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Background: Many nurses join the profession because they have altruistic intentions, but some nurses experience barriers to acting on altruistic intentions which may be a source of job dissatisfaction or burnout. Objective: The purpose of this study was to evaluate construct validity, internal consistency, and convergence reliability of the Nursing Altruistic Execution Scale (NAES), a novel instrument assessing the perceived ability to help others through work. Methods: The NAES was developed based upon a literature review examining altruistic behavior as a motivator for nursing work, with expert feedback for instrument refinement. Participants completed the NAES, Copenhagen Burnout Inventory Work-Related Burnout Scale, and Satisfaction of Employees in Health Care Survey. Exploratory factor analysis examined construct validity and factor loadings. Confirmatory factor analysis verified consistency in factor structure. Linear regression assessed for convergence reliability with burnout and job satisfaction. Results: The sample included 843 acute care hospital nurses surveyed in January-March 2023. Exploratory factor analysis revealed a two-factor solution, named altruistic engagement with work and workplace barriers to altruism. Nine instrument items were retained and demonstrated strong internal consistency (Cronbach's alpha 0.79). There was a significant relationship between both factors of the NAES and both burnout and job satisfaction, demonstrating that greater altruistic execution is associated with lower burnout and greater job satisfaction. Conclusion: Preliminary findings support the use of the NAES as a valid and reliable scale. Findings show there is correlation between altruistic intentions and burnout. Interventions aimed at enhancing altruistic execution may reduce nurse burnout and thereby improve retention. [ABSTRACT FROM AUTHOR]

Background: Exposure to suffering can lead to compassion fatigue in undergraduate nursing students. Objective: Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction. Results: In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction (F 11,145 = 4.121, P <.001), and 21.9% of the variance in burnout (F 11,144 = 3.786, P <.001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (β = 0.349, P =.025; and β = 0.309, P <.001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (β = −0.280, P <.001; β = −0.392, P =.014; and β = −0.206, P =.014, respectively). The Unorthodox view, in which a deity exists that allows suffering, had a significant main effect on secondary traumatic stress (β = 0.232, P =.027). Positive thinking did not moderate any of the relationships between the views of suffering and the dependent variables. Conclusions: Knowledge of these relationships can aid in the assessment of nursing students at risk for poor outcomes and guide intervention development to promote professional quality of life. [ABSTRACT FROM AUTHOR]

Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of the nurse and of those who must evaluate such claims. We synthesized the framework using Rest's Four Component Model of moral reasoning along with tenets of the International Council of Nursing's (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. [ABSTRACT FROM AUTHOR]

Background: The aims of this review were to describe exercise interventions, facilitators, and barriers to physical activity for parents of children with autism spectrum disorder. Methods: A systematic review of the literature, appraising the validity of each article with Melnyk and Fineout-Overholt's level of evidence, from different databases CINAHL, Cochrane, PsycINFO, PubMed, ProQuest, and Web of Science between 2000 and 2020 was conducted. As the initial search revealed no articles on exercise interventions and only 2 articles with children with autism spectrum disorder, the aim was widened to all parents of children. Results: Forty-five articles were identified on barriers to physical activity including being the primary caregiving parent, perception of guilt and selfishness, and adhering to exercise programs they do as part of research, once research ends. Facilitators for physical activity including parents being more likely to exercise if they can bring their child with them and parents preferring exercise that is a lifelong habit, such as walking. Conclusions: Due to the lack of research on parents of children with autism spectrum disorder, recommendations include development and testing of interventions for parents of children with this condition including family-based exercise interventions where children and parents have a choice to exercise together. [ABSTRACT FROM AUTHOR]

This study compares quality of discharge teaching and care coordination for parents of children with challenging behaviors participating in a nursing implementation project, which used an interactive iPad application, to usual discharge care. Unlike parents in the larger quasi-experimental longitudinal project, parents of children with challenging behaviors receiving the discharge teaching application (n = 14) reported lower mean scores on the quality of discharge teaching scale–delivery subscale (M = 8.2, SD = 3.1) than parents receiving usual care (n = 11) (M = 9.6, SD = 4.7) and lower scores on the Care Transition Measure (M = 2.44, SD = 1.09) than parents receiving usual care (M = 3.02, SD = 0.37), with moderate to large effects (0.554–0.775). The discharge teaching approach was less effective with this subset, suggesting other approaches might be considered for this group of parents. Further study with a larger sample specific to parents of children with challenging behaviors is needed to assess their unique needs and to optimize their discharge experience. [ABSTRACT FROM AUTHOR]

The purpose of this mixed methods pre-/post-pilot intervention study was to assess parental psychological health and child challenging behaviors before and after a swimming program for children with autism. Participants were 10 parent–child dyads. Child's challenging behaviors were lower in the post testing (Cohen's d = 0.07–0.45). Mean scores were improved for parent perception of general health (Cohen's d = 0.22). Three themes emerged from the post swim program focus group: (a) Parent satisfaction with instructors with sub themes (i) firmness (ii) creativity, and (iii) promotion of social interaction and sharing, (b) improved child sleeping, and (c) family dynamics with sub themes (i) siblings wanted to swim and (ii) parents' fear of drowning. Preliminary results point to improved child behaviors and parent perception of general health. Future studies can focus on expanding the swim program to include all family members. [ABSTRACT FROM AUTHOR]

Children with Rett Syndrome (RS) have neuromotor impairments that impact their mobility. Poor hand function among children with RS limits the selection of an assistive device for ambulation.Purpose:The purpose of this case report is to describe the process of selecting an assistive device for a child with RS to promote ambulation.Method:This single subject case reports on a 5-year-old girl with RS at a suburban mid-western early childhood special education setting.Results:The child in this case was able to walk the farthest distances with a metal toy shopping cart and then with an anterior facing four-wheeled walker.Conclusion:The outcome suggests that physical therapists and health professionals caring for young children with RS consider using a metal toy shopping cart to establish and practice ambulation prior to selection of a longer term, adjustable anterior facing walker like the one in this case report. [ABSTRACT FROM PUBLISHER]

Introduction: The cumulative number of COVID-19 cases has surpassed 579 million globally. Symptoms during and after COVID-19 infection vary from mild cold symptoms to severe multisystem illness. Given the wide range of symptom presentations and complications post-COVID-19, the purpose of this study was to describe the lived experience of American adults surviving COVID-19. Method: This study employed an exploratory qualitative description design. Semi-structured interviews were conducted with a sample of 35 individuals (White [94%], female [71%], Mage = 43.7 years), with proximity to a university in an urban Midwest American city. Interviews occurred between May and August 2021, 3 or more months after participants tested positive for COVID-19. Results: Forty percent of the 35 participants experienced prolonged COVID-19 symptoms impacting their lifestyle. Four themes characterized the impacts of the post-COVID-19 condition on the lives of the participants within the context of a global pandemic: (a) disruptions in health and well-being, (b) persistent uncertainty, (c) disruptions in interpersonal relationships, (d) beneficent outcomes and adaptation. Discussion: This study of COVID-19 has identified important implications for physical activity and interpersonal stress. Prolonged COVID-19 symptoms led to disruptions in the health, well-being, and interpersonal relationships of participants. Health care professionals need to attend to symptoms post-COVID-19, assess interpersonal functioning, and provide guidance on physical activity. Future studies are recommended to track consequences of COVID-19's impact on long-term health and well-being. Public Significance Statement: Adults who have had COVID-19 may have long-lasting impacts from the infection affecting their health and well-being. The uncertainty of having COVID-19 may lead to deferring needed care for symptoms unrelated to COVID-19, altered interpersonal functioning, or decreased ability to exercise. [ABSTRACT FROM AUTHOR]

Background: Patient advocacy is a duty for professional nurses; however, not all nurses are empowered to advocate for meeting patients' needs. Participation in labor unions may serve as a venue for nurses with limited institutional decision-making authority to advocate for patient needs; however, unionization can be a time-intensive and fraught process. Purpose: This study examined how nurses participating in a new union in an urban United States hospital described their reasons for participating in a labor union during collective bargaining. Methods: Content analysis of participant's interviews that took place between January and March 2023, after the nurses voted to unionize and collective bargaining had commenced but progress had stalled, and before additional actions (e.g., informational picketing, labor strikes) were authorized by union members. Findings: Content analysis generated three themes: (a) systemic barriers to advocacy, (b) unionization as an advocacy method, and (c) professional empowerment through unionization. Nurses in this study perceived barriers to meeting patient care needs that were insufficiently addressed prior to unionization. They described their motivation to participate in the union due to their desire to advocate despite adversity and finding empowerment through union activities. Implications for Practice: This study highlights the need for equity in decision-making authority and greater opportunities for nurses to effect workplace changes., Competing Interests: Data AvailabilityAccess to the data utilized in this study may be considered upon request sent to the corresponding author. Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: One coauthor is a member of the union that is described by this study.

Introduction: Nurse turnover has accelerated during the COVID-19 pandemic. Nurse refusal of mandated vaccines contributes to understaffing and affects patient health outcomes. The purposes of this study were to describe (1) nurse reasons for COVID-19 vaccine decisions and (2) the relationship between vaccine status and nurse characteristics., Methods: This cross-sectional descriptive study employed a survey of US nurses who worked in nursing during the COVID-19 pandemic. The survey included a free-text question about COVID-19 vaccine uptake rationale, self-reported vaccine acceptance/refusal, and demographic data., Results: Of the 1682 participants, 11.2% refused the COVID-19 vaccine. Higher education level was correlated with greater vaccine acceptance rates ( P  < 0.001). Themes for vaccine rationale included safeguarding well-being, trust in the science, coercion to vaccinate, perceived immunity, and concern about preexisting health conditions., Conclusions: The risks of COVID-19 vaccine mandates may be greater than the potential benefits given the potential for compounding workforce attrition during a nursing staffing crisis. Further research is needed to outline the relationships between vaccine education, advocacy, and vaccine uptake among nurses., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)

Quality discharge teaching prepares patients and families to transition safely from hospital to home. Technology can enhance and support quality discharge teaching by promoting patient family engagement during the transition. The purpose of this mixed methods study was to explore clinical nurses' experience with using Engaging Parents in Education for Discharge, an iPad application to guide quality discharge teaching. Twelve nurses at a large Midwestern Children's Hospital participated in small focus groups after use of the Engaging Parents in Education for Discharge application and completed a questionnaire on their perception of the acceptability and feasibility of the app. Findings revealed three themes: (1) development and deployment issues focused on the importance of training and support by the study team during implementation; (2) workflow integration centered on the importance of incorporating use of the app into current workflows and to preserve effective communication strategies with parents to optimize use in the healthcare setting; and (3) nurses perceived value in the use of the Engaging Parents in Education for Discharge app for beneficial scripting, questions on discharge topics often forgotten, and guidance for complex patients. Results of this study offer insight into key components for consideration when implementing and integrating technology to aid nursing practice., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)