title: Health care providers' training, perceptions, and practices regarding stress and health outcomes.
abstract: In order to assess health care providers' training, perceptions, and practices regarding stress and health outcomes, a survey was administered to primary care providers in the outpatient medical clinics of a southeastern urban hospital serving a predominantly African-American indigent population. One-hundred-fifty-one of 210 providers (72%) responded. Forty-two percent of respondents reported receiving no instruction regarding stress and health outcomes during their medical/professional education. While 90% believed stress management was "very" or "somewhat" effective in improving health outcomes, 45% "rarely" or "never" discussed stress management with their patients. Respondents were twice as likely to believe that counseling patients about smoking, nutrition, or exercise was more important than counseling them about stress. Seventy-six percent lacked confidence in their ability to counsel patients about stress. The majority of respondents (57%) "rarely" or "never" practiced stress reduction techniques themselves. Belief in the importance of stress counseling, its effectiveness in improving health, and confidence in one's ability to teach relaxation techniques were all related to the probability that providers would counsel patients regarding stress. There is a need for curriculum reform that emphasizes new knowledge about stress and disease, new skills in stress reduction, and more positive beliefs about mind/body medicine and its integration into the existing health care structure.
authors.affiliation: Grady Health System, Office of Health Promotion, 80 Jesse Hill Jr. Drive SE, P.O. Box 26101, Atlanta, GA 30303, USA. havey@emory.edu
authors.forename: Holly
authors.initials: H
authors.lastname: Avey
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Matheny
authors.forename: Anna
authors.initials: A
authors.lastname: Robbins
authors.forename: Terry A
authors.initials: TA
authors.lastname: Jacobson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education* / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011361:Professional Competence / Q000706:statistics & numerical data; D011603:Psychophysiology / Q000193:education; D012064:Relaxation Therapy / Q000193:education; D020377:Self Efficacy; D015144:Southeastern United States; D013315:Stress, Psychological / Q000628:therapy*