Running head: Stress

Health Promotion: Stress

Jennifer Edson
Ferris State University

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Abstract
This paper is related to stress management. Every day people are pulled in many different
directions and expectations get higher and higher. The author wrote this paper because of the
affects stress has on people, including coronary artery disease. There are tools learned to help
learn to deal with every day stressors. The outcomes, and goals are to ultimately live a healthy,
happy life and to turn negative energy into positive energy.

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Health Promotion: Stress
The health promotion topic the author sought is health-seeking behaviors related to stress
as a risk factor for coronary artery disease is important. Stress has many impacts on life, in
relationships and in health. Coping with stress in productive, healthy ways can prevent coronary
artery disease, create better relationships and live in optimum health. The energy used for stress
can be better channeled into a productive energy used for positive outcomes. During this
semester, the author is looking to move toward a higher level of health and learning to deal with
stress in a healthy manner. The detriments of stress play such a negative impact on health. The
American Institute of Stress states, There are numerous emotional and physical disorders that
have been linked to stress including depression, anxiety, heart attacks, stroke, hypertension,
immune system disturbances that increase susceptibility to infections, a host of viral linked
disorders ranging from the common cold and herpes to AIDS and certain cancers, as well as
autoimmune diseases like rheumatoid arthritis and multiple sclerosis. In addition stress can have
direct effects on the skin and can contribute to insomnia and degenerative neurological disorders
like Parkinsons disease. In fact, its hard to think of any disease in which stress cannot play an
aggravating role or any part of the body that is not affected (www.stress.org/stress-effects/)
Assessment of current physical health is complete. Factors include an age of 41, female,
normal cholesterol levels, normal blood pressure, normal weight, and a risk factor that includes
inactivity related to non-weight bearing orders due a foot ailment.
Characteristics include a desire for a higher level of wellness, and an observation that
there is a high level of lack of information regarding stress management and healthy outlets of
negative energy. The more knowledge gained from learning healthy ways to channel negative
energy (stress), will have better outcomes. By the end of this project, the author will be able to

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state risk factors that create stress in life, how it affects the body, and will state ways to channel
the negative energy into positive ways to process the emotion.
Health Beliefs Survey
The author has more internal tendencies regarding the Health Belief Survey. For the
basic colds and illnesses it is believed that one has control of their own health. Rest, and taking
care of ones self can make a person heal faster and better than someone who continues to run
him or herself thin. The author had mono when she was 19 years old. She ignored it, continued
on with activities, didnt rest, and finally ended up with 104 degree temperature that landed her
in the emergency room. Her spleen was evidently swollen and protruding from her abdomen.
She was unable to walk stairs or drive a car; the doctor feared rupturing her spleen. She missed
all of her final exams and was stuck in the dorm rooms for a week after school let out for the
summer. When her parents were able to pick her up from college, the author was still bed ridden
until the end of summer. The author has full beliefs, had she stopped and slept and took care of
herself at the beginning of the illness, her recovery would have been much quicker and would
have never gotten to that extent that it did.
There are conditions that the author does realize a person does not have control. Those
would include major illnesses, such as genetic diseases or cancers. There is a point where
powerful others are important. Maintaining communications and yearly physicals does help
catch diseases early in their process, which can help a person with better outcomes.
Instruments of Choice
The authors instruments of choice in supporting her stress plan are the Relax Now app
for the iPhone and computer (Appendix B). Relax Now is an app of hypnotherapy to help
unwinds and de-stress. The second resource is the book Wired for Joy (Appendix C), which is a

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book about training ones brain to block stress and rewiring the emotional brain. The author
chose the hypnotherapy (guided imagery) application for the iPhone because the benefits of
imagery include its influence on physiological responses of the autonomic nervous system that
result in stress reduction. Research supports imagery as an effective intervention for pain
management and depressive disorders and for changing health behaviors (Pender, 2011, pg
210). The Wired for Joy book was chosen because Mindfulness-Based Stress Reduction
(MBSR) is beneficial for stress reduction. MBSR was developed by John Kabat-Zinn and
teaches being aware of everything in the present moment, without judgmentsystematic
procedure to develop enhanced awareness of moment-to-moment experiences of perceptual
processes (Pender, 2011. pgs 206-207).
Transtheoretical Model
Precontemplation
It wasnt until this project was assigned was it before the author started thinking about the
stress in everyday life. Around the same time that the project started, was the same time that a
cast was put on the authors right foot and also given non-weight bearing orders and a pair of
crutches and was told no work for six to twelve weeks. It was also explained how there would
be no driving for as long as the author has the cast on, because it is her right foot and it is illegal.
The stress began to build immediately as independence was quickly stripped away. American
Institute of Stress (AIS) states, that signs and symptoms of stress include the following but are
not limited to:
Physical symptoms: fatigue, headaches, upset stomach, indigestion, weight loss or gain,
pounding heart, chest pains, and dizziness.
Emotional symptoms: anxious, nervous depressed, mood changes, and irritability.

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Mental symptoms: negative thinking, lack of interest, and loss of concentration,
confusion, and forgetfulness.
Contemplation
Within the first week of being stripped of independence, the authors stress level had
increased dramatically for so many reasons. Independence for one, stressed about the
unknowing, whether casting will be a solution, or after two-six weeks of wearing a cast, if the
problem will resurface, if surgery will be necessary, if surgery is necessary, will her job be
available when she gets back (will be over 12 week threshold), will there be enough money to
pay bills, will her relationships withstand the dependence put on said individuals. With stress
levels climbing, quickly, it was determined that twelve weeks is going to be a very long time if
the stress level does not get under control. Therefore, a plan for channeling the negative stress
energy must be turned into positive energy.
Planning or Preparation
The best way to over come obstacles is to first acknowledge them. The author has
acknowledged the stressful aspects and the negativity that stress brings into life. Now that the
author can acknowledge the stress, identify behaviors and the negative reactions secondary to
stress; it is time to put a plan into action. Acknowledgement and identification are two actions
required to put a plan into action.
Action
After acknowledging the need to put stress management into action, it is important to
understand stress. Pender , 2011, states, that interventions for stress management should aim to
achieve the following: Minimize the frequency of stress-inducing situations, increase resistance
to stress, avoid physiologic arousal resulting from stress (pg. 201). It is important to set
realistic short and long term goals. It allows for immediate success and it allows for

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accountability and staying on track. Resources are important as well. Complementary therapies
exist and are helpful to manage stress especially when combined together, and they include,
mindfulness, progressive muscle relaxation, imagery, acupuncture, yoga, and self-hypnosis
(Pender, 2011, pg. 206).
The focus for the next six months will include minimizing the frequency of stressinducing situations. Pender (2011), suggests changing the environment, avoiding excessive
change, time control and time management (pg 201). The author has put together a plan and
goals to avoid too much change in too little of a time period. Time management skills are now
being applied to any extra curricular activities and the word no is becoming easier to say.
Maintenance
Maintenance will be maintained long term. Once the author meets the short term goals
such as changing the environment, avoiding excessive change, time control and management, the
author will implement further stress reducing tools, such as yoga and a regular fitness regime.
With practice and successes, maintaining a stress free life will become easier, and automated
responses will be a way of life.
Nursing Diagnosis
The authors nursing diagnosis is to achieve health-seeking behaviors related to stress as
a risk factor for coronary artery disease as evidenced by the toll stress takes on a persons health
including elevate blood pressure and cholesterol.
Outcomes and Goals
Short-term goals include learning guided imagery, meditation, and emotional brain
training. These short-term goals will start to become a natural way of life, and automatic in
response and feeling the immediate effects by feeling the sense of calmness.

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Long-term goals and outcomes are authors ultimate goal includes health, to become
happier, to be more productive, be more rested, eat healthier and to live a life with manageable
levels of stress. Long -term goals are to also remain free from coronary artery disease, high
cholesterol and high blood pressure.
Conclusions
Emotional stress only brings out unhealthy behaviors, and feelings. Stress affects
everyone physically and mentally. Stress causes many physical ailments, including coronary
heart disease, stroke, high blood pressure, and high cholesterol. Emotionally, it causes poor
sleep, damaged relationships, unproductivity and unsettled feelings and emotions.
The authors ultimate goal is to channel stress into positive energy by using the tools
learned for this project. The meditation on the iPhone shows promising results. The book,
Wired for Joy by Laurel Mellin, with a lot of work by the author, appears to be promising.

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References
American Institute of stress. http://www.stress.org/stress-effects/ accessed on October 7,
2013.
Pender, N.J., Murdaugh, C.L. & Parsons, M.A. (2011) Health promotion in nursing practice (6th
ed.) Upper Saddle River, NJ: Pretentice-Hall.

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Appendix A
Health Beliefs Survey
The questionnaire is designed to determine the way in which different people view
certain important health-related issues. Each item is a belief statement, with which you
may agree or disagree. Beside each statement is a scale that ranges from strongly
disagree (1) to strongly agree (6). For each item, choose the number that represents the
extent to which you disagree or agree. This is a measure of your personal beliefs;
obviously, there are no right or wrong answers.
Please answer these items carefully, but do not spend too much time on any one item.
As much as you can, try to respond to each item independently. When making your
choice, do not be influenced by your previous choices. It is important that you respond
according to your actual beliefs and not according to how you feel you should believe or
how you think we want you to believe.
1 - Strongly Disagree; 2 - Moderately Disagree; 3 - Slightly Disagree; 4 - Slightly Agree;
5 - Moderately Agree; 6 - Strongly Agree
1

1. If I get sick, it is my own behavior that determines how

soon I will get well again.

2. No matter what I do, if I am going to get sick, I'll get

sick.

3. Having regular contact with my physician is the best

way for me avoid illness.

4. Most things that affect my health happen to me by

accident.
5. Whenever I don't feel well, I should consult a medically
trained professional.
6. I am in control of my health.

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X
7. My family has a lot to do with my becoming sick or
staying healthy.

8. When I get sick, I am to blame.

X
9. Luck plays a big part in determining how soon I will
recover from an illness.

10. Health professionals control my health.

X
11. My good health is largely a matter of good fortune.
X
12. The main thing that affects my health is what I myself
do.

13. If I take care of myself, I can avoid illness.

14. When I recover from illness, it's usually because other

people have been taking good care of me. (doctor,
nurses, family)

15. No matter what I do, I'm likely to get sick.

16. If it's meant to be, I will stay healthy.

17. If I take the right actions, I can stay healthy.

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18. Regarding my health, I can only do what my doctor

tells me to do.

These three subscales, and the items included in each, are as follows:

Internal Items: 1, 6, 8, 12, 13, 17

Chance Items: 2, 4, 9, 11, 15, 16

Powerful-others items: 3, 5, 7, 10, 14, 18

The score on each subscale is the sum of the values for each item in that subscale
multiplied by 2. Scores within each subscale can range from 12 to 72. The higher the
score on the internal subscale, the more personal control clients believe that they
exercise over their own health. The higher the scores on the chance subscale and
power-others subscale, the higher the beliefs in the importance of chance and others
respectively in controlling personal health. Normative means for adults on each
subscale are as follows:

Internal, 50.4
Chance, 31.0
Powerful-others, 40.9
Appendix B

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https://itunes.apple.com/us/app/relax-now/id414035026?mt=12

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Appendix C

Amazon website for the book Wired for Joy writes: In Wired for Joy,
researcher and New York Timesbestselling author Laurel Mellin presents
a simple yet proven way to train your brain to move through stress and
back to joy. Her method has been called the missing link in health care, as
it focuses on rewiring the emotional brainthe caldron of our stress
rather than the thinking brain, which has been the focus of most other
stress-busting methods.
Based on the cutting-edge science of neuroplasticity, Mellin outlines the
five states of the emotional brain. For each state she presents a specific
tool that easily and quickly switches the brain back to a state of well-being.
Once you know how to make that switch, life becomes easier, and stress
symptomsdepression, anxiety, overeating, high blood pressuretend to
fade. Finally, instead of focusing on the symptoms of stress, we can
change the wiring that triggers it and experience new sense of freedom in
our lives. (Retrieved from amazon.com)