Reducing nurses' stress: A randomized controlled trial of a web-based stress management program for nurses.

BACKGROUND: Nursing is a notoriously high-stress occupation - emotionally taxing and physically draining, with a high incidence of burnout. In addition to the damaging effects of stress on nurses' health and well being, stress is also a major contributor to attrition and widespread shortages in the nursing profession. Although there exist promising in-person interventions for addressing the problem of stress among nurses, the experience of our group across multiple projects in hospitals has indicated that the schedules and workloads of nurses can pose problems for implementing in-person interventions, and that web-based interventions might be ideally suited to addressing the high levels of stress among nurses. PURPOSE: The purpose of this study was to evaluate the effectiveness of the web-based BREATHE: Stress Management for Nurses program. METHODS: The randomized controlled trial was conducted with 104 nurses in five hospitals in Virginia and one hospital in New York. The primary outcome measure was perceived nursing-related stress. Secondary measures included symptoms of distress, coping, work limitations, job satisfaction, use of substances to relieve stress, alcohol consumption, and understanding depression and anxiety. RESULTS: Program group participants experienced significantly greater reductions than the control group on the full Nursing Stress Scale, and six of the seven subscales. No other significant results were found. Moderator analysis found that nurses with greater experience benefitted more. CONCLUSION: Using a web-based program holds tremendous promise for providing nurses with the tools they need to address nursing related stress.

Preventing prescription drug misuse: field test of the SmartRx Web program.

Purpose of the project was to test a Web-based program designed to prevent prescription drug misuse. Study sample consisted of 346 working women randomized into either an experimental or wait-list control condition. Analysis of covariance and logistic regression were used to compare responses. Women receiving the intervention had greater knowledge of drug facts and greater self-efficacy in medication adherence and ability to manage problems with medications compared with controls. Women receiving the intervention also had reduced symptoms reported on the CAGE for prescription medications. Findings suggest that multimedia Web-based programs can be a beneficial addition to substance misuse prevention services. The study's limitations are noted.

A web-based mental health program: reaching parents at work.

OBJECTIVE: The purpose of the project was to test a web-based program providing working parents with the knowledge and skills necessary for prevention and early intervention of mental health problems in youth. METHOD: Study sample consisted of 99 parents who were randomized into either an experimental (program use) or waitlist control condition. Analysis of covariance and paired t-tests were used to compare response outcomes for the two groups. RESULTS: Parents receiving the intervention had greater knowledge of youth mental health issues and greater self-efficacy in handling these issues compared to controls. CONCLUSIONS: Findings suggest that referring parents to a multimedia web-based program can improve parents' knowledge of children's' mental health and their confidence in addressing mental health issues. Web-based programs can be offered to individuals in multiple settings, including the workplace, thereby reaching large numbers of parents.

Utilization and cost of behavioral health services: employee characteristics and workplace health promotion.

The study sought to (1) model demographic and employment-related influences on behavioral health care utilization and cost; (2) model behavioral health care utilization and cost influences on general health care cost, job performance, and earnings; and (3) assess workplace-based health promotion's impact on these factors. Behavioral health care utilization was more common in employees who were female, over age 30, with below-median earnings, or with above-median general (non-behavioral) health care costs. Among employees utilizing behavioral health care, related costs were higher for employees with below-median earnings. Employees utilizing behavioral health care had higher general health care costs and received lower performance ratings than other employees. Health promotion participants were compared with a nonparticipant random sample matched on gender, age, and pre-intervention behavioral health care utilization. Among employees without pre-intervention behavioral health care, participants and nonparticipants did not differ in post-intervention utilization. Among employees utilizing behavioral health care adjusting for pre-intervention costs, participants had higher short-term post-intervention behavioral health care costs than nonparticipants.

Alcohol Consumption and Dietary Practices in the U.S. Population: 1987 and 1992.

Research indicates that the link between alcohol and poor nutrition is highly complex. Alcohol consumption is known to disrupt nutritional status via several mechanisms. One mechanism by which alcohol may affect nutrition is by inducing changes in dietary practices. Findings are presented based on 2 years of data from a national survey of health-related activities. The relationship between alcohol consumption and dietary practices-such as types of food consumed, whether vitamins were taken, belief that diet influences health, and frequency of eating out-is examined. The results show that associations exist between alcohol and diet after controlling for demographic and health variables. These findings have important implications for understanding the interaction between alcohol intake and nutritional status and the effect of this interaction on overall health.