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Teachers' resources – Programme notes

Stressed out

Background information
Curriculum relevance


This programme focuses on stress as a factor affecting health and wellbeing, shows a number of different forms of health assessment and explores participants' health improvement aspirations. The programme introduces two new families – the Miah family and the Froud family – whilst maintaining continuity with the previous programmes by also featuring the Moncholi and Bath families. The negative effects on health and wellbeing of stress, smoking and ill health identified in this programme also provide a lead-in to the subsequent programme where health improvement is covered in more detail.

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'Stressed out' largely focuses on five individuals from each of the featured families:

  • Jane Bath describes the problems she faces caring for four young children in difficult housing and financial circumstances. She identifies the effect of this on her health and wellbeing and discusses possible sources of support.
  • Karen Moncholi describes the stressful impact on herself and other family members of providing ongoing care and support for her disabled son David. Dealing with his sleep disturbances is seen as one way of reducing stress levels.
  • Hasina Miah identifies both childcare responsibilities and her continuing ill health as sources of stress that she is constantly trying to cope with.
  • · Cathy Froud works at a GP practice in an administrative role. She describes this as a major source of stress in her life. She wants to give up smoking and identifies this as a health improvement goal.

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Background information



  • Stress occurs when the demands made on a person outweigh their ability to cope or adapt. The person then feels under pressure, threatened, tense or strained.
  • Short term symptoms of stress include:

    • muscle pain
    • headaches
    • feeling sick
    • trembling
    • sweating
    • dry throat
    • disturbed sleep
    • changes in appetite
    • stomach upset
    • fast pulse rate
    • feeling faint or dizzy
    • irritability
    • poor concentration
    • feeling panicky

  • Extreme sudden stress or long-term enduring stress can lead to health problems.
  • Some people experience temporary health problems that they recover from when they manage to reduce their stress levels. For other people, stress has a long-term effect on their physical and mental health. Stress can trigger off mental health problems like depression and anxiety-based illness, for example.
  • Health problems associated with stress include:

    • anxiety and depression
    • eczema
    • asthma
    • migraine
    • angina (pain around the heart muscle)
    • high blood pressure
    • heart attack
    • stomach ulcers
    • accidents
    • Common causes of stress in people's lives include relationships, money worries, poor living or work conditions, having too much work to do, and general lack of satisfaction in life.

Cigarette smoking

  • People who smoke cigarettes run a considerable risk of causing themselves long-term health damage. Health problems associated with smoking tobacco include:

    • coronary heart disease
    • stroke
    • high blood pressure
    • bronchitis
    • lung cancer
    • other cancers, such as cancer of the larynx, kidney and bladder

  • Smoking is harmful to health because the smoke taken into the person's body contains harmful nicotine, carbon monoxide and tar.
  • Nicotine is a fast-acting and addictive substance. Absorbed into the bloodstream it increases heart-rate and blood pressure and changes the person's appetite.
  • Cigarette smoke also contains a high concentration of the poisonous gas carbon monoxide. It combines easily with haemoglobin, thereby reducing the amount of oxygen that is carried to a smoker's lungs and tissues. This reduction in oxygen transport affects the growth and repair of tissues.
  • Changes in the blood that result from smoking can cause fat deposits to form on the walls of the arteries, leading to hardening of the arteries and circulatory problems. The result is coronary heart disease.
  • Cigarette tar also contains many substances known to cause cancer. It damages the cilia, the small hairs lining the lungs that help to protect them from dirt and infection. Because these lung protectors get damaged, smokers are more likely to get throat and chest infections than non-smokers. About 70 per cent of the tar in a cigarette is deposited in the lungs when cigarette smoke is inhaled.
  • In 1996-7, just under 30 per cent of adults were still smokers and there were over 120,000 smoking-related deaths.
  • Teenage girls are one of the few social groups who are more likely to smoke now than in the past.

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Curriculum Relevance

  • The programme is primarily linked to Unit 2 Promoting health and wellbeing.
  • The content also allows a number of links to be made to the topics of needs, care workers and the availability of care services in Unit 1.
  • Risks to health and wellbeing are evident in the situations faced by Jane (stress, inadequate housing), Karen (stress, social isolation), Hasina (inherited disorder, stress) and Cathy (smoking, stress).
  • Ways of measuring and assessing physical health are illustrated through OT assessment of David's need for a new bed, Cathy completing a self-assessment questionnaire and using a carbon monoxide meter, and Hasina consulting with a homeopath about a womb infection.
  • Karen's consultation with her GP also provides an illustration of mental health assessment.
  • Cathy's goal of giving up smoking and the other participants' efforts to improve their physical health or mental wellbeing provide a good link to the health promotion aspects of the unit.

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  1. 1. When people are stressed they feel 'under pressure'. Get students to make a list of reasons why the following people in the programme felt 'stressed':

    1. Jane Bath
    2. Hasina Miah
    3. Karen Moncholi
    4. Cathy Froud

  2. How did 'stress' affect each person's health and wellbeing? Students should think about the different ways that 'stress' affected each person – physically, socially and emotionally.
  3. People sometimes make lifestyle choices that have a negative effect on their health and wellbeing. Get the students to discuss the list of lifestyle choices in the table below with one or two of their classmates, identifying effects on health and suggesting reasons why people sometimes choose to do things that have a negative effect on their health.

    Health behaviour What effects can this have on a person's health and wellbeing? Why do people choose to do it?
    Unprotected sex
    Glue sniffing
    High fat diet
    Lack of exercise
    Working very long hours

  4. Cathy Froud would like to give up smoking cigarettes for health reasons. It is now known that smoking cigarettes damages a person's physical health. But how? What effects do cigarettes have on the human body? Ask students to find out how cigarette smoke affects the human body, and to use this information to produce a table or diagram of the human body that shows clearly how cigarette smoking can damage a person's physical health.
  5. Local health promotion services have a range of practical equipment (such as carbon monoxide monitors and smoking simulators) that they loan to schools and colleges to support learners taking health education and improvement courses. A practical lesson, which might also include a talk by and discussion with a health promotion officer, is a good way of engaging students in issues relating to the risks of smoking.

More lesson ideas

Click here for more lesson ideas

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Smoking cessation
Health promotion and improvement

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