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This edition of the Evidence Based Nursing (EBN) resources page is focused on further information to support the editorial by Alison Twycross and Jane Wray ‘NHS (National Health Service (NHS) England Long-term Workforce Plan: Can this deliver the workforce transformation so urgently needed or is it just more rhetoric?’
EBN has published a number of commentaries that provide useful additional information relating to the UK NHS workforce.
Supporting positive workplace cultures focused on staff well-being is discussed in;
Phenomenography is a method of exploring the phenomenon of interest by examining how a group of individuals experience said phenomenon, uncovering the similarities and differences of this shared experience. The purpose of this paper is to outline the case for phenomenography as a research method ideally suited to explore the complex problems encountered by nurses and midwives within their everyday practice.
Phenomenography emerged in the mid-1970s from the landmark study by Marton and Saljo
Commentary on: Böhmer MN, Oppewal A, Valstar MJ, Bindels PJE, van Someren EJW, Maes-Festen DAM. Light up: an intervention study of the effect of environmental dynamic lighting on sleep-wake rhythm, mood and behaviour in older adults with intellectual disabilities. J Intellect Disabil Res. 2022 Oct;66(10):756–781. doi: 10.1111/jir.12969. Epub 2022 Aug 25.
Increasing light exposure in care facilities improves mood and behaviour in older adults with intellectual disability (ID). Light exposure protocols should be implemented and investigated to determine the optimal intervention parameters.
Sleep problems are frequently experienced by older adults with ID living in residential care facilities
Commentary on: Poncin W, Baudet L, Braem F, Reychler G, Duprez F, Liistro G, Belkhir L, Yombi JC, De Greef J. Systems on top of nasal cannula improve oxygen delivery in patients with COVID-19: a randomized controlled trial. J Gen Intern Med 2022;37(5):1226–32. doi: 10.1007/s11606-022-07419-2. Epub 8 Feb 2022.
The adverse consequences of continuous exposure to high concentrations of oxygen must be considered before instituting prolonged oxygen therapy in patients with COVID-19. Hypoxaemia is significant in patients with COVID-19, and isolated arterial oxygen pressure (PaO2) improvement may not necessarily translate into any significant survival benefit nor relieve the distress of breathlessness.
Oxygen therapy is important in COVID-19 management. The low-flow nasal cannula (NC) has some drawbacks. The patient’s peak inspiratory flow rate requirements are not met due to significant leakage around the source. A need to improve oxygen...
Commentary on: Bansal N, Karlsen S, Sashidharan SP, Cohen R, Chew-Graham CA, Malpass A. Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLoS Med. 2022 Dec 13;1912:e1004139. doi: 10.1371/journal.pmed.1004139.
Mental health service providers need to listen to the voices of ethnic minorities to offer services that align with their needs and experiences and reduce mental health disparities. Research should evaluate the effectiveness of alternative approaches to, and co-production of, biomedical mental healthcare for specific ethnic minority groups.
Mental health disparities are well documented in the UK, despite free access to healthcare. Individuals from minoritised ethnic groups are more likely than white British individuals to: suffer from undiagnosed and untreated mental illness; access healthcare via crisis pathways (and less likely to access via primary care); and receive a diagnosis of severe mental illness. This is costly...
Commentary on: Ćwirynkało K, Parchomiuk M. Support as described by fathers with intellectual disabilities. J Appl Res Intellect Disabil. 2023 Mar;36(2):320-332. doi: 10.1111/jar.13061. Epub 2022 Dec 9
Fathers with intellectual disabilities require informal and formal supports to successfully navigate parenthood. The voices of fathers with intellectual disabilities should be prominent in future disability research.
Men with intellectual disabilities become good fathers with appropriate supports in place. Some fathers with intellectual disabilities were underestimated by partners, relatives and professionals, with their abilities to parent continually questioned. While formal and informal supports were viewed as helpful and necessary, there were differences between the support required and those provided. To develop their parenting skills and competence, fathers with intellectual disabilities require additional support.
This study explored the lived experiences of social support of 20 Polish fathers with intellectual...
Commentary on: Saragih ID, Tarihoran DETAU, Rasool A, Saragih IS, Tzeng HM, Lin CJ. Global prevalence of stigmatization and violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. J Nurs Scholarsh. 2022;54(6):762–71. doi: 10.1111/jnu.12794. Epub 12 Jul 2022.
Health administrators and policymakers should appropriately address issues of stigmatisation and violence against healthcare workers through strategic planning that considers the unique nature of the workplace as well as local culture to ensure better healthcare for the patients. Future research should focus on synthesising evidence-based preventive strategies and management protocols to avert the escalation of stigmatisation and violence towards healthcare workers during catastrophic public health crises.
Violence in the workplace is a common issue in healthcare settings. However, since the beginning of the COVID-19 pandemic, there has been an increase in the number of reports in...
Commentary on: TEAM Study Investigators and the ANZICS Clinical Trials Group; Hodgson CL, Bailey M, Bellomo R, Brickell K, Broadley T, Buhr H, Gabbe BJ, Gould DW, Harrold M, Higgins AM, Hurford S, Iwashyna TJ, Serpa Neto A, Nichol AD, Presneill JJ, Schaller SJ, Sivasuthan J, Tipping CJ, Webb S, Young PJ. Early active mobilization during mechanical ventilation in the ICU. N Engl J Med 2022;387(19):1747–58. doi:10.1056/NEJMoa2209083. Epub 26 Oct 2022.
Early mobilisation may improve patient outcomes; however, starting with a higher dosage at the early stage of critical illness may not provide any added benefit. Future research should explore the intensity, timing, duration and level of activity required to optimise physical rehabilitation of critically ill patients.
Early mobilisation (EM) refers to the practice of initiating physical activity that is of sufficient intensity to elicit acute physiological effects...
Commentary on: Backhouse T, Killett A, Mioshi E, Khondoker M. What are the factors associated with people with advanced dementia refusing assistance with personal care? Int J Geriatr Psychiatry. 2023 Jan;38(1): e5857. doi: 10.1002/gps.5857.
To promote caregivers’ capacity for action, the occurrence of refusal of care in people living with a major neurocognitive disorder (NCD) can be conceptualised as a need for the caregiver to adapt the care offered, its characteristics and/or the approach used. Further research should address the relationship between agitation and refusal of care in people with an NCD, while considering its complexity, to reduce both behaviours.
Refusal of care or resistance to care is the terms frequently used to describe people living with a major NCD refusing care verbally or physically. As people with an NCD have significant cognitive impairment, these behaviours are common...
Commentary on: Neely SR, Eldredge C, Ersing R, Remington C. Vaccine Hesitancy and Exposure to Misinformation: a Survey Analysis. J Gen Intern Med. 2022 Jan;371,:179-187. doi: 10.1007/s11606-021-07171-z. Epub 2021 Oct 20.
Implementing strategic trustworthy communication that targets misinformation themes counters negative information about vaccines and helps achieve community support for vaccination programmes. Amplifying the presence of health professionals on social media and collaborating with political thought leaders may help to anticipate, identify and offset health-related misinformation.
Since the emergence of the SARS-CoV-2 in late 2019, there has been an unprecedented global change. Each country took actions to respond to the outbreak including guidance development, surveillance and epidemiology, testing, providing emergency supplies and rapid vaccine development. During this time, governments struggled to keep up with misinformation, conspiracy theories, social media rumours and uncertainty.
Commentary on: Shields GE, Rowlandson A, Dalal G, Nickerson S, Cranmer H, Capobianco L, Doherty P. Cost-effectiveness of home-based cardiac rehabilitation: a systematic review. Heart. 2023 Feb 27:heartjnl-2021-320459. doi: 10.1136/heartjnl-2021-320459. Epub ahead of print.
Home-based cardiac rehabilitation (CR) is a cost-effective alternative/supplementary model to increase CR accessibility, improve health benefits and reduce health service use. More robust clinical trials are needed as the heterogeneity in design, particularly the intervention dosage, staffing models, telehealth features, hybrid approach and individual costs, challenges the evidence base. The psychological care component is missing in the current cost-effectiveness analysis of home-based CR.
Despite evidence that exercise-based cardiovascular rehabilitation (CR) is an effective intervention, patient uptake and adherence are uncertain. Recent research suggests that home-based CR interventions are as effective and safe as those supervised in a centre.
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