Occupational burnout, tolerance for stress, and coping among nurses in rehabilitation units.

The relation of problem-solving confidence, perceived tolerance of stressors, and situation-specific coping efforts to occupational burnout was examined among 88 nurses in physical rehabilitation units. Participants completed measures of problem solving and burnout, and were administered a questionnaire that required them to list stressors encountered at work and their ability to tolerate this stressor. Participants were also asked to list their typical ways of coping with this stressor. Consistent with predictions, confidence in one's ability to handle problems and perceived tolerance were significantly predictive of lower burnout scores, regardless of time spent on the job. Of the coping variables, emotion-focused coping was significantly associated with higher burnout scores. Post-hoc analyses of self-reported coping activities indicated that some coping efforts (e.g., taking time off from work, confronting a supervisor) could be construed as symptoms of burnout, according to theoretical conceptualizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Physiological Evaluation of Time Standards For Warehouse Operations as Set by Traditional Work Measurement Techniques

This research studied physiological stresses to grocery order selectors. Sixty-three male workers from three different warehouses participated in the study. Oxygen uptake and heart rates were continuously recorded while the subjects performed their routine work. Performance levels of the workers were determined using the traditional work measurement techniques employed by the warehouses. The duration of the observations ranged from 12 to 65 min (mean 34 min) depending upon the size of the order and the pace of the worker.

The mean performance levels (allowed time per order/actual time per order * 100) were 119, 111 and 98% and the corresponding mean metabolic rates were 6.2, 6.0 and 8.3 Kcal/min and the mean heart rates were 110, 122, and 133 beats/min in warehouses 1, 2 and 3, respectively. Approximately, 24, 30 and 64% of the male workers failed to meet the 100% performance index in warehouses 1, 2 and 3, respectively, while their average energy expenditure rates were 6.3, 5.4 and 8.4 Kcal/min.

There was no significant correlation between the energy expenditure and performance index and the heart rate and performance index. In terms of the physiological cost of work performed, there were inconsistencies within a warehouse and large differences between warehouses. Physiological requirements of the order selector's job are discussed.     

Access to health care services among people with rehabilitation needs receiving Medicaid.

Objective: To investigate access to care for individuals with rehabilitation-related conditions receiving fee-for-service Medicaid. Study Design: Telephone survey. Participants: One hundred thirty-eight individuals with spinal cord injury (SCI), brain injury (BI), or stroke. Main Outcome Measures: Frequency of difficulty or failure to access medical services, perceived effect on health, services most difficult to access, and reasons for difficulty. Results: People with SCI reported the most frequent difficulty accessing services (87%), followed by persons with BI (79%) and stroke (65%). In a subgroup of respondents, 60% reported failure to receive at least 1 service; 81% reported that access difficulties affected health or daily routine. Conclusions: People with rehabilitation-related disabilities may experience greater barriers to needed services than the larger population of persons with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On psychological identity and training: Boulder is better for rehabilitation psychology.

This article addresses issues of training in applied psychology, generally, and rehabilitation psychology, specifically. The long-term success and growth of rehabilitation psychology will depend, in part, on how the field answers the following questions: How do rehabilitation psychologists define their area of competence? How is this competence to be achieved? A review of recent literature suggests that rehabilitation psychology has yet to resolve fully the fundamental issues of a young subspecialty: identity, training, and long-term direction. We maintain that the scientist-practitioner model should continue to be the framework for training future rehabilitation psychologists. Furthermore, subspecialty and cross discipline training should be completed following core training in an appropriate specialty of psychology (i.e., counseling or clinical). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining systematic differences in adaptation to chronic illness: A growth modeling approach.

Proposes the use of CURVE growth modeling (J.J. McArdle and D. Epstein; see record 1977-13920-001) to examine longitudinal data to describe individual adaptation to chronic illnesses. Two applications of CURVE growth modeling were used with samples of 69 children with juvenile diabetes (JD), 26 with juvenile rheumatoid athritis (JRA), and 99 healthy controls at 6-, 12-, and 18-mo intervals, to discriminate among competing models of adjustment. Tucker-Lewis incremental fit measures indicate that among competing models of adjustment for both emotional distress and behavior problems, unique patterns of adjustment emerge. Analysis indicated that individual growth modeling provided an alternative to traditional statistical techniques and that CURVE growth modeling allowed examination of competing models of adjustment for determining which best represent the data. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On psychological identity and training: A reply to Thomas and Chan (2000).

K. R. Thomas and F. Chan (see record 2000-13209-005) raised several concerns about the legitimacy and primacy of the Boulder model in the training of rehabilitation psychologists, particularly with regard to the unique needs and history of rehabilitation psychology. We address several of the issues they raise and maintain that the utility of the Boulder model, although in need of some revision to meet the evolving nature of health care service delivery systems, remains the most appropriate model for the training of professional psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medicaid's not-so-"quiet revolution": A call to action for psychologists.

Psychologists are research-based health care providers with much to offer to the development of programs for people with disabilities and chronic illnesses. An exemplar for psychologists' involvement in health care planning is Health Care Options Plus (HCO+), a prevention-oriented, Medicaid-funded program for people with disabilities. Contributions such as HCO+ will make a positive impact on the future of professional psychology and health care delivery models for people with disabilities. Psychologists must recognize the importance of Medicaid as well as their own potential for influencing public and private health care sectors in order to thrive in the current health care climate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing the accuracy of depression diagnosis in patients with spinal cord injury using Bayesian analysis.

Compared depressive symptoms of 80 patients with paraplegia and 53 patients with quadriplegia using Bayesian analysis. Patients completed the Inventory to Diagnose Depression. Predictive powers and efficiency of symptoms were examined. Differences in the efficiency of predictability for individuals with paraplegia and quadriplegia existed for dysphoric mood, energy, and suicidal ideation. Results suggest that differential weighing of symptoms of depression may reduce misdiagnosis, thereby enhancing rehabilitation efforts. Bayesian analysis shows promise as an alternative approach to evaluating and diagnosing depression in patients undergoing rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of health status, socioeconomic characteristics, and knowledge and use of HIV-related resources between HIV-infected women and men

OBJECTIVES: The authors compared socioeconomic characteristics, and knowledge and use of human immunodeficiency virus (HIV)-related resources and health status measures between HIV-infected women and men registered within the Denver Health and Hospitals health care system. METHODS: Data collected through two Centers for Disease Control-funded surveillance initiatives (Adult Spectrum of Disease and Supplement to HIV/AIDS Surveillance) were linked. Health status measures were obtained using the Medical Outcomes Study (MOS-20) questionnaire. To compare health status measures between genders, men were matched to women based on disease stage, intravenous drug use, race, years of education, employment status, and age. RESULTS: Among all patients interviewed (n = 419), women (n = 52) were more likely to be minority, uneducated, intravenous drug users, and at earlier stages of HIV-disease than men (n = 367). Employment status was not significantly different. Knowledge of available services was generally good among both genders. Women received public assistance and had health insurance (Medicaid) more often than men. Women used support services, social work, and shelter assistance less often than men. The matched pairs analysis (n = 46 pairs) showed no significant differences between genders in physical and social function, mental health, pain, or general health perceptions; however, role function was better in women than in men (P<0.02). CONCLUSIONS: When controlling for factors that may influence health and access to health care, HIV disease generally impacts the health status of both genders similarly. Women scored higher in role function which may reflect family caretakers' responsibilities. Although knowledge of HIV-related resources was similar by gender, men made contact more often suggesting areas for enhanced outreach toward women.