Although the UK is a multicultural society, racially minoritised populations are often under-represented in healthcare research owing to the significant barriers to participation they experience.
Commentary on: Ghavi A, Hassankhani H, Meert KL. Parental supporter in pediatric resuscitation: A mixed-method study with Delphi and analytic hierarchy process. J Nurs Scholarsh. 2023 Nov 29. doi: 10.1111/jnu.12947. Epub ahead of print. PMID: 38031298.
Implications for practice and research Parental presence during resuscitation is widely recommended, despite a lack of empirical evidence to guide its implementation. This study explores the characteristics and role of the parental supporter and provides an evidence-based foundation to develop this role in clinical practice.
International guidelines on paediatric resuscitation support parental presence during resuscitation.
Commentary on: Taylor SP, Kowalkowski MA, Skewes S, Chou SH. Real-world implications of updated surviving sepsis campaign antibiotic timing recommendations. Crit Care Med. 2024 doi: 10.1097/CCM.0000000000006240.
Implications for practice and research Antibiotic delivery in suspected sepsis must be prioritised within the clinical context emphasising the need to individualise antibiotic timing according to patient profiles. In the absence of shock, a more lenient approach to antibiotic timing could support the rational use of antibiotics.
Sepsis is a life-threatening response to infection and remains a critical challenge with high morbidity and mortality rates. The Surviving Sepsis Campaign (SSC) guidelines serve as a cornerstone for sepsis management and are pivotal in standardising care. Taylor et al’s article
Commentary on: MacGregor KA, Ho FK, Celis-Morales CA, et al. Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease. BMC Med. 2023;21:488.
Implications for practice and research Fat mass, physical activity level and cardiorespiratory fitness were identified as factors that influence the relationship between the menstrual cycle and levels of glucose, triglycerides, the triglyceride-to-glucose index, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol and the total-to-HDL cholesterol ratio. Future studies should investigate whether these relationships indicate a causal mechanism responsible for the variations in metabolic control throughout the menstrual cycle.
The rate of impaired metabolic regulation is rising among premenopausal women, characterised by decreased insulin sensitivity, increased fasting blood sugar levels and abnormal lipid profiles.
Commentary on: Veresova M, Michail M, Richards H, et al. Emergency department staff experiences of working with people who self-harm: A qualitative examination of barriers to optimal care. Int J Mental Health Nurs. 2024. doi: 10.1111/inm.13353
Implications for practice and research Support from specialist mental health clinicians is a key mechanism for improving self-harm care among emergency department (ED) staff. Findings underpin the need for compassion and empathy when treating people presenting in distress, especially those who present multiple times. Future research should focus on strategies for improving implementation of self-harm clinical guidelines in EDs.
Emergency departments (EDs) have a crucial role in suicide prevention. Around 18% of people who died by suicide presented to ED in the month prior to death, commonly for self-harm.
Commentary on: Alanazi N, Gu F, Li CS, et al.Lorenz RA, Hong CC. Sleep Quality and Associated Factors Among Survivors of Breast Cancer: From Diagnosis to One Year Postdiagnosis. Oncol Nurs Forum. 2024 Feb 19;51(2):163-–174. doi: 10.1188/24.ONF.163-–174. PMID: 38442284.
Implications for practice and research Sleeping disorders are common in breast cancer patients and increase in the first year after diagnosis. Nurses should be aware of the high frequency of these disturbances, which persist after the conclusion of most therapies. The determinants of worsening sleeping quality in breast cancer survivors need to be understood, including the role of treatments, the type of surgery and psycho-social or contextual factors.
Breast cancer is the most common cancer in women worldwide. While research in recent decades has focused on minimising treatment, the disease still impacts women’s lives in many ways. Because increased sleep disturbances affect approximately...
Commentary on: Le Lagadec MD, et al 2024, ‘Nurse by numbers: The impact of early warning systems on nurses’ higher-order thinking, a quantitative study.’ Journal of Advanced Nursing.
Implications for practice and research It is essential to ensure that early warning systems (EWS) are used in a balanced manner, enhancing clinical judgement without undermining the use and development of nurses’ critical thinking abilities. Research into the long-term effects of EWS on cognitive skills and the varying impacts across different levels of nursing experience could yield valuable insights for optimising their use in healthcare.
In modern healthcare, the use of tools such as early warning systems (EWS), has become integral to patient safety, particularly for detecting early signs of patient deterioration.
Commentary on: Goto R, Pinchuk I, Kolodezhny O, et al (2024). Mental health of adolescents exposed to the war in Ukraine. JAMA Pediatrics, 178 (5), 480-488. doi: 10.1001/jamapediatrics.2024.0295.
Implications for practice and research Individuals screening positive require diagnostic evaluation to inform psychiatric treatment decisions and mental health interventions. Future research should expand these findings with objective measures of war/trauma exposure and full diagnostic assessment.
The study by Goto et al screened adolescents across Ukraine for mental health consequences of war.
Artificial intelligence (AI) is now widely accessible and already being used by healthcare researchers throughout various stages in the research process, such as assisting with systematic reviews, supporting data collection, facilitating data analysis and drafting manuscripts for publication.
There are several...
Commentary on: Elfors FB, Widarsson M, Velandia M. Midwives' experiences of postpartum haemorrhage: A web-based survey in Sweden. Midwifery. 2024 Feb;129:103902. doi: 10.1016/j.midw.2023.103902. Epub 2023 Dec 3. PMID: 38064780
Implications for practice and research To ensure safe woman-centred care during a postpartum haemorrhage (PPH) emergency, a multimodal approach is required, incorporating simulation-based training, effective communication styles and management of short staffing. Phenomenological study designs may provide an in-depth understanding of midwives’ lived experiences of PPH, and their perceptions of interventions of PPH management strategies.
Births complicated with postpartum haemorrhage (PPH) are considered traumatic for the woman and the obstetric team, but in most cases are preventable emergencies. In this study, Elforse et al
Commentary on: Ren, LH., Wong, KLY., Wong, J., Kleiss, S., Berndt, A., Mann, J., Hussein, A., Hu, G., Wong, L., Khong, R., Fu, J., Ahmed, N., Nolte, J., Hung, L. (2024) Working with a robot in hospital and long-term care homes: staff experience BMC Nursing 23:317 https://doi.org/10.1186/s12912-024-01983-0
Implications for practice and research When implementing welfare technology, staff education needs to consider relational and cultural factors, including positivity in leadership, teamwork and staff-family relationships to facilitate use. As technological possibilities are increasing, while older populations are growing and working populations are decreasing, user-based research in implementation of welfare technology is urgently needed.
The interest of using digital technologies, robots etc in supporting old age care is growing, due to the fact that the technological possibilities are also increasing. The fact that older populations are growing while working populations are decreasing in...
Commentary on: Wen, F. H., Prigerson, H. G., Hu, T. H., Huang, C. C., Chou, W. C., Chuang, L. P., Chiang, M. C., & Tang, S. T. (2024). Associations Between Family-Assessed Quality-of-Dying-and-Death Latent Classes and Bereavement Outcomes for Family Surrogates of ICU Decedents. Crit Care Med. Published online February 1, 2024. doi:10.1097/CCM.0000000000006199.
Improving end-of-life (EoL) care in intensive care units is paramount for supporting patients and families. Supporting families with EoL decisions can impact their postbereavement health-related quality of life. Recognising and fostering spiritual self-awareness may enhance the bereavement experience.
Intensive care units (ICUs) exposes both patients and families to an unfamiliar/stressful environment, featuring the urgency for enhanced end-of-life (EoL) care within ICUs.
Commentary on: Spoelma MJ, Sicouri GL, Francis DA, Songco AD, Daniel EK, Hudson JL. Estimated prevalence of depressive disorders in children from 2004 to 2019: A systematic review and meta-analysis. JAMA Pediatrics. 2023;177(10):1017–1027.
Implications for practice and research Clinical practice with young children benefits from knowledge about the prevalence of depressive disorders in childhood and that the well-established sex differences seen for depression in adulthood may not appear until adolescence. Further research is needed to address possible changes in the prevalence of childhood depressive disorders around the world and following the COVID-19 pandemic, and whether these changes are differentially distributed across individuals and communities.
Depression in childhood is a long-documented public health concern.
...pining for lost places, for places we have once been in yet can no longer reenter. (Albrecht, 2005).
There is mounting evidence of the effects of global warming and ecological changes on human health, encompassing mental, emotional and spiritual well-being.
Commentary on: Kim MR, Chae SM. Experiences of trust in mothers of hospitalized children toward pediatric nurses. J Child Health Care. 2023 Oct 17:13674935231206214. doi: 10.1177/13674935231206214. Epub ahead of print.
The ability to develop a trusting relationship with families and carers of hospitalised children is an important skill for paediatric nurses as it can facilitate emotional support and parental empowerment Future research in this area requires the development of tools which can objectively measure trust; these must be culturally sensitive and acknowledge the culturally diverse experiences of parents, caregivers and healthcare professionals
Developing a trusting relationship with parents and caregivers is an essential component of paediatric nursing. Previous studies in this area have been largely conducted in western cultures and as such, the experiences of other cultures are not well understood. This study
Commentary on: Toledo-Chavarri A, Delgado J, Rodriguez-Martin B. Perspectives of women living with type one diabetes regarding preconception and antenatal care: A qualitative evidence synthesis. Health Expectations. 2023;27:e13876.
Enhanced peer support and coordinated care between health professionals are needed to address concerns of women with type 1 diabetes in pregnancy. The experiences and perceptions of diverse groups of women with type 1 diabetes need further exploration in order to ensure equitable care.
While guidelines provide evidence-based recommendations for women with type 1 diabetes in pregnancy, women’s perceptions of these recommendations are not well-known. Toledo-Chavarri and colleagues explore these perceptions and found that continuity of care, coordination between health professionals and services, and a more holistic approach are key aspects that are needed for more acceptable, feasible and equitable peripartum care.
Toledo-Chavarri and colleagues...
Commentary on: Rose Sin Yi L, Jing Jing S, Hammoda AO, et al. Effects of mindfulness-based interventions on neuropsychiatric symptoms and psychological well-being on people with subjective cognitive decline and mild cognitive impairment: A meta-analysis. Int J Geriatr Psychiatry. 2023;38(8):e5986. doi: 10.1002/gps.5986. PMID: 37592713.
Individuals with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) commonly experience neuropsychiatric symptoms (NPS), which increase the risk of subsequently developing dementia. This meta-analysis suggests that providing mindfulness-based interventions to persons with SCD or MCI may improve short-term measures of anxiety, stress and quality of life. The impact of these interventions on other measures or in longer-term follow-up remains unclear. To better assess the effectiveness of mindfulness training, future randomised controlled trials (RCTs) will need to be larger and longer duration, should employ strategies to optimise adherence to interventions and should evaluate a range of...
Commentary on: Yeji Hwang, Miranda V. McPhillips, Liming Huang, G. Adriana Perez and Nancy A. Hodgson, Better caregiver mastery is associated with less anxiety in individuals with cognitive impairment, BMC Nursing. 2023; 22:307.
Implications for practice and research Anxiety is one of the common neuropsychiatric symptoms (NPs) in individuals with cognitive impairment. Considering the fluctuating and variable course of NPs in dementia, studies with longer follow-up periods are required to understand the relationship between caregiver mastery and anxiety in patients with dementia. Dementia, an umbrella condition, encompasses various neurogenerative diseases that can cause behavioural problems, movement problems, autonomic dysfunction, gait and balance problems, as well as cognitive impairment. Hence, it is important to develop caregiver skills with different strategies for each type of dementia.
As the population ages, the prevalence of dementia has increased.
Commentary on: Hocking SL et al. Intensive Lifestyle Intervention for Remission of Early Type 2 Diabetes in Primary Care in Australia: DiRECT-Aus. Diabetes Care 2024;47:66–70.
Implications for practice and research Intensive lifestyle intervention in primary care can safely achieve type 2 diabetes (T2D) remission at 12 months in around half of selected participants with short-duration, well-controlled T2D. Research on the effectiveness and acceptability of strategies to improve durability of remission is needed.
Although previously thought to be inevitably progressive, evidence is growing that type 2 diabetes (T2D) can be brought into remission with weight loss.
This study by Hocking et al
Commentary on: Nielsen JM, Humaidan P, Jensen MB, et al. Early pregnancy bleeding after assisted reproductive technology: a systematic review and secondary data analysis from 320 patients undergoing hormone replacement therapy frozen embryo transfer. Hum Reprod 2023;38:2373–81.
Implications for practice and research Patients with autologous vitrified blastocyst transfer treated with a hormone replacement therapy frozen embryo transfer (FET) protocol should be informed that at least minor bleeding appears to be a common adverse event early in pregnancy. Future studies should include patients with natural timing of ovulation (natural cycle frozen embryo transfer, NC-FET) and placental attachment.
Vaginal bleeding is an adverse event that occurs in 20% of spontaneous pregnancies. Although many women with bleeding have normal term pregnancies, profuse bleeding, especially accompanied by pain, carries an increased risk of miscarriage. Our knowledge about early bleeding in pregnancy after hormone replacement therapy (HRT)...