Cost-effectiveness of a back school intervention for municipal employees.

This study investigated the effect of a back school rehabilitation program on lost work time, lost time cost, medical cost, and number of injuries in municipal employees. Seventy back-injured workers who participated in a 6-week back school were compared on the dependent variables with 70 randomly selected back-injured city employees who had not participated in a back school. Back school participants demonstrated a significant decrease on all dependent variables. Back school participants had significantly fewer injuries in the 6-month postintervention period. No statistically significant differences were found between groups on the time and cost variables. Actual dollars saved in lost time and medical costs between groups was of practical value to the city. Study findings offer support for the back school as a cost-effective measure.

A community health nursing curriculum and Healthy People 2000.

The School of Nursing at the University of Alabama at Birmingham recently revised its graduate level community health nursing curriculum based on the priority areas and health objectives in Healthy People 2000. Health priority areas are presented as class topics and provide direction for the students' fieldwork. This paper provides background on the national strategy used to develop the national health objectives, suggestions on how nursing can be at the forefront of influencing the health of the nation, and specifics involved in implementing a community health nursing curriculum using the year 2000 health objectives.

Effects of back school education and exercise in back injured municipal workers.

Low back injury is the leading cause of compensable injury. A National Health Objective for the year 2000 is to increase to at least 50% the number of worksites offering back injury protection programs. The 6 week Back School intervention included exercise and education. A portion of the sample of 74 back injured municipal employees also was assigned randomly to a counseling intervention. Pre-intervention and post-intervention testing revealed significant posttest increases in back strength and flexibility. Significant improvements also were noted in psychological well being, depression, anxiety, and perceptions of pain. No significant differences were found, on any of the measures, between employees who did and who did not receive the counseling intervention. Methodological concerns relate to the possibility of sampling bias and instrumentation. Future research with control groups is needed, as well as the testing of interventions that may be both effective and require less work release time.

A flexibility intervention to reduce the incidence and severity of joint injuries among municipal firefighters.

The present study of 469 municipal firefighters examined the effect of flexibility training on the incidence and severity of joint injuries. Both flexibility measures and costs (lost time and medical care costs) were investigated in this study. Significant differences were found in flexibility scores of the experimental and control subjects with overall flexibility increased in the experimental group. Although incidence of injury was not significantly different for the experimental and control groups, injuries sustained by the experimental group resulted in significantly less lost time costs. Findings indicate that the flexibility training program had a beneficial effect on reducing the severity and costs of joint injuries in this firefighter population.

Health promotion at the workplace.

Health promotion encompasses those activities undertaken to improve the quality of one's life, thereby moving the individual forward toward a state of wellness or optimal health. Occupational health nurses are in a prime position to impart knowledge and change attitudes and behaviors and thus are uniquely qualified to plan, develop, implement, and evaluate workplace health promotion programs. Employee health promotion programs are based on the theory that it costs less to educate workers about controllable lifestyle health risks than to pay for the cost of ill health. Comprehensive workplace health promotion programs should be targeted at three levels: awareness, lifestyle/behavior change, and supportive environments, if long-term success is to be achieved. Occupational health nurses may use the Model for Workplace Health Promotion to assist them in planning, developing, implementing, and evaluating programs that provide health and cost benefits for both employees and employers.

The effect of progressive muscle relaxation on stress among clerical workers.

Stressors such as the lack of challenge and opportunities for advancement, and the inability to influence the organization help explain why clerical work is considered a demanding and stressful occupation. One stress management technique which may be effectively implemented on the job for clerical workers is progressive muscle relaxation. In primary prevention, nursing intervention strives to reduce the effects of harmful stress by identifying and assessing stressors and then implementing measures to strengthen lines of defense.

Cardiac disease and the family: impact, assessment, and implications.

Cardiac disease is a major threat to the quality of life of both patients and families. Using King's definition of a social system, this article provides a general overview of the impact of cardiac disease on the family social system. Acute and chronic illness require emotional, cognitive, and materials support to prevent maladaptive coping by patients and family members. Techniques for family assessment are detailed. Specific interventions appropriate for acute, transitional, and rehabilitative care are provided. Implications for nursing practice and research that includes family members are given.