Parents' Degree and Style of Restrictive Mediation of Young Children's Digital Gaming: Associations with Parental Attitudes and Perceived Child Adjustment

Objectives As young children increasingly grow up in a digital environment, parents are confronted with the question whether and how to regulate young children's digital gaming effectively. The goal of this study was to examine correlates of parents' degree of restrictive mediation and their (autonomy-supportive or controlling) style of doing so. Specifically, we tested associations of parents' degree and style of restrictive mediation with parents' attitudes about digital gaming, parental perceptions of children's defiance and problematic gaming, and their interest in social play. Methods A sample of 762 parents of children between 3 and 9 years filled out questionnaires on their degree and style of restrictive mediation, their attitudes about gaming, and their perceptions of children's oppositional defiance, problematic gaming, and interest in social play. Results We found that parents who hold more negative attitudes about digital gaming were more likely to use a controlling style when mediating their child's gaming. Further, a higher degree of restrictive mediation generally related to more adaptive child outcomes (i.e., lower levels of perceived defiance and problematic gaming, higher levels of perceived interest in social play), whereas the opposite pattern was found for parents' controlling style of mediation. Finally, these associations were not moderated by children's age or gender, nor by parents' gender or educational level. Conclusions Also in the context of children's digital gaming, it seems important for parents to set clear rules. Yet, when doing so, it is equally important to refrain from using controlling strategies, as they seem to be counterproductive

Determinants of trajectories of fatigability and mobility among older medical patients during and after hospitalization; an explorative study

BACKGROUND: Fatigability is an important marker of functional decline in community dwelling older people, yet its relationship with functional decline after hospitalization is unclear. The objectives of this study were to identify trajectories of fatigability and mobility over time and to examine the association between demographic and clinical characteristics and these trajectories in medical patients aged 70 years and older admitted to a Dutch tertiary care teaching hospital. METHODS: In this prospective cohort study with baseline (in-hospital), discharge, three-, and six-months post discharge follow-up measurements, fatigability was assessed by the physical subscale of the Pittsburgh Fatigability Scale (PFS). Mobility was assessed by the De Morton Mobility Index (DEMMI). Group-based trajectory modeling was used to identify joint trajectories of fatigability and mobility. Covariates included demographic (age, sex, living situation, education) and clinical characteristics (functional status, frailty status, depression, comorbidity, length of hospital stay). RESULTS: Among 44 patients, three distinct fatigability trajectories and two mobility trajectories were identified over the course from hospital admission up to six months after discharge. Subsequently, three joint trajectories were identified, including low fatigability and high mobility (11%), improving fatigability and high mobility (52%), and high fatigability and low mobility (36%). Controlling for baseline functional status, patients with a lower comorbidity score (OR: 0.27, 95%CI 0.10; 0.74) and higher frailty status (OR: 1.36, 95%CI: 1.07; 1.74) were more likely to be a member of the high fatigability and low mobility trajectories. CONCLUSIONS: From hospital admission up to six months after discharge, three distinct trajectories of fatigability and mobility were identified among older medical patients. Our results should be interpreted with caution due to the small sample size, but may inspire other researchers to determine the value of fatigability assessment in identifying older medical patients at risk for developing mobility problems. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02714-9

Goals of older hospitalised patients:a qualitative descriptive study

Objectives Since the population continues ageing and the number of patients with multiple chronic diseases is rising in Western countries, a shift is recommended from disease oriented towards goal-oriented healthcare. As little is known about individual goals and preferences of older hospitalised patients, the aim of this study is to elucidate the goals of a diverse group of older hospitalised patients. Design Qualitative descriptive method with open interviews analysed with inductive content analysis. Setting A university teaching hospital and a regional teaching hospital. Participants Twenty-eight hospitalised patients aged 70 years and older. Results Some older hospitalised patients initially had difficulties describing concrete goals, but after probing all were able to state more concrete goals. A great diversity of goals were categorised into wanting to know what the matter is, controlling disease, staying alive, improving condition, alleviating complaints, improving daily functioning, improving/maintaining social functioning, resuming work/hobbies and regaining/maintaining autonomy. Conclusions Older hospitalised patients have a diversity of goals in different domains. Discussing goals with older patients is not a common practice yet. Timely discussions about goals should be encouraged because individual goals are not self-evident and this discussion can guide decision making, especially in patients with multimorbidity and frailty. Aids can be helpful to facilitate the discussion about goals and evaluate the outcomes of hospitalisation