A B S T R A C TBACKGROUND AND OBJECTIVES: Early mobilization of critically ill children may improve outcomes, but parent refusal of mobilization therapies is an identified barrier. We aimed to evaluate parent stress related to mobilization therapy in the PICU. METHODS:We conducted a cross-sectional survey to measure parent stress and a retrospective chart review of child characteristics. Parents or legal guardians of children admitted for $1 night to an academic, tertiary-care PICU who were proficient in English or Spanish were surveyed. Parents were excluded if their child's death was imminent, child abuse or neglect was suspected, or there was a contraindication to child mobilization. RESULTS:We studied 120 parent-child dyads. Parent mobilization stress was correlated with parent PICU-related stress (r s [119] 5 0.489; P # .001) and overall parent stress (r s [110] 5 0.272; P 5 .004). Increased parent mobilization stress was associated with higher levels of parent education, a lower baseline child functional status, more strenuous mobilization activities, and mobilization therapies being conducted by individuals other than the children's nurses (all P , .05). Parents reported mobilization stress from medical equipment (79%), subjective pain and fragility concerns (75%), and perceived dyspnea (24%). Parent-reported positive aspects of mobilization were clinical improvement of the child (70%), parent participation in care (46%), and increased alertness (38%).CONCLUSIONS: Parent mobilization stress was correlated with other measures of parent stress and was associated with child-, parent-, and therapy-related factors. Parents identified positive and stressful aspects of mobilization therapy that can guide clinical care and educational interventions aimed at reducing parent stress and improving the implementation of mobilization therapies.

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The current study examined the relationship between knowledge of adolescent brain development and attitudes about juvenile competency, responsibility, likelihood to recidivate, and rehabilitative capacity. In addition, it examined what factors-a juvenile's age, the type of crime committed, or the immediacy of the crimeinfluenced participants' perceptions. Participants displayed some knowledge of adolescent brain development and social maturity, and tended to see adolescents as not ready, emotionally or psychologically, to handle the proceedings of adult court or a jury trial. However, a delay in criminal behavior (immediate vs. next morning) and type of victim (targeted vs. random) heavily influenced ratings of responsibility, likelihood to recidivate, and rehabilitative capacity. Implications for jury decision making and public policy are discussed.

The current study provides some preliminary evidence that brief educational consultation with PCPs may increase both referrals for ADHD concerns and may influence the way PCPs diagnose and address behavioral health concerns. Implications of these findings and suggestions for future research are discussed. (PsycINFO Database Record

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