In a study to explore nurses' perceptions of their role as facilitators of parent participation in the care of hospitalized children and the factors that promoted or impeded their role, massive reform and downsizing of hospitals were noted to have created tension between the restructured health care system and the capacity of nurses to provide the optimal level of care they valued. Specifically, revised staffing patterns, (e.g., increased number of part-time and casual nurses) and workload issues (e.g., time constraints, early discharges) created concerns relative to job satisfaction and the quality of participatory care facilitated by nurses. Findings from this study support those reported in other literature.

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