PERCEIVED STRESSORS AND COPING MECHANISM AMONG CAREGIVERS OF AUTISTIC CHILDREN IN TACLOBAN CITY:...

8/3/2019 PERCEIVED STRESSORS AND COPING MECHANISM AMONG CAREGIVERS OF AUTISTIC CHILDREN IN TACLOBAN CITY:

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PERCEIVED STRESSORS AND COPING MECHANISM AMONG

CAREGIVERS OF AUTISTIC CHILDREN IN TACLOBAN

CITY: BASIS FOR RECOMMENDATION

A Research ProposalPresented to

The Faculty of College of NursingHoly Infant College

Tacloban City

In Partial Fulfillmentof the Requirements for the Degree in

Bachelor of Science in Nursing

By:

GIZEL O. FRANCISCOFRANCE IRISH L. NACIONARVIN IAN C. PEAFLORFAYE M. REMANDABANMARIEL C. SABANDAL

CRISTYLLE V. VILLANUEVA

January 2012


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CHAPTER I

INTRODUCTION

Rationale of the Study

Stress is a universal phenomenon. All people experience it.

Parents refer to the stress of raising children, working people talk of

the stress of their jobs, and students at all levels talk of the stress of

school. Stress can result from both negative and positive experiences.

For example, a bride preparing for her wedding, a graduate preparing

to start a new job, and a husband concerned about caring for his wife

and family are following a diagnosis of cancer all experience stress

reactions (Kozier & Erb, 2008).

The degree of stress in someones life is highly dependent upon

individual factors such as their physical health, the quality of their

interpersonal relationships, the number of commitments and

responsibilities they carried, the degree of others' dependence upon,

expectations, the amount of support receive from others, and the

number of changes or traumatic events that have recently occurred in

their lives (http://helpguide.org).

The model of stress is broadly discussed but the researcher focus

more on Cargiving autistic children. Autism is a mental disorder

wherein a person having this particular disorder displays a delay in
http://helpguide.org/http://helpguide.org/


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social interaction, language and symbolic play. However everyone

must be aware that these children are still a human being that need

love and care. National Autism Consciousness Week (NACW) was held

last January 22 -29, 2012 in the Philippines which was attended by 500

autistic children with their family, its purpose is to enlighten the public

what is autism really means. Mrs. Gina Nazareth stated that Meron

silang role dito sa mundo kung bakit sila binigay sa atin, and thats for

us to find out featured in a news media 24 Oras. Mas matutuwa

sana kami kung i-rerespeto din sila, hindi kakaawa-an, hindi parang

pinagbibigyan kundi dahil part sila ng society natin added by Mrs.

Dang Koe in an interview during NACW in Pasay.

Children having this particular disorder find it harder to interact

and engage in normal activities, thus in most cases, these particular

patients need supervision (http://psychcentral.com). When Ryan has a

tantrum it is not because he didnt make his way, it is because he

cannot communicate to us what he wants that can be extremely

frustrating to anyone says Rylenden in her documentary about

autism entitled: A day in the life of Ryan (youtube.com).

Most recent reviews tend to estimate a prevalence of 1 per 110

children that is being born has autism; Autism Syndrome Disorder

(ASD) affects an estimated 1 million Filipino but only 5% of them are

aware that they have autism and only 2% avail medical aid
http://psychcentral.com/http://en.wikipedia.org/wiki/Reviewhttp://psychcentral.com/http://en.wikipedia.org/wiki/Review


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(wikipedia.org/wiki/Autism). According to DSWD region 8 Information

Officer, there are about 101 persons with autism, aging zero to 59

years old, in Tacloban City, a study of the Department of Social Welfare

and Development (DSWD) field office eight revealed

(http://www.pia.gov.ph)

The role of a caregiver is more demanding in this kind of

appointment because unlike any other caregiver, this situation where

in autistic children cannot communicate clearly has a problem in social

interaction etc can bring a lot of stress on the part of caregiver

(http://psychcentral.com). Caregiving often takes a great deal of time,

effort, and work. Many caregivers struggle to balance caregiving with

other responsibilities including full-time jobs and caring for children

especially autistic ones. Lisod jun mag bantay kay Jaybee, panagsa

kapuyon na ka pero pasensyahan na jud kutob sa makaya (Its sodifficult to supervise Jaybee, sometimes you feel like giving up but still

you need to have patience) as what Aling Mariquita said, featured in

a news media 24 Oras of GMA-7 Davao. Based on this information, it

is very stressful for a caregiver to handle such responsibility, and

without proper and effective coping strategies they may tend to

experience Caregiver Stress which is a syndrome that can lead to

exhaustion and has some traits in common with exhaustion.

Caregivers may experience burnout which is a mixture of physical,

emotional, and mental exhaustion when they don't get adequate help
http://en.wikipedia.org/wiki/Autismhttp://psychcentral.com/http://en.wikipedia.org/wiki/Autismhttp://psychcentral.com/


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or when they overextend themselves physically, mentally, or

financially. Fatigue, anxiety attacks, and even depression may come

from this caregiver burnout (humanlyexhausted.com).

A child's deficits in social skills, such as the lack of appropriate

play, are also stressful for families. Individuals lacking appropriate

leisure skills often require constant structure of their time, a task not

feasible to accomplish in the home environment. As a parent, teacher,

or caregiver one may know the frustration of trying to communicate

and connect with children or adults who have autism. One may feel

ignored as they engage in endlessly repetitive behaviors. Or may

despair at the bizarre ways they express their inner needs. And he/she

may feel sorrow that his/her hopes and dreams for them may never

materialize (http://psychcentral.com).

With this enough notion, the researchers are eager to deal with

the respondents as a whole system. Not just dealing with the stressors

itself but the whole aspect that affects the entire person which might

be emotional, psychological or physiological. In this study, nursing

assessment is needed in order to give emphasis on the stress level of

these caregivers. Health education in the nursing profession is the

primary and integral part of responsibility as student nurses. Through

this study the researcher intend to direct or advise these caregivers on

how to cope up with the situation they are in based on the level of
http://psychcentral.com/http://psychcentral.com/


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stress felt in caring these kinds of children. This study will also

determine the level of stress so as to provide or recommend suitable

interventions and actions to relive their stress felt.

Theoretical Background

This study is anchored on the Adaptation Model by Sister Callista

Roy. This model comprises the four domain concepts of a person,

health, environment, and nursing and involves a six step nursing

process. The person can be a representation of an individual or a group

of individuals. Roys model sees the person as a biopsychosocial being

in constant interaction with a changing environment. The person is an

open, adaptive system who uses coping skills to deal with stressors.

Roy sees the environment on all conditions, circumstances and

influences that surround and affect the development and behavior of

the person (Andrews and Roy, 2004).

Furnham (1997) defined stress as the mental and physical

condition that results from a perceived threat or demand that cannot

be dealt with readily. Stress is perceived as an inevitable

characteristic of life (Boss, 1988). Stressor events are considered

normative or part of expected life events and transitions. Some stress

producers such as creative activities or physical exercise are

considered healthy and a normal part of life (McGuigan, 1999; McKenry

& Price, 1994). No single situation can be pinpointed as the cause of a


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reaction to stress as a variety of dissimilar situations are capable of

producing the reaction (Selye, 1983). With change, pressure or stress

can occur. Sources agree that the word stress is often overused and

that many definitions of the term exist (Furnham, 1997; McGuigan,

1999; Selye, 1983).

Several definitions of stress exist in the literature. One of the

classic definitions of stress is by Hans Selye, who defined it as the non

specific response of the body to any demand made upon it. Viewed in

this manner, every demand made on the body is unique or specific.

The stress-producing factor, called the stressor, can be either pleasant

(eustress) or unpleasant (distress) (Selye, 1983). The adaptive

response of the body to an agent or situation is the same, according to

Selye. What varies is the degree of response. The classification of

stress (eustress or distress) varies depending on the nature of a

situation, an individuals physical and psychological well-being, and on

the characteristics of a family unit (McCubbin & Patterson, 1983b).

Individuals and families subjectively define stress which is reflected by

their values and previous experience in meeting crises and dealing

with change. When subjectively defined as unpleasant or undesirable

by the individual or family, stress becomes distress (McCubbin &

Patterson, 1983b).


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Another theory that is formulated out from the nursing context is

the theory of Han Selye. He states that stress has become a universal

explanation for human behaviour in industrial society. This analysis is

framed in terms of Latour's actor-network theories, and traces the

translation of stress from the animal laboratory into the narratives of

modern life experiences. This mapping reveals that translation was

brought about by Selye's recruitment of a broadly based constituency

outside of the academic physiology, whose members each saw in

stress a validation of their pre-existing ideas of the relationship of the

human mind and body in industrial civilization (http://en.wikipedia.org).

Moreover, Selye also formulated the General Adaptation

Syndrome, or GAS. It is a term used to describe the body's short-term

and long-term reactions to stress. Stressors in humans include such

physical stressors as starvation, being hit by a car, or suffering from asevere weather. In addition to this, humans can suffer such emotional

or mental stressors as the loss of a loved one, the inability to solve a

problem, or even having a difficult day at work (Kee et al., 2005).

The First stage of the general adaptation stage is the Alarm

Reaction, which is the immediate reaction to a stressor. In the initial

phase of stress, humans exhibit a fight or flight response, which

prepares the body for physical activity. However, this initial response
http://medical-dictionary.thefreedictionary.com/Stresshttp://medical-dictionary.thefreedictionary.com/Starvationhttp://medical-dictionary.thefreedictionary.com/Stresshttp://medical-dictionary.thefreedictionary.com/Starvation


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can also decrease the effectiveness of the immune system, making

persons more susceptible to illness during this phase (Kee et al., 2005).

The Second stage might also be named the Stage of Adaptation,

instead of the Stage of Resistance. During this phase, if the stress

continues, the body adapts to the stressors it is exposed to. Changes

at many levels take place in order to reduce the effect of the stressor.

For example, if the stressor is starvation (possibly due to anorexia), the

person might experience a reduced desire for physical activity to

conserve energy, and the absorption of nutrients from food might be

maximized (Kee et al., 2005).

The Third is the Stage of Exhaustion. At this stage, the stress has

continued for some time. The body's resistance to the stress may

gradually be reduced, or may collapse quickly. Generally, this means

the immune system, and the body's ability to resist disease, may be

almost totally eliminated. Patients who experienced long-term stress

may succumb to heart attacks or severe infection due to their reduced

immunity. For example, a person with a stressful job may experience

long-term stress that might lead to high blood pressure and an

eventual heart attack (Kee et al., 2005).

Furthermore, Selye gives emphasis that stress is not purely

negative phenomenon; in fact, he frequently pointed out that stress is

not only an inevitable part of life but results from intense joy or
http://medical-dictionary.thefreedictionary.com/Heart+Attackhttp://medical-dictionary.thefreedictionary.com/Heart+Attack


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pleasure as well as fear or anxiety. Stress is not even necessarily bad;

it is also the spice of life, for any emotion, any activity, that causes

stress. Some later researchers have coined the term eustress or

pleasant stress, to reflect the fact that such positive experiences as a

job promotion, completing a degree or training program, marriage,

travel, and many others are also stressful (Smyth, 2004). In addition,

Selye also pointed out that human perception of and response to stress

is highly individualized; a job or sport that one person finds anxiety as

provoking or exhausting might be quite appealing and enjoyable to

someone else. Looking at one's responses to specific stressors can

contribute to better understanding of one's particular physical,

emotional, and mental resources and limits. Stress is one cause of a

General Adaptation Syndrome (Smyth, 2004).

Meanwhile, stress is the wear and tear in the body (Selye). Hedeveloped his framework to explain the physiologic response to

stress. Selye viewed stressor as any positive or negative occurrence or

as any emotion requiring a response. Interaction to environment or

others inevitably produces stress, depending on its individual

perception and definition. However, Selye discovered that many

individuals demonstrate the same symptoms, regardless of the

stressor (Keltner et al., 2007).
http://medical-dictionary.thefreedictionary.com/Anxietyhttp://medical-dictionary.thefreedictionary.com/Anxiety


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Similar to Selyes theory to stress, another theory also came out

in relation to it; this gives birth to the Theory of Lazarus. He states

that working more with humans and came to the conclusion that

neither the stressor, nor the response could define stress, but rather it

was the individual's perception and appraisal of the stressor that would

determine if it would create stress. Psychological stress is a

relationship between the person and the environment that is appraised

by the person as taxing or exceeding his or her resources and

endangering his or her well-being. Lazarus believed that the basis of

coping is not a result of anxiety, per se, but of personal, cognitive

appraisal of treat. There are two stages of cognitive appraisal. The

first stage in his model is primary appraisal where the subject analyzes

the stressor and determines if it will be positive or negative, exciting or

harmful, etc. The second stage is secondary appraisal, where the

subject determines if he or she can cope with the given stressor. Even

if the stressor is determined as harmful in the first stage, if the subject

decides, he or she can cope with it in the second stage, stress will be

kept at a minimum (Lazarus and Folkman, 2000).

Lazarus argued that in order for a psychosocial situation to be

stressful, it must be appraised as such. He argued that cognitive

processes of appraisal are central in determining whether a situation is

potentially threatening, constitutes harm/loss, a challenge, or is

benign. This primary appraisal is influenced by both person and


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environmental factors, and triggers the selection of coping processes.

Problem-focused coping is directed at managing the problem, while

emotion-focused coping processes are directed at managing the

negative emotions. Secondary appraisal refers to the evaluation of the

resources available to cope with the problem, and may alter the

primary appraisal (Lazarus and Folkman, 2000). In other words,

primary appraisal also includes the perception of how stressful the

problem is; realizing that one has more than or less than adequate

resources to deal with the problem which affects the appraisal of

stressfulness. Furthermore, coping is flexible in that the individual

generally examines the effectiveness of the coping on the situation; if

it is not having the desired effect, he/she will generally try different

strategies to cope up with the situation (Lazarus and Folkman, 2000).

According to McCubbin and Patterson (1983b), stress is not

stereotypic, but varies depending upon the nature of the situation, the

characteristics of the family, and the psychological and physical well-

being of the family members. An unexpected event that is not

disastrous may be stressful, such as winning the lottery or receiving a

promotion (McKenry & Price, 1994). Families with similar

circumstances could perceive the same event either as a crisis or as a

normative event, depending on their coping resources (e.g., economic,

emotional, family support). One classification of events used by family

stress researchers is normal or predictable events versus


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unpredictable, situational, or non-normative events. Normal events are

viewed as a part of life and represent transitions in the family life

cycle. By definition, these are of a short duration. Non-normative

events are the product of a unique situation that could not be

predicted and is often not likely to reoccur (Boss, 1988).

Stress has behavioral, cognitive, and physiological symptoms or

consequences. When faced with a stressor, the physiological

symptoms link to the bodys fight-or-flight response. Psychological

symptoms that can occur are anxiety, fear, emotional disorder, and

defensive attitudes and behavior (Furnham, 1997). There also are

various factors that seem to make individuals prone to stress, such as

worry, external locus of control (a 25 belief that life is controlled by

external forces).

However, the type of personality of an individual has directrelation to the intensity of stress felt and the way one cope with stress.

Research has indicated that certain personality traits can make us

more vulnerable to stress (http://stresscourse.tripod.com). These

personalities are categorized as type A, B, C, and D. The individuals

that come under personality type A are of a highly independent nature.

These can best be described as the bulldozers. People falling under the

type A personality classification will have characteristics that portray

them as people with a lot of time urgency and impatience. Money and

finances mean a lot to them, so much so, that even their relationships,
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they think, should be based on money. Type A personality people

prioritize their work over all their relationships, since they are so

particular about time and the way they spend their time. They have

the urge to do something productive all the time or else may be

engulfed with guilt of wasting time. A good thing about these people

are that they are achievers in everything that they get themselves

into, they have the ability to succeed even in ventures they know

nothing about due to their competitiveness and challenging spirit. You

will find such people planning out their time and also adhering to the

plan most of the time. Other characteristics of the type A personality

include aggressiveness and a short tempered nature, they are

achievement oriented and have a great deal of trouble relaxing and

taking it easy (http://www.buzzle.com).

The type B personality people are quite the opposite of the typeA personality people. They are described as the bombers. These

people are patient to a large extent, are easygoing and take things

slowly and steadily. They do not believe in hurrying into things, take

time to think and ponder before acting and may also delay their work

to the last minute. These people love to socialize and be in the

company of both known and unknown people. They often manage to

grab quite a lot of attention wherever they go and seek comfort more

than success while working. They are considerate, caring and

approachable and know how to maintain their relationships well. They
http://www.buzzle.com/http://www.buzzle.com/


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also know how to maintain a balance between their professional and

personal life, which leads them to be lot more satisfied with their lives.

These characters are extroverts to the soles of their boots, and think

that life is nothing else but getting under the spotlight and spell

binding the rest. Individuals that fall under the personality type B are

human magnets that can attract attention of everyone in a gathering

without so much of an effort. This makes type B special, among the

various other personalities. Persons of personality type B thrive on the

interactions with the others. Your act of ignoring them or their efforts is

as good as you sticking a knife in their back, for them

(http://www.buzzle.com).

Type C personality people are perfectionists and tend to take

everything seriously. The apt term to describe these people is

the Seekers. They dress very neatly and work very devotedly. Theyhave a tendency to go deep into details of things and are always

striving for accuracy in whatever they do. They are very consistent and

follow all the rules and procedures in both work and life in general. This

trait in them makes them very dependable as they do not rush things,

and because they always check a thing inside out before proceeding

further. They are deep thinkers, who like to know each and every detail

of how and why certain things work. They are very patient and do not

rest unless and until they get at the bottom of things. One of the

peculiar type C personality traits is that these people are unable to
http://www.buzzle.com/http://www.buzzle.com/


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express their emotions, feelings or needs to other people. These

people are true introverts and you will never find them showing their

anger or being over ecstatic about anything. In fact these people often

ignore and deny their feelings and maintain a kind of rational, no-

nonsense and unemotional outward demeanor all the time. They have

a tendency to please other people, even if it means that they hurt

themselves in the process. They deny their feelings and cannot stand

up for themselves; tend to suffer from stress and depression more than

any other personality type. Some of the other common health related

type C personality disorders are rheumatoid arthritis, asthma, multiple

sclerosis, lupus and amyotrophic lateral sclerosis. Clearly, most of

these are autoimmune disorders. Researches show that due to the

strong mind-body connection in humans, when an individual with type

C personality suppresses his wishes and does things only for others

repeatedly, the immune system responds by attacking the self, instead

of defending it. A type C personality can never say no to others,

becomes stressful because of this, and ends up with many illness and

diseases (http://www.buzzle.com).

Individuals with a Type D personality have the tendency to

experience increased negative emotions across time and situations

and tend not to share these emotions with others, because of fear of

rejection or disapproval (http://en.wikipedia.org). These gentlemen

really believe in inertia which they have no shortage of. These people
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prefer to stick to the trodden paths and established routines over the

uncertainty of change. These are followers of the spent actions and

executors of the direct commands. You will find them doing their best

not to stretch their neck out when it comes to taking responsibility and

risk. With the help of professionals in the field of personality

development and through sheer power of self motivation or self

improvement, these people can overcome their handicap to some

extent. These individuals, which make 21 percent of the population,

are afflicted by negativity such as worry, irritability, gloom, etc., and

hardly feel self-assured. To avoid rejection, tends not to open up and

share their negative emotions. This causes them to suffer from

enormous amount of stress which makes them prone to heart related

diseases. The study shows that as many as 18 to 53 percent of cardiac

patients have type D personality (http://www.buzzle.com).

This study is also bounded to the theory of Banduras (1997)

which is the Self-efficacy Belief. This theory states that in human

functioning, peoples level of motivation, affective states and actions

are based more on what they believe and what is objectively true. For

this reason, how people behave can often be better predicted by the

beliefs they hold about their capabilities than by what they are actually

capable of accomplishing, for these self-efficacy perceptions have

determined that individuals do with the knowledge and skill they have

(www.des-emory.edu.com).
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One very difficult form of stress to cope with and manage is

emotional stress. After all, it is often self-created, it can come out of

nowhere and the stress caused by it only heightens the emotions felt.

Thus, as the emotional stress increases, the emotions get worse,

heightening the emotional stress. Thus, the problem recreates the

cause and the problem only gets worse.Emotional stress is often

triggered by a dramatic event that puts a person's nervous system

under severe strain. This could be an event such as losing a loved one,

seeing someone die, or being put into a life-threatening situation. An

event such as this can put severe strain on a person's mind and nerves

and the incredible strain can cause changes in the way that the brain

works. In fact, a severe emotional strain could even cause someone to

suffer from post-traumatic stress disorder (loweryourstress.com).

According to an article entitled Dealing with Emotional

Stress Emotional stress is often triggered by a dramatic event that

puts a person's nervous system under severe strain. This could be an

event such as losing a loved one, seeing someone die, or being put

into a life-threatening situation. An event such as this can put severe

strain on a person's mind and nerves and the incredible strain can

cause changes in the way that the brain works. In fact, a severe

emotional strain could even cause someone to suffer from post-

traumatic stress disorder. However, emotional stress does not arise

from a sudden shock. It can also arise from a total emotional strain


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that adds up to an overwhelming strain that prevents a person from

thinking about anything other than the problems that seem to have no

solution. Then, as the stress mounts, the mind is left in its own cocoon

of stress that can only call attention to it, cutting the person off from

the world outside. Thus, emotional stress can lead to detachment, and

inability to concentrate, fatigue, and even memory problems.

Unfortunately, emotional stress also increases moodiness, which can

often make things worse. In fact, those attacks of emotional excess

can turn emotional excess up to unbearable levels, leading to further

attacks. Then, as these bouts of emotional stress keep adding up, it all

becomes too much and the sufferer is left almost completely lost and

alone in their own cycle of emotion that hammers incessantly at the

brain (articlesbase.com).

Stress actually occurs before a child takes his/her first breathe(Bittman, 1999) in a survey of U.S. adults aged 25 to 74 years of age,

just 8% of young adults said they had even one stress-free day in a

given week, compared with 12% of mid-lifers and 19% of those over

60. The difference appears to be one of attitude according to Almeida

of The University of Arizona. Were finding that older people are

mellowing a bit, he said. According to his research, the older we get,

we kind of realize that hey, its not worth getting upset about the

small things (Mundell, 2002). In the study, Almeida and his colleagues

examined data from a large government survey of over 1,000


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American adults known as The National Study of Midlife in the United

States. As part of the study, researchers telephoned participants every

evening for eight consecutive evenings, quizzing them on the amount

and type of stressors they had faced that day. And we found that, in

sheer number of stressors that people reported, there was no

difference between younger adults and midlife adults, Almeida said.

While these daily hassles tended to really upset those aged 25 to 39,

boomer types aged 40 to 59 were more likely to shrug them off. The

younger people in our sample would report that as more disruptive,

more upsetting, than older people, Almeida said (Mundell, 2002).

Autism causes kids to experience the world differently from the

way most other kids do. It's hard for kids with autism to talk with other

people and express themselves using words. Kids who have autism

usually keep to themselves and many can't communicate withoutspecial help. They also may react to what's going on around them in

unusual ways. Normal sounds may really bother someone with autism

so much so that the person covers his or her ears. Being touched,

even in a gentle way, may feel uncomfortable. Kids with autism often

can't make connections that other kids make easily. For example,

when someone smiles, you know the smiling person is happy or being

friendly. But a kid with autism may have trouble connecting that smile

with the person's happy feelings. A kid who has autism also has trouble

linking words to their meanings. Imagine trying to understand what


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your mom is saying if you didn't know what her words really mean. It is

doubly frustrating then if a kid can't come up with the right words to

express his or her own thoughts. Autism causes kids to act in unusual

ways. They might flap their hands, say certain words over and over,

have temper tantrums, or play only with one particular toy. Most kids

with autism don't like changes in routines. They like to stay on a

schedule that is always the same. They also may insist that their toys

or other objects be arranged a certain way and get upset if these items

are moved or disturbed. If someone has autism, his or her brain has

trouble with an important job: making sense of the world. Every day,

your brain interprets the sights, sounds, smells, and other sensations

that you experience. If your brain couldn't help you understand these

things, you would have trouble functioning, talking, going to school,

and doing other everyday stuff. Kids can be mildly affected by autism,

so that they only have a little trouble in life, or they can be very

affected, so that they need a lot of help (http://kidshealth.org).

For parents of autistic children, there's often no such thing as a

good night's sleep. Children on the autism spectrum are often prone to

wakefulness well into the night, making it hard for others to sleep and

leading parents to worries that their child will harm himself if Mom and

Dad fall asleep. This fear is well founded. It is not unusual for autistic

children to leave the house in the middle of the night - all without a

care in the world (voices.yahoo.com).
http://kidshealth.org/kid/body/brain_noSW.htmlhttp://kidshealth.org/http://voices.yahoo.com/topic/37321/autistic_children.htmlhttp://voices.yahoo.com/topic/37321/autistic_children.htmlhttp://kidshealth.org/kid/body/brain_noSW.htmlhttp://kidshealth.org/http://voices.yahoo.com/topic/37321/autistic_children.htmlhttp://voices.yahoo.com/topic/37321/autistic_children.html


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According to a thesis entitled The effect of age on stress

levels and its affect on overall performance by Dr. Marian and

James Schultz there are different predisposing factor related to the

occurrence of stress among caregiver. These include the age,

finances/salary and vital signs. Based on their notion there is no age at

which we are exempt from stress. Most of us are well aware that as a

person chronologically ages, there are more responsibilities and

situational stressors that become part of our lives which subsequently

can bring about consequences affecting our well being. As adults,

stress is a daily event, but children are not exempt from its impact and

subsequent consequences. Symptoms of stress are especially apparent

in teenagers (Bittman, 1999)

On the study entitled Family Caregiving Stress Filled and

Isolating by Steven Zarit, professor and head, human developmentand family studies, and his colleagues studied the 15 most common

stressors for caregivers -- including financial strain, patient behaviors,

and frequency of help from family and friends, and caregiving time

demands. The findings, published in a recent issue of Aging & Mental

Health, showed that the 67 people in the study experienced radically

different types and amounts of stress "Behavior issues are a common

stressor, but caregivers don't always report that their family member

has behavior issues," said Zarit. "Some people feel more strain from

the sense that they've lost a relationship with their family member or


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because of conflict with siblings or other relatives. It's different for

everyone."

Caregivers with higher levels of depressive symptoms exhibited

lower levels of warmth and higher levels of hostility during both loss

and conflict tasks. In the loss task, the child was asked to share with

family members his/her experience of a previously identified sad

event, such as a death or an injury. In the conflict task, parent and

child were asked to resolve a disagreement previously identified by

each of them in separate interviews, such as a disagreement about

chores, sibling conflict, or privileges. As expected, caregivers tended to

show more hostility and less warmth during the conflict task than

during the preceding loss task. However, caregivers with

moderate/severe depressive symptoms showed a greater rise in

hostility from the loss to the conflict task than caregivers withminimal/mild depressive symptoms. By including a task designed to

elicit warmth, the study allowed for a more valid exploration of how

caregivers respond to childrens need for support and nurturance,

expanding upon traditional procedures for collecting observational

data. The study provides a better test of models for understanding how

parenting behaviors associated with caregiver depression may lead to

child maladjustment (sciencedaily.com).


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The relationship of stress and care imparted by the caregivers is

well defined. Studies have indicated that stress can affect the way of

caring psychological challenge children such as autism. The body

doesnt distinguish between physical and psychological threats. When

one is stressed over a busy schedule, an argument with a friend, a

traffic jam, or a mountain of bills, the body reacts just as strongly as if

one was facing a life-or-death situation. If one has a lot of

responsibilities and worries, the emergency stress response may be

on most of the time. The more the bodys stress system is activated,

the easier it is to trip and the harder it is to shut off. Long-term

exposure to stress can lead to serious health problems. Chronic stress

disrupts nearly every system in your body. It can raise blood pressure,

suppress the immune system, increase the risk of heart attack and

stroke, contribute to infertility, and speed up the aging process. Long-

term stress can even rewire the brain, leaving you more vulnerable to

anxiety and depression (http://helpguide.org).

Coping may be described as dealing with change successfully

or unsuccessfully. A coping Strategy (coping mechanism) is a natural

or learned way of responding to a changing environment or specific

problem or situation. According to Folkman and Lazarus (1991), coping

is the cognitive and behavioral effort to manage specific external

and/or internal demands that are appraised as taxing or exceeding the

resources of the person (Kozier & Erb 2008).
http://helpguide.org/http://helpguide.org/


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Two types of coping strategies have been described: problem-

focused and emotion-focused coping. Problem/Solution-focusedcoping

refers to efforts to improve a situation by making changes or taking

some action (Lazarus, 2000). Some Example of this coping are: Taking

Control this response involves changing the relationship between

yourself and the source of stress. Examples: escaping from the stress

or removing the stress. Information Seeking the most rational action.

This involves the individual trying to understand the situation and

putting into place cognitive strategies to avoid it in future. Information

seeking is a cognitive response to stress. Evaluating the pros and

cons of different options for dealing with the stressor

(simplypsychology.org). Emotion-focusedcoping includes thoughts and

actions that relieve emotional distress. Emotion-focused coping does

not improve the situation, but the person often feels better (Kozier &

Erb 2008). These includes; keeping yourself busy to take your mind off

the issue, Letting off steam to other people, Praying for guidance and

strength, Ignoring the problem in the hope that it will go away,

Distracting yourself (e.g. TV, eating), Building yourself up to expect the

worse (simplypsychology.org). Both types of strategies usually occurs

together (Lazarus, 2000).

Coping strategies are also viewed as long term or short term.

Long-term coping strategies can be constructive and realistic. For

example, in certain situations, talking with others and trying to find out


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more about the situation are long-term strategies. Other long-term

strategies include a change in lifestyle patterns such as eating a

healthy diet, exercising regularly, balancing leisure time with working,

or using problem solving in decision making instead of anger or other

nonconstructive responses (Kozier & Erb 2008). Short-term coping

strategies can reduce stress to a tolerable limit temporarily but are

ineffective ways to permanently deal with reality. They may even have

a destructive or detrimental effect on the person. Examples of short-

term strategies are usually alcoholic beverages or drugs, daydreaming

and fantasizing, relying on the belief that everything will work out, and

giving in to others to avoid anger (Kozier & Erb 2008).

Coping strategies vary among individuals and are often related

to the individual's perception of the stressful event. Three approaches

to coping with stress are to alter the stressor, adapt to the stressor, or

avoid the stressor. A person's coping strategies often change with a

reappraisal of a situation. There is never only one way to cope. Some

people choose avoidance; others confront the situation as a means of

coping. Still other seeks information or relies on religious beliefs

(Kozier & Erb 2008). Coping can be adaptive or maladaptive. Adaptive

coping helps the person to deal effectively with stressful events and

minimizes distress associated with them. Maladaptive coping can

result in unnecessary distress for the person and others associated

with the person or stressful event. In nursing literature, effective and


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ineffective coping are often differentiated. Effective coping results in

adaptation; ineffective coping results in maladaptation (Kozier & Erb

2008). The effectiveness of an individual's coping is influenced by a

number of factors, including:

1. The number, duration, and intensity of the stressors.

2. Past experiences of the individual.

3. Support systems available to the individual.

4. Personal qualities of the person.

If the duration of the stressors is extended beyond the coping

powers of the individual, that person becomes exhausted and may

develop increased susceptibility to health problem. Reaction to long-

term stress is seen in family members who undertake the care of a

person in the home for a long period. This stress is called caregiver

burden and produces responses such as chronic fatigue, sleeping

difficulties, and high blood pressure. Prolonged stress can also result in

mental illness. As coping strategies or defense mechanisms become

ineffective, the individual may have interpersonal problems, work

difficulties, and a significant decrease in abilities to meet basic human

needs (Kozier & Erb 2008). Examples of the negative effect of stress on

Basic Human Needs are; Physiologic needs altered elimination

pattern, change in appetite, altered sleep pattern. Safety and Security


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Expresses nervousness and feelings of being threatened, Focuses on

stressors, inattention to safety measures. Love and Belonging

isolated and withdrawn, becomes overly dependent, blames other for

ones problems. Self-esteem fails to socialize with others, becomes a

workaholic, and draws attention to self. Self-actualization

preoccupied with own problems, shows lack of control, unable to

accept reality (Kozier & Erb, 2008).

Another Definition of coping is a behavioral and cognitive effort

to master, reduce, or tolerate the internal and external demands that

are created by stressful transactions (Folkman & Lazarus, 1986). The

concept of coping, like that of stress, is not a unified construct with a

41 41 meaning that is readily agreed upon by experts (Eckenrode,

1991). A prerequisite for coping is the presence of a condition or event

that is appraised as harmful or threatening to an individual (Lazarus &

Folkman, 1986).

There are two functions of coping: (a) regulation of emotions or

distress, and (b) management of the problem that is causing the

distress (Folkman & Lazarus, 1984). Coping processes for handling

stress vary from encounter to encounter according to what is at stake

for the individual (e.g., self-esteem, physical health) and the options

for coping (e.g., whether something can be done to change the

situation) (Folkman & Lazarus, 1986). Whether people suffer from


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stress or not is often dependent on their coping strategies (Furnham,

1997). Coping strategies are responses to the perceived stressor

threat. Like stress, coping can have both positive and negative

consequences (Boss, 1998). Coping strategies are not always positive.

Coping strategies outlined by Carver, Scherer, and Weintrab (1989) (as

cited in Furnham, 1997) are positive reinterpretation, planning,

seeking support for problems, religion, acceptance, denial, alcohol use,

humor, and mental disengagement. Commonly used approaches are

life-style changes such as diet and exercise, meditation, and

relaxation. (Furnham,1997). In addition, the meaning a family attaches

to a stressful situation is a form of coping behavior (McCubbin,

Thompson, & McCubbin, 1996).

A familys coping resources are its individual and collective

strengths during the time a stressor event occurs (Boss, 1988). Job

skills, health, economic security, social supports, relationship skills,

and proximity of support are examples of coping resources. Resources

are defined as the means capable of meeting the demands placed

upon a family (Deacon & Firebaugh, 1988). They are whatever is

available to use (Goldsmith, 1996) or the economic, psychological, or

physical assets individuals can draw upon in response to stressor

events (Boss, 1988).


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When individuals or family members have sufficient resources,

they are less likely to view a stressful event as a problem (McKenry &

Price, 1994). Resources mediate the impact of a stressful event

(McCubbin & Patterson, 1983b). Family stress has been found to be

lower among families with financial resources, social support, and 42

42 adaptive family system characteristics (Voydanoff, 1984) and

satisfaction with life (Bailey, Woodiel, Turner, & Young, 1998).

Spirituality and health has no definite relationship. However, it

seems that the body, mind and spirit are connected. The health of

anyone of these elements seems to affect the health of the others.

Some research shows that things such as positive beliefs, comfort and

strength gained from religion, meditation and prayer can contribute to

healing and a sense of well-being. Improving your spiritual health may

not cure an illness, but it may help you feel better, prevents some

health problems, and help you cope with illness, stress or even death

(www.familydoctor.org.com).

A person coping with behavior problems may also have other

difficulties not targeted by this single-stressor intervention. Some

caregivers will not need to cope with behavior problems at all. "The

majority of caregivers are living at home, with little or no help," said

Zarit. "The family has to pay the physical, emotional, and financial cost

of the caring, which can be staggering. When the caregiver gets
http://www.familydoctor.org.com/http://www.familydoctor.org.com/


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overwhelmed, it raises the probability of a breakdown in the care

situation." In a few cases, there are reports of neglect or abuse. Most

interventions operate as a preventive measure -- they reach people

before the stress becomes overwhelming. "Because stress profiles vary

so widely, we just don't know how much of a given stressor will hit a

threshold and when we should make an intervention," Zarit said.

According to Zarit, a promising approach is to use an adaptive

intervention, one that can be customized to address the varying risk

factors of each individual. Some of these interventions exist in the real

world and are successful. However, most of these interventions are

published and never become used widely, said Zarit. Even if current

interventions are not always effective, options exist to alleviate stress

and maintain well-being in a caregiving relationship. Zarit's past

research has found that family meetings -- which enlist the support ofextended family -- can improve well-being for both individuals in the

relationship (sciencedaily.com).

On the Article entitled Caregiver Depression: A Silent

Health Crisis it state that One of todays all-too silent health crises is

caregiver depression. A conservative estimate reports that 20% offamily caregivers suffer from depression, twice the rate of the general

population. Of clients of Californias Caregiver Resource Centers,

nearly 60% show clinical signs of depression. And former caregivers


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may not escape the tentacles of this condition after caregiving ends. A

recent study found that 41% of former caregivers of a spouse with

Alzheimers disease or another form of dementia experienced mild to

severe depression up to three years after their spouse had died. In

general, women caregivers experience depression at a higher rate

than men (caregiver.org).

Acording to sudy conducted last May 2007 in the San Jose State

university by Twoy R, and et.al, entitled Coping strategies used by

Parents of Children with autism, shows that the level of

adaptation was within the normal limits with coping scores similar to

the norm scores of the family crisis oriented personal evaluation skills

(F-COPES) with males scoring slightly higher than females in the coping

scale. Subscale scores of the F-COPES that indicated that the parents

sought encouragement and support from friends, informal support

from other family who face similar problems, and formal support from

agencies and programs. Reframing revealed similar result as the norm

with less use of spiritual support, and more passive appraisals were

noted from the parent of children with ASD

(http://www.ncbi.nlm.nih.gov).

A study entitled Coping Over Time: The parents of children

with autism, authored by Gray shows result that coping strategies

changed from the time of the initial study, as fewer parents coped

through reliance on service providers, family support, social withdrawal
http://www.ncbi.nlm.nih.gov/http://www.ncbi.nlm.nih.gov/


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and individualism and relatively more parents coped through their

religious faith and other emotion focused strategies. The results

tentatively support previous research on coping that indicates that

aging is linked to the use of more emotion-focused coping strategies

(http://www.ncbi.nlm.nih.gov).

A research in Taiwan authored by Chang and et al, entitled

Coping Mechanism of Parents of Children recently diagnosed

with autism in Taiwan: A Qualitative Study, wherein it aims to

understand the coping mechanism of Taiwanese parents whose

children have recently diagnosed with autism. The result was that the

study sample of parents of children with autism described nine main

coping mechanisms that fell into three core categories: adjusting to

self-change, developing treatment for the autistic child and seeking

support (http://www.ncbi.nlm.nih.gov).

The following are few coping strategies that Laura may help find

strength and the support that a caregiver may need. (1) Educate

yourself. Learn the vocabulary necessary to effectively communicate

your childs need. Remember, knowledge is power and if nothing else,

youll be able to quickly ascertain the depth of education or experience

a professional may or may not have with respect to your particular set

of circumstances. (2) Get more than a second opinion. Dont just

consult more than one doctor; consult more than one type of doctor. If,

for example, your child is having difficulty with assimilating
http://www.ncbi.nlm.nih.gov/http://www.ncbi.nlm.nih.gov/


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information, dont conclude your fact finding at your pediatricians

general practitioners office. You may want to see a specialist, a

neurologist, or even an ophthalmologist. Sometimes a child can be too

quickly diagnosed by school officials as learning disabled when in

fact the child may actually have a vision problem. Consulting several

doctors will help to ensure the most accurate diagnosis possible. (3)

Keep up on current research. Be careful, however, this may prove to be

an emotional trap for a loving parent who can become obsessed with

finding answers. It might be a good idea to assign a family member or

friend to be the go to person when new information needs to be

sought. This point person can be the one to surf the net, subscribe to

newsgroups, visit parents forums and read medical journals or science

articles on the latest research. Delegating this task will allow you to

focus on quality time with your child and focus on his or her

developmental needs. (4) Maintain a separate identity. You are not

your child and this isnt happening to you. The disease or disability is

happening to your child, and dont forget that. As attempting as it is,

you cannot take that specific burden on yourself. Financial burdens,

housing burdens and transportation burdens yes, those can be yours

but not the disability itself. If able, the child must learn that,

ultimately, he will be his best advocate. Empower him or her as early

as possible. As much as you may desperately wish to relieve your child

of the burden you believe he or she surely must be suffering, you


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cannot. Your child may not be able to comprehend the gravity of his or

her situation, but a child has no difficulty grasping your responses to it.

Try not to allow your grief and anxiety to define your child. The best

thing you can do for your child is to teach self-sufficiency, encourage

resourcefulness and advocate self-determination. (5) Dont take no

for an answer no one is a better advocate for your child than your child

or you. Do not allow anyone to speak for you if they do not respect

your views, needs or best interests, or those of your child. Build a team

of trusted professionals, cheerleaders and supporters. (6) Give yourself

a break. Avail yourself of professional, peer or group counseling. You

may feel alone, but youre not. Let others help you. Allowing another

person to help you can be a tremendous gift for you both.

Understanding the extent to which you feel overwhelmed can be

detrimental to your decision-making ability. Take good care of yourself,

so you can be the best caregiver for your child

(http://ezinearticle.com).

Though serving an autistic child is very difficult to bear, there is

this something like very unique part because one can experience how
http://ezinearticle.com/http://ezinearticle.com/


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hard it is to care such children. Many people still wonder the impact of

stress on these caregivers and how they affect in the routine of their

daily lives. However, caregiving is an important aspect in the lives of

these kinds of children, and also a great deal when it comes to

supervising such creature.

Profile of Caregiversof Autistic Children

a. Ageb. Genderc. Civil Statusd. Monthly incomee. Highest EducationalAttainmentf. Relation to the

autistic childg. Personality type

BASIS

FOR

RECOMMEND

ATION

Caregivers

of Autistic

Children

In

Tacloban

City


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Figure I. Conceptual Framework of the Study

Figure I, illustrates the conceptual framework of the study. The

study will use purely descriptive research design to determine the

profile of the respondent who care for an autistic child; specifically the

study on hand will describe the variables included in the study such as

Perceived Stressorsand level of stress:

1. Personal stressors2. Family stressors3. Caregiving stressors

Coping mechanism &extent of employment

1. Emotion-Focused

Perceived symptomsof stress

1. Physical2. Emotional3. Behavioral4. Psychological5. Relational symptoms


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the age, gender, civil status, monthly income, highest educational

attainment, relation to autistic child personality type.

Furthermore it will also determine the perceived stressors which

are categorized into three namely personal, family and caregiving

stressors, and the level of stress of the respondents, the perceived

physical, emotional, behavioral, mental and relational. The symptoms

of stress as manifested by the respondents, their coping mechanisms

and extent of their employment. Based on the findings of the study,

basis for recommendation may be formulated.

THE PROBLEM

Coping mechanism &extent of employment


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Statement of the Problem

This study aims to determine the perceived stressors and coping

strategies among caregivers of autistic children in Tacloban City.

Findings will serve as basis for recommendation.

Specifically, it seeks to answer the following questions:

1. What is the profile of the respondent in terms of:

1.1 Age;

1.2 Gender;

1.3 Civil status;1.4 Monthly income;

1.5 Highest educational attainment;

1.6 Relation to the autistic child; and

1.7 Personality type?

2. What are the perceived stressors of the respondents in terms of

the following:

2.1 Personal stressors;

2.2 Family stressors; and

2.3 Caregiving stressors?

3. What is the level of stress of the respondents?

4. What are the perceived symptoms of stress commonly

manifested by the respondents in terms of the following:

4.1 Physical;4.2 Emotional;

4.3 Behavioral;

4.4 Mental; and

4.5 Relational symptoms?


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5. What coping mechanisms do the respondents employed, and to

what extent?

5.1 Emotion-Focused Coping

5.2 Problem-Focused Coping

6. Based on the findings of the study, what recommendation can be

formulated?

Significance of the Study

The findings of this study are beneficial towards evaluating the

stress levels of caregivers of autistic children. The study would likewise


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present the importance of stress management for Caregivers of

autistic children so as to prevent stress related problems to the

respondents.

The findings of this study will be of great benefit to the following:

Caregivers of autistic children. Caregivers of autistic are the

main respondents of this study. Determining their levels of stress can

be a great achievement thus providing the necessity to look for

interventions to alleviate or change their ineffective coping towards

stress.

Family of Autistic Children. This research will provide

different ideas and recommendation that will be of great help in

promoting stress free child care.

School Administrators. Knowing the stress level of caregivers

and the different stressors and factors that contribute to its

aggravation and alleviation, the care system will provide proper

interventions and programs for these caregivers that are prone to

stress impacted by autistic children and will enable them to manage

their stress in a healthy and efficient manner.

Student Nurses. Student nurses will be able to base their care

management to their patients especially autistic ones in coping with

stress using the proposed stress management guide.


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Nurse Educators. Knowing the stress level of caregivers and

the different stressors and factors that contribute to its aggravation

and alleviation, the nurse educators will reinforce the students

knowledge regarding stress and stress management for these persons

Autism Society of the Philippines. Coping with stress among

autism caregivers is easily facilitated when interacting to those whom

they can share some of their common experiences.

Future Researchers. The result of this study may be used as

input data for future researchers.

DEFINITION OF TERMS


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RESEARCH METHODOLOGY

This section presents the research methods and approaches to

be used in conducting the present study. This includes the discussion

of the research design, research locale, research respondents,


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research instrument, gathering and processing, analysis and statistical

treatment of data.

Research Design

The research design to be utilized in this study will be a purely

descriptive research design. Descriptive Research will accurately

portray a population that was chosen because of some specific

characteristics (Cristobal and dela Cruz- Cristobal, 2009). This method

was used to describe the respondents according to their Profile, The

Perceived Stressors in terms of personal, family, and care giving

stressors; Perceived Symptoms of Stress categorized to Physical,

Emotional, Behavioral, Mental, and Relational Stress; and Coping

Mechanism used by them and the extent of employment either

Emotion-Focused or Problem-Focused Coping strategies. The design

had clearly given more information and explanation of each variable.

Research Locale

The study will be conducted at Sto.Nio Sped Center. Sto. Nio

SPED Center (SNSC) is a Public school located at Cor. T Claudio St., and

Santo Nio Extension, Tacloban City, Philippines established in 1988.

At present, the school has grown to a population of 1,038 pupils and 34

teachers. It caters not only to fast learners but also to children with

special needs such as hearing impaired, the visually impaired and

mentally challenged. It has also eight pre - elementary classes. A


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leading center providing and promoting quality education for persons

with autism and other developmental disabilities become independent,

well-adjusted, and productive members in the community. Sto. Nio

Sped Center believes that persons with autism and developmental

disabilities are human beings created in the image of God and

therefore should be given equal opportunities to develop their unique

potential for self enhancement and employment.

Research Respondents

The researcher will be utilizing as subjects the Caregivers of

Autistic Children in Sto. Nio Sped Center. Sto. Nio SPED Center

(SNSC). There is a total population of 32 caregivers, and all of them are

desired to participate in this study.

Research Instrument

The study will utilize a researcher made interview guide

consisting of four (4) parts. Part I is a checklist that will describe the

profile of the respondents in terms of age, gender, civil status, monthly

income, highest educational attainment, relation to autistic child, and

personality type.

Part II will elicit information on the perceived stressors of the

respondents which include personal, family and caregiving stressors.

Each stressors consists of six (6) statements where in the respondent


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will indicate their level of stress using likert type scale and their

responses will be scored from 3 (always) 2 (sometimes) 1 (never).

Part III is a checklist that will measure the symptoms of stress

commonly manifested by the respondents; these include physical

symptoms, emotional symptoms, behavioral symptoms, mental stress,

and relational stress.

Part IV will measure the common coping mechanisms employed

by the respondents and extent by which it is being used by them.


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APPENDIX C

PERCEIVED STRESSORS AND COPING MECHANISM AMONG

CAREGIVERS OF AUTISTIC CHILDREN IN TACLOBAN

CITY: BASIS FOR RECOMMENDATION

Research Instrument

PART I: PROFILE OF THE RESPONDENTS

INSTRUCTION: Below is checklist that will answer your personalprofile. Please fill- out the questions below by putting a check () markon the space provided. The given information will remain confidential.

Name (optional): __________________________________Age: __________

Gender:

( ) Male ( ) Female

Civil Status:

( ) Single ( ) Married

Others (please specify): ________________________

Religion:

(Please specify):_______________________________

Monthly Income:

( ) 1000 and Below ( ) 5001 - 6000

( ) 1001 2000 ( ) 6001 - 7000

( ) 2001 3000 ( ) 7001 - 8000

( ) 3001 4000 ( ) 8001 - 9000

( ) 4001 5000 ( ) 9001 - Above

Highest Educational Attainment:


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( ) Elementary Level ( ) College Graduate

( ) Elementary Graduate ( ) Postgraduate with units

( ) High School Level ( ) Postgraduate with degree

( ) High School Graduate ( ) Never been to school

( ) College Level

Relation to the Autistic Child:

( ) Son/ Daughter ( ) Cousin

( ) Nephew/ Niece ( ) Not a Relative

Others please specify: ________________________

Personality Type:

( ) Type - A (Independent, Impatient, Competitiveness,Aggressive)

( ) Type - B (Easygoing, Do not hurry in to things, Love tosocialize, approachable, relationship oriented)

( ) Type - C (Perfectionist, Take everything seriously, Deepthinkers, patient, Tends to deny feelings)

( ) Type - D (Follow direct commands, Fear of rejection,Responsibility oriented)

Part II: PERCEIVED STRESSORS AND LEVEL OF STRESS OF THE

RESPONDENTS


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INSTRUCTION: The following is a list ofthe Perceived Stressors. Ifa symptom applies to you, please rate the severity of the symptom youhave experienced on the 3 point scale next to the item. Kindly put acheck () mark on the appropriate box as to:

SCALE INTERPRETATION

3 Always2 Sometimes1 Never

Part III: PERCEIVED SYMPTOMS OF STRESS COMMONLY

MANIFESTED BY THE RESPONDENTS

PERCIEVED STRESSORS LEVEL OFSTRESS3 2 1

1. Personal Stressors

1. Not being able to make ends meet

2. Lack of sleep3. Needing to express emotions but not able to4. Getting upset about small things5. High level of hostility6. Exhausted in dealing with other life changes

2. Family Stressors1. Child- care2. Caring for other dependents3. Financial trouble4. Low level of warmth relationship with family

members5. Support deficit from family and friends6. Conflict with husband, sibling and relatives

3. Care Giving Stressors

1. More demand of care giving time2. Caring autistic children is difficult because theyhave their own world

3. Unpredictable child behavior4. Increase caregiving burdens5. Serving an autistic child is difficult to bear


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INSTRUCTION: The following is a list of Physical, Emotional,Behavioral, Mental and Relational Symptoms of Stress. I f asymptom applies to you over the past six months or you anticipate thesymptom occurring in the coming year, kindly put a check () mark onthe appropriate box. Choose all that applies.

1. Physical Stress

( ) headache( ) loss bowel movement( ) dizziness( ) tiredness( ) sleep problems( ) others (please specify): ___________________________________

2. Emotional Stress( ) anger/ irritability/ impatient( ) depressed/ detachment( ) anxious/ panic( ) fatigue( ) work against will( ) others (please specify): ___________________________________

3. Behavioral Stress( ) poor work performance/ low motivation( ) unable to complete task( ) criticizing others( ) arguing with or picking fights( ) poor time management

( ) others (please specify): ___________________________________4. Mental Stress( ) lack of concentration/ attention( ) irrational beliefs( ) forgetfulness( ) difficulty of making decision( ) making more mistakes in doing work

5. Relational Stress( ) resenting good times other have( ) nagging( ) not trusting others

( ) withdrawn/ isolated( ) using people to your advantage( ) others (please specify): ___________________________________

Part IV:COPING MECHANISM AND THE EXTENT OFEMPLOYMENT


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INSTRUCTION: The following is a list ofCoping Mechanisms that areeffective for combating and preventing Stress. Kindly put a check ()mark on the appropriate box as to:

SCALE INTERPRETATION

3 Always2 Sometimes1 Never

Coping MechanismExtent of

Employment3 2 1

How do you usually handle stressful situation?

1. Emotion-Focused Coping

1. I maintain a sense of humor2. I use relaxation techniques to reduce bodytension such as yoga or imagery guide.

3. I keep myself busy4. I pray for guidance and strength5. I Distract myself thru (watching T.V., eating, etc)6. I ignore problem in a hope that it will just go

away

2. Problem-Focused Coping

1. I am able to ask for and receive support from

friends, family members or professionals as abuffer against stress.2. I try to Learn the vocabulary necessary to

effectively communicate with the childs need3. I try to arrive a certain solution for the problem

encountered4. In conflict situations, I am able to speak up on

my own behalf, honestly express my opinions,feelings, and wishes, give constructive criticism,and refuse unrealistic requests.

5. I am able to establish priorities, take action on

my plans, schedule effectively, avoidprocrastination and pace my efforts.

6. I take time out

BIBLIOGRAPHY


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1. Books

Erb, K. &. (2008). Fundamentals of Nursing. Philippines:

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Furnham, A. (2005). The Psychology of Behaviour at Work.

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Lange, A. &. (1999). The Roy Adaptation Model. London:

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2. Documentary

RLeynden1. (2009, January 28). Autism Documentary: A Day

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3. Electronic Sources

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Auutism Thesis. (2011, november 15). Retrieved from

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Caring for a Child with Autism Spectrum Disorder: Severe

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Deborah Leader, R. (2009, July 25). Caregiver Coping Tips.

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http://copd.about.com/od/caregiversupport/qt/caregivertips.htm

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Kanade, S. (2011, December).Personality Types A B C D.

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Krohne, H. W. (2002). Stress and Coping Theories. Retrieved

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Sally Bloch-Rosen, P. (1999, april 8).Asperger's Syndrome,

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Isolating. Retrieved december 2011, from

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Caregivers of Mentally Ill Kin Can Cope. Retrieved december

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4. Interview


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Bairulla, M. (2012, January 24). National Autism

Consciousness Week itinanghal sa Davao. (D. Mais,

Interviewer)

Koe, G. N. (2012, January 22). Daan-daang pamilya, lumahok

sa National Autism Consciousness Week. (R. Reyes,

Interviewer)

PERCEIVED STRESSORS AND COPING MECHANISM AMONG CAREGIVERS OF AUTISTIC CHILDREN IN TACLOBAN CITY:...

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