Download - Respon psikologis terhadap stress
RESPON PSIKOLOGIS TERHADAP STRESSDiyan Yuli Wijayanti
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Program Studi Ilmu Keperawatan Universitas Diponegoro
Psychologic Responses
Anxiety Fear Anger Depression Defense mechanisms: compensation,
denial, displacement, identification, intellectualization, introjection, minimization, projection, rationalization, reaction formation, regression, repression, sublimation, substitution, undoing.
Anxiety
Gelisah Apprehension Dread Firasat Tidak berdaya
Can be experienced at the conscious, subconscious, or unconscious level
Anxiety
Berbeda dengan fear :
Anxiety Fear
Sumber tidak teridentifikasi Sumber teridentifikasi
Berhubungan dengan “future” Sekarang
Tidak jelas Jelas
Result of psychological or emotional conflict
Result of a discrete physical or psychologic entity
Level cemasVidebeck (2008)
1. Cemas ringana. Respons fisik
Ketegangan otot ringan Sadar akan lingkungan Rileks atau sedikit gelisah Penuh perhatian Rajin
Level cemasVidebeck (2008)
b. Respon kognitif Lapang persepsi luas Terlihat tenang, percaya diri Perasaan gagal sedikit Waspada dan memperhatikan
banyak hal Mempertimbangkan informasi Tingkat pembelajaran optimal
Level cemas Videbeck (2008)
c. Respons emosional Perilaku otomatis Sedikit tidak sadar Aktivitas menyendiri Terstimulasi Tenang
Level cemasVidebeck (2008)
2. Cemas sedanga. Respon fisik :
Ketegangan otot sedang Tanda-tanda vital meningkat Pupil dilatasi, mulai berkeringat Sering mondar-mandir, memukul tangan Suara berubah : bergetar, nada suara
tinggi Kewaspadaan dan ketegangan
menigkat- Sering berkemih, sakit kepala, pola tidur
berubah, nyeri punggung
Level cemas Videbeck (2008)
b. Respons kognitif Lapang persepsi menurun Tidak perhatian secara selektif Fokus terhadap stimulus
meningkat Rentang perhatian menurun Penyelesaian masalah menurun Pembelajaran terjadi dengan
memfokuskan
Level cemas Videbeck (2008)
c. Respons emosional Tidak nyaman Mudah tersinggung Kepercayaan diri goyah Tidak sabar Gembira
Level cemasVidebeck (2008)
3. Cemas berata. Respons fisik
Ketegangan otot berat Hiperventilasi Kontak mata buruk Pengeluaran keringat meningkat Bicara cepat, nada suara tinggi Tindakan tanpa tujuan dan serampangan Rahang menegang, mengertakan gigi Mondar-mandir, berteriak Meremas tangan, gemetar
Level cemas Videbeck (2008)
b. Respons kognitif Lapang persepsi terbatas Proses berpikir terpecah-pecah Sulit berpikir Penyelesaian masalah buruk Tidak mampu mempertimbangkan
informasi Hanya memerhatikan ancaman Preokupasi dengan pikiran sendiri Egosentris
Level cemas Videbeck (2008)
c. Respons emosional Sangat cemas Agitasi Takut Bingung Merasa tidak adekuat Menarik diri Penyangkalan Ingin bebas
Level cemas Videbeck (2008)
4. Panik a. Respons fisik
Flight, fight, atau freeze Ketegangan otot sangat berat Agitasi motorik kasar Pupil dilatasi Tanda-tanda vital meningkat kemudian
menurun Tidak dapat tidur Hormon stress dan neurotransmiter
berkurang Wajah menyeringai, mulut ternganga
Level cemas Videbeck (2008)
b. Respons kognitif Persepsi sangat sempit Pikiran tidak logis, terganggu Kepribadian kacau Tidak dapat menyelesaikan masalah Fokus pada pikiran sendiri Tidak rasional Sulit memahami stimulus eksternal Halusinasi, waham, ilusi mungkin
terjadi
Level cemas Videbeck (2008)
c. Respon emosional Merasa terbebani Merasa tidak mampu, tidak
berdaya Lepas kendali Mengamuk, putus asa Marah, sangat takut Mengharapkan hasil yang buruk Kaget, takut Lelah
Fear
Respon terhadap sesuatu yang sudah ada atau jelas.Contoh :
The beginning nursing student may be fearful in anticipation of the first experience in a client setting. The student may fear that the client will not want to be cared for by the student or that the student might harm the client
Anger
Subjective feeling of animosity Can be expressed in a non alienating
verbal manner – positive emotion and sign of emotional maturity
Do the verbal communication than – constructive
Depression
Negative Extreme feeling of sadness, despair, dejection,
lack of worth, emptiness Tanda dan gejala berbeda antara individu satu
dengan yang lain Emotional symptom: tiredness, sadness,
emptiness, numbness Behavior sign: irritability, inability to
concentrate, difficulty making decision, loss of sexual desire, crying, sleep disturbance, social withdrawal
Physical sign: loss of appetite, weight loss, constipation, headache, dizziness
Defense mechanisms
Unconscious Psychologic adaptive mechanisms/
mental mechanisms to defend, establish compromises among conflicting impulses, allay inner tension
Protect person from anxiety – precursors to conscious cognitive coping mechanisms – solve problem
Defense mechanisms
Defense mechanism
Examples Use/purpose
Compensation: Covering up weaknesses by emphasizing a more desirable trait or by overachievement in amore comfortable area
A high school student too small to play football becomes the star long-distance runner for the track team
Allow a person to overcome weakness and achieve sucess
Denial:An attempt to screen or ignore unacceptable realities by refusing to acknowledge them
A woman, though told her father has metastatic cancer, continues to plan a family reunion 18 months in advance
Temporarily isolated a person from the full impact of a traumatic situation
Defense mechanisms
Defense mechanism
Examples Use/purpose
Displacement:The transferring or discharging of emotional reaction from one object or person to another object or person
A husband and wife are fighting, and the husband becomes so angry he hits a door instead of his wife
Allows for feelings to be expresses through or to less dangerous objects or people
Identification:An attempt to manage anxiety by imitating the behavior of someone feared or respected
A new graduate suddenly left in charge emulates her faculty role model
Helps a person avoid self-devaluation
Defense mechanisms
Defense mechanism Examples Use/purpose
Intellectualization:A mechanism by which an emotional response that normally would accompany an uncomfortable or painful incident is evaded by the use of rational explanation that remove from the incident any personal significance and feeling
The pain over a parent’s sudden death is reduced by saying, “he wouldn’t have wanted to live with a disability”
Protect a person from pain and traumatic events
Defense mechanisms
Defense mechanism
Examples Use/purpose
Minimization:Not acknowledging the significance of one’s behavior
A person says, “Don’t believe everything my wife tells you. I wasn’t so drunk I couldn’t drive”.
Allows a person to decrease responsibility for own behavior.
Projection:A process in which blame attached to others or the environment for unacceptable desires, thoughts, shortcomings, and mistakes
A mother is told her child must repeat a grade in school, and she blames this on the teacher’s poor instruction. A husband forgets to pay a bill and blames his wife for not giving it to him earlier
Allows a person o deny the existence of shortcomings and mistakes; protect self image
Defense mechanisms
Defense mechanism Examples Use/purpose
Rationalization: Justification of certain behavior by faulty logic and ascribing motives that are socially acceptable but did not in fact inspire the behavior
A mother spanks her toddler too hard and says it was all right because he couldn’t feel it through the diapers anyway
Helps a person cope with the inability to meet goals or certain standards.
Introjection:A form of identification that allows for the acceptance of others’ norms and value into oneself, even when contrary to one’s previous assumptions
A 7-year-old tells his little sister, “Don’t talk to strangers”. He has introjected this value from the instructions of parents and teacher
Help a person avoid social retaliation and punishment; particulary important for the child’s development of superego
Defense mechanisms
Defense mechanism
Examples Use/purpose
Reaction formation:A mechanism that causes people to act exactly opposite to the way they feel
An executive resent his bosses for calling in a consulting firm to make recommendation for change in his department but verbalizes complete support of the idea and is exceedingly polite and cooperative
Aids in reinforcing repression by allowing feelings to be acted out in a more acceptable way.
Regression:Resorting to an earlier, more comfortable level of functioning that is characteristically less demanding and responsible
An adult throws a temper tantrum when he does not get his own way. A critically ill client allows the nurse to bathe and feed him
Allows a person to return to appoint in development when nurturing and dependency were needed and accepted with comfort
Defense mechanisms
Defense mechanism Examples Use/purpose
Sublimation:Displacement of energy associated with more primitive sexual or aggressive drives into socially acceptable activities
A person with excessive sexual drives invests psychic energy into a well-defined religious value system
Protect a person from behaving in irrational, impulsive ways
Substitution:The replacement of a highly valued, unacceptable, or unavailable object by a less valuable, acceptable, or available object.
A woman wants to marry a man exactly like her dead father and settles for someone who looks a little bit like him
Helps a person achieve goals and minimize frustration and disappointment
Defense mechanisms
Defense mechanism Examples Use/purpose
Undoing:An action or words designed to cancel some disapproved thoughts, impulses, or act in which the person relieves guilt by making reparation
A father spanks his child and the next evening brings home a present for him.
Allow a person to appease guilty feelings and atone for mistakes
Repression:An unconscious mechanism by which threatening thoughts, feelings, and desires are kept from becoming conscious; the present material is denied entry into consiousness
A teenager, seeing his best friend killed in a car accident, becomes amnesic about the circumstances surrounding the accident
Protect a person from a traumatic experience until he or she has the resources to cope.
Common coping mechanisms grouped by developmental appropriateness
Age Coping mechanisms
0-5 Delusional projection
Denial
Distortion
3-15 Projection
Fantasy
Somatization
Acting out
Passive-aggressive behavior
Common coping mechanisms grouped by developmental appropriateness
Age Coping mechanisms
3-adulthhood IntellectualizationRepressionDisplacementReaction formationDissociation
12-adulthhood AltruismHumorSuppressionAnticipation Sublimation