Problems in Health Education
Problems in Health Education
Edited by
Dr. Ogundele B. O.
Senior Lecturer
Health Education/Promotion
University of Ibadan
Ibadan Nigeria
PUBLISHED CODAT PUBLICATIONS, IBADAN
Problems in Health Education
Stress
By OYERINDE O.O., Ph.D.
DEPARTMENT OF PHYSICAL AND HEALTH EDUCATION
UNIVERSITY OF LLORIN, ILORIN
Introduction
Over forty-five years ago, Selye theorised that stress is a common factor causing diseases.
The events of today and the history of disease or in heath institutions have shown that this theory
has credibility. Stress in its rramifications is a good servant but a bad master. This is also because
hardly would you find any man that is not stressed. Leaders in high positions, executives, teachers,
professionals, secretaries, labourers, housewives, teenagers, and children experience stress in many
ways. It is a good servant in that we need it to achieve our goals in life. However, it is a bad master
in that when stress is overwhelming, it is bad and injurious. This is why what is considered
stressful by one individual may not be stressful to another. It is therefore important to note that not all
stress is negative or detrimental to health. Achoku (1991) posited that some amount of stress is
actually needed for survival.
What is Stress: Stress is not defined by its cause but by the various reactions that these causes bring
(about in) out of man. These reactions are present in the ten areas of health and they are stated as
follow:
1.
The physical growth and development
2.
The mental
3.
The social and family health
4.
The spiritual
5.
Nutrition
6.
Exercise and fitness
7. Drugs
8.
Diseases and disorders
9.
Consumer and personal health
10. Safety and first aid
I1. Community and environmental health
The
are
result
demonstrated
of
not
in
knowing
these
ten
how
to
appropriately
areas
of
health,
to
Webb.
factors
Suchilling,
of
stress
Jackson
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and
Babb
there
is
fact
that
(1988)
the
problems
and
affect
the
organ
tendency
symptoms
can
ensure
empasised
this
body
to
of
be
affects
malfunction
regard
stress
not
by
the
stress
can
also
as
structure
lowering
appear
and
resistance
pathological
of
many
psychologists
Psychologist
overemphasised.
the
or
consensus
as
problem
very
real
Psychosomatic
functions
to
disease
changes.
Some
of
responses to stress on either a short or long run basis include: Headaches
Backaches
Asthma
Skin reactions
Stroke
Sleep disturbance
High blood pressure
Digestive disorder
Coronary heart
Increased heart rate
Disease
Increased adrenaline level
Mental illness
'of
body
by
the
the
physiological
diseases
the
or
alone,
that
and
causing
also
can
direct
physiological
Pubic Ulcers
This list is in exhaustive and is caused by life events, social, environmental, personality and
occupation (Achalu, 1994).
Stress according to Meeks-Mitchell and Heit (1987) is the nonspecific response of the body to
any demand made upon it. Also, Ohaeri and Olajide (1991) see stress as the biological response to
events that threatens to overwhelm the individual's capacity to cope satisfactorily in the environment.
In the analysis given by Webster (1971), stress comes from the English world "stress" which was
short of "distresses" or "distress". The verb can be traced to a combination of the middle English
word "distress" and the middle French world "estrecier" (to constrain or to force); the middle French
form comes from the Latin word "strictus" which is the past participle of "stingers" and means to
draw tight or to press together.
From this analysis stress may simply mean being subjected to external forces or pressures,
which can be either positive or negative depending on the intensity and type of the external force.
However, the underlying negative meaning associated with "distress" is attached to the word. Typing
stress to the idea of a constraining force which causes distress or suffering seems much more in
common use and referred to as distress which Meeks-Mitchell et al (1987) say is harmful responses to
a Stressor. That is, unsuccessful coping or a harmful response to a stressor. Whereas, when individuals
respond to a stressor in a way that produces positive results, he has coped well and experienced feeling
of success, he is said to have experienced eustress, which is a healthful response to a stressor.
What then is a stressor? This is expressed by authorities as a demand made upon the body.
The stressor may be from any of the ten areas of health. For instance, it could be mental-taking a test,
physical running a race or social taking or making a phone call for a date. It is not implied that at all
Problems in Health Education
times, different stressors produce only a stereo type stress pattern. Then same stressor may produce
enstress or distress effects depending on the individual under stress and his response to the stressor.
Body changes and composition also determine this.
In illustrating specific effects of a stressor on individuals, Meeks-Michel et al (1987) used the
gymnast. The gymnast can suffer distress following a demand made on him/her to compete. If
he/she is overwhelmed, he may train too long and too hard to the extent of shipping his meal or
missing his sleep or rest. He/she have been so overwhelmed by the competition that there is panic
and he fails to perform here routine. On the other hand the gymnast has experienced eustress if he/she
displays a healthful response to the stress presented by the impending competition. That is, the
competition motivated him/her to eat a balanced diet, get enough sleep, practiced his/her routine
continuously.
Causes of Stress
Stress can develop via two primary channels. The circumstances and situations that are external to us
can be stressors. Such situations include our environment, job, families, studies, religion etc. the
other primary source is dependent on our state of physical and mental health that is internal to us.
These influence the amount of stress we experience. This means that our biological make up,
personality, temperament, self-control, and ability are in fact, sources of stress. It is however
necessary to add that the weakest stress factor can produce stress in a psychologically weak
individual while the strongest stress favor may produce no stress in the best equipped people
provided all other conditions are not lacking.
External Causes of Stress: Many at times, we are faced with events and occurrences that produce
stress. Some occur in great magnitude and do produce immediate devastating effects. Some are
mild and of less significance but which can become dangerous with increased and continuous
input of the stimuli.
These external causes are highlighted below accordingly.
(a)
Traumatic Experiences: Many people that are stressed have undergone one form of
trauma of the other. Trauma rank very high in the order of causes of stress. These include:
1.
Natural catastrophes like earthquakes, hurricanes, floods and lightening.
2.
Human
catastrophes
like
wars,
accidents,
nuclear disasters, attempted
murder, assault, rape, and armed robbery attack.
When individuals are traumatized by any of the events listed and they pass through a period of
stress both during and after such cases.
(b)
Stressful
Events:
Whether
it
is
acceptable
to
all
or
not,
scientists
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like
Holmess
case,
43
even
when
type
and
Rahe
events
are
they
are
of stress
instance,
they
have
stressful.
not
they
are
found
precipitate
-
that
Human
traumatic.
negative
out
as
many
events,
beings
These
positive
in
failing
their
experience
events
-
in
also
vary
them
in
the
or negative.
an
For
examination
or
positive - as in winning an award.
Stressful events are relative in nature. In its relativity, age and culture have influences. For
instance, to an adult, sexual problems rank lower than to a youth while the African considers the
death of a family member more stressful than would the Europeans or the American.
(c)
Day-to-Day
with
Frustration:
numerous
magnitude
ourselves
but
to
In
frustrations
when
these
let
our
and
they
downs,
daily
letdowns.
become
they
encounters,
Often,
frequent
soon
they
and
reach
we
a
are
are
of
faced
little
when
we
release
stress
level
which
may be as dangerous as stress that comes from more impressionable stressor.
Example of these daily let downs are: Expecting a letter that will not come, car splashing
surface water on us as commuters, uncomplimentary statements directed at us by co-workers
or students.
(d)
Physical and Social Environment: Our environment play a major role in the
maintenance of our emotional well being or otherwise. Conducive environments in terms
of neatness, low population, good weather condition, fresh air, clean water, beautiful lawns
and security of life and property will lead to a life with minimal stress and relaxation. On the
other hand, environments that guarantee security of life and property, that is consumed by
pollution and other environmental discomforts is the nest of stress to individuals living in
such an environment.
Other external origins of stress are: Noise-excess noise can cause tiredness,
irritability, insomnia, headaches, and muscle tension to mention only few.
Living Space: Lack of space cause stress. In recognition of this, the World Health
Organisation has recommended 170sq ft living space per person as necessary territory.
Despite this, both the third world and the advanced cities do not enjoy this kind of space.
This in itself cause stress to many people. Personal Space: This depends on culture,
religion and familiarity. Whatever the relativity, personal space is important for less stress.
The physical distance maintained is very significant.
Internal Causes of Stress: Conflicting Choices: When individuals are faced with the need to choose
from similar alternatives. Stress may ensue. This is explained in the need to choose from a
multiplicity of similar job opportunities, choosing between two evils, choosing between two
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approaches that gives the same result, choosing between two ambivalent circumstances and
choosing from two opportunities both with positive and negative point i.e. both exercising
advantages and disadvantages. The indecision which is often attached to making a choice is frequently
a reason for stress. The problem choosing which might be stressful as the options look equal in value
and disadvantage (one may reason that the resultant stress from choosing between two similar things
is unnecessary since either choice yields similar results anyway). This production of stress from
choosing is traceable to the selfish traits in man who wants to enjoy the best of two worlds. Many
naturally want the positive options and avoids the negative ones. This tendency brings him to
postponing making a choice, calculating and worrying over which choice to make.
There exist six other internal causes of stress. These are; hurrying, been unable to predict
the future (uncertainty), and that feeling of not being in control (uncontrollable event), competition
consumption and guilt.
Hurry is common to many people especially when there is a deadline to meet, a time to
meet; there is a last chance, a last day, a few seats etc. even though results should be achieved under
stress, the chance of an accident or forgetting or something unexpected happened is very high when a
sense of urgency is great.
One principle to explain with uncertainty as another source of stress, is that, in which an event,
infection or disaster has occurred in which a long-term effect is expected and unknown for
sometimes. The time of anxiety produce stress. For instance been involved in a nuclear accident or
with a sexual partner of doubtful character where it takes several years before one is certain of been
affected or not, or being unaffected with AIDS or by the nuclear radiation, makes the individual to
live in fear.
In the cases of competition and consumption, they are external stressors yet they have an
innate or acquired relationships with internal and personals stress factors(s). The problem with
competition is in it, becoming exaggerated and compulsive. When our urge to progress in our sphere
of life becomes covetous and insatiable, such that anguish and depression are created because of
our failure in achieving these objectives stress emanate. Exaggerated competition, desire for
success power and desire for possession are concrete cases of competition and consumption as
inevitable stress factors.
Finally under internal causes of stress is guilt. When an irrational feeling of guilt takes the better
of an individual, stress ensures. Even when guilt is reasonably generated or brought about, it is an
active source of stress. Except if victims are equipped well in jettisoning these feelings of guilt through counselling, good reactioning, seeking pardon and reconciliation - feelings of guilt inevitably
brings about stress.
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Effects of Stress
One is reminded here that stress is experienced when the body defenses, especially the
sympathetic, parasympathetic and adrenal glands respond to stimuli that produce the flight or fight
reaction. As these reactions continue and stress is contumely produced, body's normal activities are
interfered with and resistance is broken down in almost all organs at the same time, separately or at
designated organs.
Stress effect(s) response(s) is produced physiologically, and psychologically. Stress also disturbs
cognitive activity and brings about frustration, aggression, inhibited sexual desires, anxiety and
depression, beyond these, the real and physchosomatic effects of stress on the health of man are even
more pronounced in the heart and the circulatory system, the digestive system and the immune
system. The effects of stress on the body system produce different kinds of physiological,
psychological and emotional illness, behavioural and cognitive disorder.
The following culled from Melgosa (1997) summarise the overall effects of stress on man.
Cognitive Effects
a.
Difficulty in concentrating on a demanding activity. Frequent loss of attention.
b.
Short-term and long term memory decrease.
c.
Problems, which need an immediate and spontaneous response, are solved in haphazard and
unpredictable way.
d.
Any problem which requires logical thinking tends to be solved with a higher than normal
number of errors.
e.
The mind is unable to accurately analyse and evaluate present situations or to project them
into the future.
f.
Thinking does not follow logical and coherent thought patterns but is disorganised.
Psychological/Emotional Effects
a.
Difficulty relaxing emotionally and physically.
b.
In addition to physical illness, new illnesses are suspected.
c.
Impatience, intolerance, authoritarianism and the lack of consideration for others
develop.
d.
Ethical and moral principles, which govern the life, relax and there is less self control.
e.
Increased discouragement, deceased desire to live.
c.
Though the worthlessness and inferiority.
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Behavioural Effects
a.
Inability to verbally address a group of people satisfactorily, Stuttering, inability to speak
fluently.
b.
Lack of enthusiasm for preferred activities such as hobbies or favorite past times.
c.
Absenteeism from work and school.
d.
Increase in consumption of alcohol, tobacco, coffee or drug use.
e.
Energy levels fluctuate from day to day and tend to be on the low side.
f.
Sleep patterns change. Generally, insomnia increases to levels of extreme deprivation.
g.
The tendency towards suspicious increases. A tendency to blame others and put the
responsibility for mistake upon others. Broken down relationships.
h.
The appearance of strange reactions, which are not normally a part of the person, also tic
i.e. quick repeated movements of a muscle appear.
i.
Thoughts of suicide increase along with suicide attempts.
Physical Health Effects
a.
Have a fix time daily for your exercise at least 15-20 mintues Daily.
b.
Choose an activity you enjoy and cherish.
c.
Try not to be alone.
d.
Try to enjoy your exercise. Be full of zeal and put yourself into your exercise.
e.
Do not exhaust yourself, start from simple to moderate to complex.
f.
Prepare a data of activities, progress and improvement. This helps you to evaluate your
routine.
g.
Consult a physician before you start your regimen especially if you have past early
adulthood, advancing in age or ill.
h.
Be adequately dressed.
i.
Give some time after meal before you go into exercise. ,
j.
Be consistent and regular at your exercise.
2
REST: Rest is sure after a rewarding session of exercise. Exercise breaks the stress, rest
renew you. Rest could take a time, weekly, daily or an annual vacation dimension. One
important factor is that it must be quality rest.
3.
DIET: Certain dietary characteristics are common to stressed persons. They either lack
appetite, fail to eat or eat too little, when they choose to eat, they are under pressure and in
haste to complete, their meal and get on to other things. Meanwhile they use more energy and
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undertake more work.
Without necessarily attempting to recount what good diet is the following hints on diet will help
to control stress in stressed persons and go a long way to prevent it in unstressed persons (if we
have such people):
a.
It is imperative to consume less of fat, 30% of your diet is recommended.
b.
Limited frequency and quality of food eaten away from home. Fast foods only emphasise
taste and not health.
c.
Eat plenty of fruits, vegetables, and cereals. These increase your Vitamins A, B and C intake.
These help to assist brain function and indeed the nervous system activities. They therefore
assist in the control of stress. This is especially so with vitamin C. Water is vital in the control
of stress. Water intake is important because stress affect the digestive system, i.e. the salivary
gland and blood hormones secretion is inhibited.
d.
Water help to balance homostasis and metabolism. Use of water for external body cleansing
and cooling is also helpful in stress management.
e.
Avoid the use of drugs, tobacco, stimulants and Alcohol.
4.
OTHERS: Find time to be in close contact to nature. The sense organs of the eye, ears, nose,
taste and indeed the whole body.
The whole body benefits from nature through its colours, silence, music from birds, nature
smells, pure air and sunlight.
a.
Find time for relaxation. This is beneficial and controls stress appreciably. Some of the values
are that routine is put behind us, interaction and interrelationships are improved, vitality is
renewed after work, problems are put behind us and excitement is added to the day. All these
values are salient in the control of stress and its prevention.
b.
Have clearly set goals and objectives. Be organised enough towards these objectives. Note
that the goal and objectives must be achievable and enjoy the achievement of these goals at
every sub-station.
c.
Spend time with your family.
d.
Develop the right attitudes.
e.
Plan well at all stages.
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Summary and Final Notes
Stress creeps up on persons unnoticed. In its mild does (eustress), it is desirable for success,
development and continuity of life. This is how advances and innovations in science; medicine,
engineering and agriculture are achieved. Man has through these been able to live a fuller life, live
longer, and feed well. However, when the threshold of desirable stress is surpassed, it become
deleterious, injurious and distressing.
The effect of stress/distress i.e. harmful responses to a stressor, on persons have a holistic
dimension affecting individuals mental, family and social health, growth and development,
nutrition, fitness, physical and personal health, safety, community and environmental health.
Fortunately, a lot of efforts have been spent on determining how best to manage stress. Among
others, the following management skills were highlighted; exercise, diet, relaxation and recreation.
On a final note, if man will adopt the natural gifts of nature, stress will not be able to take the
better of him. These natural gifts have been transformed into stress therapy and are in the form of
Hydrotherapy -sauna and lukewarm bath; use of medicinal plants - savory (satereja hortensis L.)
guiseg (panx guising C. A Meyer) spearmint (metha piperita I.) and rosemary (rosmarinus
officials L.); meditation - it's the oldest procedure and is yet efficacious in dispelling stress; and
concentration.
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References
Achalu, E.I. (1992): Occupational Stress: Your Job can be Dangerous to your Health: Paper
Presented at the Annual Conference of NSHA, Ilesa, Osun State.
Achalu E.I. (1994): Psychosocial Stress Management: Behavioural Engineering Model.
Nigeria School Health Journal.
Meeks, M.I. and Heit, P. (1987): Health: A Wellness Approach, Ohio: Merrill Publishing
Company; A Bell and Howell Company, pp. 125-141.
Melgosa, J. (1997): Less Stress. 2nd Edition, Spain: New Lifestyle Series.
Oyerinde, O.O. (1994): An All-Time Health Education for Individuals and Students, Ibadan:
FABONIS Publishers, Positive Press Ltd.
Oyerinde, O.O. and Oloyede, R.O. (1993V- Analysis of Stress Situation in Sports. Sports
Science and Medicine, Journal of the Nigerian Association of Sports Science and Medicine (v), pp.
117-122.
Oyerinde, O.O. and Oloyede, R.O. (1996): Home Environment in the Personality of the
Child. Journal of Sports Management and Researcher.
Oyerinde, O.O. and Oloyede, R.O. (1997): The Executive and Stress Management, llorin
Journal of Health, Physical Education and Recreation.
Selye, H. (1956): The Stress of Life, New York: McGraw-Hill.