Managed care: controlling costs and changing practice.

The emergence of cost control and managed care stem from economic realities. While managed care is built on economic principles, it promises to change the way Americans consume health services. As one of the largest single groups providing services to acutely and chronically-ill adults, medical-surgical nurses must understand the key aspects of managed care and how its implementation may change practice.

Easing the transition from hospital nursing to home care: a research study.

With the increased need for staff nurses, home healthcare agencies can ease the transition for experienced nurses who have worked in settings other than the home. Formal instruction, employment orientation, and preceptorship can effectively prepare new home care nurses for their duties.

The relationship of burnout, use of coping strategies and curricular program of registered nurses.

This study examined the relationships of nursing curricular program, burnout, and use of coping strategies among 150 randomly selected staff nurses from four hospitals. The instruments used were the frequency dimension of the Maslach Burnout Inventory (Maslach & Jackson, 1981) and the Ways of Coping (Revised) (Folkman & Lazarus, 1985). Discriminant analysis demonstrated that (a) diploma graduates differed from associate-degree graduates in their greater experience of Emotional Exhaustion (p less than .05) and (b) baccalaureate-degree graduates differed from associate-degree graduates in their greater use of Planful Problem Solving and Confronting Coping (p less than .05). Recommendations include additional research to discover relevant factors for the greater experience of Emotional Exhaustion among diploma graduates. If related to perceptions of limited career mobility due to the lack of a baccalaureate degree, expansion of educational opportunities is indicated. Another recommendation is curricular incorporation of content on burnout and coping.

Burnout and coping strategies among hospital staff nurses.

This study examined the relationship between use of coping strategies and burnout among 150 randomly selected staff nurses from four hospitals. The instruments used were the frequency dimension of the Maslach Burnout Inventory (Maslach & Jackson 1981) and the Ways of Coping (Revised) (Folkman & Lazarus 1985). In the canonical correlation analysis, two significant canonical variate sets differentiated nurses on the dimension of burnout. Nurses who experienced increased levels of burnout used the coping strategies of escape/avoidance, self-controlling and confronting (P less than 0.001). Nurses who experience decreased levels of burnout used the coping strategies of planful problem solving, positive reappraisal, seeking social support, and self-controlling (P less than 0.003). Self-controlling coping, although present in both variate sets, was used to a lesser extent by nurses with decreased burnout levels. The positive relationship between planful problem solving and reduced burnout levels supports the theoretical framework of Lazarus. This framework asserts that during the appraisal process, persons evaluate the harmfulness of an event and their own coping resources. Persons with lower levels of burnout may perceive the event as amenable to change or they may perceive their coping resources as adequate. Either perception may promote the view that the situation is amenable to problem solving. Another rationale for the effectiveness of particular coping strategies may lie in the reactions that these strategies engender in others. The use of planful problem solving, seeking social support and positive reappraisal has been reported to result in the offering of greater social support than when confronting and self-controlling coping were used.(ABSTRACT TRUNCATED AT 250 WORDS)