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CHAPTER 2 REVIEW OF RELATED LITERATURE AND STUDIES The related literature and studies are presented in both local and foreign. These helped the researchers on the analysis and interpretation of the data presented on this study.

Literature Local. According to Chebat (2001), stress is here to stay. What people must do is to learn more about its nature, source and alternative so that the people use the energy positively, and they perform efficiently. Orlandi (2002) stated, Your ability to tolerate stressors depends on the number of stressors in your life. People handle stress by the use of coping mechanism, which is powerful tool to use and to analyze events objectively and observe firmly. Gather information at the state of equilibrium, understanding of what to produce the tension that helps you feel that the stress is alleviated. Miranda (2002) specified that the most effective way of managing stress is through relation and exercise, which are extremely aesthetical acts which involved dynamics of the mind and body. People who are

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always stress survivors stay healthy throughout their lives. They consider stressful situation opportunist for growth. Foreign. Stress is a feeling that is created when we react to particular events. It is the bodys way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina, and heightened alertness. The events that provoke stress are called stressors, and they cover a whole range of situations everything from outright physical danger to making a class presentation or taking a semesters worth of your toughest subject. The human body responds to stressors by activating the nervous system and specific hormones. The hypothalamus signals the adrenal glands to produce more of the hormones adrenaline and cortisol and release them into the bloodstream. These hormones speed up heart rate, breathing rate, blood pressure, and metabolism. Blood vessels open wider to let more blood flow to large muscle groups, putting our muscles on alert. Pupils dilate to improve vision. The liver releases some of its stored glucose to increase the bodys energy. Moreover, sweat is produced to

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cool the body. All of these physical changes prepare a person to react quickly and effectively to handle the pressure of the moment. This natural reaction is known as the stress response. Working properly, the bodys stress response enhances a persons ability to perform well under pressure. However, the stress response can also cause problems when it overreacts or fails to turn off and reset itself properly. According to Huber (2013), an individual's personality

characteristics, perceptions of the external environment, and past experiences with similar stressors determine which coping mechanisms they select as most useful. Coping mechanisms are used to maintain or regain equilibrium in order to adjust to stressful situations. Effective coping mechanisms reduce emotional distress, enhance problem resolution, and facilitate self-esteem. Examples of coping strategies include humor, complying, resigning, using a support network, spending time with hobbies, exercising, meditation/prayer, and using relaxation techniques. Frey (2009) said that stress in human results from interactions between persons and their environments that are perceived as straining or exceeding their adaptive capacities and threatening their well-being. The

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element of perception indicates that human stress responses reflect differences in personality, as well as differences in physical strength or general health. Risk factors for stress-related illness are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over ones physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk of developing stress-related illnesses. Other risk factors include feeling of hopelessness, extreme fear or anger, and criticism or distrust of others. Selye (2007) explained that stress is non-specific response of the body to pay demand made upon it under ordinary circumstances, the bodys reaction to specific stimulus anticipates because of the repeti tive pattern. Therefore, a person experiences pain. When the body is warm, it perspires and it used the body shivers. All human exhibits uniform response to stimulus because of homeostasis. When response is erotic and does not uniform to the usual reaction expected from the application

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of the stimulus, the body is said to be in stress. (The Nature of Stress http://www.icnr.com/articles/thenatureofstress.html) Cannon (2009) in the meantime said that the human body reacts either positively or negatively to a stress factor producing two kinds of possible reaction. When the human body tries to flee from stress situation, negative reaction is exhibited. Positive reaction comes about when the body makes the principle of homeostasis apply the body to overcome stressful situation which is known as adaptation or coping. He advocated that while the concepts about stress are an absolute fact, its presence and intensity reception are all relative in accordance with the physical and psychological makeup of the individual. All people therefore, experience stress but the way stress is present and is handled by each individual is unique for each other. A little difficulty is hardly felt by another. By understanding, we can more easily identify stress factors and their effects on who need or seek healthcare. Each individual is experiencing stress, in her own particular manner. How the individual adopt or fails to adapt depend on several factors: personality and conditional make past experiences dealing with stress.

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It is important to remember that stress syndrome can be both positive and negative. Any change or alteration in the balance of life can create stress. We are all unique individuals, we respond differently to various stressors. Thus, it does not matter. Whether, it is positive or negative light or severe. What matters is how we develop adaptive mechanism to cope with these stressors and can be translated as the ability to withstand stress and create a life experiences that do not work against you. The implication of stress theory is by being able to withstand stress and by coping with it. Diluting it when occurs and eliminating it, you can actually affect your life. You are not programmed for premature aging. The fact is you control your own health. The quote of the journal of American Medical Association says, Nature did not intend to grow old and ill, we were designed to die young in old age but free of disease. Schafer (2000) defined stress as the arousal of mind and body in response on the demand made upon them. The concept of stress is important because it provides a way of understanding the person as a human being who responds in totality (mind, body, and spirit) to a variety of changes that takes place in daily life.

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Studies Local. According to Calderon (2001), people who experience a high level of stress for a long time and who cope poorly with this stress may become irritable, socially withdrawn and emotionally unstable. They may also have difficulty concentrating and solving problems. Some people under intense and prolonged stress may start to suffer from extreme anxiety, depression and other severe emotional problems. Ancheta (2006) says that, Stress gives us energy to cope with the demanding activity of life. It is true that stress is a normal constant part of our life because it involves changes, challenges and emotions. Try to imagine life without stress. You would not have any challenges anything to affect your emotions and anything new and exciting. It gives energy because its activity involves physically and emotionally. Stress might be considered a problem because we often bear stress in a negative light that people may only associates bad experiences with stress. How you perceive and handle stressors will determine whether the stress is good or bad for you. A situation that seems extremely stressful to you could be perceived as very calm to someone else.

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Flores (2000) said that a person who is stressed typically less anxious thoughts and difficulty concentrating or remembering. Stress can also change outward behaviors. Teeth clenching, hand wringing, pacing, nail biting and heavy breathing are common signs of stress. People also feel physically different when they are stressed. Butterflies in the stomach, cold hands and feet, dry mouth and increase heart rate are all physiological effects of stress that we associate with the emotion of anxiety. Foreign. According to Tomeyet et al (2007), stress is a part of every students daily life. Leaving home or commuting daily managing, finances, living with roommates, and juggling work, classes and relationships all contribute to the normal stress of being a student. In addition, it is not uncommon for students to feel stressed and anxious about wasting time, meeting high standards, or being lonely. Stress can also come from exciting and positive events. Falling in love, preparing to study abroad, or buying a car can be just as stressful as less-happy events. One of the most important things you can do is to recognize when your stress levels are building. The amount of stress that you can tolerate before you become distressed varies with your life situation and your age.

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A critical first step in coping with stress is taking stock of the stressors in your life. Whenever stress is present, your body reacts. It acts like an alarm system that prepares your body to depend yourself. A little stress is good. It helps you think faster and harder and makes you put that extra bit of effort to meet in the challenge of life. On the other hand, Lether and Woolfolk (2011) say that the relaxation is the very valuable stress management technique that can soothe the emotional turmoil and suppress problematic psychological arousal. While Martin and Lefcourt (2013), suspected humor might be worthwhile coping response. Empirical evidence to that effect has emerged only recent years. For them, good humor functions as buffer to lessen the negative impact of stress. The health care environment is stressful, with high client condition severity levels, inadequate staffing, specialty care requirements, ethical dilemmas, and dangerous situations that jeopardize individual safety. In addition, each professional nurse has her or his own personal stressors. Taking steps proactively to manage and minimize the stress in your

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personal and professional lives will enhance your level of productivity and satisfaction.

RELEVANCE OF THE REVIEWED LITERATURE AND STUDIES TO THE PRESENT STUDY

Numerous recent studies have explored work stress among health care personnel in many countries. Researchers have assessed work stress among medical technicians, therapists and physicians. Most of the studies does not focus on nurses. The past study discussed in this chapter has given the researcher the concept, theories and principles that pave the way to the ideas of the present study and good starting point for the researcher in assessing the distressors and the stress management performed by the respondents with regards to their clinical duties. The review has enabled the researchers to have a better understanding of ideas of different well known writers which resulted to broadening the researchers own thinking in relation to the present study.

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The present study differs from the other studies regarding stress management in terms of the respondents. The researchers have chosen staff nurses while many other studies use other professions other than those that of concerning health fields. Moreover, the present study emphasizes the stressors experienced by nurses in every aspect of life with specific coping mechanisms commonly used by almost everyone that can be easily understood by the readers.