Adaptive and maladaptive coping responses

Adaptive and maladaptive coping responses

Health Care

 

Professional

 

Concepts, Practice, and Evidence

 

Gwen van Servellen

 

CHAPTER 15

 

© 2009 Jones and Bartlett Publishers

 

Chapter 15

Communicating with Patients in Crisis

© 2009 Jones and Bartlett Publishers

 

Objectives

 

Define crisis response

Individuals and groups in crisis

Dysfunctional communication in times of crisis

Relevance of stress and adaptation in periods of crisis

Adaptive and maladaptive coping responses

© 2009 Jones and Bartlett Publishers

 

Objectives Continued

 

Stressors, coping resources, and stress resistance resources

Differentiate between situational and developmental crisis

Stages of crisis resolution

Interventions to manage highly anxious patients

Interventions to manage agitated and/or confused patients

© 2009 Jones and Bartlett Publishers

 

Definition of Crisis and Crisis Responses

 

More change is required of an individual than capable to deal with at the time

Assumptions

Not all crises are incapacitating

Persons experience crisis in isolation of others

Persons can worsen each others responses through further excitation

Crisis is not the same as the stressor itself

© 2009 Jones and Bartlett Publishers

 

Dysfunctional Aspects of Crisis Communication

 

Difficulty in perceiving accurately

Abilities of processing information may be impaired

Ability to express ideas, thoughts, and emotions may be limited

Perceived state of disorganization can increase these deficits

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Impact: Over Stimulation and Under Stimulation

 

Over stimulation

Rapid bombardment or excessive stimuli

Not too much but stimuli are noxious

Exceed tolerance level

Inability to hear, speak, and if they do hear, unable to move

© 2009 Jones and Bartlett Publishers

 

Stress Theories and Understanding Crisis

 

Levels of anxiety and effects on patients; mild to severe and panic

Stress and adaptation

Lazarus and Folkman (1984) coping always discussed when stress effects are analyzed

Studies of stress of different kinds; and stress of the same kind across several groups of individuals

© 2009 Jones and Bartlett Publishers

 

Adaptive Coping Responses

 

Seek information

Seek comfort/support from friends or family

Search for solutions to the problem(s)

Self-talk that will help them feel better

Seek professional counseling or advice

© 2009 Jones and Bartlett Publishers

 

Types of Crisis

 

Developmental Crises: interruption or unsatisfactory passing from one psychosocial task and developmental phase that correspond also to physical developmental growth

 

Situational: Crisis emanates from precipitating events that occur and are typically out of the person’s realm of expectancy.

 

© 2009 Jones and Bartlett Publishers

 

Caring for Patients in Crisis

 

Do not re-victimize in the process of helping

Establish an emotional or psychological connection with the patient and family

Do not challenge the validity of the crisis situation or underestimate its effect

Practice active listening skills, direct straightforward approach, become aware of personal responses and their impact

© 2009 Jones and Bartlett Publishers

 

Summary

 

Crisis is unavoidable; many illness or injury events can be perceived as a crisis to the patient and family. More needs to be known about the unique expression of crisis across individuals and communities.

 

© 2009 Jones and Bartlett Publishers