Stress perceptions in community clinic: a pilot survey of patients and physicians

Abstract

This pilot survey of 103 patients and 17 physicians in an urban family medicine clinic gathered information pertinent to the design of a feasible stress intervention for patients bothered by stress, but who did not have a psychiatric diagnosis. Among patients, 45% reported being excessively bothered by stress in the preceding month, with the chief stressors being job (70% reporting), financial worries (58%) and family concerns (50%). Patients reported a variety of problems perceived to be related to stress, such as headaches, insomnia, eating control, and gastrointestinal symptoms. Although about 80% reported using positive coping methods (e.g., talking, exercising, and relaxing), 42% reported using alcohol, and 10% used non-prescribed drugs to cope with stress. Only 37% of patients had sought help for stress from their physician. The wide variety of responses from the physicians reflected a lack of standardized approaches, inadequate training, and a reluctance to engage patients about their stress problems. About 42% of the physicians reported routinely asking patients about stress, and 77% felt that dealing with patient stress was a significant burden on their practice of medicine. Overall, the findings indicate that opportunities are being missed for helping patients to deal with stress constructively, and that a standardized stress self-management program might be one solution.

Decentralized Health Service Delivery System in Bangladesh: Evaluating Community Clinics in Promoting Healthcare for the Rural Poor

“…Mental disorders, disability, and stress management appear on the prospectus as treatments available at the community clinics; however, none of those diseases are managed here because of the shortage of workforce and time. The findings of my study are consistent with the earlier findings of (Goodrick et al, 2005). The service users of the CCs in Bangladesh are not satisfied with the quality and quantity of health care services.…”

“…Moreover, cultural diversification and local class relations negatively affect healthcare provision strategies and draw public criticism due to corruption, low pay for the staff, and poor working conditions in the community clinics themselves (Foster, 2005). Although the mental healthcare service provided by the community clinics is typically effective, the problem of stress is overlooked in community clinics due to a shortage of time, lack of skilled workforce, and the reluctance of the patients (Goodrick, Kneuper, & Steinbauer, 2005).…”

Physiological and Neurobiological Aspects of Stress and Their Relevance for Residency Training

“…These recommended changes are undeniably important to curtail such events, however, they fail to recognize the mental and physical health-related effects of such conditions on its trainees. While forty-five percent of outpatients visiting primary care physicians report being excessively bothered by stress in the last month [13], we physicians seem to do little to practice what we preach to our patients. By comparison, residents report a greater number of health complaints than the average worker [14].…”