives. Let’s face it – life is stressful, we need to be proactive in order to learn ways to better cope with it at work, at home, and in our communities. With practice, we all can learn how to better spot stressors and stay in control when the pressure builds With stress management, we strive to relax and find the opposite physical reaction to fight or flight – decreasing our heart rate, blood pressure, respiration and muscle tension. Like developing any new skill, it takes time, commitment, self-exploration and experimentation. A central part of stress management is finding ways to build new habits for yourself, so that you have practical tools readily available as stressful situations arise.