In-hospital mobility is an important modifiable factor related to functional decline in older adults in immediate and short-term (1-month follow-up) functional outcomes.

No abstract

The stress parenting responsibilities place on parents increases in situations involving pediatric illness, and therefore can potentially interfere with the normal family life. The present review examines sources of parenting stress across a wide spectrum of illnesses, using three illness groups as exemplars: Congenital heart disease, pediatric cancer, and Autism Spectrum Disorder. A systematic review of the literature using PubMed, CINAHL, Scopus, and PsycINFO databases yielded 66 observational studies investigating sources of parenting stress in parents of young children with congenital heart defects, cancer, and Autism Spectrum Disorder. Quality assessment, using the STROBE and COREQ quality indexes, was further conducted for the included studies. Stressors were categorized, and then analyzed in light of the diagnostic characteristics of the populations in focus. Findings indicate that parents across all illness groups experience increased levels of parenting stress. Several categories were identified in accordance to the parenting stress model as follows: illness-related factors, parental factors, child characteristics, familial factors, and social factors. Further analysis has revealed distinct parental concerns within the groups deriving from the diagnostics, care demands, or social responses specific to each group. Theoretical and practical implications for Family-Systems Nursing Practice were further discussed. Future research and assessment of parenting stress should account for the illness course and address family needs within the specific context of the illness.

Personal traits are important antecedents of personal accountability, which relates to missed nursing care. Findings delineate the profile of the accountable nurse and might help in developing strategies for the selection of nurses with high personal accountability and determining the best means to strengthen accountable behaviours in the workplace.

The COST CARES project aims to support healthcare cost containment and improve healthcare quality across Europe by developing the research and development necessary for person-centred care (PCC) and health promotion. This paper presents an overview evaluation strategy for testing 'Exploratory Health Laboratories' to deliver these aims. Our strategy is theory driven and evidence based, and developed through a multi-disciplinary and European-wide team. Specifically, we define the key approach and essential criteria necessary to evaluate initial testing, and on-going large-scale implementation with a core set of accompanying methods (metrics, models, and measurements). This paper also outlines the enabling mechanisms that support the development of the "Health Labs" towards innovative models of ethically grounded and evidenced-based PCC.

Parenting stress increases in the presence of serious-acute or chronic pediatric health conditions, potentially triggering negative outcomes for families. Parenting stress reduction interventions have been widely disseminated. The current review describes the types, components, and outcomes of these interventions in diverse pediatric populations. A systematic literature search yielded 26 experimental and quasi-experimental studies describing such interventions. Quality assessment was conducted by two doctorally prepared nursing researchers using the Downs and Black's checklist for randomized and nonrandomized studies of health care interventions. Interventions were categorized as follows: interventions with supporting and cognitive components (n = 3), interventions with empowerment and skill development components (n = 18), interventions targeted to children's condition (n = 9), and interventions focusing on the parent-child relationship (n = 5). Most interventions reduced immediate parenting stress levels (n = 23), but failed to demonstrate long-term gains. Future family interventions should target long-term parenting stress, while focusing on specific family needs across pediatric conditions.

Aims To explore nurses’ perspectives regarding the decision‐making processes that lead to missed nursing care and to identify the personal and contextual attributes involved in these processes. Design A qualitative study was undertaken between April – October 2018. Methods A total of 28 registered nurses working in different wards in hospital settings participated in nine focus groups with semi‐structured interviews. An interview guide encouraged nurses to share perceptions of missed care and the personal and contextual attributes shaping their decision‐making. Results Content analysis revealed three themes related to nurses’ decision‐making processes for whether to omit or delay care. First, nurses emphasized the role of nurses’ agency, suggesting explicit or implicit rationing of care, regardless of scarce resources. Second, nurses distinguished between two modes of thinking that they labelled “automated thinking,” activated in routine situations and “effortful thinking,” initiated in more novel situations. Finally, nurses identified situational factors triggering fluctuations in their awareness such as task type, difficult patients and the presence of relatives and the head nurse. Conclusions Nurses are aware of the processes guiding a decision to omit or delay care. They pointed to patient, nurse and ward conditions that serve as cues in their decision whether to miss care. Identifying these cues supports Hammond's cognitive continuum theory of decision‐making and may serve in the development of training programmes for nurses aimed at limiting the phenomenon. Impact The study addressed missed nursing care through a decision‐making lens. The findings pointed to nurses’ agency as shaping decisions about whether to miss care and identified the personal and contextual cues that guide nurses’ decisions. These findings call for organizational training programmes encouraging nurses to identify barriers and facilitators of missed nursing care and how to overcome them.

Aim To examine whether job resources moderate the relationship between job demands and occupational strain, and whether occupational strain mediates the relationship between job demands and job satisfaction. Background The job demand–resource model suggests that job demands and job resources are related to occupational strain, and occupational strain is associated with job satisfaction. Methods In 2018, a cross‐sectional study was conducted with a convenience sample of 85 nurses from six haemodialysis units. Linear regression with moderation–mediation analysis was conducted using SPSS software. Results Under low workload levels, no association between autonomy and occupational strain existed, but under high workload levels, a negative relationship was found between autonomy and occupational strain. Under low workload levels, a negative relationship was found between social support and occupational strain, but under high workload levels, a positive relationship was found. Finally, there was no association between occupational strain and job satisfaction. Conclusion Job resources are moderators of the relationship between job demands and occupational strain. However, there was no significant association between occupational strain and job satisfaction. Implications for Nursing Management Nurse leaders should strengthen nurses' autonomy, which can reduce occupational strain. Additionally, sources of support are needed to help nurses cope with the workload and occupational strain.