05 Stress, Coping, and Resilience
Understand how stress and appraisal shape coping, how resilience can be supported, and how nurses can work collaboratively to strengthen adaptive coping.
and appraisal
is a normal part of life, but persistent can affect sleep, concentration, mood, physical health, and management of existing health conditions. A person may experience worry, irritability, sadness, changes in appetite or energy, headaches, or stomach discomfort.
Responses vary among individuals and are shaped by health, past experiences, culture, resources, and the meaning a person gives an event. A does not determine the outcome by itself: appraisal of whether a situation feels threatening, manageable, or beyond available resources influences emotional responses and choices. For example, a new diagnosis may feel overwhelming to one person and manageable to another who has reliable support and clear information.
strategies
refers to thoughts and actions used to manage demands and the feelings they produce. Strategies are not inherently adaptive or maladaptive in every situation; their usefulness depends on context, safety, and consequences.
addresses a changeable through steps such as identifying the problem, gathering information, setting priorities, making a plan, and taking manageable actions. A patient worried about transportation to appointments might work with the care team to arrange a ride.
helps manage distress when a situation cannot be quickly changed. Examples include paced breathing, mindfulness, journaling, spiritual practices, relaxation, and talking with a trusted person.
draws on family, friends, community, peer groups, or professional services. Asking for help is a constructive action, not a failure of independence.
may include problem-solving, realistic reframing, healthy routines, relaxation, and seeking support. Avoidance, isolation, or using alcohol or other substances to manage distress may bring brief relief but can create additional problems. Nurses should explore what a strategy does for the person rather than label it without understanding its context.
and its supports
is a dynamic process: the capacity to adapt, recover, or find ways forward during adversity. It is not a fixed trait, a guarantee of being unaffected, or a demand that someone remain positive.
Personal skills, relationships, cultural and community resources, access to care, and practical conditions such as safe housing and adequate rest can support . Nurses can strengthen it by recognizing existing strengths and helping address barriers to .
Nursing support for
Nursing care should be individualized and collaborative. The nurse can use the following process to understand the person’s needs, support , and evaluate whether the plan helps.
Assess the situation and response. Ask what has changed, what feels most difficult, how affects daily functioning, and what the person has already tried. Observe mood, behavior, sleep, concentration, and physical symptoms. Assess strengths, preferred methods, support people, cultural or spiritual practices, and practical needs. Consider whether distress is persistent or worsening and whether further evaluation is needed.
Build a respectful relationship. Use a calm tone, open-ended questions, active listening, and reflection. Questions might include, “What has been hardest for you this week?” and “What has helped, even a little, in the past?” Avoid minimizing concerns, giving premature advice, or assuming one approach suits everyone.
Reduce avoidable demands and connect resources. When possible, address environmental stressors, clarify confusing information, help prioritize tasks, and connect the person with social work, counseling, peer support, community services, or other appropriate resources. Include chosen support people with the patient’s permission.
Practice manageable skills. Collaborate on small, realistic steps, such as paced breathing, a brief relaxation exercise, planning one next action, regular sleep routines, physical activity as appropriate, enjoyable breaks, or contacting a trusted person. Encourage strategies that fit the patient’s preferences and circumstances. Healthy daily routines and social connection can support management.
Set goals and evaluate. Agree on a specific, attainable goal and a timeframe, then review whether it helped. For example: “By tomorrow, the patient will identify one person to contact and one next step for addressing the transportation concern.” If the plan is not working, reassess the , barriers, and needed supports rather than blaming the patient.
Applying the approach
A patient says, “I can’t manage all these appointments.” The nurse listens and clarifies which part feels most difficult. Together they identify transportation as the main barrier, contact the appropriate resource, and choose a brief breathing exercise to manage distress while arrangements are made. At follow-up, the nurse checks whether transportation was arranged and whether the step was useful.
This approach combines with emotional support and evaluation. If the plan does not help, the nurse can reassess the barrier and the supports needed.