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Hans Selye's theoretical propositions and empirical findings provided many of the principles currently used in stress research, and are often cited as scientific bases for nursing theory, research and practice His General Adaptation Syndrome (GAS) has been a useful model for realizing the physiologic processes involved in the relationship between stress and acute illness, and the evolution of diseases such as cancer The GAS can also serve as a useful paradigm for understanding the symptomatic expression and progression of a chronic physical illness, however This paper analyses the physiologic processes of stress from this perspective, proposing that individuals with a chronic illness are at risk for experiencing acute symptomatic distress and/or exacerbations of their illness in response to stress Specific examples involving chronic disease are cited and several additional insights gained from this approach are proposed