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 |