The Society for Social Work and Research

2014 Annual Conference

January 15-19, 2014 I Grand Hyatt San Antonio I San Antonio, TX

Level of Perceived Stress Among Patients in Primary Care Settings

Saturday, January 18, 2014: 8:30 AM
HBG Convention Center, Room 003A River Level (San Antonio, TX)
* noted as presenting author
Pat Conway, PhD, Senior Research Scientist, Essentia Institute of Rural Health, Duluth, MN
Background and Purpose: Perceived stress, one behavioral health issue, has been found to correlate with poorer health outcomes[i]. The integration of behavioral health into primary care is recommended as an effective and efficient way to improve health outcomes[ii]. This study examines the level of perceived stress experienced by primary care patients and factors that influence that stress. The results provide guidance for social workers and other primary care staff regarding early identification, treatment, and referrals.

The research questions are: 1) What is the level of stress of primary care patients in a large health system in the Upper Midwest? 2) Does level of stress vary by gender, age, place, and job satisfaction?

Methods. This cross-sectional study surveyed adult primary care patients aged 25 to 64. A stratified random sample of 1134 patients was selected, with the goal of obtaining a final sample of 1000 subjects, equally distributed between rural and urban residents. Males were oversampled by 10%, since they are less likely to respond to surveys. Thirty-eight percent (522) responded. Participants were slightly more likely to be rural (51.3%), female (56.3%), and married (75%), with an average age of 46. Measures were drawn from the PhenX Toolkit[iii] (The Perceived Stress Scale, Work Productivity and Activity Impairment instrument, individual items commonly used to measure life and job satisfaction, income, gender, and actual age). Differences by gender and by rural and urban residence were calculated using t-tests. The relationship between age and job satisfaction with perceived stress was determined through correlation. Multiple stepwise regression were computed to examine effects of age and job satisfaction on perceived stress.

Results. The mean level of stress was 25.13 (SD=7.81, Range=10-50). Stress varied by gender and age. Women reported higher levels of stress (t=.048, p=.000; women’s mean=26.88, men’s mean=23.42). Age was negatively correlated with stress (R=-.137, p=.02); people who were older reported lower stress. Perceived stress did not vary by place. It is possible that perceived stress is influenced by job satisfaction, therefore, the job satisfaction of the 406 subjects who were currently working and its correlation with perceived stress was calculated. Age and job satisfaction predicted 11.6% of the variance in perceived stress. Job satisfaction and age did not vary by gender or region.

Implications. Patients in primary care settings in the Upper Midwest reported relatively high rates of stress. The results regarding gender and age are similar to those in other studies. The rates did not vary by whether the patient lived in a rural or urban setting. Screening for stress in primary care settings, regardless of the place in which they are located, would identify patients who might benefit from a more thorough assessment and treatment, in order to improve their health outcomes. Social workers and other primary health care professionals might explore external factors such as job satisfaction when conducting the assessment, to better serve patients.

[i] Cohen, S., & Janicki-Deverts, D. (2012). Journal of Applied Social Psychology, 42(6), 1320-1334.