Effects of stress on the psychological symptoms and general health of rural primary care patients.

Abstract

This study was designed to enhance our understanding of how the stress of rural life affects the mental and physical health of rural Americans. Fifty patients of a primary care medical facility in rural Oklahoma participated by completing a battery of instruments comprised of a measure of stress, the Rural Experiences Questionnaire; a measure of mental health, the Brief Symptom Inventory; a measure of physical health, the Duke-UNC Health Profile; and a demographic form. As a group, events deemed most unique to rural living produced the greatest relative stress. Results found the overall sample and, in particular, the female subsample to have psychological distress scores that were significantly elevated compared to nonpatient norms. The most prominent mental health symptoms were those indicative of somatization and obsessive-compulsive disorders. In terms of physical health, symptoms often noted as the first and perhaps only indicators of general health status were found to be the most problematic. Physical symptoms of health problems were also found to be elevated compared to available norms. Regressions revealed that stress predicted neither psychological distress nor general health status. Only obsessive-compulsive symptoms predicted physical health, and this prediction held true only for group results and for those derived from the female subgroup. Factors related to small sample size, age and medical service status of participants, techniques of instrument administration and participant selection, and the length of the assessment battery were among those having the strongest impact on interpretation of the findings and implications for future research.