Comparing disparities in the health-promoting lifestyles of Taiwanese workers in various occupations

Association between lifestyle behaviors and health-related quality of life among primary health care physicians in China: A cross-sectional study

Background

Primary health care (PHC) serves as the gatekeeper of health system and PHC physicians take on significant obligations to provide health care services in the pursuit of Universal Health Coverage (UHC). PHC physicians' health-related quality of life (HRQoL) can have a strong impact on patients, physicians and the health care system. Lifestyle interventions are found to be effective to improve HRQoL. The purpose of this study was to evaluate the association between lifestyle behaviors and HRQoL among PHC physicians, so that lifestyle intervention can be tailored by policy makers for health promotion.

Methods

A survey covering 31 provinces and administrative regions in China was conducted in 2020 using a stratified sampling strategy. Data on sociodemographic characteristics lifestyle behaviors and HRQoL were collected by a self-administered questionnaire. HRQoL was measured through EuroQol-five dimension-five level (EQ-5D-5L) instrument. A Tobit regression model was performed to evaluate the association between sociodemographic characteristics, lifestyle behaviors and HRQoL.

Results

Among 894 PHC physicians who completed the survey, Anxiety/Depression (AD) was the dimension with the most problems reported (18.1%). Regular daily routine (β = 0.025, 95%CI 0.004 to 0.045) and good sleep quality (β = 0.049, 95% CI = 0.029 to 0.069) were protective factors for HRQoL, while smoking (β = −0.027, 95% CI = −0.079 to −0.003) and frequency of eating breakfast (β = −0.041, 95%CI = −0.079 to −0.003) were negatively associated with HRQoL. Physical activity and alcohol drinking were not significantly associated with HRQoL.

Conclusion

These findings suggest that tailored interventions on daily routine, improving sleep quality, and tobacco control among PHC physicians may be effective strategies to improve their HRQoL.

Healthy life-style behaviors and related factors among Turkish primary health care professionals

Objective: The role of health professionals working in primary care in providing services to all segments of society and in protecting and improving the health of all individuals is extremely important. The aim of this study is to determine the healthy lifestyle behaviors of primary health care workers in Karabük city center and to examine some factors that may affect the choice of a healthy lifestyle. Materials and Methods: This cross-sectional study was conducted between October-December 2019 with the participation of 334 healthcare professionals in Karabük. The questionnaire with 27 questions and the Healthy Lifestyle Behaviors Scale II (HLBS-II) were administered. Results: The median age of the health care workers participating in the study was 38.2 ± 10.6. Of the participants 53.8% were women and approximately three-quarters of the participants (70.8%) were married. In terms of occupational groups, 10.9% of the participants were physicians, 25.0% were nurses and midwives, 16.7% were health officers/technicians and 47.4% were composed of other employees. The HLBS-II total score was found to be 126.8±21.3. The HLBS-II total score were higher in women, those who defined their health status as good, university graduates those who did not smoke, had good nutrition, exercised, and were satisfied with their body appearance. Conclusion: In our study, it was found that the healthy life behavior scores of health workers were at a good level. Especially men, smokers, high school graduates, obese, those who do not pay attention to their nutrition and physical activity should be informed and be supported by healthy living behavior programs.

Healthy Lifestyle Behaviors Among 18- to 49-Year-Old Women: A Comparative Study

INTRODUCTION

The prevalence of obesity has become a remarkable public health concern in a global extent. This study aimed to examine the difference between the healthy lifestyle behaviors of women with normal weight and those who are obese.

METHOD

This comparative descriptive study included a total of 302 women aged 18-49 years.

RESULTS

According to regression analysis; duration of education (β = -0.154), (age (β = 0.376), presence of obese individuals in the family (β = 0.177) and HLSBS II scores (β = -0.115) were the factors that affected the BMI. The predictive value of these variables was 34.1%.

DISCUSSION

A significant difference was found between women with normal weight and obese women in terms of several sub-dimensions and overall HLSBS II score. We recommend that healthcare staff should design training and counseling services to improve the health behaviors of overweight and obese women.

Health Promoting Lifestyle and its Relationship with Self-Efficacy in Iranian Mastectomized Women

INTRODUCTION

Lifestyle modification has an important role in long-term health of breast cancer patients. As a result, this study aimed to identify the health-promoting lifestyle and its subdomains in mastectomized women and its relationship with self-efficacy.

MATERIALS AND METHODS

This cross-sectional study investigated 100 mastectomized women in Tabriz-Iran, 2018. The participants were selected using the convenience sampling method. Data was collected using a sociodemographic questionnaire, the Health Promoting Lifestyle Profile II (HPLP-II), and the General Self-Efficacy Scale by Sherer. The multivariate general linear model with adjusting the sociodemographic variables was used to determine the relationship of the health-promoting lifestyle with self-efficacy.

RESULTS

The mean±SD total score of the health-promoting behaviors was 135.5±16.7 from the obtainable score of 52 to 208. The highest and lowest mean scores were observed in the spiritual growth (25.4±4.3) and physical activity (15.2±4.4), respectively. The mean±SD self-efficacy score in this study was 57.3±7.4 from the obtainable score of 17 to 85. There was a significant positive correlation between the total score of the health-promoting lifestyle (r= 0.369; p<0.001) with self-efficacy. Results from the adjusted general linear model showed that the age, educational attainment of the spouse, and self-efficacy were the health-promoting lifestyle predictors.

CONCLUSION

The findings of this study indicate the importance of self-efficacy and modifiable variables such as education in the engagement of mastectomized women in the health-promoting lifestyle. Regarding the positive relationship of self-efficacy with the health-promoting lifestyle, it seems that the interventional attempts to improve self-efficacy in these patients especially with considering the variables of age and spouse's educational level can contribute to the improvement of the health-promoting lifestyle.

The Effect of Cognitive-Behavioral Counseling on Lifestyle in Pregnant Women: A Randomized Controlled Clinical Trial

The lifestyle of pregnant women has a close relationship with maternal and fetal health. In pregnant women, health-promoting behaviors lead to the promotion of quality of life and improvement of pregnancy outcomes. Therefore, the present study aimed to determine the effect of cognitive-behavioral counseling on pregnant women's lifestyle. This randomized controlled clinical trial study was performed in the health centers of Sanandaj, Iran. Seventy pregnant women were randomly assigned to intervention (n = 35) and control (n = 35) groups. The study was completed with 33 pregnant women in each group. In addition to routine pregnancy care, the control group received, the intervention group received 8 consecutive 60-90-minute counseling sessions with a cognitive-behavioral approach weekly. The Walker Health Promotion Lifestyle Questionnaire was completed before, immediately, and one month after the intervention by the participants of control and intervention groups. Data were collected from February until June 2017. Data were analyzed using SPSS version 16. The mean score of lifestyle in the intervention and control group was 139.78 ± 21.71 and 142.63 ± 19.12 before the intervention, which reached 151 ± 17.72 and 159.14 ± 14.77, respectively, after the intervention. The difference was significant in the intervention group (P = 0.001) but not in the control group (P = 0.619). Also, the mean scores of the two groups were not significantly different before intervention (P = 0.574), but this difference was statistically significant after the intervention (P = 0.029) and one month after the intervention (P = 0.001). Based on the results of this study, cognitive-behavioral counseling improves the lifestyle of pregnant women. Therefore, it is suggested that this type of counseling be used along with other services to improve the lifestyle of pregnant women in health care centers.

Determining health-promoting behavior in smokers preparing to quit: a holistic and personalized approach

Background

Smoking cessation practices enable health professionals to identify lifestyle of their patients as an initial step to achieve predictive, preventive, and personalized medicine (PPPM). In this study, we aimed to investigate the relationship between the smoking habit and health-promoting behavior of patients who planned to quit smoking.

Methods

In this descriptive study, Health-Promoting Lifestyle Profile II (HPLP-II) was implemented to current smokers admitted to smoking cessation outpatient clinics of two tertiary hospitals. Patients without any comorbidities were included. Sociodemographic variables, Fagerström dependency test, and smoking habit were recorded. Descriptive and analytical statistical evaluations were performed.

Results

A total of 200 patients, 134 men (67%) and 66 women (33%) with a mean age of 34.49 ± 8.82, were included to the study. Among them, 90 (45%) were white collar, and 110 (55%) were blue-collar workers. Patients with BMI ≥ 25 were 126 (63%); Fagerström test score median was 7. Packages per year, dependency scores, the age the patients started smoking, and cigarettes smoked per day inversely correlated with health-promoting behavior. Our patients had high scores in spiritual growth and interpersonal relationships and had low scores in physical activity and stress management. Health-promoting behavior, health responsibility, self-actualization, and interpersonal relationships were less favorable in blue-collar workers than white-collar workers.

Conclusions

Smoking behavior affects especially physical activity and stress management in the study population preparing for smoking cessation. Health-promoting activities in smokers are influenced by occupation as well as dependency levels and smoking habits. Differences exist among white and blue-collar workers in health-promoting behavior. Defining and screening multiple health risk behavior in smokers empower predictive measures and targeted preventive medicine, such as maintaining healthy nutrition and leaving sedentary lifestyle along with efforts to quit smoking. Awareness about health-promoting behavior and thus identifying smokers who need lifestyle interventions can provide and attenuate a holistic and personalized approach in preventive medicine.

Health promoting behaviors of staff in a university of medical sciences in southeast of Iran

Background Health promoting behaviors are appropriate indicators to determine individuals' health status. The staff of a health care system plays an important role in enhancing health promoting behaviors in society; therefore, the present study is aimed to evaluate health promoting behaviors of the staff in a university of medical sciences. Methods A descriptive study was conducted on 140 staff of the Kerman University of Medical Sciences in the southeast of Iran. Data were collected using the Persian version of the Health Promotion Lifestyle Profile-II questionnaire with six dimensions of spiritual growth, health responsibility, interpersonal relationships, stress management, exercise and physical activity and nutrition habits. The data were analyzed using SPSS (version 18), descriptive statistics, Student's t-test and analysis of variance (ANOVA). Results The mean of health promoting behaviors of the staff was at the moderate level (2.22 ± 0.10). The highest and lowest means were related to the dimensions of nutrition habits (2.75 ± 0.29) and exercise and physical activity (1.70 ± 0.24), respectively. There was a significant difference in the scores of health promotion behaviors based on age, so that the health promoting behaviors in the age group younger than 40 years old were higher than that in other age groups (p = 0.04). Conclusion Some health promoting behaviors such as exercise and physical activity have not been appropriately merged into daily life. It is recommended to provide educational programs for all aspects of health promoting behaviors of the staff's health in order to promote productivity.

Health-Promoting Behaviors and Their Predictors in Iranian Women of Reproductive Age: A Cross-Sectional Study

Health-promoting behaviors are one of the main determinative components of health in the prevention of many diseases. This cross-sectional study aimed to determine health-promoting behaviors and their relationship to sociodemographic variables on 330 women of reproductive age admitted to the selected primary health-care centers in Qom city (one of the biggest cities in Iran) from March 2016 to July 2016. Data were collected using the health-promoting lifestyle profile II (HPLP-II) questionnaire and the sociodemographic characteristics and also were analyzed by one-way analysis of variance, with post hoc (if necessary), and multivariable linear regression. The total HPLP-II mean score of women was 136.64 ± 22.37. The highest score in the HPLP-II subscales of women was found for interpersonal relations subscale (26.43 ± 4.21) and the lowest score for physical activity subscale (14.66 ± 4.62). The educational level and income had significant association with some subscales ( p < .05).

Healthy lifestyle behavior of employees in small and medium-sized enterprises in Aydin, Turkey

OBJECTIVE

To determine healthy lifestyle behavior and affecting risk factors in workers at small and medium-sized enterprises from four different sectors in Aydin, Turkey.

METHODS

This cross-sectional study was conducted at four different small and medium-sized enterprises in Aydin, Turkey and 264 employees participated in the study. A questionnaire was used for data collection. It consisted of questions about socio-demographic features (age, gender, marital status, education, perceived income, occupation and having children), health status, and medical history, medication use, having occupational accidents and occupational health and safety. Healthy Lifestyle Behavior Scale, which was developed by Walker et al. in 1996, was used to evaluate healthy lifestyle behaviors of the workers.

RESULTS

The mean score for Healthy Lifestyle Behavior Scale was 135.46±22.49. Gender, marital status, perceived income, sector of workplace, title, presence of a chronic disease, finding oneself healthy in the previous year and having an occupational accident in the previous year did not significantly affect any subscales of Healthy Lifestyle Behavior Scale. The workers aged over 50 years had significantly higher scores for health responsibility than those aged 20-29 years (p<0.05). The workers living in a village got significantly higher scores for Healthy Lifestyle Behavior Scale and its subscales health responsibility, physical activity, nutrition and spiritual development than those living in a city (p<0.05).

CONCLUSION

Although workers have good spiritual development, they may not adopt physical activity as a healthy lifestyle and that workers benefiting from occupational health and safety services can display healthy lifestyle behavior.

The influence of healthcare workers' occupation on Health Promoting Lifestyle Profile

To compare the adoption of healthy lifestyle behaviors, including: spiritual growth, nutrition, physical activity, interpersonal relations, health responsibility, and stress management, of healthcare workers with workers of other professions. Cross-sectional observational study among a convenience sample of 285 healthcare workers and 137 of other professions. The Health-Promoting Lifestyle Profile-II (HPLP-II), a 52-item measure regarding the six components of healthy lifestyle. Demographic characteristics, education, income, work duration and self-rated health were also collected. Multivariable linear models were specified for each of the components of healthy lifestyle. Both groups were comparable in their age, family status, income and self-rated health. Results of multivariable linear models revealed that healthcare workers adopt better nutrition (β=0.228, p<0.001), more physical activity (β=0.133, p=0.049), and greater health responsibility (β=0.131, p=0.016), compared to other professions. Such differences were not found with regard to spiritual growth (β=0.097, p=0.121), interpersonal relations (β=0.039, p=0.444), or stress management (β=0.053, p=0.299). Healthcare workers adopt better healthy lifestyle only in components that may be perceived to have direct influence on health outcomes, namely nutrition, physical activity, and health responsibility. Further research that will explore the reasons for the observed differences may enable designing health-improving interventions.

The development and achievement of a healthy cities network in Taiwan: sharing leadership and partnership building

The World Health Organization (WHO) Healthy Cities (HC) projects are the best known of the settings-based approaches to health promotion. They engage local governments in health development through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects. Many cities have promoted HC projects in Taiwan since 2002. In 2008, the Taiwan Alliance for Healthy Cities (TAHC) was launched to assist local governments in effectively establishing, operating and promoting HC projects. In this article, we share our experiences of establishing a platform and network to promote the HC program in Taiwan. Based on individual city profiles and governance in Taiwan, the TAHC developed a well-organized framework and model to encourage strong leadership in local governments and to promote participation and engagement in their communities. In the last 6 years, leaders from Taiwan’s local governments in HC networks have integrated the HC concepts into their governance models, actively engaging and combining various resources with practical expertise and private sectors. The network of health in Taiwan allows each city to develop its unique perspective on the HC projects. Using this method, not only local government meets its needs, but also increases governance efficiency and effectiveness, resulting in the promotion of its citizens’ overall sustainable urban health development. This HC network in Taiwan has partnerships with government and non-governmental organizations (NGOs), with academic support and citizen involvement, a dynamic data collection system and demonstrated leadership in the sharing of information in the Asian region.

The effect of health promoting intervention on healthy lifestyle and social support in elders: a clinical trial study

Background:

Many of the problems pertaining to old age originate from unhealthy lifestyle and low social support. Overcoming these problems requires precise and proper policy-making and planning.

Objectives:

The aim of the current research is to investigate the effect of health promoting interventions on healthy lifestyle and social support in elders.

Patients and Methods:

This study was conducted as a clinical trial lasting for 12 months on 464 elders aged above 60 years who were under the aegis of health homes in Tehran, Iran. Participants were selected through double stage cluster sampling and then divided into intervention and control groups (232 individuals in each). Tools for gathering data were a demographic checklist and two standard questionnaires called Health-Promoting Lifestyle Profile version 2 and personal resource questionnaire part 2. Data were analyzed using descriptive and analytical tests including paired t test, analysis of covariance (ANCOVA) and Pearson correlation coefficient.

Results:

The average age of elders in this study was 65.9 ± 3.6 years (ranging between 60 and 73 years old). Results showed that the differences between the mean post-test scores of healthy lifestyle and its six dimensions as well as perceived social support and its five dimensions in the control and intervention groups were statistically significant (P value < 0.0001).

Conclusions:

Aging is an inevitable stage of life. However, effective health promoting interventions can procrastinate it, reduce its consequences and problems, and turn it into a pleasant and enjoyable part of life.

An educational program based on the successful aging approach on health-promoting behaviors in the elderly: a clinical trial study

Background:

Many criteria of successful aging are directly connected with Health-Promoting Behaviors.

Objectives:

The current study aimed to evaluate the effect of an educational program based on the successful aging approach on health promoting behaviors in the elderly.

Patients and Methods:

This clinical trial study was conducted on 464 Iranian elderly people over 60 years who were admitted at Health Houses for 12 months. Participants were selected through a two-stage cluster sampling and were placed in the control and intervention groups (232 participants in each group). The data collection tools included: a demographic checklist, Palmore Facts on Aging Quiz and the second version of Health Promoting Lifestyle Profile. The intervention was designed based on adult strategy education in five 45-minute sessions. The data obtained 3 months after the intervention were compared with the data obtained before the intervention. The data were analyzed using the descriptive and analytical tests such as paired T-test with SPSS version 20, at the statistical significant level 0.05.

Results:

The mean age of the participants in this study was 65.9 ± 3.6 (range 60-73). Results showed a statistically significant difference between the intervention and control group after the intervention in the mean scores of awareness of aging facts and score of health promoting behaviors.

Conclusions:

Focusing on successful aging and adopting HPBs can prevent and decrease aging problems which in turn decreases the financial burden and related costs. This is especially important for the policy and decision makers of the health systems.

A population-based study of health-promoting behaviors and their predictors in Iranian women of reproductive age

Health-promoting behaviors have been recognized as major factors for maintenance and improvement of health. The objective of this study was to determine the status of health-promoting behaviors and their predicting factors in Iranian women of reproductive age. This was a population-based cross-sectional study in which 1359 Iranian women of reproductive age were selected by proportional random multistage cluster sampling in Tehran. Questionnaires including sociodemographic characteristics, Health-Promoting Lifestyle Profile-II (HPLP-II) and Personal Resource Questionnaire 85-Part 2 (PRQ85-Part 2) were completed by interview. The association between the dependent variables (HPLP-II and subscales) and the independent variables (social support and sociodemographic characteristics) was analyzed using the multivariable linear regression model. Among the six dimensions of health-promoting behaviors, women scored highest in interpersonal relations (3.08 ± 0.51) and lowest in physical activity (2.04 ± 0.64). The Pearson test indicated perceived social support to be significantly correlated with HPLP-II (r = 0.53; p < 0.001) and all its subscales (r = 0.12-0.60; p < 0.001). Multivariable regression analysis indicated social support to be a predictor of HPLP-II and all its subscales, except for physical activity. Social support and sociodemographic characteristics accounted for 29.8% of the variance in the HPLP-II score and 6.9-39.3 in the six subscales. The findings of the present study confirm the importance of social support and modifiable variables (sociodemographic) in the occurrence of health-promoting behaviors in women and accredit the theoretical relationships among the concepts of the health-promotion model.

Determinants of health-promoting lifestyle behaviors among Arab immigrants from the region of the Levant

Arab immigrants in the United States are at risk for heart disease, stroke, and diabetes. We explored health-promoting lifestyle behaviors among Arab immigrants to the United States from the Middle Eastern region of the Levant. In 218 male and female Arab adults surveyed with the revised Health-Promoting Lifestyle Profile (HPLP-II), the mean for the HPLP-II was 2.73 (range 1-4), with spiritual growth and interpersonal relations the most frequently reported practices and physical activity the least frequently practiced dimension of health-promoting behaviors. Multiple linear regression analysis highlighted four determinants of health-promoting lifestyle behaviors: health insurance, acculturation, self-efficacy, and social support. Health promotion programs serving Arab immigrants should take these determinants into consideration.

The influence of health-promoting lifestyles on the quality of life of retired workers in a medium-sized city of Northeastern China

OBJECTIVES

The aim of this study was to clarify the actual state of retired workers' lifestyles and quality of life (QOL) in a medium-sized city of Northeastern China and to assess the relationship between these according to differences between gender groups.

METHODS

The Chinese version of the Health Promotion Lifestyle Profile II (HPLP-II), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and demographic variables were used to measure 343 (aged 50-79 years) retired workers' lifestyles and QOL. The results were analyzed using the t test, one-way analysis of variance, correlation analysis, and multiple linear regression analysis.

RESULTS

Among the six lifestyle subscales of HPLP-II, the highest mean score was for Interpersonal Relations (IR) and the lowest was for Health Responsibility (HR), which has not been reported previously. The youngest group (50-60 years) had higher scores for lifestyles and QOL than the other age groups. When the results were analyzed based on financial situation, the lowest income group (below ¥2000) had the poorest scores. Analysis according to gender group revealed different tendencies for the scores of lifestyle and QOL, as well as in the multiple regression analysis between variables.

CONCLUSION

Our results suggest that an effective approach to maintain a desirable lifestyle and QOL for retired workers at the regional level would be to introduce daily activities to improve HR and to maintain and enhance social support for the low-income populations. Further research is needed to understand the complex causal pathways between regional health and welfare factors, health behavior, and QOL.

Factor analysis of a health-promoting lifestyle profile (HPLP): application to older adults in Mainland China

This research reports preliminary psychometric properties, especially the factor structure, of a Chinese version of a health-promoting lifestyles profile designed for older adults; and examines the distribution of the health-promoting behavioral patterns - both for the purpose of developing culturally sensitive health advancement strategies for Chinese seniors. Responses to this questionnaire were used to measure health-promoting behaviors in a random sample of 1012 elderly Chinese from thirty communities in Xi'an Shaanixi-Province.

DESIGN

Factor analysis relied on polychoric correlations with ordinal categorical data were used to evaluate reliability and validity of a revised Chinese version of the health-promoting lifestyles profile (HPLP-C). Because this revised version was used to assess elderly adults, we termed it the HPLP-CE. This factor analysis supported a six-factor model of the original HPLP-C scale. Confirmatory factor analysis indicated a good fit, with factors explaining 88.1% of the common variance of the HPLP-CE scores. Cronbach's α coefficients were 0.91 for the revised instrument, and ranged from 0.67 to 0.88 for six dimensions. The split-half reliability was 0.92, while the test-retest reliability was 0.68. Relationships between HPLP-CE, perceived health status, SF-36 scale scores, and associations with selected demographic variables were significantly positive.

CONCLUSIONS

We concluded that this revised scale, based on the 40-item HPLP-C, was considered suitable for measuring health-promoting lifestyles of older adults in China. Mental and inner self-reflection planes were the most salient factors for assessing health-promoting behaviors of seniors. Such factors need to be considered if preventive programs are to be designed to promote seniors' health.

Factors and symptoms associated with work stress and health-promoting lifestyles among hospital staff: a pilot study in Taiwan

BACKGROUND

Healthcare workers including physicians, nurses, medical technicians and administrative staff experience high levels of occupational stress as a result of heavy workloads, extended working hours and time-related pressure. The aims of this study were to investigate factors associated with work stress among hospital staff members and to evaluate their health-promoting lifestyle behaviors.

METHODS

We conducted a cross-sectional study from May 1, 2010 to July 30, 2010 and recruited 775 professional staff from two regional hospitals in Taiwan using purposive sampling. Demographic data and self-reported symptoms related to work-related stress were collected. Each subject completed the Chinese versions of the Job Content Questionnaire (C-JCQ) and The Health-Promoting Lifestyle Profile (HPLSP). Linear and binary regression analyses were applied to identify associations between these two measurements and subjects' characteristics, and associations between the two measurements and stress symptoms.

RESULTS

Self-reported symptoms of work-related stress included 64.4% of subjects reporting nervousness, 33.7% nightmares, 44.1% irritability, 40.8% headaches, 35.0% insomnia, and 41.4% gastrointestinal upset. C-JCQ scores for psychological demands of the job and discretion to utilize skills had a positive correlation with stress-related symptoms; however, the C-JCQ scores for decision-making authority and social support correlated negatively with stress-related symptoms except for nightmares and irritability. All items on the HPLSP correlated negatively with stress-related symptoms except for irritability, indicating an association between subjects' symptoms and a poor quality of health-promoting lifestyle behaviors.

CONCLUSIONS

We found that high demands, little decision-making authority, and low levels of social support were associated with the development of stress-related symptoms. The results also suggested that better performance on or a higher frequency of health-promoting life-style behaviors might reduce the chances of hospital staff developing stress-related symptoms. Our report may contribute to the development of educational programs designed to encourage members of high stress groups among the hospital staff to increase their health-promoting behaviors.