Life stress and illness: a systems approach

The link between stress and illness has been forged by researchers like Holmes and Rahe whose Social Readjustment Rating Scale can be used by family physicians to assess their patients' stress. The concept of stress has been clarified by the systems approach to illness. Stress and illness are embedded in a biopsychosocial matrix of several systems levels, each of which may be a source of stress as well as a support system. Stress is not the end result of a linear chain of causes and effects, but part of a feedback system in a community or family. The family is the major source of lifestyle and personality, the health belief system and modes of problem solving and coping, as well as of stress and support. The family physician can have a major role in educating the individual and family about stress and illness, and in altering the meaning of stress from catastrophe to challenge and source of growth. Anticipatory guidance for the normal crises of the life cycle and the crises of illness, loss and death can help prevent further family dysfunction and illness.