Behav Med
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This article offers a review of the research literature on complementary and alternative medicine (CAM) and presents the findings from an exploratory survey of the beliefs, attitudes, intentions, and behaviors of conventionally trained physicians toward CAM. Earlier studies of CAM focused primarily on patients' attitudes and behaviors rather than those of physicians. Physicians play a crucial role in moderating patients' beliefs about and use of CAM treatments. ⋯ The findings from a survey mailed to a random sample of California physicians revealed that physicians' use or recommendations of CAM in their practices are limited by concerns about medical professional norms, yet are positively associated with their use of computer technology for self-education and communication with peers. Sixty-one percent of physicians do not feel sufficiently knowledgeable about CAM safety or efficacy, and 81% would like to receive more education on CAM modalities. The findings raise important issues for medical education and patient care.
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A high level of anticipatory distress in women scheduled for surgery to detect or treat breast cancer emphasizes the importance of investigation of potential targets for distress-reducing interventions. Exercise and sleep have been examined in relation to distress in this population, focusing on the postsurgery period. In this study the authors examined the contributions of physical activity and sleep to anticipatory distress levels in 124 women prior to breast surgery. ⋯ Additionally, the authors hypothesized that the effects of physical activity on distress would be accounted for by (mediated) sleep quality. Results indicated that physical activity and sleep quality were negatively related to distress (p < .05); however, activity effects were not mediated by sleep. These findings have implications for designing interventions to reduce anticipatory breast surgery distress.
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Randomized Controlled Trial Clinical Trial
Talking effect and white coat phenomenon in hypertensive patients.
Both white coat effect (the tendency of blood pressure to rise during a medical visit) and talking effect were analyzed in 42 patients with essential hypertension. Blood pressure was measured during the clinic visit and over the subsequent 24-hour ambulatory period, with the physician performing 49 +/- 4 measurements for each patient. Three silent periods and two talking periods (stress and relaxation) were randomly allocated in a crossover design and studied, using analysis of variance. ⋯ Measures of systolic/diastolic blood pressure were higher during stressful talking than during relaxed talking. The talking and its emotional contents seemed to explain 70% of the white coat phenomenon. To minimize the white coat phenomenon in the clinic, physicians, nurses, and clinicians are advised to measure blood pressure during an initial period of silence.
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Randomized Controlled Trial Clinical Trial
Effect of chronic aerobic exercise and progressive relaxation on motor performance and affect following acute stress.
The effects of a 10-week aerobic exercise and progressive relaxation training program on somatic, emotional, and behavioral responses to acute stress, as determined by quality of motor performance and affect, were examined. The participants consisted of 60 unfit male university undergraduate students with no previous training in stress management who were randomly and evenly assigned to engage in one of four treatments over 10 weeks: (a) moderate aerobic exercise, (b) progressive relaxation, (c) a placebo group that engaged in group discussion but did experience acute stress, and (d) a nonintervention control group that did not experience stress while performing the motor task. Acute stress consisted of "losing" against a competitor of the opposite sex on the criterion motor task while receiving unpleasant information about their performance over 30 preintervention and 30 postintervention trials. ⋯ Progressive relaxation markedly reduced systolic blood pressure but did not favorably influence performance or affect in response to acute stress. Placebo and control groups were statistically similar on all measures. The findings indicated support for the use of chronic aerobic exercise as a strategy for improved coping with acute stress.
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The authors analyzed empirically the roles of impatience-irritability and ambition-energy components of the Type A behavior pattern (TABP) in the occupational stressor-strain relationship. They tested three models, using a sample of 659 industrial managers to determine whether the TABP components affected strain independently from perceived stressors (the direct effects model); or indirectly, by moderating effects of perceived stressors (the moderated effects model); or whether perceived stressors provoked TABP components, which influenced the number of strain symptoms (the mediated effects model). Multiple regression procedures showed, as expected, that the two TABP components acted quite differently in the stress process. ⋯ The ambition-energy component, on the other hand, was activated by an abundance of development possibilities experienced at work. This, in turn, partly explained the decrease in perceived levels of psychological and physiological symptoms. The results relating to the ambition-energy component supported the mediated effects model and demonstrated a positive effect on subjective health perceptions.