Stress management in primary care: physicians' beliefs and patterns of practice.

We examined attitudes and practices related to stress management in a random sample of Texas primary care physicians. Two fifths of the physicians indicated that avoiding undue stress was very important, and more than one third reported that they gathered information about stress on a routine basis. Over two thirds of the physicians said that they had counseled their patients regarding stress and 13 percent had referred patients with high stress to outside programs. The physicians' confidence that they had the skills to help patients with high stress, their belief in the benefits of avoiding undue stress, and their estimate of patient follow-through on recommendations were positively associated with history-taking and counseling regarding stress. Recommendations for medical education include incorporating information about stress and health into medical school curriculums, building skills in stress management, and increasing feedback from patients who have coped successfully with high stress.