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Occup Environ Med 60:10-15 doi:10.1136/oem.60.1.10
  • Review

The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review

Table 2

Findings and appraisals of studies using stress related scale

Russler (1991), USA Berg et al (1994), Hallberg and Norberg (1993), Sweden Melchior et al (1996), Netherlands
Symbols •, Seems no problem; T, treatment group; (E), environmental management; P, placebo group; (P), personnel support; C, control group.
Design features
Type of study RCT PCS PCS
Population 57 student nurses 2 wards (31 nurses) 161 nurses
T19, P19, C19 T16, C15 T60, C101
Focus of intervention Cognitive education + role playing (P) Nursing method change + supervision (E) Nursing method change + support training (E)
Duration 1 semester (16h) 1 year constantly 1 year constantly
Reliability and validity of scale Present R data reported 3 scales, present R&V data reported Previous R&V mentioned
Authors’ conclusion Effective when analysed as overall subjects Reduce negative effects Potentially effective (decreased turnover and stable stress)
Validity of results
Randomisation Strategy not clear N/A N/A
Sample attrition Not clear 8, not included in analysis Not reported
Blinding Not given Not given Not given
Similarity at start
Confounding factors Effects of placebo on stress not considered Not reported Imitation of intervention by C
Authenticity of differences
Main outcome (scale) Not reported Larger decrease in T than C Stable in both T and C
Statistical test ANOVA Mann-Whitney ANCOVA
Not significant on all subscales Not significant on most subscales Not consistent
Way of comparison Overall analysis Total score not analysed Total score not analysed
Within group analysis
Clinical significance Not reported Not clear Not clear
Conclusion of appraisals Evaluation impossible Potentially effective Evaluation impossible

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