Wayne State University, Department of Family Medicine and Public Health Sciences, Detroit, MI 48201, USA.
Fam Pract. 2011 Apr;28(2):156-62. doi: 10.1093/fampra/cmq091. Epub 2010 Nov 10.
Stress and stress-related disorders are common in primary care. The stress-related needs for patients are often unmet partially due to the time and resource constraints inherent to many primary care settings. We examined the relative significance of key demographic and lifestyle factors related to stress among primary care patients. This information is unknown and needed to strategize these increasingly limited resources.
We distributed surveys to 100 consecutive adult patients in each of four family medicine centres in metropolitan Detroit between 2006 and 2007. Hierarchical multivariable regression analyses were used to assess the relative significance of the demographic and lifestyle factors related to stress.
Of the 400 distributed surveys, 315 (78.7%) answered a minimum of 70% of the questions and were included in the analysis. The lifestyle factors [exercise, body mass index (BMI), sleep, social support, recovery or self-care skills (such as the ability to rest, relax and recuperate)] explained 39% (P < 0.001) of the variance in stress compared to 10% (P < 0.001) by the demographic factors (age, gender, race, employment, education and marital status). Stress was inversely related to sleep (P < 0.001), recovery (P < 0.001) and social support (P = 0.02) and positively to education (P < 0.001).
The modifiable lifestyle factors explained significantly more of perceived stress among primary care patients than the demographic factors. Sleep and recovery had the biggest inverse relationship with stress, which suggests that they should be the primary target for assessment and intervention in patients who report stress or stress-related disorders.
压力和与压力相关的障碍在初级保健中很常见。由于许多初级保健环境固有的时间和资源限制，患者的与压力相关的需求往往得不到满足。我们研究了与初级保健患者压力相关的关键人口统计学和生活方式因素的相对重要性。这些信息对于制定这些日益有限的资源的策略是未知的和必要的。
我们在 2006 年至 2007 年间在底特律都会区的四个家庭医学中心向每 100 名连续成年患者分发了调查。使用分层多变量回归分析来评估与压力相关的人口统计学和生活方式因素的相对重要性。
在分发的 400 份调查中，有 315 份（78.7%）回答了至少 70%的问题，并被纳入分析。生活方式因素[运动、体重指数（BMI）、睡眠、社会支持、恢复或自我保健技能（如休息、放松和恢复的能力）]解释了压力的 39%（P < 0.001），而人口统计学因素（年龄、性别、种族、就业、教育和婚姻状况）解释了 10%（P < 0.001）。压力与睡眠（P < 0.001）、恢复（P < 0.001）和社会支持（P = 0.02）呈负相关，与教育呈正相关（P < 0.001）。
可改变的生活方式因素比人口统计学因素更能解释初级保健患者感知到的压力。睡眠和恢复与压力呈最大的反比关系，这表明它们应该是报告压力或与压力相关障碍的患者评估和干预的主要目标。
