Page 86 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

60 Chapter 3. Stress

et al. 2009 , 2010a , b ). In particular, the evidence suggested
that the stress of dressing change was a significant factor in
those with a chronic wound.
This overview has indicated that stress may have an impor-
tant part to play in both acute and chronic wound healing and
hence it is important for the practitioner to be aware of stress,
its definition and measurement and the potential impact it
has on healing along with potential remediation strategies.
Although there are many complex models of stress, there are
two fundamental theories: The General Adaptation Syndrome
(GAS) and the Interactional Model. These will be explored
next since they underpin some of the subsequent observa-
tions and interventions in wound care.

General Adaption Syndrome (GAS) Model
of Stress

The physiological model of stress- the General Adaption
Syndrome (GAS) was proposed by Selye ( 1956 ). When a
patient is experiencing stress there are usually a number of
common bodily responses that can be identified, including;
increased respiration, blood pressure or heart rate. These
responses are all part of the ‘fight or flight’ syndrome that
prepares the body and which are mediated through the ner-
vous and endocrine system. The GAS describes three stages
that are evident within the stress process, consisting of: (1)
Alarm stage; (2) Resistance stage; (3) Exhaustion stage:
:
• Alarm stage whereby the body prepares for the stressor
by mobilising its available resources. This stage echo’s that
of the ‘fight or flight’ response in that the body’s resources
are mobilised for action. Nonetheless, if the stressor is per-
sistent, resources become depleted leading to fatigue and
subsequently triggers the resistance stage.
• Resistance stage here the body adapts to the stressor,
:
allowing physiological arousal to decline but still remaining
higher than normal. It is here that the individual becomes
at risk of health implications due to impaired immune func-
tioning. Consequently, the exhaustion stage is triggered.