Page 90 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

64 Chapter 3. Stress

Potential stressor

Primary appraisal: Is
this stressful?

Yes –potentially harmful
No -harmless

Secondary appraisal:
No stress Yes
Can I cope with the stress?
Unable to cope

Stress

Figure 3.3 The interactional model of stress (Based on Lazarus and
Folkman ( 1984 , 1987 ))

response to a particular demand. From this, then two possible
outcomes are available: either a threat or not (and the latter may
either be positive, or neutral). If an individual perceives the situ-
ation to be threatening, secondary appraisal occurs; where the
individual’s ability to cope and the resources available are
assessed (see Prati et al. 2010 ) and put into action. The available
choices from this assessment reflects the control that the patient
may have; taking control of the situation themself, gaining help
from another, or avoiding the situation (this can be particularly
influential when considering patient’s treatment concordance,
discussed later in this book). When an individual believes that,
given their secondary appraisal, they have limited resources to
cope with the situation, they will experience some form of stress
and ultimately negative physiological consequences.
From this description of the model, a number of
considerations for the wound care clinician can be noted.
Firstly, clinicians cannot simply characterise a situation as