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PURPOSE. To describe the phenomenon of stress overload as a nursing diagnosis.
METHODS. A qualitative study using case study method was conducted with nine adults experiencing stress overload to fully describe the experience and identify possible defining characteristics. Current literature sources on stress and its related factors were examined to support stress overload as a nursing diagnosis for inclusion in the NANDA International classification.
FINDINGS. Stress overload, defined as excessive amounts and types of demands that require action, is a human response that is experienced as a problem and contributes to the development of other problems. The proposed defining characteristics are perceives situational stress as excessive, expresses a feeling of tension or pressure, expresses difficulty in functioning as usual, expresses problems with decision-making, demonstrates increased feelings of anger and impatience, and reports negative effects from stress such as physical symptoms or psychological distress.
PRACTICE IMPLICATIONS. Nursing interventions such as active listening and decision-making support are needed to help people reduce stress levels. Studies are needed to further validate the defining characteristics and related factors of this new diagnosis.
The stress experience exists in all human beings at all ages in varying degrees (Holmes & Rahe, 1967; Keil, 2004; Lazarus & Folkman, 1984; Motzer & Hertig, 2004; Power, 2004; Selye, 1956, 1974, 1976). Stress occurs in relation to Stressors that are positive (e.g., being in love) and negative (e.g., being in an abusive relationship). Stress also contributes to positive and negative effects (e.g., happiness or extreme discomfort). Stress stimulates individuals and groups to use coping responses such as redefining the situation and problem solving (Lazarus & Folkman). At times, however, the amounts and types of Stressors are excessive, and effective coping strategies are not adequate to reduce the related risks of the stress response. Patterns of excessive or high stress may lead to the fight-or-flight response (Selye, 1956,1974,1976), psychological and physical illnesses or symptoms (e.g., Cropley & Steptoe, 2005; Hannigan, Edwards, & Burnard, 2004; Holmes & Rahe; Lazarus & Folkman; Lloyd, Smith, & Weinger, 2005; Motzer & Hertig; Neilsen et al, 2005), extreme discomfort (Drew, Goodenough, Maurice, Foreman, & Willis, 2005; Golden-Kreutz et al., 2005), exacerbation of age-related declines in memory (Vendras, Powless, Wheeler, & Snudden, 2005), decreased quality of life (Golden-Kreutz et al.; Lustyk,...