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AnteayerEvidence-Based Nursing

Infertility and poor reproductive outcomes as potential predictors of early and premature menopause: lets act before it would be too late!

Por: Etrusco · A. · Lagana · A. S.

Commentary on: Liang C, Chung HF, Dobson AJ, Cade JE, Greenwood DC, Hayashi K, Hardy R, Kuh D, Schouw YTV, Sandin S, Weiderpass E, Mishra GD. Is there a link between infertility, miscarriage, stillbirth, and premature or early menopause? Results from pooled analyses of 9 cohort studies. Am J Obstet Gynecol. 2023 Jul;229(1):47.e1-47.e9. doi: 10.1016/j.ajog.2023.04.009. Epub 2023 Apr 13.

Implications for practice and research

  • Women with a history of recurrent miscarriages, infertility, or stillbirths should be informed of their increased risk of early or premature or menopause.

  • Future studies should aim to evaluate whether a tailored counselling and management strategies considering this risk can improve patient outcomes and overall quality of care.

  • Context

    Menopause is a significant milestone for women, marking the permanent cessation of menstruation after 12 months of amenorrhoea. The onset of menopause is influenced by various factors, including genetics, lifestyle and...

    Gender differences found in fall-related factors among community-dwelling Korean older adults

    Por: Zhang · N. · Arunachalam · U.

    Commentary on: Suh M, Kim DH, Cho I, Ham OK. Age and gender differences in fall-related factors affecting community-dwelling older adults. J Nurs Res. 2023 Apr 1;31(2):e270. doi: 10.1097/jnr.0000000000000545.

    Implications for practice and research

  • Future research could explore and test the efficacy of gender-specific fall prevention protocols.

  • In practice, understanding that there are gender-based risk factors for falls would assist and prompt nurses and health professionals to perform assessments or interventions to specifically mitigate those risks

  • Context

    Falls are an incredibly common issue among older adults, with potentially serious downstream consequences. Suh et al (2023) aimed to explore not only the prevalence of falls but also the factors relating to age, gender and falls. It is well established that there are gender differences in the prevalence of falls, however, the reasoning is not fully understood. This study was conducted to address the paucity in...

    Improving nutritional care for older adults: the role of massive open online courses and implementation science in enhancing health professional knowledge and attitudes

    Por: Bonetti · L. · Caruso · R.

    Commentary on: Eglseer D. Development and evaluation of a Massive Open Online Course (MOOC) for healthcare professionals on malnutrition in older adults. Nurse Educ Today. 2023 Apr;123:105741. doi: 10.1016/j.nedt.2023.105741. Epub 2023 Feb 4.

    CommentaryImplications for practice and research

  • Massive open online course (MOOCs) can improve health professionals (HPs)’ knowledge and nutritional care skills for malnutrition in older adults efficiently.

  • Implementation science studies are necessary to effectively change HPs’ behaviours and attitudes towards malnutrition by considering organisational, cultural and self-efficacy aspects.

  • Future research should focus on identifying effective strategies for implementing evidence-based nutritional care for older adults, emphasising HPs’ attitudes and self-efficacy.

  • Context

    Malnutrition is a prevalent condition among older adults in acute hospital settings that can result in adverse clinical outcomes such as increased pressure ulcer development, reduced wound healing, increased infections and higher mortality rates.1 Providing adequate nutritional care...

    Early career nurse researchers: insights, challenges and strategies for success

    Por: Sisson · H.

    The term early career researcher (ECR) is commonly used, although its meaning is expressed by a wide range of definitions which vary globally, and may be institutionally determined.1 2 Length of time since the start or completion of doctoral training (or equivalent professional training) or a first academic appointment is often used by research councils such as the UK Research and Innovation (UKRI) (see Early career researchers–UKRI). Stage of career is also sometimes referred to with ECRs being a catch-all term for doctoral and immediately postdoctoral researchers as well as those making the transition to an independent research career (see Early career researchers–UKRI).

    Increasingly, the challenges associated with such time-bound definitions of ECRs are being acknowledged. Many bodies which offer funding for ECRs (eg, see Early career research fellowships–InterAct Hub (interact-hub.org) and Early career researchers: career and skills development–UKRI)...

    Engaging clinicians in research: barriers, benefits and building a blueprint

    Por: Mickan · S.

    Commentary on: Boucher NA, Tucker MC, White BS, et al. Frontline clinician appraisement of research engagement: "I feel out of touch with research". J Gen Intern Med 2023:1–7. doi: 10.1007/s11606-023-08200-9.

    Implications for practice and research

  • Leadership action by prioritising clinical research activities and introducing a range of clinician engagement strategies for research can lead to better staff retention and patient care.

  • Implementation of clinician engagement strategies needs further research to clarify and enhance key benefits for staff and patients.

  • Context

    There is a growing body of international research evidence highlighting the benefits of clinicians’ research engagement and documenting associated barriers and facilitators.1 This study offers an insightful consolidation of clinicians’ perception of research alongside their barriers and facilitators to effective engagement.2 Full time clinicians in a specific healthcare system often do not see research as a core part of their...

    Unravelling the complexities of nutritional behaviours in hospital nurses: a commentary on enablers and barriers to healthy eating

    Por: Abujaber · A. A. · Nashwan · A. J.

    Commentary on: Marko S, Wylie S, Utter J. Enablers and barriers to healthy eating among hospital nurses: a systematic review. Int J Nurs Stud. 2023 Feb;138:104412. doi: 10.1016/j.ijnurstu.2022.104412. Epub 2022 Dec 5

    Implications for practice and research

  • Multi-faceted interventions are key in addressing various influences on nurses’ healthy eating beyond individual choices.

  • Rigorous studies are needed to assess multi-level socio-ecological interventions’ effectiveness on nurses’ eating habits.

  • Context

    Nurses, despite playing a significant role in healthcare, have been found to possess poor dietary habits and face elevated rates of chronic illnesses. A recent systematic review by Marko and colleagues explored factors influencing healthy eating among nurses in hospital settings. Barriers included high accessibility of unhealthy foods, high costs and lack of storage/preparation facilities. Enablers included proximity to healthy options, roster planning and structured workplace programmes. Supportive networks were an interpersonal enabler, while work culture and...

    Low-quality evidence for medication errors reduction strategies in hospital paediatrics

    Por: Desforges · J. · Roumeliotis · N.

    Commentary on: King C, Dudley J, Mee A, Tomlin S, Tse Y, Trivedi A, Hawcutt DB; Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacist Group Joint Standing Committee on Medicines. For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review. Arch Dis Child. 2023 Jul;108(7):583–588. doi: 10.1136/archdischild-2022-324772. Epub 2023 Feb 15. PMID: 36792347.

    Implications for practice and research

  • Medication errors can occur throughout many complex steps.

  • Children are exposed to a higher risk of harm than adults when it comes to medication errors.

  • High-quality evidence for interventions that reduce medication errors in children on rounds is lacking.

  • Context

    King et al conducted a systematic review of interventions aimed at reducing medication errors during inpatient rounds in children’s hospitals.1 Medication errors in hospitals may arise at many points in a complicated cascade of steps...

    How healthy dietary patterns have an impact on overall and cause-specific mortality?

    Por: Nguyen · N. T. H. · Duong · T. V.

    Commentary on: Shan Z, Wang F, Li Y, Baden MY, Bhupathiraju SN, Wang DD, Sun Q, Rexrode KM, Rimm EB, Qi L, Tabung FK, Giovannucci EL, Willett WC, Manson JE, Qi Q, Hu FB. Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality. JAMA Intern Med. 2023 Feb 1;183(2):142-153. doi: 10.1001/jamainternmed.2022.6117. Erratum in: JAMA Intern Med. 2023 Jun 1;183(6):627.

    Implications for practice and research

  • Wholesome eating diets can be customised to align with person’s culinary traditions and tastes in accordance with the Dietary Guidelines for Americans to decrease the mortality risk.

  • Provide updated scientific evidences on the benefits of maintaining a healthy diet throughout the life course to take appropriate strategies and policies.

  • Context

    Healthy eating patterns play a prominent role in preserving public health. The association between dietary patterns with the mortality risk has been investigated in numerous countries.1 2

    Who gets to die at home? Race and disease-related cause of death impacts young adults place of death

    Por: Sansom-Daly · U. M. · Mack · J. W.

    Commentary on: Gustafson CM, Higgins M, Wood KA, Song MK. Place of death for young adults with chronic illness. Nurs Res. 2023 Jul 11. doi: 10.1097/NNR.0000000000000681. Epub ahead of print.

    Implications for practice and research

  • Clinicians must communicate with young adults (YAs) throughout their disease course about end-of-life care preferences, including place-of-death.

  • Future research must explore YAs’ preferences for place-of-death.

  • Context

    Young adults (YAs) with serious illnesses report wanting choices in their end-of-life care.1–3 Where YAs would prefer to die is highly personal, though some studies have reported that many YAs prefer home-based palliative care and death.2 3 Yet, many YAs experience high-intensity, inpatient care at the end of their lives,4 with approximately half of YAs with cancer dying in hospital.4 Factors influencing these patterns of care—and the extent to...

    Clinicians signal the need to improve competency in the care of patients who identify as LGBTQ+

    Por: Ryan Schultz · T.

    Commentary on: Kelleher ST, Barrett MJ, Durnin S, Fitzpatrick P, Higgins A, Hall D. Staff competence in caring for LGBTQ+ patients in the paediatric emergency department. Arch Dis Child. 2023 Jul;108(7):525–529. doi: 10.1136/archdischild-2022-325151. Epub 2023 Apr 24.

    Implications for practice and research

  • Emergency department staff self-identified the need for training in the care of youth who identify as LGBTQ+ to close a gap in knowledge and clinical preparedness.

  • Intervention studies, using evidence-based science, are needed to improve competency and advance health equity for LGBTQ+ youth.

  • Context

    Individuals who identify as LGBTQ+ report discrimination in healthcare settings.1 Clinicians describe a lack of formal education in LGBTQ+ care needs.2 Adolescence is complex; adolescents who identify as LGBTQ+ are among our most vulnerable. International statistics illuminate that these youth are at exponentially higher risk for suicide.3 This study by Kelleher and...

    Digital assets should be included in advance care planning discussions for patients receiving palliative care

    Por: Al Qadire · M. · Abdelrahman · H.

    Commentary on: Stanley S, Higginbotham K, Finucane A, Nwosu AC. A grounded theory study exploring palliative care healthcare professionals’ experiences of managing digital legacy as part of advance care planning for people receiving palliative care. Palliat Med. 2023 Oct;37(9):1424–1433. doi: 10.1177/02692163231194198. Epub 2023 Aug 23.

    Implications for practice and research

  • Digital legacy could be incorporated into advance care planning policies in practice, with explicit inclusion in advance care planning documents.

  • Further research is required to explore the diverse facets of digital legacies within various patient populations and cultural backgrounds.

  • Context

    The rapid growth of technology, including increased internet access and smartphone usage, has made digital legacy management an important aspect of end-of-life care. Digital legacy refers to the digital assets and online presence that individuals leave behind after they pass away.1 However, a study on healthcare professionals indicated that a significant majority...

    Patient-centered perspectives in diabetic retinopathy care: phenomenology and practice

    Por: Raman · R. · Kumar · S.

    Commentary on: Zhang M, Zhang C, Chen C, et al. The experience of diabetic retinopathy patients during hospital-to-home full-cycle care: a qualitative study. BMC Nurs. 2023 Mar 3;22(1):58. doi: 10.1186/s12912-023-01206-y.

    Implications for practice and research

  • Consideration of patients' life experiences, which aids in examining their feelings and patient’ experiences.

  • Future research should further investigate the phenomenological approach in diverse healthcare contexts.

  • Context

    The transition from hospital to home treatment for patients with diabetic retinopathy (DR) is the subject of a study by Zhang and colleagues. The authors attempt to comprehend the substance of this phenomenon a shift towards patient-centric healthcare research by using a phenomenological method.1 Such first-hand experiences may help to close the gap between patient demands and medical practise, laying the groundwork for personalised and emphathetic care strategies.

    Methods

    The descriptive phenomenology method was used to implement this...

    Cultural competence in nursing education: examining the nexus of cultural sensitivity and effectiveness among nursing students

    Por: Tosun · B.

    Commentary on: Kardas U, Yilmaz Sahin S. Investigation of the relationship between cultural sensitivity and effectiveness levels among nursing students. Nurse Educ Pract. 2023 Oct;72:103773. doi: 10.1016/j.nepr.2023.103773. Epub 2023 Aug 29 .

    Implications for practice and research

  • Nurse educators and policymakers can draw valuable insights from these findings to shape evidence-based strategies for enhancing cultural competence in nursing education, ultimately contributing to the provision of culturally sensitive and effective healthcare services.

  • The unexpected decline in cultural sensitivity and effectiveness levels as students approach graduation raises intriguing questions about the factors influencing these dynamics. Longitudinal studies are recommended to provide a comprehensive understanding of how cultural competence evolves over the course of nursing education.

  • Context

    When intercultural competence is comprehensively addressed in providing healthcare services, it positively influences patients’ satisfaction levels, participation in care and safety.1 To achieve this, cultural sensitivity and cultural...

    Better cardiovascular health for a longer life without major diseases

    Por: Lopez-Bueno · R.

    Commentary on: Wang X, Ma H, Li X, et al. Association of Cardiovascular Health With Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in UK Adults. JAMA Intern Med. 2023 Apr 1;183(4):340-9. doi: 10.1001/jamainternmed.2023.0015. Erratum in: JAMA Intern Med. 2023 Apr 1;183(4):394. Erratum in: JAMA Intern Med. 2023 May 15.

    Implications for practice and research

  • Improving cardiovascular health may contribute to a higher and healthier life expectancy.

  • Healthcare professionals may prioritise cardiovascular health promotion and support patients in adopting healthy behaviours.

  • Context

    The problem addressed in this study is the contribution of cardiovascular risk factors to a healthier life expectancy.1 Life expectancy has been boosted in recent decades in developed countries, but not all of the increased life expectancy elapses in good health.2 This study aims to investigate the associations between levels of cardiovascular health through Life’s Essential...

    Are we ready for prehospital troponin testing by paramedics?

    Por: Vrints · C. J. M.

    Commentary on: Dawson LP, Nehme E, Nehme Z, Zomer E, Bloom J, Cox S, Anderson D, Stephenson M, Ball J, Zhou J, Lefkovits J, Taylor AJ, Horrigan M, Chew DP, Kaye D, Cullen L, Mihalopoulos C, Smith K, Stub D. Chest Pain Management Using Prehospital Point-of-Care Troponin and Paramedic Risk Assessment. JAMA Intern Med. 2023 Mar 1;183(3):203-211. doi: 10.1001/jamainternmed.2022.6409.

    Implications for practice and research

  • In patients calling the emergency medical system for acute chest pain without ST-segment elevation, prehospital risk stratification using validated risk scores and point-of-care (POC) cardiac troponin measurement by emergency nurses or paramedics can result in substantial cost savings.

  • The safety of this strategy needs confirmation by sufficiently powered prospective randomised clinical trials.

  • Context

    Acute chest pain is one of the most common reasons for emergency system activation and transfer to the emergency department (ED).1 Only a minority of...

    Factors that enable or hinder the rebuilding of the therapeutic relationship following an episode of physical restraint in acute forensic services

    Por: Askola · R. · Lantta · T.

    Commentary on: Moyles J, Hunter A, Grealish A. Forensic mental health nurses’ experiences of rebuilding the therapeutic relationship after an episode of physical restraint in forensic services in Ireland: A qualitative study. Int J Ment Health Nurs. 2023 May 26. doi: 10.1111/inm.13176. Epub ahead of print.

    Implications for practice and research

  • Ensuring routine postrestraint-focused clinical supervision, experiential training for forensic mental health nurses involved in rebuilding therapeutic relationships postphysical restraint, effective debriefing and positive role modelling from senior staff is needed.

  • Studies on models to combine goals of the therapeutic relationship and maintain safety are needed, besides establishing the effectiveness of different methods to facilitate a therapeutic relationship.

  • Context

    Forensic mental health nurses (FMHNs) are expected to manage potentially serious levels of risk while maintaining a proportionate balance between therapeutic care and potentially restrictive security.1 The use of coercion in mental health...

    Impact of moral distress on early career nurses: an integrative review

    Por: Finch · N.

    This is a summary of Loyd et al.1

    Background and purpose

  • ‘Moral distress’ is described by Jameton as ‘...aris[ing] when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’ (p. 6).2

  • Moral distress may cause nurses to question their career choice, and to feel disempowered and unhappy in their work. This may have a negative impact on the physical and mental well-being of nursing staff, leading to burnout and high staff turnover.

  • Nurses in the first 5 years of their career (early career nurses) may be particularly at risk of experiencing moral distress as they make the stressful and challenging transition from student to qualified practice.

  • The purpose of the review is to synthesise the literature regarding moral distress in the first 5 years of qualified practice.

  • ...

    Nurturing healthy futures: unveiling promising policy avenues to tackle root causes of poor health in early years

    Por: Ospina · M. B. · Bailleux · M.

    Commentary on: Stewart E, Pearce A, Given J, Gilbert R, Brophy S, Cookson R, Hardelid P, Harron KL, Leyland A, Wood R, Dundas R. Identifying opportunities for upstream evaluations relevant to child and maternal health: a UK policy-mapping review. Arch Dis Child. 2023 Jul;108(7):556-562. doi: 10.1136/archdischild-2022-325219. Epub 2023 Mar 31.

    Implications for practice and research

  • Prioritising policies targeting social determinants of health is crucial for improving early-life health outcomes. Public involvement in policy prioritisation is vital for equitable and effective policies.

  • Investing in comprehensive evaluations using harmonised and accessible administrative data is necessary to understand long-term effects of policy effectiveness.

  • Context

    Reducing early-life health inequalities is a critical challenge amid the COVID-19 socioeconomic impact.1 Sociostructural policies addressing upstream determinants are important, but evidence is limited compared with individual interventions—a discrepancy known as the inverse evidence law.2 3 To...

    Trajectory patterns of self-care behaviour over 1 year provide nurses insights to tailor individualised care for patients with heart failure

    Por: Chang · W.-T. · Chen · H.-M.

    Commentary on: Son YJ, Jang I. One-year trajectories of self-care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study. J Clin Nurs. 2023 Sep;32(17-18):6427-6440. doi: 10.1111/jocn.16658. Epub 2023 Feb 23.

    Implications for practice and research

  • Timely identifying self­care behaviour patterns over time may reduce the risk of hospital readmissions in patients with heart failure (HF).

  • Further research studies are required to examine the effects of every 3–6 months self-care intervention on hospital readmissions among patients with HF.

  • Context

    Unplanned readmissions within 30 days and 6 months postdischarge are notably common in patients with HF.1 2 Effective self-care behaviours are essential to lower readmissions. However, the trajectories of self-care behaviours throughout the HF progression can vary among patients.3 Limited research studies have examined the relationships among the influencing variables, self-care behaviours and readmissions over...

    Death education: the importance of terror management theory and of the active methods

    Por: Testoni · I.

    Commentary on: Wu Q, Zhu P, Ji Q, et al. The effect of death education course utilizing constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death: A mixed study design. Nurse Educ Today. 2023 Jul;126:105809. doi: 10.1016/j.nedt.2023.105809. Epub 2023 Apr 6.

    Implications for practice and research

  • Death education courses (DECs) prepare healthcare students to manage future relationships with end-of-life (EOL) patients and their relatives. It would be better for DECs to use active methodologies, for example, creative arts therapies and constructivist and narrative techniques.

  • Research should longitudinally monitor students who have completed a DEC to check their levels of willingness to work in palliative care and their levels of work satisfaction versus burn-out in both the EOL and other hospital wards after they become healthcare professionals.

  • Context

    Many healthcare practitioners suffer from a lack of competence in death...

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