George S. Everly

Perceived dimensions of job satisfaction for staff registered nurses.

To measure the importance of dimensions of job satisfaction 144 female registered staff nurses in four East Coast metropolitan hospitals were given an 18-item Likert-ivpe instrument. Results indicated that the traditional intrinsic/extrinsic dichotomy, which exists in elements of job satisfaction, did not apply. The nurses perceived their job satisfaction in a more complex fashion, in that four statistically independent dimensions emerged with “relationship orientations” accounting for almost 24 percent of the total variance. The study implies that previous considerations in job satisfaction for the professional may need to be reexamined in terms beyond the traditional intrinsic/extrinsic dichotomy.

What Is Stress

The focus of this text is on the treatment of excessive stress. Yet before the clinician can effectively intervene, he or she must thoroughly comprehend the nature of the clinical problem to be faced. In this first chapter the reader will be introduced to some of the basic considerations or foundations on which the treatment of the stress response is inevitably based.

THE DOGMATISM/EXTERNALITY CORRELATION FOR COLLEGE STUDENTS

While relevant literature in the field of personality suggests the presence of a positive relationship between Rokeachs (1960) dogmatic belief system and Rotters (1966) external locus of control, the effect of sex differences on that relationship has yet to be determined. Studies by Clouser and Hjelle (1970) and Everly, Coronett, and Strouse suggest that there is a positive correlational relationship between these two personality variables, yet neither study examines the effect of sex in the re!ationship. The notion that sex may, indeed, affect the suggested relationship may be inferred from the theoretical foundations of both of these personality variables. Rokeach suggests that dogmatism may be considered as the composite structure of defenses against anxiety. Similarly, Rotter suggests that high externality may be viewed as a defensive structure that seems to occur in male college students more than in female college students. Therefore, there appears to be at least theoretical support for the hypothesis that a stronger positive correlational relationship exists between dogmatism and externality for college males than for females. The random sample included 144 male and 175 female college students at the University of Maryland, College Park, Md. Each of the students was given the I-E scale and the Dogmatism Scale (Form E), in a random order. Males artained a mean of 12.8 and a SD of 3.9 for externality, while the females mean was 10.6 and the SD 5.0 for that scale. A mean of 11.6 and SD of 4.7 was in evidence for all Ss. For the dogmatism scale, males demonstrated a mean of 3.5 and SD of .75, while females had a mean of 3.1 and SD of .71. The dogmatism mean and SD for all Ss were 3.3 and .75, respectively. Pearson product-moment correlations between scores on these scales were positive, as predicted, for both samples (males, fi < ,001, one-tailed; females, fi < .OOl, one-tailed). However, for males r was .74, which accounted for 54% of the common variation. For the women r was .29, accounting for only 8% of the variation. Therefore, as predicted, the 7 for males was stronger between dogmatism and externality than for females. Perhaps prior srudies need re-examining to take this finding into consideration.

The Pharmacological Treatment of Excessive Stress

Previous chapters have provided clinically relevant discussions of and protocols for the elicitation of the relaxation response. Not only is the relaxation response the natural antithesis of pathogenic stress arousal, but skill in its elicitation engenders in the patient an improved sense of self and a therapeutically useful increase in self-efficacy. Nevertheless, there do come instances where the stress arousal is so intense in magnitude or the target-organ effects are so discomforting that the autogenic elicitation of the relaxation response seems impossible. In such instances, the pharmacological treatment of the stress response warrants serious consideration. The purpose of this chapter is to provide a useful overview of the pharmacological treatment of excessive stress.

The Clinical Use of Relaxation Techniques General Considerations

The purpose of this chapter is to provide a rationale and general introduction for the clinical use of behavioral techniques for relaxation. More specifically, this discussion will focus on techniques which the client may employ for the self-inducement of relaxation. So to provide a common frame of reference, we shall use the term relaxation to refer to an awakened state of hypoaroused psychophysiological functioning, experienced organism-wide or within any given bodily system.

The Pharmacological Treatment of the Stress Response

The purpose of this chapter is to provide a practical introduction to the pharmacological treatment of excessive stress. In presenting this material, we have attempted to provide information which will be useful to both the medically and the nonmedically trained clinician.

Voluntary Control of Respiration Patterns in the Reduction of Excessive Stress

The purpose of this chapter is to discuss using voluntary control of respiration patterns in the reduction of excessive stress. As used in this text, voluntary controlled respiration refers to the process by which the client exerts voluntary control over his or her breathing pattern—in effect, breath control. There exist hundreds of diverse patterns of controlled respiration; we shall examine only several which we feel have particular introductory utility for the clinician concerned with the treatment of the stress response. The exercises presented here are by no means to be considered the only exercises that may be used. We have simply chosen several patterns which we have found to be extremely simple to learn, as well as effective. Simply stated, the goal of voluntary controlled respiration in the treatment of excessive stress is to have the client voluntarily alter his or her rhythmic pattern of breathing so as to create a more relaxed state. The following discussion is most relevant to that stated goal.

The Use of Hypnosis in the Treatment of the Stress Response

The purpose of this chapter is to discuss the use of hypnosis in the prevention and treatment of excessive psychophysiological stress arousal. Since this is seen as an introductory chapter and the topic of hypnosis is complex, only some brief background into the nature of hypnosis with the intent of clarifying its role in the treatment of stress will be presented.

Self-Responsibility as a Therapeutic Force

The purpose of this chapter is to address the issues of self-responsibility in the treatment of the stress response. Health care is seen by many as being in a phase of change. The traditional medical model where the patient/client assumes a totally passive role in his or her treatment appears to be on the decline. In place of such a model we see emerging individual self-responsibility. This model manifests itself in the form of the individual’s becoming an active participant with the clinician in the treatment paradigm. Although such a model does have the potential to be taken to a dangerous extreme (as in the case of the individual’s diagnosing and treating him- or herself without the direction of a trained clinican), or perhaps perceived as a threat by some clinicians, the role of self-responsibility in health care will probably not recede. Self-responsibility plays a particularly important role in the treatment of the stress response. The purpose of this chapter, therefore, becomes to examine that role.

The Measurement of the Stress Response

The previous chapters of this text have described the nature of the stress response. However, no discussion of the nature of any given phenomenon is complete without describing how to identify or measure the phenomenon of interest. The purpose of this chapter is briefly to introduce the reader to the most commonly used criteria for the measurement of the stress response in human beings. Our discussion will entail the most commonly used physiological and psychological criteria.