This study compared the frequency and sources of nursing job stress perceived by 35 intensive care (ICU), 30 hospice and 73 medical-surgical nurses. Analysis of variance revealed no significant differences among the three groups of nurses on the overall frequency of job stress. Post-hoc Tukey tests demonstrated a significant difference in three stress subscales among the three groups. ICU and hospice nurses perceived significantly more stress than medical-surgical nurses related to death and dying; ICU and medical-surgical nurses perceived significantly more stress than hospice nurses related to floating; and medical-surgical nurses perceived significantly more stress than ICU and hospice nurses related to work-overload/staffing. Spearman-Rank Correlation revealed no significant correlations among the three groups in their rank-ordering of the eight stress subscales. Death and dying situations were the most stressful to ICU and hospice nurses, while work-overload/staffing situations were the most stressful to medical-surgical nurses. Results of the study, although not generalizable, have implications for nurse managers.

Twenty-four family caregivers of bone marrow transplant (BMT) patients were interviewed to describe the burden of care and health outcomes (anxiety, depression, symptom distress and fatigue). A descriptive correlational research design with repeated measures was used. Data were collected in a conference room in the oncology unit of a midwestern university hospital using a battery of questionnaires. Questionnaires were administered pre-BMT (prior to the patient's hospitalization) and 5 and 20 days post-BMT. Objective burden remained at a similar level throughout the study (mean range 31.4 to 32.9), whereas subjective burden was highest pre-BMT (mean range 25.3-21.7). Significant correlations were found between objective burden and all health outcomes (P < 0.01 to P < 0.001) on day 5. Symptom distress was significantly correlated to subjective burden pre-BMT and to both types of burden on days 5 and 20. Results of this study suggest that family caregivers of BMT patients may experience more objective burden than subjective burden, and that burden of care may contribute to negative health outcomes, especially on day 5 post-BMT. Interventions designed to reduce sources of caregiver burden and negative health outcomes should be planned according to critical time periods of the BMT patient's hospitalization.

Thirty clients with chronic obstructive pulmonary disease (COPD) and their spouses were interviewed to examine differences in the relationships among loneliness, depression, and social support. Data were collected during structured in-home interviews using the UCLA loneliness scale, the Center for Epidemiological Studies depression scale, and the social support questionnaire. The clients and spouses did not differ significantly on measures of loneliness and depression, with mean scores for both groups higher than those in other comparable groups. Spouses, however, tended to be a little lonelier than clients, and clients tended to be a little more depressed than spouses. The two groups were also similar with respect to the number of people in their social networks but different as to network composition. Spouses were less satisfied with their networks than clients. Social support satisfaction was linked to loneliness and depression for clients but not for spouses. Results of the study suggest that community nurses working in home settings must be sensitive to clients' and spouses' psychologic reactions to COPD, which may be expressed in feelings of loneliness and depression.

Thirty-two African American nurses (AAN) and 78 Caucasian nurses (CN) were compared on breast self-examination (BSE) practice and health beliefs. Relationships between these variables were also examined. The Health Belief Model provided the framework for the study. The sample is a subset of 269 women from a larger study. AANs were recruited from a professional nurses' group. CNs were recruited from a list of female employees of a university medical centre. The results of t-tests revealed no significant group differences on BSE frequency (P = 0.06) or BSE proficiency (P = 0.10). Noted was that 42% of AANs compared to 20% of CNs examined their breasts 12 or more times during the year. AANs were more likely to consider BSE beneficial (P = 0.002) and to feel confident (P = 0.006) about doing BSE; CNs perceived more barriers (P = 0.001) to BSE. For AANs, BSE frequency and proficiency were positively related to confidence and inversely related to barriers; BSE frequency was also related to health motivation. For CNs, BSE frequency and proficiency were inversely related to seriousness. Implications include additional research to validate findings and to increase the knowledge base of all nurses regarding BSE.

Twelve practices with a total list of 74,111 patients were audited; 429 patients were identified with a diagnosis of gout. A wide variation in various clinical and laboratory assessments was detected. Similar variations were also noted regarding dietary advice and medical treatment. Monitoring of patients was infrequent. As a result of this audit, guidelines are proposed to improve the diagnosis and management of gout in the community.