A pretest-posttest, repeated-measures design was used to evaluate the effects of two stress management interventions on a battery of outcomes derived from a psychoneuroimmunological (PNI) framework. The effects of cognitive-behavioral relaxation training groups (CBSM) and social support groups (SSG) were compared with a WAIT-listed control group on the outcomes of psychosocial functioning, quality of life, neuroendocrine mediation, and somatic health. Participants were 148 individuals (119 men, 29 women), diagnosed with HIV disease; 112 (76%) completing the study groups. Using analysis of covariance, the CBSM group was found to have significantly higher postintervention emotional well-being and total quality-of-life scores than did either the SSG or WAIT groups. SSG participants had significantly lower social/family well-being scores immediately postintervention and lower social support scores after 6 months. The findings point to a pressing need for further, well-controlled research with these common intervention modalities.

No abstract

Since the early 1970s, clinical ladder programs have been a method of defining, recognizing, and rewarding nursing practice. As clinical practice in an institution grows and evolves, so must the program that supports the development of the practitioner. An in-depth evaluation of one clinical ladder program was conducted to determine if it was reflective of current practice. The authors discuss the method of evaluation, findings, and the revised program.

This study of39 Richmond, Virginia residents with Alzheimer's disease and/or their primary caregivers was intended to replicate and extend Bennett's Needs Assessment of40 persons in the District of Columbia area using the Older American Resources and Services Multidimensional Functional Assessment Questionnaire and the Caregiver Strain Questionnaire. teaching undergraduate psychiatric nursing and graduate research methodology."good" socioeconomic resources, "moderately impaired" mental health resources, "severely impaired" physical health resources and Activities of Daily Living. The top three services used were housekeeping, legal/protective and supervision. Minimal cost in time per family was one and one-half hours per day at a weekly cost of$140. Caregiver strain wasfound to be in the moderate range. The most severe areas of strain were related to personality and behavioral changes. B.A. Munjas, PhD, FAAN, is a professor at