MANAGING STRESS: YOUR ACTION PLAN! AAHAM HARRIETT WALL SR. PROJECT MANAGER NETWORK FOR REGIONAL HEALTHCARE IMPROVEMENT

Transcription

1 MANAGING STRESS: YOUR ACTION PLAN! AAHAM HARRIETT WALL SR. PROJECT MANAGER NETWORK FOR REGIONAL HEALTHCARE IMPROVEMENT

2 ROAD MAP DISCUSS THE IMPACTS OF STRESS IDENTIFY JOB (AND HOME) STRESS TRIGGERS EXPLORE AND PRACTICE STRESS REDUCTION (SELF- MANAGEMENT) ACTIVITIES DEVELOP AN ACTION PLAN FOR MANAGING STRESS HAVE FUN! 2

3 STRESS RESPONSE THE HUMAN BODY IS DESIGNED TO HANDLE ACUTE STRESS IN THE FACE OF PERCEIVED DANGER, OUR BODIES RESPOND WITH A CASCADE OF HORMONES THE PHYSICAL RESPONSE THE FIGHT OR FLIGHT RESPONSE INCLUDES REACTIONS SURE AS INCREASED HEART RATE, DILATED BRONCHIAL TUBES, AND A HOST OF OTHER REACTIONS EVOLVED TO HELP US SURVIVE MANY OF US EXPERIENCE CHRONIC STRESS, PREVENTING US FROM RETURNING TO THE RELAXED (NON STRESSED) STATE 3

4 STRESS IMPACTS FORTY-THREE PERCENT OF ALL ADULTS SUFFER ADVERSE HEALTH EFFECTS FROM STRESS. 75% TO 90% OF ALL DOCTOR'S OFFICE VISITS ARE FOR STRESS-RELATED AILMENTS AND COMPLAINTS. STRESS CAN PLAY A PART IN PROBLEMS SUCH AS HEADACHES, HIGH BLOOD PRESSURE, HEART PROBLEMS, DIABETES, SKIN CONDITIONS, ASTHMA, ARTHRITIS, DEPRESSION, AND ANXIETY. THE OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) DECLARED STRESS A HAZARD OF THE WORKPLACE. STRESS COSTS AMERICAN INDUSTRY MORE THAN $300 BILLION ANNUALLY. THE LIFETIME PREVALENCE OF AN EMOTIONAL DISORDER IS MORE THAN 50%, OFTEN DUE TO CHRONIC, UNTREATED STRESS REACTIONS. 4

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7 CHANGE & AMBIGUITY THE RATE OF CHANGE IS ACCELERATING WITH TECHNOLOGY AND OTHER SOCIETAL CHANGES IT SEEMS AS THOUGH EVERYTHING IS CHANGING! CHANGE IS A BIG STRESSOR FOR MANY PEOPLE. WHILE RELATIONSHIPS, RESPONSIBILITIES, AND ACTIVITIES ARE IN FLUX, THERE IS OFTEN AMBIGUITY. AMBIGUITY IS A STRESSOR FOR MANY PEOPLE. WHILE THE HEALTHCARE INDUSTRY IS ALWAYS CHANGING RAPIDLY, THE RATE OF CHANGE SEEMS HIGHER NOW THAN EVER 7

8 CHANGES IN HEALTHCARE REGULATION $$$ ICD-10 MERRY-GO-ROUND 2 MIDNIGHTS QUALITY MEASURE EXPLOSION ACOS/POPULATION HEALTH PAY FOR VALUE PRICE TRANSPARENCY PUBLIC REPORTING TECHNOLOGY 8

9 HEALTHCARE PROFESSIONALS AND STRESS: SURVEY IN LATE 2011, HEALTH CARE COMPLIANCE ASSOCIATION (HCCA) AND SOCIETY OF CORPORATE COMPLIANCE AND ETHICS (SCCE) JOINTLY CONDUCTED A SURVEY OF THEIR MEMBERS ON THE EFFECTS OF STRESS. OVERALL, 58% OF SURVEY RESPONDENTS REPORTED THAT THEY OFTEN WAKE UP DURING THE MIDDLE OF THE NIGHT WITH JOB-RELATED WORRIES 60% REPORTED HAVING CONSIDERED LEAVING THEIR JOB IN THE LAST 12 MONTHS DUE TO JOB-RELATED STRESS. 9

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11 JOB STRESSORS

12 JOB STRESSORS JOB STRAIN LOW DECISION LATITUDE ON WORK TYPE AND PACE HIGH JOB DEMANDS COMPETING JOB DEMANDS WORK-LIFE INTERFERENCE SPILL OVER OF JOB ROLES AND RESPONSIBILITIES INTO LEISURE TIME JOB INSECURITY University of Michigan Depression Center 12

13 EXPLORING JOB STRESSORS WHAT ARE MY TOP JOB-RELATED STRESSORS? WHAT ARE THE SPECIFIC TRIGGERS WITHIN EACH STRESSOR? WHAT ARE THE PATTERNS? WHAT CAN I LEARN ABOUT ME FROM THIS? WHAT CAN I CHANGE? WHAT DO I HAVE TO ACCEPT? WHAT CAN I ALWAYS CHANGE? 13

14 EMPLOYER INITIATIVES MANY EMPLOYERS OFFER EMPLOYEE ASSISTANCE PLANS (EAPS) AS A BENEFIT. EAPS GENERALLY POINT EMPLOYEES TO RESOURCES TO ASSIST THEM WITH PERSONAL AND FAMILY ISSUES. THEY DO NOT GENERALLY ADDRESS REDUCING WORKPLACE STRESS. PROGRAMS DESIGNED TO PREVENT WORKPLACE VIOLENCE ARE NOT UNCOMMON. RECENTLY, FLEDGLING INITIATIVES HAVE DEVELOPED DESIGNED TO STOP WORKPLACE BULLYING 14

15 HOME STRESSORS

16 EXPLORING YOUR HOME STRESSORS WHAT ARE MY TOP HOME-RELATED STRESSORS? WHAT ARE THE SPECIFIC TRIGGERS WITHIN EACH STRESSOR? WHAT ARE THE PATTERNS? ARE THERE ANY PATTERNS THAT ARE SIMILAR TO MY WORK STRESSORS? WHAT CAN I LEARN ABOUT ME FROM THIS? WHAT ELSE CAN I LEARN ABOUT ME? WHAT CAN I CHANGE? WHAT DO I HAVE TO ACCEPT? WHAT CAN I ALWAYS CHANGE? (YOU KNOW THE ANSWER!) 16

17 HOW S MY STRESS LEVEL? HOLMES AND RAHE STRESS SCALE THE HOLMES AND RAHE STRESS SCALE IS A WELL-KNOWN TOOL FOR MEASURING THE AMOUNT OF STRESS YOU VE EXPERIENCED WITHIN THE PAST YEAR. TAKING THE TEST CAN HELP YOU DETERMINE IF YOU RE AT RISK OF ILLNESS DUE TO STRESS. INDIVIDUAL ASSESSMENT SHARING 17

18 HOLMES AND RAHE STRESS SCALE RAHE CARRIED OUT A STUDY IN 1970 TESTING THE RELIABILITY OF THE STRESS SCALE AS A PREDICTOR OF ILLNESS. THE SCALE WAS GIVEN TO 2,500 US SAILORS THEY RATED LIFE EVENTS OVER PAST SIX MONTHS OVER THE NEXT SIX MONTHS, DETAILED RECORDS WERE KEPT OF THE SAILORS' HEALTH. THERE WAS A CORRELATION BETWEEN STRESS SCALE SCORES AND ILLNESS, WHICH WAS SUFFICIENT TO SUPPORT THE HYPOTHESIS OF A LINK BETWEEN LIFE EVENTS AND ILLNESS THE SCALE HAS BEEN ASSESSED AGAINST DIFFERENT US ETHNIC POPULATIONS THE SCALE HAS BEEN TESTED IN JAPAN AND MALAYSIA 18

19 THE STRESS SCALE Life Event Uni t Death of a spouse 100 Divorce 73 Marital separation 65 Imprisonment 63 Death of a close family member 63 Personal injury or illness 53 Marriage 50 Dismissal from work 47 Marital reconciliation 45 Retirement 45 Change in health or behavior of family member 44 Life Event Unit Pregnancy 40 Sexual difficulties 39 Gain a new family member 39 Business readjustment 39 Change in financial state 38 Death of a close friend 37 Change to different line of work Change in frequency of arguments Major mortgage 32 Foreclosure of mortgage or loan Change in responsibilities

20 THE STRESS SCALE Life Event Unit Child leaving home 29 Trouble with in-laws 29 Outstanding personal achievement Spouse starts or stops work Beginning or end school 26 Change in living conditions Revision of personal habits Trouble with boss 23 Change in working hours or conditions 20 Change in residence 20 Life Event Unit Change in recreation 19 Change in church activities 19 Change in social activities 18 Minor mortgage or loan 17 Change in sleeping habits 16 Change in number of family reunions 15 Change in eating habits 15 Vacation 13 Christmas 12 Minor violation of law 11 20

21 INTERPRETING RESULTS Score <150 Comment You have a high or very high risk of becoming ill in the near future. You have a moderate to high chance of becoming ill in the near future. You have only a low to moderate chance of becoming ill in the near future. 21

22 HAPPINESS IS AN INSIDE JOB. - WILLIAM ARTHUR WARD (SCHOLAR, AUTHOR, TEACHER, PASTOR) 22

23 SO, WHAT CAN WE DO? STUDIES HAVE SHOWN THAT EMOTIONAL QUOTIENT (EQ) IS A BETTER PREDICTOR FOR LIFE SUCCESS THAN IS INTELLIGENT QUOTIENT (IQ) THE GREAT NEWS IS THAT, WHILE IQ IS RELATIVELY FIXED; EQ CAN BE IMPROVED. BY USING EQ STRATEGIES, STRESS CAN BE SIGNIFICANTLY REDUCED. Emotional Intelligence 2.0, Travis Bradberry & Jean Graves BUT HOW?

24 EMOTIONAL INTELLIGENCE COMPONENTS Emotional Intelligence Components Personal Competence Self- Awareness Self Management Social Competence Social Awareness Relationship Managemen t Emotional Intelligence 2.0, Travis Bradberry & Jean Graves

25 FOCUS: PERSONAL COMPETENCE THE BOOK CONTAINS NUMEROUS ACTIONABLE STRATEGIES ACROSS THE FOUR DIMENSIONS. OUR FOCUS TODAY IS ON THE PERSONAL COMPETENCE WHICH INCLUDES BOTH SELF-AWARENESS AND SELF MANAGEMENT - LEARNING AND PRACTICING STRATEGIES THAT HELP US BE AWARE OF OUR EMOTIONS AND THEN USE THAT AWARENESS TO ACT IN A POSITIVE WAY TIME CONSTRAINTS DICTATE MORE EMPHASIS ON SELF MANAGEMENT 25

26 PERSONAL COMPETENCE: SELF- AWARENESS AS SELF-AWARENESS INCREASES, PEOPLE S SATISFACTION WITH LIFE DEFINED AS THEIR ABILITY TO MEET THEIR GOALS AT WORK AND AT HOME - SKYROCKETS. 83% OF PEOPLE WITH HIGH SELF-AWARENESS ARE TOP JOB PERFORMERS. SOME OF MY FAVORITE SELF-AWARENESS STRATEGIES (OF 15 TOTAL) QUIT TREATING YOUR FEELINGS AS GOOD OR BAD KNOW WHO AND WHAT PUSHES YOUR BUTTONS DON T BE FOOLED BY A BAD MOOD DON T BE FOOLED BY A GOOD MOOD EITHER VISIT YOUR VALUES Emotional Intelligence 2.0, Travis Bradberry & Jean Graves

27 PERSONAL COMPETENCE: SELF MANAGEMENT SELF MANAGEMENT IS YOUR ABILITY TO USE AWARENESS OF YOUR EMOTIONS TO ACTIVELY CHOOSE WHAT YOU SAY AND DO. THERE IS FAR MORE TO SELF MANAGEMENT THAN PUTTING A CORK IN IT WHEN YOU RE ABOUT TO BLOW UP. THERE ARE SUBTLE THINGS YOU CAN DO EACH AND EVERY DAY Emotional Intelligence 2.0, Travis Bradberry & Jean Graves

28 SELF MANAGEMENT STRATEGIES 1. BREATHE RIGHT 2. CREATE AND EMOTION VS. REASON LIST 3. MAKE YOUR GOALS PUBLIC 4. COUNT TO TEN 5. SLEEP ON IT 6. TALK TO A SKILLED SELF-MANAGER 7. SMILE AND LAUGH MORE 8. SET ASIDE SOME TIME IN YOUR DAY FOR PROBLEM SOLVING 9. TAKE CONTROL OF YOUR SELF TALK Emotional Intelligence 2.0, Travis Bradberry & Jean Graves

29 SELF MANAGEMENT STRATEGIES 10. VISUALIZE YOURSELF SUCCEEDING 11. CLEAN UP YOUR SLEEP HYGIENE 12. FOCUS YOUR ATTENTION ON YOUR FREEDOMS, RATHER THAN YOUR LIMITATIONS 13. STAY SYNCHRONIZED 14. SPEAK TO SOMEONE ELSE WHO IS NOT EMOTIONALLY INVESTED IN YOUR PROBLEM 15. LEARN A VALUABLE LESSON FROM EVERYONE YOU ENCOUNTER 16. PUT A MENTAL RECHARGE INTO YOUR SCHEDULE 17. ACCEPT THAT CHANGE IS JUST AROUND THE CORNER Emotional Intelligence 2.0, Travis Bradberry & Jean Graves

30 MINDFULNESS AND STRESS REDUCTION MINDFULNESS MEANS PAYING ATTENTION IN A PARTICULAR WAY; ON PURPOSE, IN THE PRESENT MOMENT, AND NONJUDGMENTALLY. JON KABAT-ZINN, FOUNDER OF THE MINDFULNESS-BASED STRESS REDUCTION PROGRAM AT THE UNIVERSITY OF MASSACHUSETTS MEDICAL CENTER. 30

31 MINDFULNESS MEDITATION MINDFULNESS IS AN EMOTIONALLY NON-REACTIVE STATE. EXPERIENCES AREN T JUDGED AS GOOD OR BAD. OR IF WE DO MAKE THOSE JUDGMENTS WE SIMPLY NOTICE THEM AND LET GO OF THEM. CHOOSE A POSTURE. FOCUS ON BREATHING IS AN EASY WAY TO START. THERE ARE MANY AIDS TO MEDITATION TRY SEVERAL. START WITH MINUTES. MINDFULNESS MAY OF THE BODY, PHYSICAL SENSATIONS, MENTAL STATES, OR CONSCIOUSNESS. MANY PEOPLE MOVE FROM ONE FOCUS TO ANOTHER. YOUR MIND WILL WANDER. DON T WORRY ABOUT IT JUST REDIRECT TO YOUR FOCUS. 31

32 IMPACTS OF MINDFULNESS MEDITATION MINDFULNESS MEDITATION CHANGES THE BRAIN STRUCTURE IN 8 WEEKS PARTICIPANTS REPORTED AN AVERAGE PRACTICE OF 27 MINUTES PER DAY THICKENING OF CEREBRAL CORTEX IN AREAS ASSOCIATED WITH ATTENTION AND EMOTIONAL INTEGRATION INCREASED GREY MATTER DENSITY IN THE HIPPOCAMPUS, KNOWN TO BE IMPORTANT FOR LEARNING AND MEMORY PARTICIPANT REPORTED REDUCTIONS IN STRESS CORRELATED WITH DECREASED GREY MATTER DENSITY IN THE AMYGDALA, Psychiatry Research: Neuroimaging, January, Research by MGH KNOWN TO PLAY A ROLE IN ANXIETY AND STRESS Psychiatric Neuroimaging Research Program. 32

33 IMPACTS OF MINDFULNESS MEDITATION MINDFULNESS MEDITATION RESEARCH HAVE FOUND IT TO RESULT IN STRESS REDUCTION AS WELL AS TO BE USEFUL IN THE TREATMENT OF PAIN, STRESS, ANXIETY, DISORDERED EATING, DEPRESSION AND ADDICTION. A STUDY ON MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FOUND A DECREASED RECURRENCE RATE OF 40% -50% IN DEPRESSION IN PATIENTS WITH THREE OR MORE PREVIOUS EPISODES. MINDFULNESS MEDITATION PRACTITIONERS REPORT REDUCED STRESS, INCREASED PEACEFULNESS, AND PHYSICAL RELAXATION. MY EXPERIENCE IS INCREASED ABILITY TO BE PRESENT FOR MY OWN LIVE, INCREASED GRATITUDE; INCREASED JOY; AND AN ABILITY TO Psychiatry SLEEP WELL Research: MOST NIGHTS. Neuroimaging, January, Research by MGH Psychiatric Neuroimaging Research Program. 33

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36 CELEBRATE ACHIEVEMENT! 36

37 DEVELOPING A PLAN REVISIT STRESSORS AND ESPECIALLY PATTERNS WHAT ARE SOME STRATEGIES THAT I AM WILLING TO TRY? WHAT ONE THING WILL I DO TODAY? WHAT WILL WORK BEST FOR ME AT WORK? AT HOME? 37

38 MY PLAN And Who you do it with and Where you do it. -Harriett Wall 38

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49 GROUP EXERCISE 49

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