title: Upper respiratory infection: stress, support, and the medical encounter.
abstract: BACKGROUND
  The purpose of this study was to examine the relationship between stress and social support to behaviors of patients and physicians during an episode of upper respiratory infection (URI).
  
  
  METHODS
  This was a cross-sectional study of 104 patients older than age 14 from three family practice sites; all of the patients had experienced a URI during an 8-week period. Stress scores were calculated for each patient's family using several standard instruments. Clinical and medical care utilization data were also reviewed. Data were analyzed to determine if there were relationships among stress and support scores and measures of patient and physician behaviors.
  
  
  RESULTS
  Measures of stress and support were related to the use of medical services, seeking additional medical care, extra phone calls, and longer perceived duration of illness. Physicians prescribed more medications, ordered more laboratory tests, and scheduled more return visits for patients with high stress or low support scores.
  
  
  CONCLUSIONS
  Stress and support are related to patient utilization of health services and perception of illness severity. Physicians respond to patients with high stress and low support by offering more medical services.
authors.affiliation: Department of Family Medicine, Case Western Reserve University School of Medicine.
authors.forename: S
authors.initials: S
authors.lastname: Frank
authors.forename: S
authors.initials: S
authors.lastname: Zyzanski
authors.forename: S
authors.initials: S
authors.lastname: Alemagno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D015203:Reproducibility of Results; D012141:Respiratory Tract Infections / Q000523:psychology* / Q000628:therapy; D012720:Severity of Illness Index; D012944:Social Support; D013315:Stress, Psychological