Ambiguities concerning the nursing home as a home and place to live, a social environment in which the residents experience most of their social life and the institution where professional health service is provided were uncovered. High-quality care was when ambiguities were managed well and a home could be created within the institution. Implication for practice. Achieving quality care in nursing homes requires reconciling the ambiguities of the nursing home as a home. This implies helping residents to create a private home distinct from the professional home, allowing residents' personal habits to guide institutional routines and supporting meaningful activities. Using these resident developed quality indicators is an important step in improving nursing home services.

Successful adaptation to parenthood may require that parents believe they have the ability to succeed at this challenging task Relationships of selficacy, stress, and parental adaptation were assessed during the early transition to parenthood. Mothers exceeded fathers in self-efficacy, confidence, satisfaction, and support. For mothers, stress and self-efficacy were inversely related, and self-efficacy postpartum was positively associated with partner relationship, satisfaction, confidence, and support. Forfathers, self-efficacyand stress were not related, and self-efficacy at 4 months was associated with confidence and life situation. Self-efficacy and stress as predictor variables modestly explained adaptation to parenthood. Gender predicted confidence in parenting, and the interaction of gender and self-efficacy predicted support for parenting. Strategiesforassessingandenhancingparentingself-efficacyand implicationsforfuture research are discussed.

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BackgroundResidents in nursing homes (NHs) are often frail older persons who have impaired physical activity. Urinary incontinence (UI) is a common complaint for residents in NHs. Reduced functional ability and residence in NHs are documented to be risk factors for UI.ObjectiveTo investigate if an individualized training program designed to improve activity of daily living (ADL) and physical capacity among residents in nursing homes has any impact on UI.Materials and methodsThis randomized controlled trial was a substudy of a Nordic multicenter study. Participants had to be >65 years, have stayed in the NH for more than 3 months and in need of assistance in at least one ADL. A total of 98 residents were randomly allocated to either a training group (n = 48) or a control group (n = 50) after baseline registrations. The training program lasted for 3 months and included accommodated physical activity and ADL training. Personal treatment goals were elicited for each subject. The control group received their usual care. The main outcome measure was UI as measured by a 24-hour pad-weighing test. There was no statistically significant difference between the groups on this measure at baseline (P = 0.15). Changes were calculated from baseline to 3 months after the end of the intervention.ResultsAltogether, 68 participants were included in the analysis, 35 in the intervention group and 33 in the control group. The average age was 84.3 years. The 3 months’ postintervention adjusted mean difference between groups according to amount of leakage was 191 g (P = 0.03). This result was statistically significant after adjusting for baseline level, age, sex, and functional status. The leakage increased in residents not receiving the experimental intervention, while UI in the training group showed improvement.ConclusionThe intervention group had significant better results compared with the control group after an individualized training program designed to improve ADL and physical capacity. Further studies are needed to evaluate the effect of a goal-oriented physical training program toward NH residents UI complaints.