STRESS AS A STIMULUS FOR DISEASE
Relating life events to illness (the theoretical approach that de-fines stress as a stimulus) has been a major focus of psychosocial studies. This can be traced to Adolph Meyer, who in the 1930s observed in “life charts” of his patients a linkage between illnesses and critical life events. Subsequent research revealed that people under constant stress have a high incidence of psychosomatic disease.
Holmes and Rahe (1967) developed life events scales that as-sign numerical values, called life-change units, to typical life events. Because the items in the scales reflect events that require a change in a person’s life pattern, and stress is defined as an ac-cumulation of changes in one’s life that require psychological adaptation, one can theoretically predict the likelihood of illness by checking off the number of recent events and deriving a total score. The Recent Life Changes Questionnaire (Tausig, 1982) contains 118 items such as death, birth, marriage, divorce, pro-motions, serious arguments, and vacations. The events listed include both desirable and undesirable circumstances.
Sources of stress for patients have been well researched (Bal-lard, 1981; Bryla, 1996; Jalowiec, 1993). People typically experi-ence distress related to alterations in their physical and emotional health status, changes in their level of daily functioning, and de-creased social support or the loss of significant others. Fears of im-mobilization, isolation, loneliness, sensory changes, financial problems, and death or disability increase a person’s anxiety level. Loss of one’s role or perceived purpose in life can cause intense discomfort. Any of these identified variables plus a myriad of other conditions or overwhelming demands are likely to cause in-effective coping, and a lack of necessary coping skills is often a source of additional distress for an individual. When a person en-dures prolonged or unrelenting suffering, the outcome is fre-quently the development of a stress-related illness. Nurses possess the skills to assist people to alter their distressing circumstances and manage their responses to stress.