Effectiveness of in-patient rehabilitation for sub-chronic and chronic low back pain by an integrative group treatment program (Swiss Multicentre Study).

In this multicentre intervention study, we compared an integrated group treatment program which combines psychological and education methods into a more active training approach, with the traditional individual approach of physiotherapy and physical procedures for sub-chronic and chronic low back pain. Our 411 patients had a 4-week inpatient treatment: 243 patients in an experimental program and 168 in a traditional program. Outcomes of 283 patients were assessed 3 months and 1 year after entry. The dropout rate was 31.1%. Both conditions demonstrated favourable initial effects on functional and psychological parameters, but the integrated approach showed better long-term results for work rehabilitation than the traditional approach. The most successful patients (n = 58) were younger and had a higher educational level in comparison to the unsuccessful subgroup (n = 71). The main conclusion is that an integrated approach promoting self control and behaviour change through educational measures achieves better long-term results than the traditional individual physiotherapy approach.

Computer-aided self-observation psychological stressors in an ICU.

We have developed a procedure for a computer-aided self-observation method in stressful situations. Staff members of an ICU recorded their experiences on a computer placed in the ICU, immediately after having experienced a stressful event. The computer asked for and stored psychologically relevant information about cognitive, affective and behavioural aspects. An external stress memory of an ICU was established, allowing a personal/institution-orientated stress diagnosis to be made on the basis of 192 episodes. Sixteen nurses in an intensive care unit in a Swiss hospital used this methodology for 12 weeks. One hundred and ninety-two stressful events were recorded (12 episodes per person), forming a good sample of the stressful episodes for the unit. To the same 16 nurses and 31 nurses at the same hospital (N total = 47) the Nursing Stress Scale was administered. The results from both groups showed that problems dealing with death and work load were predominant. Nurse characteristics such as levels of training (unskilled, skilled) and experience (number of years working as a nurse) were analysed by different statistical procedures and related to their stress experience.

[The inducers of stress in a hospital department]. / Induttori di stress in un ente ospedaliero.

The stress level of general medical ward (18), intensive care (15) and emergency department nurses (13) was measured with a questionnaire. For 13 intensive care and 3 emergency department nurses stress level was measured also with a computerized system (COMES). Main sources of stress among nursing personnel are death and dying, and workload. There are no differences between full time and part time nurses and apparently intensive care and emergency department nurses do not experience more stress than general medical ward nurses.