Emotional distress reported by women and husbands prior to a breast biopsy.

The purpose of this study was to describe the emotional distress of women (N = 300) and husbands (N = 265) prior to the women's breast biopsy and to identify factors related to their levels of distress. Standardized instruments were used to measure social support, uncertainty, marital satisfaction, family functioning, concurrent stress, hopelessness, and emotional distress. Women reported moderately high levels of emotional distress and significantly more distress than their husbands. Forty-two percent of the variance in women's distress scores and 42% of the variance in husbands' distress scores were accounted for by the independent variables. Concurrent stress, lower education, hopelessness, and uncertainty explained the most variance in women's distress, while concurrent stress, hopelessness, and family functioning explained the most variance in husbands' distress.

Computerized management of respiratory care.

Respiratory care as an organized discipline is only about 45 years old, and the management of this dynamic allied health profession has usually been characterized by a demand-for-service mentality. As pressure continues to control costs, those departments that maximize quality patient care cost-effectively with thoroughly documented outcomes are in a better position to compete for future resources. The practice of respiratory care is changing as is the practice of medical care in general. Accountability for resource consumption and the quality of the product delivered are essential elements in the delivery of respiratory modalities. We have developed and implemented a comprehensive patient-data-based approach to the management of respiratory care. The essential elements of this approach are (1) relative-value-unit procedure base; (2) individual, shift, and department productivity that is attached to the annual performance review process; (3) management reporting on a 24-hour basis, with biweekly review at the management level; (4) development and implementation of a comprehensive patient-data-documentation system that permits automatic patient billing and 100% data review for quality-assurance documentation; (5) the development of a medical alerting system that alerts the Medical Director and Respiratory Care staff to potentially harmful events that, if untreated, may result in increased morbidity or mortality; and (6) the development of concurrent and retrospective tools for patient-outcomes research. These functions are supported by an active Medical Informatics Department that is nationally recognized in medical computing and logic application.