The questionnaire was designed to assess patients' beliefs about stress in terms of which symptoms they considered to be indicative of stress and their help-seeking behaviour. To this end a questionnaire was devised based upon two pilot studies:
The final questionnaire consisted of 25 symptoms and patients were asked to rate each of these for whether they were indicative of stress (beliefs about stress) and whether they would seek help for them (help-seeking behaviour). Although each symptom was examined individually, for ease of analysis symptoms groupings were also created. The symptoms were grouped into four conceptual areas and the reliability of the grouped symptoms was assessed using Cronbach's α:
negative mood symptoms (for example, feeling depressed, feeling anxious, feeling angry, feeling sad), α = 0.8,
specific somatic symptoms (for example, high blood pressure, having a headache, weight loss, and chest pain), α = 0.71,
non-specific somatic symptoms (for example, feeling panic, tired all the time, breathless, dizzy), α = 0.81,
social symptoms (for example, inability to have fun, feeling lonely, feeling that nobody cares), α = 0.76.
How this fits in
Evidence suggests that patients are increasingly coming to their GP with symptoms of stress. This study suggests that patients associate a range of symptoms with the term stress including sleeping problems, feeling depressed, feeling panic, feeling anxious and ‘high blood pressure’. This model of stress was consistent across ethnic groups. Ethnic group differences were found for the association between the model of stress and help-seeking behaviour. While white British patients consistently reported that the more a symptom was seen as indicative of stress, the more likely they would be to visit the doctor for that symptom, this association was not found for either black Caribbean or African patients. The belief that stress-related symptoms are a legitimate problem for the GP is not universal and varies according to ethnic group.