The relationship between stress and health care use: an investigation of the buffering roles of personality, social support and exercise.

The main and interactive effects of social support, physical exercise, and personal hardiness on objective measures of health were investigated using a longitudinal research design. Data were collected from 192 working adults. Results showed main effects for hardiness and exercise on the dependent variables of health care costs and the number of health insurance claims filed. Hardiness appeared to be associated with fewer health problems. Contrary to prediction, those who exercised more appeared to have greater health care use. Three-way interactions suggested that health care use was lowest for those high in all three resistance resources: exercise: hardiness: and social support. But, the converse of this reasoning, that absence of these resources is associated with higher levels of illness, was not entirely supported. The interactions suggested that hardiness in the absence of exercise and social support was associated with the highest health care costs. The highest number of claims was apparent for those exhibiting hardiness and exercise. Thus, the presence of exercise, hardiness, and social support seemed to decrease health care use, but the factors contributing to greater health costs and claims were more complicated to interpret.

Occupational stress and health care use.

This study investigated the relationship between health care use and (a) stressful work events; (b) strain; (c) social support; (d) type of job and industry; and (e) the individual characteristics of control, commitment, and length of time in position. A sample of 260 individuals (95 men, 165 women) from two different industries was used. Correlational analyses suggested that health care claims and costs were positively related to stressful work events and strain and negatively related to employees' length of time in position. Industry type also played a role in predicting the health care variables. Multivariate analyses suggested that environmental, stressor, and strain variables accounted for up to 16% of the variance in health care costs and 21.5% of the variance in number of health care claims.

Occupational stress, social support, and the costs of health care.

Relationships among health care costs, social support, and occupational stress are investigated. Health care cost data were collected over two years for 260 working individuals. Multiple regression analyses were used to control for initial health care costs, age, and gender in predicting later costs; independent variables were stress, strain, social support, and their interactions. Main effects and interactions each accounted for significant proportions of the variance in various health care costs.

Development of a measure of nurses' AIDS attitudes and conservative views.

The literature concerning measurement of nurses' attitudes toward AIDS was reviewed. A short scale to measure nurses' attitudes toward AIDS was developed and evaluated. The instrument has three subscales on (a) willingness to care for those who are HIV positive, homosexuals, and intravenous drug users as patients, (b) attitudes toward homosexuals and intravenous drug users, and (c) general conservative views on religious, political, and family issues. The three subscales were supported by results of a factor analysis. Coefficient alpha ranged from .69 to .92.

Health care workers' AIDS attitudes and willingness to provide care--India.

Although AIDS is a world-wide pandemic, relatively little has been published on health care workers' attitudes and intentions to provide AIDS care outside of the U.S. This is a critical omission concerning countries such as India which is predicted to have tremendous increases in AIDS cases. Such information is important for health care administrators attempting to cope with disease transmission on a global level. The present research explored Indian health care workers' attitudes, knowledge, and willingness to provide AIDS care. A majority of those in the sample indicated a willingness to care for patients with AIDS. These intentions, however, were not predicted by health care workers' attitudes or knowledge of the disease.

AIDS patients' perceptions of nursing care quality.

The authors propose a model, adapted from literature on quality in health care and services marketing, that identifies dimensions of quality in nursing care for persons with AIDS. In focus groups, respondents expressed concern about structural factors such as formal hospital practices, and process factors, which include nurses' knowledge of AIDS treatment and issues, their use of universal precautions, discrimination issues, expressions of empathy, and provision of health status information to the patient.