The focus of Unit 10 is patient stress.

Stress is a common experience for patients in healthcare settings. Understanding how stress manifests in behaviour can significantly enhance your ability to provide effective care. In this unit, we’ll explore the common behavioural responses patients exhibit when under stress, how to interpret non-verbal cues and apply communication techniques tailored to different stress responses.

Learning Objective

By the end of this unit, you will be able to better understand behavioural responses to stress, interpret non-verbal cues and apply appropriate communication techniques tailored to alleviating anxiety in patients.

Patients’ behaviours in stressful situations often reflect their emotional state. These behaviours can range from anxiety and withdrawal to aggression and irritability.

Anxiety is one of the most common stress responses. A patient feeling anxious might exhibit signs such as restlessness, excessive talking or a raised voice. They may appear tense, have a rapid heartbeat or show shallow breathing.

Withdrawal. Some patients may withdraw from interactions when stressed. They may avoid eye contact, speak less or physically distance themselves. This behaviour may be a sign that they feel overwhelmed or fearful, but it does not necessarily mean that they do not want any treatment or care.

Aggression. In some cases, stress can trigger aggression. Patients may raise their voice, make sharp or defensive comments or even lash out physically. This behaviour often stems from fear, frustration or a feeling of loss of control.

Non-Verbal Cues. Non-verbal cues such as body language, facial expressions and posture often reveal much more than words. For example, clenched fists, rapid eye movement or an inability to stay still all indicate stress. Recognizing these cues can help you respond appropriately before the situation escalates.

Pause for Thought

How can you tell when a patient is becoming anxious without them saying it directly?
Think about the last time you interacted with a patient who was visibly stressed. What body language or other non-verbal cues helped you recognize their anxiety?

„Giving information is often the first step in helping anxious patients, so much so that it has been said that knowledge is reassurance. While information must be tailored to the wishes of the individual, many patients want more information than they are given.

Effective communication is central to information giving, with evidence that anxiety is associated with poor communication.” ¹

Effective Communication Techniques with Anxious Patients

Once you understand a patient’s stress response, it’s important to choose communication strategies that can help alleviate anxiety and improve the situation. Here are a few techniques:

1. Active listening:

Actively listening to the patient without interrupting helps them feel heard and understood. Show empathy through verbal affirmations like “I understand how you feel” or “That must be really tough for you.”

2. Clear and calm language:

Use simple, clear language to explain procedures, options, and what to expect. Avoid medical jargon that may increase confusion and stress.

3. Offer reassurance:

Reassurance can go a long way in easing anxiety. Let the patient know they are not alone in the process, and that you are there to support them. Statements like “You’re in good hands” can be helpful.

4. Give control when possible:

Patients often feel more anxious when they feel out of control. Whenever possible, allow the patient to make choices or express their preferences. This can reduce feelings of helplessness and build trust.

5. Non-verbal communication:

Your own body language plays an important role in calming a stressed patient. Maintaining open body posture, making appropriate eye contact and offering a reassuring touch (if appropriate) can create a sense of safety.

Pause for Thought

Imagine you are working with a patient who is withdrawing due to stress. How would you help them feel more comfortable?

Key Takeaways

• Anxiety, withdrawal and aggression are common behavioural responses to stress.
• Recognize non-verbal cues like body language and facial expressions to better understand a patient’s emotional state.
• Use active listening, clear language, reassurance and giving control to help ease patient anxiety.
• Non-verbal communication is as important as verbal communication in stressful situations.

Next Steps

• Do the exercises.
• Watch illustrative videos accompanying Simulation 10.
• Participate in Role-play Simulation 10.
• Share reflections and key takeaways during debrief.

1. House A., Stark D., „Anxiety in medical patients”, https://pmc.ncbi.nlm.nih.gov