J Dove

Perceived stress among nursing and administration staff related to accreditation.

Background: Nurses in hospital administration and management positions may experience workplace stress, which can have important consequences on the health and well-being. Purpose: The aim of this study was to examine the effects of perceived stress on nursing hospital management and administrative employees of a large health care organization before and after a review by The Joint Commission on the Accreditation of Healthcare Organizations. Methods: A total of 100 hospital employees were randomly selected to complete questionnaires assessing their perception of stress and its effect on their well-being before and after the site review. They were also asked to rate their subjective experience of sleep, anxiety, depression, and job satisfaction. Results: Perceived stress was significantly related to employees’ increased health concerns, symptoms of depression and anxiety, interpersonal relationships, and job satisfaction (p = .003). Conclusions: Hospital accreditation reviews may increase perceived stress and appears to be related to emotional and physical well-being. Application: The implications include evidence there is a need for organizations to initiate corrective action to help nurses in administrative roles to cope with increased levels of job strain, minimize potential psychological and physiological consequences, and preserve job satisfaction.

Effects of Adherence to a Higher Protein Diet on Weight Loss, Markers of Health, and Functional Capacity in Older Women Participating in a Resistance-Based Exercise Program

Resistance training and maintenance of a higher protein diet have been recommended to help older individuals maintain muscle mass. This study examined whether adherence to a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition, markers of health, and/or functional capacity in older females in comparison to following a traditional higher carbohydrate diet or exercise training alone with no diet intervention. In total, 54 overweight and obese females (65.9 ± 4.7 years; 78.7 ± 11 kg, 30.5 ± 4.1 kg/m2, 43.5 ± 3.6% fat) were randomly assigned to an exercise-only group (E), an exercise plus hypo-energetic higher carbohydrate (HC) diet, or a higher protein diet (HP) diet. Participants followed their respective diet plans and performed a supervised 30-min circuit-style resistance exercise program 3 d/wk. Participants were tested at 0, 10, and 14 weeks. Data were analyzed using univariate, multivariate, and repeated measures general linear model (GLM) statistics as well as one-way analysis of variance (ANOVA) of changes from baseline with [95% confidence intervals]. Results revealed that after 14 weeks, participants in the HP group experienced significantly greater reductions in weight (E −1.3 ± 2.3, [−2.4, −0.2]; HC −3.0 ± 3.1 [−4.5, −1.5]; HP −4.8 ± 3.2, [−6.4, −3.1]%, p = 0.003), fat mass (E −2.7 ± 3.8, [−4.6, −0.9]; HC −5.9 ± 4.2 [−8.0, −3.9]; HP −10.2 ± 5.8 [−13.2, –7.2%], p < 0.001), and body fat percentage (E −2.0 ± 3.5 [−3.7, −0.3]; HC −4.3 ± 3.2 [−5.9, −2.8]; HP −6.3 ± 3.5 [−8.1, −4.5] %, p = 0.002) with no significant reductions in fat-free mass or resting energy expenditure over time or among groups. Significant differences were observed in leptin (E −1.8 ± 34 [−18, 14]; HC 43.8 ± 55 [CI 16, 71]; HP −26.5 ± 70 [−63, −9.6] ng/mL, p = 0.001) and adiponectin (E 43.1 ± 76.2 [6.3, 79.8]; HC −27.9 ± 33.4 [−44.5, −11.3]; HP 52.3 ± 79 [11.9, 92.8] µg/mL, p = 0.001). All groups experienced significant improvements in muscular strength, muscular endurance, aerobic capacity, markers of balance and functional capacity, and several markers of health. These findings indicate that a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition compared to a higher carbohydrate diet in older females.