The relationship of burnout (BO), compassion fatigue (CF), compassion satisfaction (CS), and secondary traumatic stress (STS) to personal/environmental characteristics, coping mechanisms, and exposure to traumatic events was explored in 128 trauma nurses. Of this sample, 35.9% had scores consistent with BO, 27.3% reported CF, 7% reported STS, and 78.9% had high CS scores. High BO and high CF scores predicted STS. Common characteristics correlating with BO, CF, and STS were negative coworker relationships, use of medicinals, and higher number of hours worked per shift. High CS correlated with greater strength of supports, higher participation in exercise, use of meditation, and positive coworker relationships. Caring for trauma patients may lead to BO, CF, and STS; identifying predictors of these can inform the development of interventions to mitigate or minimize BO, CF, and STS in trauma nurses.

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OBJECTIVE—This study examined 1) whether the benefits of mothers’ and fathers’ accepting relationships with their adolescents regarding diabetes control were due to parental monitoring and 2) how parents together may provide sufficient acceptance and monitoring for diabetes management. RESEARCH DESIGN AND METHODS—Adolescents aged 10–14 years with type 1 diabetes (n = 185) and their mothers (n = 185) and fathers (n = 145) completed assessments of parental acceptance and monitoring of diabetes tasks. Adolescents completed a modified version of the Self-Care Inventory (1) to measure adherence. A1C scores were used as a marker of glycemic control. RESULTS—Mediational analyses revealed that the benefits of adolescents’ reports of fathers’ acceptance on A1C and mothers’ and fathers’ acceptance on better adherence were partially mediated by monitoring. Both mothers’ and fathers’ monitoring and fathers’ acceptance had independent effects in predicting adherence. However, only fathers’ monitoring had an independent effect on A1C. The effect of fathers’ monitoring on A1C occurred as fathers were monitoring at a lower level than mothers. Mothers’ and fathers’ reports of their own acceptance and monitoring were not associated with A1C or adherence. CONCLUSIONS—Results reveal the importance of fathers’ acceptance and monitoring in diabetes management, a role that should be encouraged, despite the little attention it has received.

A concerted global response is needed to tackle rising rates of antibiotic resistance, say Otto Cars and colleagues

Enhancing nurses' coaching skills for supporting patients and their families in decision making can be fostered through interventions aimed at the nurses, educational systems, and regulatory organizations. Further research and pragmatic evaluation are needed to better support the acquisition and implementation of decision coaching for all types of health decisions. APPLICATION TO NURSING PRACTICE: The framework indicates the practitioner's role in diagnosing the problem, providing options, and screening for decisional conflict. Decision coaching involves assessing factors influencing patients' decisional conflict, providing support to address decisional needs, monitoring progress in decision making, and screening for factors influencing implementation. Informed patients share their values and preferences shaped by their personal situation.

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Research into the burden of illness has focused predominantly on family caregivers, with little consideration of the other side of the caregiving relationship-care recipients' perspectives on having become a 'burden to others'. However, there is now a small but growing body of evidence to suggest that worry about creating burden to others is a common and troubling concern for people who are nearing the end of their lives. This concern is referred to as 'self-perceived burden'. The present study provides a systematic review of the literature, addressing self-perceived burden at the end of life. Using standard methods, literature was searched for relevant studies in palliative care and related fields. The review revealed that self-perceived burden is reported as a significant problem by 19- 65% of terminally ill patients. It is correlated with loss of dignity, suffering, and a 'bad death'. Self-perceived burden has also been identified as a relevant factor in death-hastening acts among patients with life-threatening illness, as well as in clinical decisions, such as the choice of place of care at the end of life, advance directives, and acceptance of treatment. Given the unique challenges faced by patients with advanced disease and their families, there is a need for further investigation into this under-researched area.