Cultural discourse and the myth of stress in nursing and medicine.

Nursing has within the last 20 years firmly embraced the idea that practice should be based on substantive research. Yet many of the issues with which modern nursing is grappling encompass complex multifaceted aspects which are difficult to conceptualise or define. Stress is one such concept which has been increasingly invoked in both health care and lay discourses as an explanation for illness and general misfortune. A number of models of stress have been proposed which have to a greater, or lesser extent also been adopted by the lay public. In many respects nursing models of health and illness have more in common with lay, rather than biomedical, conceptualisations of illness aetiology. However, it is unclear to what extent nursing, lay and biomedical ideas about stress overlap. This paper attempts to explore some of these issues by describing the semantic origins of stress and the ways in which it is conceptualised and invoked in both the professional and lay discourse. The many approaches to stress research are explored and some of the constraints pertaining to them discussed. The question is also raised as to why certain discourses on stress have arisen within particular professional domains, and why the nursing contribution to stress research has been marginalised. An ideological component to the stress discourse is identified, and the importance of nursing and other professional disciplines recognising this, and also those macro-level factors which may affect health and illness, is stressed.