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A Steptoe

Publications and source records attributed to A Steptoe.

At least 55 records · Page 3Linked to original sources
PubMed2000

Gender, family structure and cardiovascular activity during the working day and evening.

This study applied psychophysiological methods to the investigation of social roles and well-being, using cardiovascular function over a working day and evening as an index of physiological activation. One hundred and sixty-two full-time school teachers (102 women and 60 men) were assessed using automated ambulatory blood pressure monitoring apparatus, with readings every 20 min through the working day (9.00 am-5.40 pm), and every 30 min in the evening (6.00-10.30 pm). The influence of gender, marital status and parenthood (defined as having at least one child living at home) on blood pressure during the working day and on day-evening differences was examined. There were no differences in blood pressure and heart rate across the working day in relation to marital roles or family structure. However, the decrease in blood pressure between working day and evening was greatest in parents, intermediate in married non-parents, and smallest in single participants without children. Differences in systolic pressure adjusted for age and body mass index averaged -4.46, -1.76 and +0.22 mmHg in the three groups, respectively. A similar pattern was observed for diastolic pressure but not heart rate. We also found that the day-evening fall in systolic pressure was moderated by social support, with the greatest change (mean adjusted difference -6.76 mmHg) in parents who reported high levels of social support. These blood pressure responses did not differ between men and women, and there was no indication of multiple role strain for full-time working mothers. The results were independent of concomitant physical activity, location during measurement, or reported job strain. We argue that findings are consistent with an enhancement model of multiple social roles, and with lower allostatic load on individuals who are working, married and parents. Psychophysiological studies of daily life can complement epidemiological and sociological investigations of social roles and health.

Adult↗
PubMed2000

Coping with new treatments for cancer: a feasibility study of daily diary measures.

This article describes a study of the feasibility and value of using daily diary measures to assess coping, adjustment and symptoms in patients participating in phase I clinical trials of new anticancer drugs. Ten patients (six women, four men) with advanced metastatic cancer were studied during a four-week phase I trial. Measures of psychological well-being, mental adjustment and symptoms were determined prior to treatment, and participants also completed daily ratings of psychological coping responses, mood and symptoms. Completion rates for diaries were high, and the amount of missing data averaged only 3.2% per patient. Overall, the most frequently endorsed coping responses were 'acceptance' and 'positive reinterpretation and growth'. There were systematic variations in coping by seeking social support across the trial, with more frequent use during phases of hospitalisation. Idiosyncratic fluctuations in patterns of coping were also observed. Positive daily mood was greater among patients who coped by ignoring their condition, and was also correlated with fighting spirit. Daily symptoms were inversely associated with positive mood and with fighting spirit. It is concluded that the daily diary approach is feasible, and may help to increase understanding of the experience of patients taking part in experimental anticancer drug trials.

Adaptation, Psychological↗
PubMed2000

Task demands and the pressures of everyday life: associations between cardiovascular reactivity and work blood pressure and heart rate.

Associations between cardiovascular stress reactivity and blood pressure and heart rate recorded in everyday life were hypothesized to depend on the stressfulness of the ambulatory monitoring period relative to standardized tasks and on activity levels at the time of measurement. One hundred two female and 60 male school teachers carried out high- and low-demand tasks under standardized conditions and ambulatory monitoring during the working day. Stress ratings during the day were close to those recorded during the low-demand task. Reactions to the low-demand task were significant predictors of ambulatory blood pressure and heart rate independent of baseline, age, gender, and body mass. Associations were more consistent for ambulatory recordings taken when participants were seated than when they were standing and when the ambulatory monitoring day was considered to be as stressful as usual or more stressful than usual, and not less stressful than usual. Laboratory-field associations of cardiovascular activity depend in part on the congruence of stressfulness and physical activity level in the 2 situations.

Activities of Daily Living↗
PubMed2000

Sociodemographic and psychological predictors of changes in dietary fat consumption in adults with high blood cholesterol following counseling in primary care.

The associations between sociodemographic variables, psychological factors, and changes in dietary fat consumption over 4 months were assessed in a randomized controlled trial of behavioral counseling versus standard advice. Patients were 141 men and 150 women, with an average age of 52.1 years and total cholesterol level of 7.27 mmol/l (278 mg/dl). Smokers, younger patients, and those with greater body mass index had higher fat intake at baseline. Behavioral counseling led to greater reductions in fat intake than did standard advice. Self-efficacy and ratings of benefits of low-fat diets were related to fat consumption at baseline, and changes in these measures were correlated with changes in fat intake. Family support, baseline anticipated regret, and (for the behavioral counseling group only) baseline behavioral intentions predicted reductions in fat intake. The results indicated that psychosocial variables associated cross-sectionally with fat consumption do not necessarily predict change and that factors involved in the process of change and the prediction of change need to be differentiated.

Adult↗
PubMed2000

Migration, culture conflict and psychological well-being among Turkish-British married couples.

This study assessed culture conflict within marriage and the psychological well-being of Turkish men and women and their British partners. The hypothesis was tested that among migrants who are well established economically and socially within a new country, the perception of cultural conflict within marriage might override acculturation as a determinant of psychological well-being. Interviews were carried out with 33 relatively affluent Turkish men (n = 23) and women (n = 10) who had been born in Turkey and had been resident in the UK for an average of 12.2 +/- 6.2 years, and with their British partners. A marital cultural difficulties index was constructed from ratings of problems stemming from cultural differences in 22 aspects of daily living. Depression, assessed with the Beck Depression Inventory, was correlated with marital cultural difficulties in both Turkish and British respondents, independently of sex, age and duration of marriage. Depression scores were higher among respondents who reported greater cultural conflict. No associations of psychological well-being with acculturation (indexed by maintenance of traditional Turkish activities), age, years of marriage, or level of contact with Turkey were observed. The results highlight the implications of residual cultural conflict within mixed marriages for psychological well-being.

Acculturation↗
PubMed2000

Persistent high job demands and reactivity to mental stress predict future ambulatory blood pressure.

OBJECTIVE: To test the hypothesis that work stress (persistent high job demands over 1 year) in combination with high reactivity to mental stress predict ambulatory blood pressure. DESIGN: Assessment of cardiovascular responses to standardized behavioural tasks, job demands, and ambulatory blood pressure over a working day and evening after 12 months. PARTICIPANTS: We studied 81 school teachers (26 men, 55 women), 36 of whom experienced persistent high job demands over 1 year, while 45 reported lower job demands. METHODS: Participants were divided on the basis of high and low job demands, and high and low systolic pressure reactions to an uncontrollable stress task. Blood pressure and concurrent physical activity were monitored using ambulatory apparatus from 0900 to 2230 h on a working day. RESULTS: Cardiovascular stress reactivity was associated with waist/hip ratio. Systolic and diastolic pressure during the working day were greater in high job demand participants who were stress reactive than in other groups, after adjustment for age, baseline blood pressure, body mass index and negative affectivity. The difference was not accounted for by variations in physical activity. CONCLUSIONS: Cardiovascular stress reactivity and sustained psychosocial stress may act in concert to increase cardiovascular risk in susceptible individuals.

Adult↗
PubMed2000

Health related quality of life and psychological wellbeing in patients with dilated cardiomyopathy.

OBJECTIVE: To assess the health related quality of life and psychological wellbeing of patients with dilated cardiomyopathy, and relate these to clinical variables and psychological adjustment. DESIGN: Postal questionnaire survey of 99 adult patients with dilated cardiomyopathy, selected at random from a larger database (60.6% response rate). Assessments included the short form 36 (SF-36) health survey, the hospital anxiety and depression scales, the sleep problems index, and a measure of psychological adjustment to cardiomyopathy. RESULTS: Patients with dilated cardiomyopathy reported significant impairments in physical functioning, role limitations owing to physical and emotional problems, social functioning, mental health, perceptions of general health, sleep, and vitality. Anxiety and depression levels were higher than in population samples. Impairment in several domains of quality of life was associated with low shortening fraction, high left ventricular end diastolic diameter, and the presence of heart failure and mitral regurgitation. Patients with familial cardiomyopathy had less impairment in quality of life than those with non-familial disease. Psychological adjustment scores were associated with several aspects of quality of life and emotional wellbeing. In multivariate analysis, demographic and clinical variables accounted for 0.1-40.7% of the variance in different domains of quality of life, and psychological adjustment scores accounted for an additional 0.5-22.4% of variance. CONCLUSIONS: Patients with dilated cardiomyopathy experience pronounced restrictions in quality of life and psychological wellbeing. These limitations are only partly accounted for by symptoms and the severity of underlying disease. Patients may benefit from efforts to improve psychological adjustment to the condition.

Adolescent↗
PubMed2000

Psychosocial factors in the development of hypertension.

The role of psychosocial factors in human hypertension is being investigated with three research strategies: epidemiological studies of blood pressure, psychological characteristics and life experience in population samples, naturalistic studies of the covariation between blood pressure, psychological state and everyday life events, and experimental studies of cardiovascular and neuroendocrine responses to behavioural stimuli. This article summarizes recent research on hypertension and psychological traits, job characteristics and social support, emphasizing the convergent knowledge deriving from complementary research strategies. The roles of stress-induced cardiovascular responses and prejudicial life styles in mediating influences on risk of hypertension are discussed.

Adult↗
PubMed1999

Psychosocial and clinical factors predicting resumption of work following acute myocardial infarction in Japanese men.

We investigated psychosocial and clinical factors related to work resumption, delay in returning to work and level of work activity after an acute myocardial infarction in Japanese male patients. A total of 111 married male patients experiencing a first acute myocardial infarction, aged less than 66 years and in full-time employment participated. Interviews and questionnaires were administered during hospitalization to assess potential predictors of work-related outcomes, with follow-up (81.6%) after an average of 8 months. We found that failure to return to work was predicated independently by older age (P=0.019), an introverted personality (P=0.011) and the presence of depressive symptoms during hospitalization (P=0.031). Delay in returning to work was predicted by greater concerns about health (P=0.011), low social support (P=0.021), and a failure to recognise a link between stress, coping style and illness (P=0.001). Resuming work at a lower activity level than before infarction was associated with older age (P=0.008), higher health concerns (P=0.012), and patients' predictions of their lower work activity (P=0.001). Clinical indices of infarction size and disease severity did not predict work-related outcomes. We conclude that psychosocial factors are associated with work resumption in Japanese men characterised by a job-centred lifestyle, with different factors being important for different work outcomes. The psychosocial factors found to be important are similar to those identified in Western societies.

Age Factors↗
PubMed1999

Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial.

OBJECTIVE: To measure the effect of behaviourally oriented counselling in general practice on healthy behaviour and biological risk factors in patients at increased risk of coronary heart disease. DESIGN: Cluster randomised controlled trial. PARTICIPANTS: 883 men and women selected for the presence of one or more modifiable risk factors: regular cigarette smoking, high serum cholesterol concentration (6.5-9.0 mmol/l), and high body mass index (25-35) combined with low physical activity. INTERVENTION: Brief behavioural counselling, on the basis of the stage of change model, carried out by practice nurses to reduce smoking and dietary fat intake and to increase regular physical activity. MAIN OUTCOME MEASURES: Questionnaire measures of diet, exercise, and smoking habits, and blood pressure, serum total cholesterol concentration, weight, body mass index, and smoking cessation (with biochemical validation) at 4 and 12 months. RESULTS: Favourable differences were recorded in the intervention group for dietary fat intake, regular exercise, and cigarettes smoked per day at 4 and 12 months. Systolic blood pressure was reduced to a greater extent in the intervention group at 4 but not at 12 months. No differences were found between groups in changes in total serum cholesterol concentration, weight, body mass index, diastolic pressure, or smoking cessation. CONCLUSIONS: Brief behavioural counselling by practice nurses led to improvements in healthy behaviour. More extended counselling to help patients sustain and build on behaviour changes may be required before differences in biological risk factors emerge.

Adult↗
PubMed1999

Mood and drinking: a naturalistic diary study of alcohol, coffee and tea.

Understanding the pattern of associations between mood and consumption of alcohol, coffee and tea may provide information about the factors governing beverage drinking. The associations between mood and the consumption of alcohol, coffee and tea during everyday life were assessed. A naturalistic study was carried out with 18 male and 31 female volunteers from two working groups (psychiatric nursing and school teaching). Participants completed daily records of drink consumption, together with ratings of anxious and positive moods for 8 weeks. Potential moderators of associations were self-reported drinking to cope, high perceived job demands and social support at work. Day-by-day associations were analysed using Spearman correlations. There were substantial individual-differences in associations between mood and daily alcohol, coffee and tea consumption. Overall, alcohol intake was associated with high positive and low anxious mood. This effect was not present among participants with high drinking to cope ratings. Coffee and tea drinking were not consistently related to mood across the entire sample. However, job demands influenced the association between coffee consumption and anxious mood in men, and those who experienced high job demands drank more coffee on days on which they felt anxious. In contrast, women but not men who enjoyed high social support at work felt more relaxed on days on which they drank more tea. These results indicate that people vary widely in the extent to which mood is related to the drinking of alcohol, coffee and tea. The strength of associations is influenced by gender, motivational factors, and by stress and coping resources.

Adaptation, Psychological↗
PubMed1999

Job strain and psychiatric morbidity.

BACKGROUND: This study examined the association between job strain and psychiatric morbidity using interview-based assessments of mental health. We assessed the prevalence of neurotic disorder in high job strain (high demand, low control) and low job strain (low demand, high control) school teachers, and compared these rates with data from individuals with similar educational qualifications from the National Psychiatric Morbidity Survey of Great Britain. METHODS: One hundred and sixty primary and secondary school teachers were selected from a larger survey on the basis of high or low job strain, and were assessed for psychiatric morbidity using the Revised Clinical Interview Schedule (CIS-R). The prevalence of neurotic symptoms and a total psychiatric morbidity score were calculated. RESULTS: After adjusting for age, gender and occupational grade, the prevalence of psychiatric morbidity was greater in high job strain than low job strain individuals. The prevalence of severe anxiety, worry and fatigue symptoms was significantly greater in the high job strain teachers. In comparison with the British psychiatric morbidity survey, the prevalence of neurotic disorders was greater in the high job strain, but not in low job strain teachers. Individuals in the low job strain group were more likely to report severe anxiety, irritability and fatigue in the week prior to interview, than comparably educated individuals in the national survey. CONCLUSION: Job strain is associated with psychiatric morbidity. The high levels of neurotic psychopathology among teachers is consistent with previous research that has found teaching to be a highly stressful occupation.

Adult↗
PubMed1999

The influence of abdominal obesity and chronic work stress on ambulatory blood pressure in men and women.

OBJECTIVE: To assess the influence of abdominal obesity and work stress (operationalised as low control over work) on ambulatory blood pressure on a working day and evening. PARTICIPANTS AND METHODS: 156 school teachers (58 men and 98 women) carried out ambulatory blood pressure and heart rate monitoring on a work day and evening. Cardiovascular activity was also measured under baseline conditions on another occasion, when body weight, height, waist and hip circumference were assessed. Perceived control over work was assessed by questionnaire, along with mental health, anger expression and social support. 126 participants repeated the protocol after 12 months. Waist/hip ratio was used as the index of abdominal obesity. RESULTS: Baseline blood pressure was positively associated with waist/hip ratio in men, but ambulatory blood pressure and heart rate were not independently related to waist/hip ratio or job control. However, blood pressure and heart rate recorded during the working day and evening were elevated in men with high waist/hip ratio who experienced low job control, independently of age and body weight. Effects for diastolic blood pressure and heart rate were replicated after 12 months. Body mass index was not related to blood pressure or heart rate during the day or evening after adjustment for age and waist circumference. Low job control was associated with poor psychological well-being, negative mood and lack of social support. CONCLUSIONS: The results are consistent with the hypothesis that abdominal obesity in men is characterised by a tendency towards heightened stress-induced physiological activation, but that this tendency will only be manifest in the presence of appropriate environmental challenges such as chronic work stress.

Adult↗
PubMed1999

Attitudes to cardiovascular health promotion among GPs and practice nurses.

BACKGROUND: Cardiovascular health promotion is an important element of national health strategy, but doubts have been raised about current methods, and attitudes among general practice staff are ambivalent. OBJECTIVES: We aimed to assess attitudes to cardiovascular health promotion, opinions about efficacy and perceptions of skills in lifestyle counselling in GPs and nurses from the same practices. METHOD: A questionnaire survey of 107 GPs and 58 practice nurses from 19 group practices (100% response rate). RESULTS: Practice nurses were seen to have the main responsibility for cardiovascular health promotion. Although attitudes to health promotion were generally positive, lack of training in lifestyle counselling was perceived to be a problem. Few responders believed that they were very influential in helping people change their lifestyles. Beliefs about the effectiveness of lifestyle counselling were mixed, with cigarette smoking, physical inactivity and obesity being seen as difficult to change. Beliefs in the effectiveness of lifestyle counselling were associated with positive attitudes towards health promotion and greater confidence in training. No association between personal health behaviour and attitudes towards health promotion were observed. CONCLUSIONS: It is recognized that health promotion involves more than the provision of simple information and advice, but GPs and practice nurses lack confidence in lifestyle counselling skills. The attitudes of health professionals are crucial to the implementation of prevention strategies and require regular review.

Attitude of Health Personnel↗
PubMed1999

Job strain, blood pressure and response to uncontrollable stress.

OBJECTIVE: The association between cardiovascular disease risk and job strain (high-demand, low-control work) may be mediated by heightened physiological stress responsivity. We hypothesized that high levels of job strain lead to increased cardiovascular responses to uncontrollable but not controllable stressors. Associations between job strain and blood pressure reductions after the working day (unwinding) were also assessed. DESIGN: Assessment of cardiovascular responses to standardized behavioral tasks, and ambulatory monitoring of blood pressure and heart rate during a working day and evening. PARTICIPANTS: We studied 162 school teachers (60 men, 102 women) selected from a larger survey as experiencing high or low job strain. METHODS: Blood pressure, heart rate and electrodermal responses to an externally paced (uncontrollable) task and a self-paced (controllable) task were assessed. Blood pressure was monitored using ambulatory apparatus from 0900 to 2230 h on a working day. RESULTS: The groups of subjects with high and low job strain did not differ in demographic factors, body mass or resting cardiovascular activity. Blood pressure reactions to the uncontrollable task were greater in high than low job-strain groups, but responses to the controllable task were not significantly different between groups. Systolic and diastolic blood pressure did not differ between groups over the working day, but decreased to a greater extent in the evening in subjects with low job strain. CONCLUSIONS: Job strain is associated with a heightened blood pressure response to uncontrollable but not controllable tasks. The failure of subjects with high job strain to show reduced blood pressure in the evening may be a manifestation of chronic allostatic load.

Adult↗
PubMed1999

An investigation of coping strategies associated with job stress in teachers.

BACKGROUND: School teaching is regarded as a stressful occupation, but the perception of the job as stressful may be influenced by coping responses and social support. AIMS: To assess the associations between teacher stress, psychological coping responses and social support, taking into account the plaintive set engendered by negative affectivity. METHOD: Questionnaire survey of 780 primary and secondary school teachers (53.5% response rate). RESULTS: In stepwise multiple regression, social support at work and the coping responses behavioural disengagement and suppression of competing activities predicted job stress independently of age, gender, class size, occupational grade and negative affectivity. High job stress was associated with low social support at work and greater use of coping by disengagement and suppression of competing activities. CONCLUSIONS: It is suggested that behavioural disengagement and suppression of competing activities are maladaptive responses in a teaching environment and may actually contribute to job stress. Coping and social support not only moderate the impact of stressors on well-being but influence the appraisal of environmental demands as stressful.

Adaptation, Psychological↗
PubMed1998

A longitudinal study of work load and variations in psychological well-being, cortisol, smoking, and alcohol consumption.

The effects of variations in work load (indexed by paid work hours) on psychological well-being, cortisol, smoking, and alcohol consumption were examined in a sample of 71 workers (44 women, 27 men) in the retail industry. Measures were obtained on four occasions over a six-month period, and assessments were ranked individually according to hours of work over the past seven days. Job strain (demand/control) and job social support were evaluated as potential moderators of responses. Paid work hours ranged from a mean of 32.6 to 48.0 hours per week, and ratings of work-home conflict and perceived stress varied across assessments. Salivary cortisol was inversely associated with job strain and did not vary across sessions. Female but not male smokers consumed more cigarettes during periods of long work hours, and self-reported smoking and cotinine concentrations were greater among smokers with higher nicotine dependency scores. Men but not women with poor social supports consumed more alcohol as work hours lengthened. These data indicate that health behaviors are affected only to a limited extent by variations in work load. Results are discussed in the context of adaptation to work and the pathways linking stressful experience with health risk.

Adult↗