Stres Yönetimi
Özet
Stres, bireyin tehdit algıladığında ve baş etme gücü tükendiğinde ortaya çıkan fizyolojik ve psikolojik bir durumdur. Yaşamdaki büyük travmaların yanı sıra günlük hayattaki küçük çatışmalar da strese yol açabilir. Stres; alarm, direnç ve tükenme olmak üzere üç aşamadan oluşur. Alarm aşamasında adrenalin ve kortizol hormonları salgılanırken, uzun süren kronik stres; obezite, kardiyovasküler hastalıklar ve bağışıklık sisteminin baskılanması gibi ciddi sağlık sorunlarına neden olur. Stresör algılandığında vücut "savaş, don ya da kaç" tepkisi verir. Bu süreçleri yönetmek için duygu odaklı ve problem odaklı başa çıkma stratejileri kullanılır. Kanıta dayalı stres yönetimi teknikleri arasında aşamalı kas gevşemesi, otojenik eğitim, gevşeme yanıtı, biyolojik geri bildirim, diyafragmatik solunum, transandantal meditasyon, bilişsel davranışçı terapi (BDT) ve farkındalık temelli stres azaltma (mindfulness) yer almaktadır. Ayrıca düzenli aerobik egzersizler (koşu, yürüyüş, yüzme), kitap okumak ve sosyal iletişimi artırmak gibi aktiviteler de kortizol seviyelerini düşürerek ruh sağlığını olumlu etkiler. Sonuç olarak, stres tükenme aşamasına gelmeden önce bireysel ve uzman müdahaleleriyle kontrol altına alınmalıdır.
Stress is a physiological and psychological condition that arises when an individual perceives a threat and exhausts their coping capacity. Both major life traumas and minor daily conflicts can induce stress, which progresses through three stages: alarm, resistance, and exhaustion. During the alarm stage, adrenaline and cortisol are released, but long-term chronic stress leads to serious health issues like obesity, cardiovascular diseases, and immune suppression. When a stressor is perceived, the body initiates the "fight, freeze, or flight" response. To manage this, emotion-focused and problem-focused coping strategies are utilized. Evidence-based stress management techniques include progressive muscle relaxation, autogenic training, relaxation response, biofeedback, diaphragmatic breathing, transcendental meditation, cognitive behavioral therapy (CBT), and mindfulness-based stress reduction. Additionally, regular aerobic exercises (running, walking, swimming), reading books, and increasing social communication positively impact mental health by reducing cortisol levels. In conclusion, stress must be controlled through individual and expert interventions before reaching the exhaustion stage.
Referanslar
Riva S, Chinyio E. Stress factors and stress management interventions: The heuristic of “Bottom Up” an update from a systematic review. Occupational Health Science. 2018;2(2):127-55.
Wirtz PH, von Känel R. Psychological stress, inflammation, and coronary heart disease. Current Cardiology Reports. 2017;19(11):1-10.
Bonanno GA, Galea S, Bucciarelli A, Vlahov D. What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. Journal of Consulting And Clinical Psychology. 2007;75(5):671.
Ornelas S, Kleiner BH. New developments in managing job related stress. Equal Opportunities International. 2003.
Yu B, Funk M, Hu J, Wang Q, Feijs L. Biofeedback for everyday stress management: A systematic review. Frontiers in ICT. 2018;5.
Varvogli L, Darviri C. Stress management techniques: Evidence-based procedures that reduce stress and promote health. Health Science Journal. 2011;5(2):74.
Smyth JM, Sliwinski MJ, Zawadzki MJ, Scott SB, Conroy DE, Lanza ST, et al. Everyday stress response targets in the science of behavior change. Behav Res Ther. 2018;101:20-9.
Braithwaite V. Understanding stress in informal caregiving: Is burden a problem of the individual or of society? Research on Aging. 1996;18(2):139-74.
McCubbin HI, Joy CB, Cauble AE, Comeau JK, Patterson JM, Needle RH. Family stress and coping: A decade review. Journal of Marriage and the Family. 1980:855-71.
Fox GL, Benson ML, DeMaris AA, Van Wyk J. Economic distress and intimate violence: Testing family stress and resources theories. Journal of Marriage and Family. 2002;64(3):793-807.
Applebaum D, Fowler S, Fiedler N, Osinubi O, Robson M. The impact of environmental factors on nursing stress, job satisfaction, and turnover intention. J Nurs Adm. 2010;40(7-8):323-8.
Kessler RC, Price RH, Wortman CB. Social factors in psychopathology: Stress, social support, and coping processes. Annual Review Of Psychology. 1985;36(1):531-72.
Xin Y, Wu J, Yao Z, Guan Q, Aleman A, Luo Y. The relationship between personality and the response to acute psychological stress. Scientific Reports. 2017;7(1):1-8.
de Berker AO, Rutledge RB, Mathys C, Marshall L, Cross GF, Dolan RJ, et al. Computations of uncertainty mediate acute stress responses in humans. Nature Communications. 2016;7(1):10996.
Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annual Review Of Clinical Psychology. 2005;1.
Boonstra R. Reality as the leading cause of stress: rethinking the impact of chronic stress in nature. Functional Ecology. 2013;27(1):11-23.
Russell G, Lightman S. The human stress response. Nat Rev Endocrinol. 2019;15(9):525-34.
Civan A, Özdemir İ, Gencer YG, Durmaz M. Egzersiz ve stres hormonları. Türkiye Spor Bilimleri Dergisi. 2018;2(1):1-14.
Scott LD, Hwang W-T, Rogers AE. The impact of multiple care giving roles on fatigue, stress, and work performance among hospital staff nurses. JONA: The Journal of Nursing Administration. 2006;36(2):86-95.
Eskin M, Harlak H, Demirkıran F, Dereboy Ç, editors. Algılanan stres ölçeğinin Türkçeye uyarlanması: güvenirlik ve geçerlik analizi. New Symposium Journal; 2013.
Akın A, Çetin B. Depresyon anksiyete stres çlçeği (DASÖ): Geçerlik ve güvenirlik çalışması. Kuram ve Uygulamada Eğitim Bilimleri. 2007;7(1):241-68.
Durak M, Durak EŞ. Stres değerlendirme ölçeği süreklilik formu’nun (SDÖ-S) Türkçe geçerliliği. Eğitim ve Bilim. 2012;37(165).
Mason HD. Stress-management strategies among first-year students at a South African University: A qualitative study. Journal of Student Affairs in Africa. 2017;5(2):131-49.
Powell TJ, Enright SJ. Anxiety and stress management: Routledge; 2015.
Holman D, Johnson S, O'Connor E. Stress management interventions: Improving subjective psychological well-being in the workplace. Handbook of well-being Salt Lake City, UT: DEF Publishers DOI: nobascholar com. 2018.
Xenaki N, Bacopoulou F, Kokkinos A, Nicolaides NC, Chrousos GP, Darviri C. Impact of a stress management program on weight loss, mental health and lifestyle in adults with obesity: a randomized controlled trial. Journal of Molecular Biochemistry. 2018;7(2):78.
Park S, Jang MK. Associations between workplace exercise interventions and job stress reduction: A systematic review. Workplace Health & Safety. 2019;67(12):592-601.
Wipfli BM, Rethorst CD, Landers DM. The anxiolytic effects of exercise: a meta-analysis of randomized trials and dose–response analysis. Journal of Sport and Exercise Psychology. 2008;30(4):392-410.
Stults-Kolehmainen MA, Sinha R. The effects of stress on physical activity and exercise. Sports Medicine. 2014;44(1):81-121.
Sharon-David H, Tenenbaum G. The effectiveness of exercise interventions on coping with stress: research synthesis. Stud Sport Humanit. 2017;21:19-29.
Jackson EM. Stress relief: The role of exercise in stress management. ACSM's Health & Fitness Journal. 2013;17(3).
Robb SL. Music assisted progressive muscle relaxation, progressive muscle relaxation, music listening, and silence: A comparison of relaxation techniques. Journal of Music Therapy. 2000;37(1):2-21.
Kerr K. Critical review on relaxation techniques. Critical Reviews™ in Physical and Rehabilitation Medicine. 2017;29(1-4).
McCallie MS, Blum CM, Hood CJ. Progressive muscle relaxation. Journal of Human Behavior in the Social Environment. 2006;13(3):51-66.
Chellew K, Evans P, Fornes-Vives J, Pérez G, Garcia-Banda G. The effect of progressive muscle relaxation on daily cortisol secretion. Stress. 2015;18(5):538-44.
Park ER, Traeger L, Vranceanu A-M, Scult M, Lerner JA, Benson H, et al. The development of a patient-centered program based on the relaxation response: The relaxation response resiliency program (3rp). Psychosomatics. 2013;54(2):165-74.
Sharma M, Rush SE. Mindfulness-based stress reduction as a stress management intervention for healthy individuals: A systematic review. Journal of Evidence-Based Complementary & Alternative Medicine. 2014;19(4):271-86.
Hede A. The dynamics of mindfulness in managing emotions and stress. Journal of Management Development. 2010.
Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal Of Behavioral Medicine. 2008;31(1):23-33.
Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research. 2004;57(1):35-43.
Bishop SR. What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine. 2002;64(1):71-83.
Courtney R. The functions of breathing and its dysfunctions and their relationship to breathing therapy. International Journal of Osteopathic Medicine. 2009;12(3):78-85.
Paul G, Elam B, Verhulst SJ. A longitudinal study of students' perceptions of using deep breathing meditation to reduce testing stresses. Teaching and Learning in Medicine. 2007;19(3):287-92.
Brown RP, Gerbarg PL, Muench F. Breathing practices for treatment of psychiatric and stress-related medical conditions. Psychiatric Clinics. 2013;36(1):121-40.
Perciavalle V, Blandini M, Fecarotta P, Buscemi A, Di Corrado D, Bertolo L, et al. The role of deep breathing on stress. Neurological Sciences. 2017;38(3):451-8.
Blandini M, Fecarotta P, Buscemi B, Ramaci T, Buscemi A. An anti-stress protocol based on the psychological functional model. Internat J Edu Res. 2015;3:459-68.
Lorenzo-Luaces L, Keefe JR, DeRubeis RJ. Cognitive-behavioral therapy: Nature and relation to non-cognitive behavioral therapy. Behavior Therapy. 2016;47(6):785-803.
Claspell E. Cognitive-behavioral therapies. Routledge Handbook of Applied Sport Psychology. 2010:131-40.
Williams MT, Chapman LK, Buckner EV, Durrett EL. Cognitive behavioral therapies. In: Breland-Noble AM, Al-Mateen CS, Singh NN, editors. Handbook of Mental Health in African American Youth. Cham: Springer International Publishing; 2016. p. 63-77.
Hamdan-Mansour AM, Puskar K, Bandak AG. Effectiveness of cognitive-behavioral therapy on depressive symptomatology, stress and coping strategies among jordanian university students. Issues in Mental Health Nursing. 2009;30(3):188-96.
