Psychophysiological processes of stress in chronic physical illness: a theoretical perspective

This paper proposes a theoretical framework and conceptual model for clinicians and investigators working with people who have a chronic physical illness. The framework is based upon nursing theory and classical propositions from psychology and physiology. The major premise of the model is that individuals with limited psychosocial attributes and a preponderance of unmet basic needs are more likely to perceive events as threatening and experience a maladaptive stress response, such as heightened symptoms and acute exacerbations of their illness. Conversely, those with strong attributes and a perception of need satisfaction are more likely to view events as challenging, thus avoiding symptomatic discomfort and enhancing personal growth. Implications for nursing practice and research are addressed.