Cognitive and Behavioral Strategies of Stress Management Among the Chinese Urban Residents
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Slide 1 :
Cognitive and Behavioral Strategies of Stress Management Among the Chinese Urban Residents Tingzhong Yang,M.D (Ytingzhongyang@yahoo.com) Department of Social Medicine,Zhejiang University,China
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Objective To identify effective stress management strategies among the Chinese
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Methods The study design: In a cross-sectional design study, survey data were collected from the four Chinese urban cities: Hangzhou, Guangzhou, Chongqing and Taiyuan, located in the east, west, south, and north areas in China. A multistage sampling was used for drawing the sample, the four cities were first pre-selected, followed by the selection of residential districts within each city, identification of blocks of apartment buildings within each district, and sampling households within each block of buildings.
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Procedures A face-to-face interview was scheduled. All interviews were conducted in a private setting by trained research interviewers. The same interview protocol was used across four cities to ensure identical interview and data collection procedures.
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Measures The Chinese Perceived Stress Scales (CPSS) measured stress (Cohen S, Kamarck T, Mermelstein(1983) ;Yang T,2003). Stress management strategies included the cognitive and behavioral ones, the former were further divided into positive ones: ( encouraging facing problem optimistically, thinking positively), neutral ones: (take advantage of an opportunity(“Suiyuan”), spiritual beliefs) and negative ones: ( resigned thinking, getting victory in spirit) and the latter were divided into looking for support: ( organizational, medical, psychological or spiritual support) releasing and distracting: (including solving problems, confiding, working or studying, watching TV or listening to music, etc) and relaxing and dispersing: (including doing physical athletics, common relaxing, relaxing in places where you have to pay, commonly doing amusement, doing amusements in places where you have to pay, doing outdoor activities, enjoying arts, smoking, and drinking, etc). The frequency of their usage and their perceived effectiveness were assessed.
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Data analysis Multivariable analyses were conducted to assess the association between various stress management strategies and stress.
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Results 3760 Subjects was included in this study. The mean scores on the CPSS for the total samples was 24.22, standard deviation was 5.81. The prevalence of HRS (Health Risk-Stress )was 44.54%(95%CI:42.90%-46.12%. The rate decreased with age and increasing educational level, the highest rate was 59.29% in the less than 21years group and an x2 test showed that the rates were significantly higher for those in the high school education and lower category as compared to those in the junior college education category.
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HRS associated with occupation; the rates were very high in students, unemployed people and those who have not been employed. HRS was also significantly related to marriage status,the household’s economic level and social contact activities. Among the cognitive strategies, all the positive strategies and “Suiyuan”) were associated with lower HRS, the rest of them had no effect. Among the behavioral strategies, a number of them were associated with lower HRS. (See Table1).
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Table 2: Significant Elements of Management Strategies for Relieving Stress _____________________________________ Group OR 95% C.I _____________________________________ Cognitive strategies: Facing up to solve the problem 0.78** 0.71-0.86 Look at the problem optimistically 0.86* 0.78-0.95 Thinking positively 0.78** 0.71-0.86 Taking advantage of opportunities(“Suiyuan”) 0.78** 0.71-0.85 Behavioral strategies: Solving problems 0.63** 0.58-0.69 Confiding 0.86* 0.79-0.94 Working or studying 0.79** 0.71-0.88 Watching TV or listening to music 0.78** 0.71-0.85 Doing physical athletics 0.77** 0.69-0.87 Common relaxing 0.79** 0.72-0.87 Relaxing in paying facilities * Doing common amusements 0.83** 0.74-0.87 Doing amusement doing in paying facilities 0.97* 0.95-0.94 Doing activities outdoors 0.86* 0.78-0.94 _______________________________________________________________________________________
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Conclusion The effective stress management strategies identified in this study may be used to develop a stress management program.
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