Page 522 - Encyclopedia of Nursing Research

STReSS n 489

1970. Although the word “stress” is familiar theory is the life event theory proposed by
to many and has become part of our every- holmes and Rahe (1967). Stress is operation-
day vocabulary, the term conveys divergent alized as a stable additive phenomenon that S
meanings, and multiple theories have been is measurable by researcher-selected life
proposed to explain it. most of the theories events or life changes that typically have
attempting to describe and explain stress preassigned normative weights. The pri-
as a human phenomenon can be catego- mary theoretical proposition of the stimu-
rized under one of three very different ori- lus-based orientation is that too many life
entations to the concept: response based, events or changes increase vulnerability to
stimulus based, and transaction based. The illness. Results of studies (lyon & Werner,
response-based orientation was developed 1983) using the life event perspective have
by Selye (1976), who defined stress as a non- failed to explain illness, accounting for only
specific response of the body to any demand. 2% to 4% of the incidence of illness. noting
That is, regardless of the cause, situational the limitations of the stimulus-based ori-
context, or psychological interpretation of entation yet recognizing the need to attend
the demand, the stress response is charac- the “initiator” of a stress experience, Werner
terized by the same chain of events or same (1993) proposed a useful classification of
pattern of physiological correlates. Defined stressors that includes dimensions of locus,
as a response, stress indicators become duration, temporality, forecasting, tone, and
the dependent variables in research stud- impact.
ies. nurse researchers who have used the The third way to conceptualize stress
response-based orientation measure cat- is a transaction between person and envi-
echolamines, cortisol, urinary na/K ratio, ronment. In this context stress refers to
vital signs, brain waves, electrodermal skin uncomfortable tension-related emotions
responses, and cardiovascular complaints as that arise when demanding situations tax
indicators of stress. The demand component available resources, and some kind of harm,
of Selye’s definition is treated as an inde- loss, or negative consequence is anticipated
pendent variable, whereas hospitalization (lazarus, 1966; lazarus & Folkman, 1984). As
surgery or critical care unit transfer were a special note, the lazarus (1966) reference
commonly the assumed stressor in much of represents a class work in demonstrating
the nursing research using this orientation. how theory informs research and then how
The response-based model of stress is not research in turn shapes and reshapes theory.
consistent with nursing’s philosophical pre- In the transactional orientation, stress repre-
suppositions that each individual is unique sents a composite of experiences, including
and that individuals respond holistically threatening appraisals, stress emotions (anx-
and often differently to similar situations iety, fear, anger, guilt, depression), and cop-
(lyon & Werner, 1987). ing responses. As such, the term “stress” has
The stimulus-based theoretical expla- heuristic value but is a difficult construct to
nation treats stress as a stimulus that causes study. Use of a transactional theoretical ori-
disrupted responses. As a stimulus, stress entation requires that the researcher clearly
is viewed as an external force similar to the delineate which aspects of the person–
engineering use of the term to represent environment transaction are to be studied
dynamics of strain in metals or an external (lazarus; lazarus & Folkman). Commonly,
force directed at a physical object. Defined the independent variables in experimental
in this way, stress becomes the independent and quasi-experimental studies based on
variable in research studies. The most fre- the transactional orientation are personal
quently cited example of a stimulus-based resources such as self-esteem, perceived