STRESS AND COPING MECHANISM

CHAPTER I

INTRODUCTION

1.      Background Of Stress

Stress is popular technical term that often used within discussion every day. The employing is unlimited to especially person. The stress concept first putting forward by Hans Selye, somebody physiology members from Canada on 1936 years, into his research that analyzing the exciting relation environment and health with tracing the hormonal reaction is very difficult as result existence more emotional pressure  from people. The emotional pressure that continue can cause death (Subowo, 1993:17).

The raising demand and need for life of something is good, cause all person must compete to get the needs that they want. But in fact something that they want sometimes can’t get easly so can be makes somebody confused, imagination and even stress. Stress that occurs in each individual will vary depending on the problems encountered and the ability to resolve the problem or commonly referred to as coping mechanisms. If the problem can be solved by either the individual is happy, but if the problem is not resolved properly can cause the individualis angry,frustrated to depression (Sari, 2007:3).

Stress is the body's response or reaction to the various demands or expenses that are non-specific. However, besides that stress can also trigger factors, the cause and a consequence of a disorder or disease. Psychosocial factors have enough meaning to the occurrence of stress in a person. When the demands on a person beyond his ability, then that state is called diistres. Stress in life is something that can’t be avoided. The problem is how people with stress without distress (Sari ,2002:15).

Generally there are no people in this world are planning to stop having fun, unless such person is in the condition of depression or distress. Everyone wants to live happy, and prosperous, including the people. They now eager to get comfortable life in the old days. That is why since young people are already working hard, so that parents will get salary althoght day of sufficient savings to enjoy his old age (http.///www.z-psikologi.com. accesed on october 14 2011. 20:52 GMT).

Stress is the optimal role and has a positive and constructive called eustres. Instead there is a harmful and destructive stress called distress or distruktif. Stress becomes distress eustres or influenced by the assessment and resilience to stressful events san state (Hardjana, 1994:25).

2.      Formulation Of  Problems

Based on the background of the above problems, it can be formulated the problem of how stress can occur and the coping mechanisms used.

CHAPTER II

DISCUSSION

A.     Definition

2.1.    Stress

     Stress is the body's reaction or response to psychosocial stressors in the form of pressure or burden of life (Hawari, 2002:41). Stress is a reality of daily life that can not be avoided (Keliat, 1999:32). Stress can be defined as a stimulus that resulted in an imbalance of physiological and psychological function (Hudak&Gallo,1997:12).

Psychiatric science, normality and mental health disorders seen as one continuous line, at the end of the one located under normal circumstances and on the other end lies psychosis. The transition between normality to abnormality is often clear or not clear. In clinical phase of the transition between normality and mental disorders can be known as the stress syndrome. Stress is a form of the boundary between the normal state with psychiatric disorders. This stress level, the individual can still perform daily functions,quitewell.(Bahar,1995:26).

There are three terms of stress proposed by Townsend (1995:10),namely:
1)         Stress a biological response

Hans Selye in Townsend (1996:37) suggested that stress is a manifestation of the syndrome consists of all changes the spesific biology systems that are not specific.

This phenomenon is known as fight and flight. Selye called this process as a general adaptation syndrome or GAS (General Adaptation Syndrome) which is described in three phases.

a.       Phase warning

The body prepares itself to face all possibilities or react to stressors. If the stress factor continues the body will work best to deal with these stressors. In this phase occurs physiologically fight and flight response.

b.      Phase resistant

The function of antibodies to normal gradually. Changes or damage were revamped. Individuals become more resistant to stressors encountered. However, if the stress persists, then the individual will reach the exhaustion phase.
c.  Exhaustion Phase

There was a fatigue so that adaptation began to run out of energy and if this situation continues, then the entire energy reserves will be depleted at all. Individuals no longer have the endurance and turns into apathy and called psikomatik disorders.

2) Stress as environmental events

Stress is an event that causes the occurrence of physiological and psychological responses of individuals. In this case focused on changing one's lifestyle so-called stress as a change of life (Townsend,1996:37).
3) Stress as a transaction between the individual and the environment.

 Stress emphasis on the relationship between the individual and the environment. Between humans and the environment in which mutual influence and be influenced (http. / / / www.z-psikologi.com. Accesed on October 14 2011. 20:52 GMT).

2.2. Source of Stress.

Stress is a term that is widely known in the community, generally referred to stress is a reaction pattern to face stressors that originate from within individual of the environment (Anonymous, 2004:46). Safarino (1999:59) distinguish the sources of stress, namely:
1. In a person

Stress will appear on a person through assessment of the motivational forces that fight, when a person experiencing the conflict                

2. In families

Stress may arise from the interaction between a person's family members such as disputes in financial problems, feelings of mutual indifference, TV shows differences in the desire to be selected.

3. In the community and the environment

 Interaction subjects outside the family environment. For example the experience of stress in school children (Smet,1994:69).

2.3. Stages of Stress

According Hawari (1997) stress disorder usually develop slowly, it is not clear when starts and often be unknown. However, from the experience of practicing psychiatry, experts are trying to divide the stress in six stages, namely:
I. Stress Level 1

This stage is the most mild stress levels and usually accompanied by feelings of great passion, vision is not sharp, as usual, as well as excessive nervous energy and ability to complete the work followed more than usual. This phase is usually fun and people get the spirit, without realizing that the actual energy reserves are being depleted.
II. Stress Level 2

In this stage the impact of stress a fun start to disappear and complaints arise due to longer sufficient energy reserves throughout the day. Complaints are often perceived to feel tired when getting up early, feeling tired after lunch, feeling tired all the afternoon, sometimes in the digestive system disorders, feelings of tension in the muscles of the back and neck, feeling unable to relax.

III. Stress Level 3  

In this stage the complaint is accompanied by fatigue increasingly apparent intestinal symptoms were more tense, feeling increasingly tense, the body feels like fainting and insomnia. At this stage the patient should consult a doctor has, unless the load stress is reduced and the body gets a chance to rest or relaxation to restore oxygen supply.

IV. Stress Level 4

At this stage showed a more deteriorated state, which is marked by the characteristics to be able to survive throughout the day more difficult, fun activities that previously were difficult, lose the ability to respond to situations of social gatherings and other activities were heavy, restless sleep, decreased ability to concentrate sharp sense of fear that can not be explained.
V. Stress Level 5

This stage is a more profound stage characterized by profound fatigue, unable to do simple jobs, digestive system disorders more often, feeling of fear which becomes.

VI. Stress Level 6

This stage is the top stage a state of emergency is marked by painfully loud heartbeat, tightness of breath, body bergeta, cold body, sweat a lot, power to the light can not be done.

2.4. Body Reaction Against Stress

Someone who is stressed by  Hawari (2001) will show the following symptoms:

v  Head of Hair

Easy hair loss, hair color will change the original color of red to white may even be partially bald on the scalp.

v  Eye

 When you're stressed, your eyes will often blur, but if you checked out the expert eye or eye glasses your vision is normal.

v  The  thought

v  Power of thought you could-could be disrupted, forget fulness, decreased concentration, irritability tired to think and is usually accompanied by headache.

v  Mouth
Often, your mouth feels dry and hard to swallow, as if there is something you in throat. This makes you often drink to relieve dryness of the mouth and relax your throat.

v  Skin

Excessive sweating are common symptoms that occur in those who experience tension, but at that time is not hot air. Usually a cold sweat and strangely not merata, for example, only part of your body's skin and other skin reactions were itching.

v  Respiratory
Many people become frightened when suddenly, or chest tightness and breathing heavy. Your lungs are less free to develop due to a relatively narrow chest cavity caused by the muscles of the chest cavity is less elastic.

v  Heart

Pounding the common symptoms of any changes or emotional tension. This heartbeat was strong at all, so it will feel chest tightness, dizziness and fainting as if I would.

v  Blood sugar

Prolonged stress makes the blood sugar rises, the body's defense already has the power to reduce the high sugar content. But the function of stabilizing blood sugar levels over time will affect this also, if you are experiencing stress that prolonged and not immediately top. In other words the production of insulin (blood sugar stabilizers) are no longer able to lower your blood sugar levels result you will suffer from diabetes mellitus.

v  Intestine

Mules, mules, diarrhea, irregular bowel movements and so on.

v  Line art

Frequent urination or frequency to urinate more than customarily

v  Libido
Libido can be decreased or increased sometimes vice versa.

v  Other
Other complaints you may experience are the muscles of the body feel tetanus, so you often complain of sore pains, weakness, or could have easily fit your body feels the wind, never felt nervous and did not feel relaxed fit. In the field of mental emotional, you become a bad-tempered or easily depressed.

B.     Coping Mechanisms

1.1.1     Definition

Coping is problem-solving behavior that can directly affect, change the state of balance. According to an Folkaman Lazarus (1997:58) defined coping as a realistic and flexible thinking and problem-solving measures that can reduce stress. Coping is a process of management of external and internal demands are considered as a burden or exceeding the resources owned. In this context, coping is an act of problem solving, not static but changes in quality and intensity with continuous changes in cognitive assessment.

 Coping mechanisms according to Stuart and Sunden (1998:85), coping mechanisms is any effort directed at stress management. It includes direct remedy and defense mechanisms are used to protect themselves.
According to Stuart and Sunden (1998:21), is basically a defense mechanism against the changes that occur either within and outside the self. In this case there are two kinds of coping mechanisms, namely:

a.       Adaptive

Adaptive behavior is behavior that can adapt and behavior constructively. Additionally, individuals are better able to survive and to anticipate the possibility of danger. Included in adaptive coping mechanisms are constructive coping mechanisms, where there are two kinds of constructive coping mechanisms, namely: survival used constructive coping mechanisms for survival and is associated with something threatening. Is an adaptive behavior. For instance health check periodically to the hospital
 motivate constructive coping mechanisms for example, when a new problem has talked to family or have a problem with a new health check-up.

b.      Maladaptive

 In the maladaptive behavior, the individual cannot resolve the problem so that destructive behavior tends to emerge, giving rise to a maladaptive response. Maladaptive responses can occur in severe anxiety and panic. Which includes maladaptive coping mechanisms which are destructive coping, such as anger, irritability and depression attacks. According Keliat (1998), there are some characteristics in maladaptive coping mechanism such as a slow reaction or excessive, avoidance, injuring him self and drinking alcohol.

1.1.2              Source of Coping

According to Stuart and Sunden (1998:46), coping is the source evaluations of one's choice of coping and strategies. While the kinds of coping resources used include: personal skills, social support, material assets and positive beliefs.

 There are some factors that affect the ability of coping: According Vascarolis (11990:30), the factors that affect individual coping mechanisms for adaptive and maladaptive responses include genetic factors, past experience that exist in the individual as an individual's health status, motivation, age, education and economic status. Meanwhile, according to Ericson (1994), coping abilities are influenced by several factors:

1.      Internal factors

It is a factor that comes from within ourselves which include age, personality,intellegence, education, values, beliefs, cultural, emotional and cognitive.

2.      external factors

It is a factor that comes from outside is to include support systems, environment, financial conditions and diseases.

When there is stress the body will have the coping mechanisms coping mechanism to cope with change is accepted or received by the load, so it sort of defense of the body. If the coping mechanisms are satisfied, then the person can adapt to change is happening. The ability of these coping mechanisms of each person depends on individual temperament and perception and cognition to stressors are acceptable (Carlson, 1994:67).

Coping strategies demonstrated in a variety of efforts, both mental and behavioral, to master, tolerate, reduce or minimize the situation or a stressful event. By mastering stress situations as a result of the pressing problems being faced by the cognitive and behavioral changes in order to get sense of security for himself.

Experts classify the two coping strategies typically used by individuals that is problem-solving focused coping in which individuals actively seeking to resolve the problem for relieve stressful situations and emotional-focused coping, which in this case involves individuals, businesses need to manage their emotions in order to adjust to the impact that will be caused by a condition or a stressful situation (Lazarus & Folkman, 2002:48).

1.1.3       Mechanisms of psychological adaptation

According to Hidayat (2004), an adjustment process due to psychological stressors that exist, by providing self-defense mechanism, hoping to protect or defend from attacks or things that are not fun.

In the process of psychological adaptation, there are two ways to defend themselves from various stressors is coping or handling them perform a task-oriented (task oriented), known as problem solving strategies and ego-oriented or self-defense mechanism oriented on the ego.

1.      Task Oriented Reaction (Reaction Task Oriented)

This reaction is used in coping with the problem-oriented problem-solving process, including affective or feeling, cognitive and psychomotor. This reaction can be performed such as talking with others about the problems faced to look for a way out, find out more about the problems encountered through reading books, or the expert, or can also be associated with supernatural powers, do exercises that can reduce stress and create alternative solutions by using a strategy of priority issues.

2.      Ego Oriented Reaction (Reaction Oriented Ego)

This reaction is known as a psychological defense mechanism in order not to disturb deeper psychological disorders. Among the self-defense mechanism that can be used to make the process of psychological adaptation among others, namely:

a) Rationalization

Is an attempt to avoid psychological problems by always providing a rational reason, so the problems encountered can be resolved.
b) Displacement

 An attempt to overcome the psychological problems by performing displacement behavior in other objects, for example if someone disturbed by noisy conditions, a friend who will be blamed.

c) Compensation

Efforts to find solutions for problems with how to find satisfaction in other situations such as someone has a problem because of declining memory it will high light the capabilities it has.

d) Projection

Self-defense mechanism by placing his own inner nature of the inner nature of another person, like himself hating on others and then tell people that the people hate it.

e) Repression

 Efforts to resolve the problem with pressing problems that are unacceptable to the conscious and the individual does not want to think about the things that are less pleasant.

f) Denial

Self-defense efforts by the rejection of the problems encountered or will not accept the fact that it faces.

CHAPTER III

CONCLUSIONS AND RECOMMENDATIONS

A.            CONCLUSION

Based on the description above can be concluded that stress is the body's reaction or response to a stressor or stressors as well as a variety of coping are performed in an effort to adapt to the stress reaction among which the task-oriented and ego-oriented reaction.

B.                                         ADVICE

Based on the above conclusion the author wants to give suggestions as follows:

1.      For patients with stress

a. To the sufferer of stress are expected to get closer to God and deepen knowledge religion, in order to realize that each of the living must die. Moreover, it can also socialize with their surroundings, to fill free time with social or religious activities, and always follow the guidance and health education to increase knowledge and insights that can improve physical and mental health and ultimately avoid stress.

b. In addition, patients are expected to have high motivation to resolve any problems encountered to look for a way out, find out about an issue faced by a lot of reading, supernatural, the Experts, and doing exercises that can reduce stress.

2.      For Researchers

Develop this research by adding the respondent and conduct research with a more variety of instruments.

 

 

 

 

 

 

 

 

 

 

BIBLIOGRAFI

Ericson, J.H.1994. Oncologic Nursing. Ed. 2. USA: Sringhouse Corporation.

Hawari, D.2002. Manajemen Stres, Cemas dan Depresi. FK UI. Jakarta: Gaya Baru.

Hidayat, A.2004. Pengantar Konsep Dasar Keperawata. Ed 1. Jakarta: Salemba Medika.

Keliat, B.A.1998. Proses Keperawatan Kesehatan Jiwa. Jakarta: EGC.

Kuntjoro, Z.S.2002.Dukungan Sosial pada Lansia. Avilable from: http.///www.z-psikologi.com. accesed on october 14 2011. 20:52 GMT.

Potter and Perry. 2005. Buku Ajar Fundemental Keperawatan. Ed 4. Jakarta: EGC.

Subowo.1993.Imunologi Klinik. Bandung: Angkasa Bandung.            

Smet, B.1994. Psikologi Kesehatan. Jakarta: PT Grasindo.

Townsond, M.C.1996. Psyciatric Mental Health Nursing. Ed 2. Philadhelpia: F.F. Davis Company.

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