Sample Healthcare Essays on Stress and Coping Theory

Lazarus and Folkman proposed a model that stresses the transactional characteristics of stress. Based on their model, a transaction occurs between an individual and the setting. Stress is a result of an imbalance between demands and resources (Oxington, 2005, P. 54).  Therefore, individuals get stressed when their demands exceed their resources (individuals’ ability to cope and mediate stress) (Oxington, 2005, P. 54). According to Lazarus and Folkman stress is a “particular relationship between an individual and the environment that is appraised by the individual as a taxing or exceeding his/her resources and endangering his/her well-being” (Lazarus & Folkman, 1984; Hobfoll, 2004). This association is described by two main phases; Cognitive appraisals and coping.

Cognitive Appraisal

This is a method of classifying an experience and its different features, based on its necessity for well-being (Lazarus & Folkman, 1984, P. 31). It is important to cognitively evaluate a situation as being potentially stressful, before coping with it. Cognitive appraisal is a mental course whereby two key factors are considered; whether individuals’ demand endangers their well-being and whether an individual considers that he/she has the resources to meet the demands of the stressor. There are two main types of appraisals; the primary appraisal and the secondary appraisal ( Bartlett, 1998).

  • Primary Appraisal

This is a review of what is at risk. At this phase, individuals seek answers to the meaning of a situation regarding their well-being. For instance, individuals may ask themselves whether they are in trouble, or they are benefiting now or in the future, and in what ways? If the answers to these questions are positive, then the situations can be classified as being a threat, a challenge, or a loss. Loss appraisal entails an injury or mischief that has already occurred. Threat and challenge appraisals describe occurrences in the past or the ones that are anticipated. Threat describes a potential danger to an individual’s well-being, while challenge suggests that one concentrates on the success that a situation might bring about. Threats and challenges are known to be negatively correlated, however, there are instances where they can occur simultaneously. For instance, Lazarus and Folkman demonstrated that students waiting for an examination appraised the forthcoming event as mainly threatening and challenging (Lazarus & Folkman, 1984).

  • Secondary Appraisal

This is normally occurring on the same occasion as the primary appraisal. It is an evaluation of the coping resources and solution to the question of whether an individual is able to cope with a situation. It demonstrates confidence in an individual’s ability to cope with a situation because of the availability of resources to do so. Resources may be corporeal, societal, emotional, or material. A secondary appraisal is a review of the perceived resources, deal with danger. Individuals who are considered affluent, healthy, and optimistic are regarded as resourceful and thus less vulnerable to stressful situations (Driskell & Salas, 1996).  For example, research was once carried out concerning the association between self-efficacy and precise health consequences, such as recuperation from a surgical treatment or the process of adapting to a chronic illness. The result of the research was that patients with high self-efficacy beliefs were found out to be better able to cope with pain than the patients with low self-efficacy. Self-efficacy is considered to have an effect on blood pressure, heartbeat, and serum catecholamine levels in coping with incidents that are regarded as a challenge or a threat (Schwarzer, 1998; Schwarzer & Fuchs, 1996).


There are cognitive and behavioral efforts to understand, minimize or endure the inner and the outer demands that develop as a result of the stressful operation (Lazarus & Folkman, 1984). Lazarus and Folkman stated that coping serves two main functions; the regulation of sentiments and distresses that lead to stressful situations and the management of an issue that causes stress by directly altering the factors of a stressful situation. These forms of coping are based on the way individuals appraise a situation and the antecedents of the model.  Lazarus and Folkman identified two main classifications of antecedents, which directly influence the way individuals appraise and cope with situations; the ones associated with the nature of an individual and those associated with the nature of the event. Early researchers investigated the relationship between stressful situations and individual distress. The result was that stressful situations accounted for ten percent of the changes in distress. The coping behavior of a person may contribute to the evaluation of the amount of distress one experiences (Robert-McComb, 2001).

Lazarus and Folkman classified coping into two main categories; Problem-focused and emotional-focused, where problem-focused entails efforts to manipulate a situation that causes stress. Conversely, emotionally focused entails the demonstration of the emotional responses that are as a result of a situation that causes stress (Fridenberg, 2004, P. 281). For example, to understand the determinants of life of a cancer patient, numerous treatments are required, which should contain cognitive appraisals and coping strategies. In this case, the cognitive appraisals include the recognition of threat occurrence and self-efficiency in the adaptation of health behavior recommendations. The coping strategies may include motivational messages as well as coping abilities, training practices (Glanz & Viswanath, 2008; Lyon, 2000).


Lazarus and Folkman Stress and coping theory is a system for assessing the process of coping with stressful experiences. Stressful encounters are interpreted as individual-environment transactions, which are dependent on the impact of the external stressor. This is arbitrated by an individual’s appraisal of the stressor and the social as well as the cultural resources at one’s disposal. The model by Lazarus and Folkman is mainly helpful for health learning and support as well as disease deterrence. Stress affects individuals differently and may cause illness and bad experiences. Coping with stress is thus a fundamental issue.




Bartlett, D. (1998). Stress: Perspectives and processes. Buckingham: Open University Press.

Driskell, J. E., & Salas, E. (1996). Stress and human performance. Mahwah, N.J: Lawrence Erlbaum Associates.

Frydenberg, E. (2004). Thriving, surviving, or going under: Coping with everyday lives. Greenwich: Information Age Pub.

Hobfoll, Stevan E. (2004). Stress, Culture, And Community: The Psychology And Philosophy Of Stress. Plenum Pub Corp.

Lazarus, R. S., & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer Pub. Co.

Lyon, B. L. (2000). Stress, coping, and health. Handbook of stress, coping and health: Implications for nursing research, theory, and practice, 3-23.

Oxington, K. V. (2005). Psychology of stress. New York: Nova Biomedical Books.

Robert-McComb, J. J. (2001). Eating disorders in women and children: Prevention, stress management, and treatment. Boca Raton: CRC Press.

Schwarzer, R. (1998). Stress and coping resources: Theory and review.Advances in health psychology research [CD-ROM]. Berlin: Freie Universität Berlin, Institut für Arbeits-, Organisations-und Gesundheitspsychologie. Retrieved from

Schwarzer, R., & Fuchs, R. (1996). Self-efficacy and health behaviors.Predicting health behavior, 163-196. Retrieved from

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: Theory, research, and practice. San Francisco, CA: Jossey-Bass.