COPING MECHANISM

BAHAN DISKUSI
 STRESS
Nonspesifik respon tubuh

situasi yang mengancam / tekanan / tuntutan

Tension
Ketidakseimbangan
ADAPTASI
Kemampuan tubuh → mempertahankan keadaan seimbang

Changes ----- adaptive coping mechanisms

( Stressor )

Long – term short - term

Homeostasis
Fisiologis tubuh ; saraf dan endokrin → medulla oblongata, reticular
formation, pituitary gland
Teori lain mengenai kecemasan
Psikoanalitik Interpersonal

Behavioral Family

Model of stress :

A. Response – Based Model

1. Pure fisiologis
2. Stress → responses → GAS
3. Kurang fleksibel
B. Model adaptasi
◦ Koping
◦ Practices dan norma – norma dalam kelompok tertentu.
◦ Dampak dari lingkungan sosial
◦ Sumber koping untuk mengatasi stress
◦ Cemas & stress → unprepared to cope

C. Stimulus – Based Model

◦ Fokus pada gangguan lingkungan
◦ Life changes – normal – adjustment
◦ Individu sebagai penerima pasif → stress
D.Transaction – Based Model.

Person Environment
Relationship
Interactive
Dynamic
Reciprocal

Faktor – faktor yang mempengaruhi stress – adaptasi

1. Intensitas
2. Scope
3. Durasi
4. Jumlah
5. Nature of the stressor

→ Dimensi : fisik, developmental,emosional,intelektual,sosial dan spiritual

 RESPON TERHADAP STRESS

Fisiologis Psikologis

LAS Task – Oriented Behaviors

◦ pain Ego- Defense Mechanism
◦ inflammantory

GAS
◦ Alarm
◦ Resistance
◦ Exhaustion
 GAS
General Adaptation Syndrome
Alarm reaction

1.Hypothalamus Recovery
2.Posterior pituitary
↑ADH → ↑ reabsorbsi H2O
Resistance
↓ urine output

3.Anterior pituitary Exhaustion

↑ACTH → adrenal cortex 1.Stabilisasi
↑ cortisol → Gluconeogenesis
Katabolisme CHON 2.Kadar hormon N
Katabolisme lemak 1.↑ Respon fisiologis
↑aldosteron→ reabsorbsi sodium 3.Aktivasi spt pd fase alarm
reabsorbsi H2O SS parasimpatetik
eskresi K+ 2.↓ Energy level
↓urine output 4.Adaptasi thd stress
3.↓ Fisiologis
4.SSS + adrenal medulla adaptation
↑ epinephrine→ HR,O2 intake,
Gula darah, 4.Death
mental activity
↑norephineprine → ↑ BF, ABP

5.Flight or fight Nursing ???

EVENT

Problem Focused
Coping
APPRAISAL

Emotion Focused
Coping
RESPONSE
Respon Psikologis

Task – Oriented Behaviors

Kognitif – problem solving
→ attack, withdrawal, compromise
Ego – Defense Mechanisms
Theories of Coping:
Problem- & Emotion- Focused
Lazarus & Folkman
(Strategy)

Problem-Focused Emotion-Focused

Resolve cause of Managing emotional

problems impact of problem

Seeking info. Talk to friends

Going to GP Think Going shopping
of options Devise Drinking Relaxing
plan Change job Avoidance
Defense mechanism classification

Narcissism Immature Neurotic Mature

Denial Acting out Displacement Altruism
Projection Regression Dissociation Humor
Distortion Passive- Reaction Sublimation
aggressive formation
behavior
Splitting Schizoid Repression Anticipation
fantasy
Somatization Isolation Suppression
Introjection Rationalization Asceticism
Hypochondria Sexualization
Blocking Intellectualizati
on
Implikasi Keperawatan

Physiological indicators
Developmental indicators
Emotional indicators
Intellectual indicators
Social indicators
Spiritual indicators