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Stress, which is a body's reaction towards any change that demands adjustments or responses, is part of the present life coupled with dynamic equilibrium, and which is affected by internal or internal forces - stressors. Stress is perceived when the threshold of a stressor is exceeded yet negatively impacts an individual at intrapersonal and physical levels (Smith, Gerdner Hall and Buckwalter 2004). Healthcare practitioners are obliged to understand the effective evidence-based stress management techniques and teach them to their clients, which include Relaxation Response (RR), Progressive Muscle Relaxation (PMR), biofeedback, Autogenic Training (AT), Guided Imagery (GI), Emotional Freedom Technique (EFT), and Mindfulness-Based Stress Reduction (MBSR).
The Relaxation Response (RR) method of stress management utilizes the physiological response of the body. Routine operations such as repetition of words, thoughts, or phrases are used. The targets may also be asked to repeat prayers, sounds, or even muscular movements to achieve more concentration. Individuals with stress may also be asked to return to repetition as soon as other thoughts prevail. During a physiological response, the body does not exist in any dangers, and various functioning including that of autonomic nervous system stabilizes (Esch, Fricchione and Stefano 2003). The normal functioning is the RR as the body moves from heated conditions such as elevated hormone releases, decreased blood flow, and increased blood pressure to the levels of mental relaxation. RR in healthcare can lead to various advantages such as reduced hypertension, and improved cardiac rehabilitation (Chang, Casey, Dusek and Benson 2010). The RR is, therefore, an effective evidence-based stress management technique.
Progressive Muscle Relaxation (PMR), on the other hand, involves alternating relaxing and tensing of muscles. A human's body consists of various muscles situated at the legs, arms, chest, face, and various other areas. For individuals performing PMR, they are exposed to a sequential pattern of muscle relaxation where they place tension on a given muscle for a finite time and then acting on the other muscle group (Ghoncheh and Smith 2004). However, most patients find difficulty with differentiating between emotions and muscle relaxation. The exercise aims to create pleasant mental states from tension and reduce pain through relaxation. As a result, tension leads to a reduction in anxiety, which is a response to stress. Other advantages include an improved concentration, an increased feeling of control and lowering of the cardiac index. The PMR exercise is useful as the advantages of decreased anxiety, disappearing of headaches, decreased heart rate rates and better management of cardiac rehabilitation.
The biofeedback method of stress management insists on the health and performance effect of mental activity. However, it may need health practitioners to use tools such as instruments measuring breathing, skin temperature, and heart function. The instruments provide information to their users - healthcare personnel - who interpret them in terms of psychological changes (Al Osman, Eid and El Saddik 2014). Due to adaptation, the changes cannot be felt after continued use of the instruments. The drawdown of this method is that biofeedback therapists are required to perform the training. As soon as they provide succinct information to their patients, a natural form of adaptation may be realized with them in that they would not require their presence any longer. They may also develop abilities to observe changes before they can happen (Al Osman, Eid and El Saddik 2014). The biofeedback method is more applicable to the treatment of headaches and control of high blood pressures. If well implemented, biofeedback can be used to detect cardiac diseases.
In Autogenic Training (AT), patients are informed of the exercises and procedures to make their body relax and relieve them of stress. It can well be described as a psychophysiological process that consists of various exercise for a patient. These activities are for the commanding of the body to relax, regulate pressure, temperature, and heartbeat (Rice and Schindler 1992). Healthcare professionals teach the patients on the proper exercises before they can implement them. As soon as positive feedback is provided from the training, patients get adapted to stress regulation. The various benefits of AT include treating migraine, hypertension, asthma, anxiety, and the major impact of heart disease.
The Guided Imagery (GI) method of stress management is taught by trained professionals in the activities. It is unique in that it relies on images personalized by the patient to enhance their health and well-being (Arbuthnott, Arbuthnott and Rossiter 2001). For GI, an expert lets the patient engage their images for which they use as a symbol for their health condition. In doing so, they let them better develop health-directed notions and the necessary behaviors to overcome stress. As GI uses images in its representation, it is advantageous in various applications such as treatment of depression, anxiety, as well as reducing the stress levels of cancer patients. The method may also apply to obese individuals who are coupled with stress regarding their weight.
Emotional Freedom Technique (EFT) is also another method used in evidence-based stress management that incorporates the tapping of nine acupoints while shouting a given sentence. EFT is more sensitive than other methods as calibration of the intensity of physical and emotional pain is needed (Fone, 2010). It is through calibration that the healthcare practitioner and their patient to have a scale over which they can measure progress. Since the EFT needs the brain in its operation, it lowers the midbrain hyperarousal as well as conditions of anxiety and trauma. EFT is in itself an exposure therapy that leads to an increase in neurochemical changes in the brain, which cause the reduction of pain, the lowering of heart rates, and anxiety levels. The main benefits of the EFT are that it leads to a reduced pain by involving the cognitive ability, leads to enhanced acceptance from the patient, and an increase in coping abilities.
Finally, Mindfulness-Based Stress Reduction (MBSR) is a therapy employed to a patient for eight weeks that utilizes mindfulness meditation to let their mental and physical issues be revealed better. Through such alleviations, a patient may be widely exposed to their mental experiences, which may be caused by stress. MBSR however, assumes that the more aware of the patient, the more clearly they would be in their condition (Grossman, Niemann, Schmidt and Walach 2004). MBSR may also be combined with systematic mindfulness that affects the brain areas involved with the regulation of awareness, attention, and emotion. For that reason, MBSR is used to regulate moods and cardiovascular diseases besides its effect on stress management.
In conclusion, it is evident that Relaxation Response, Progressive Muscle Relaxation, biofeedback, Autogenic Training, Guided Imagery, Emotional Freedom Technique, and Mindfulness-Based Stress Reduction are some of the available evidence-based stress management techniques. While stress leads to the enhancement of a disease to a patient, these evidence-based techniques may be important in stress reduction. Stressors are universal and healthcare practitioners ought to be informed of the various strategies to use to their patients in the medical sector.
Al Osman, H., Eid, M., and El Saddik, A., 2014. U-biofeedback: a multimedia-based reference model for ubiquitous biofeedback systems. Multimedia tools and applications, 72(3), pp.3143-3168.
Arbuthnott, K.D., Arbuthnott, D.W. and Rossiter, L., 2001. Guided imagery and memory: Implications for psychotherapists. Journal of Counseling Psychology, 48(2), p.123.
Chang, B.H., Casey, A., Dusek, J.A. and Benson, H., 2010. Relaxation response and spirituality: Pathways to improve psychological outcomes in cardiac rehabilitation. Journal of Psychosomatic Research, 69(2), pp.93-100.
Esch, T., Fricchione, G.L. and Stefano, G.B., 2003. The therapeutic use of the relaxation response in stress-related diseases. Medical Science Monitor, 9(2), pp.RA23-RA34.
Fone, H., 2010. Emotional freedom technique for dummies. John Wiley & Sons.
Ghoncheh, S. and Smith, J.C., 2004. Progressive muscle relaxation, yoga stretching, and ABC relaxation theory. Journal of Clinical Psychology, 60(1), pp.131-136.
Grossman, P., Niemann, L., Schmidt, S. and Walach, H., 2004. Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of psychosomatic research, 57(1), pp.35-43.
Rice, B.I. and Schindler, J.V., 1992. Effect of thermal biofeedback-assisted relaxation training on blood circulation in the lower extremities of a population with diabetes. Diabetes Care, 15(7), pp.853-858.
Smith, M., Gardner, L.A., Hall, G.R. and Buckwalter, K.C., 2004. History, development, and future of the progressively lowered stress threshold: a conceptual model for dementia care. Journal of the American Geriatrics Society, 52(10), pp.1755-1760.
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