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AnteayerEvidence-Based Nursing

Nurses must be aware of the potential for causing distress when recruiting vulnerable populations to research projects

Por: White · C. M.

Commentary on: Alexander S, Pillay R, Smith B. A systematic review of the experiences of vulnerable people participating in research on sensitive topic. Int J Nurs Stud 2018;88:85–96.

Implications for practice and research

  • Nurses can confidently recommend a research study to patients from vulnerable populations because the overall impact on their well-being is generally modest and most patients with research-induced distress are still glad they participated.

  • Vulnerable patients value their role as research participants and, even if there is some distress caused by participating, most patients still feel their participation is worth it.

  • Context

    Vulnerable populations (e.g. mentally ill, terminally ill, physical or sexual trauma, children, cognitively impaired, homeless, prisoners, migrants/refugees) are at the risk of distress when asked sensitive questions (eg, past trauma, mental illness, illegal activity, addiction).1 2 This systematic review by Alexander et al summarises the current literature exploring...

    EBN perspectives: care of the older person

    Por: Barrett · D. · Green · L.

    EBN Perspectives brings together key issues from the commentaries in one of our nursing topic themes.

    Triangulation in research, with examples

    Por: Noble · H. · Heale · R.
    What is triangulation

    Triangulation is a method used to increase the credibility and validity of research findings.1 Credibility refers to trustworthiness and how believable a study is; validity is concerned with the extent to which a study accurately reflects or evaluates the concept or ideas being investigated.2 Triangulation, by combining theories, methods or observers in a research study, can help ensure that fundamental biases arising from the use of a single method or a single observer are overcome. Triangulation is also an effort to help explore and explain complex human behaviour using a variety of methods to offer a more balanced explanation to readers.2 It is a procedure that enables validation of data and can be used in both quantitative and qualitative studies.

    Triangulation can enrich research as it offers a variety of datasets to explain differing aspects of a phenomenon of...

    Intimate partner violence, post-traumatic disorders and menopausal symptoms

    Por: Ali · P. · McGarry · J.

    Commentary on: Gibson CJ, Huang AJ, McCaw B, et al. Associations of intimate partner violence, sexual assault, and posttraumatic stress disorder with menopause symptoms among midlife and older women. JAMA Intern Med 2019;179(1):80–7.

    Implications for practice and research

  • Healthcare professionals need to be aware of the impact of intimate partner violence (IPV) experienced by mid-life and older women as IPV experiences and post-tramautic stress disorder (PTSD) can have an impact on menopausal symptoms

  • Further robust and longitudinal research is needed to explore the impact of IPV on mid-life and older women’s lives.

  • Context

    IPV is a major public health problem which intersects ethnic, religious, societal and geographical boundaries and results in serious physical and psychological consequences for those affected. IPV can exist in same sex relationships and men can also be victims of IPV, however, the frequency and severity of IPV experienced by women is...

    Routine health checks can provide opportunities for alcohol health promotion in older adults who identify as responsible drinkers

    Por: Alfred · L.

    Commentary on: Bareham BK, Kaner E, Spencer LP et al. Drinking in later life: a systematic review and thematic synthesis of qualitative studies exploring older people’s perceptions and experiences. Age Ageing 2019; 48:134-146.

    Implications for practice and research

  • Healthcare professionals should incorporate alcohol health promotion during routine health checks with older adults who identify as responsible drinkers.

  • Personalised interventions should also consider the positive role that alcohol plays in maintaining social connections and cultural identity.

  • More research that explores the gender differences in consumption over time is required.

  • Context

    Over the last 15 years, alcohol-specific mortality in older adults has risen by approximately 45%.1 Older adults may drink less alcohol than those under 50 years old, however they tend to consume it more frequently and have comparatively higher numbers of alcohol-related hospital admissions.2 National surveys from high-income countries such as Great...

    Opioid users reflect on their experiences responding to suspected opioid overdoses using take-home naloxone

    Por: Donaghy · J.

    Commentary on: Neale J, Brown C, Campbell ANC, et al. How competent are people who use opioids at responding to overdoses? Qualitative analyses of actions and decisions taken during overdose emergencies. Addiction. 2018 Nov 26. doi: 10.1111/add.14510.

    Implications for practice and research

  • Opioid users described using take-home naloxone (THN) to deliver emergency treatment to victims of opioid overdose.

  • Insights from opioid users who have responded to overdoses could improve THN.

  • This study provides a foundation for research exploring the competency of individuals delivering first-line treatment to opioid overdose victims.

  • Context

    In the USA, opioid overdose accounted for 42 249 deaths during 2016. Respiratory depression caused by opioid overdose can be reversed by the timely administration of naloxone. THN programmes supply naloxone and advice in responding to opioid overdose crisis to non-medical professionals.1 Current provision does not appear to meet the clinical need.

    Australian study reveals challenges faced by maternal and child health nurses in caring for refugee families

    Por: McKnight · P.

    Commentary on: Willey SM, Cant RP, Williams, et al. Maternal and child health nurses work with refugee families: perspectives from regional Victoria, Australia. J Clin Nurs 2018;27:3387–96.

    Implications for practice and research

  • Families from a refugee background face significant barriers to accessing healthcare, including communication, underlying health needs and cultural differences.

  • Further professional development is needed to ensure nurses and midwives have the required skills to provide care for refugee and asylum-seeking families.

  • Future research should take account of the legal frameworks governing asylum seekers’ entitlement to health.

  • Context

    As a signatory to the United Nations High Commission for Refugees Convention1, Australia has a long history of resettling asylum-seeking families and refugees. Access to universal healthcare is available to all refugees with a permanent protection visa and some asylum seekers dependent on visa status, which includes maternal and child health services (MCH). Families from...

    Blunted stress reactivity is a distinctive feature in clinically depressed patients

    Por: Alfred · L. · Howard · V.

    Commentary on: Schiweck C, Piette D, Berckmans D et al. Heart rate and high frequency heart rate variability during stress as biomarker for clinical depression. A systematic review. Psychol Med 2018 23:1–12. doi: 10.1017/S0033291718001988.

    Implications for practice and research

  • Nurses must be aware that clinically depressed patients may exhibit reduced heart rate variability in response to stress.

  • Future research in this area needs to use larger sample sizes, and consider other factors such as childhood trauma history, subjective stress ratings, sleep quality and co-morbidity with anxiety disorders.

  • Context

    Depression is the leading cause of disability and morbidity worldwide.1 A complex mix of biopsychosocial risk factors is thought to contribute to the development and maintenance of depression.2 One of these factors is chronic mental stress.3 The review by Schiweck et al indicates that despite an increasing volume of research, there remains...

    Patient and carer involvement in healthcare education, service delivery and research: avoiding tokenism

    Por: Smith · J. · Dransfield · A.

    We are delighted to have been invited to write this editorial on patient and carer involvement in health education, service delivery and research. Within developed countries, the involvement of patients and carers has become central to healthcare delivery. Health services, research and education policy directives, particularly with the UK, are explicit that patient and carer input is an integral part of healthcare. Input ranges from service design and delivery, across the research processes to the development, delivery and evaluation of programmes of study offered to healthcare students. The overarching aim is to ensure healthcare delivery, research and the preparation of health professionals is more responsive to the needs of the patient and their carers.1 Valuing and listening to patients and carers is central to the quality agenda, including ensuring care is patient and family centred, and there is appropriate use of resources that meets patient needs figure 1.


    Promoting patient involvement through person-centred handovers in nursing

    Por: Kidd · L.

    Commentary on: Kullberg A, Sharp L, Dahl O, et al. Nurse perceptions of person-centered handovers in the oncological inpatient setting - A qualitative study. Int J Nurs Stud 2018;86:44–51.

    Implications for practice and research

  • Person-centred handovers can enhance patient participation in healthcare decision-making, supporting the provision of high quality, safe person-centred care.

  • Consideration is needed to how person-centred handovers are understood and implemented in clinical practice to ensure that they foster genuine participation and partnership working between nursing teams and patients.

  • Context

    Nurse handovers are a routine form of communication and information exchange that occurs when one nurse hands over the responsibility of care for a patient to another nurse, for example at the end of a nursing shift.1 In daily practice, different models of handover are used.1 Evidence on nurses’ perspectives of person-centred handover (PCH) models, which incorporate and...

    Virtual reality can enhance mens engagement with health screening and awareness

    Por: McGrath · L.

    Commentary on: Saab MM, Landers M, Cooke E, et al. Enhancing Men’s Awareness of Testicular Disorders Using a Virtual Reality Intervention: A Pre-Post Pilot Study. Nurs Res 2018;67:349–58.

    Implications for practice and research

  • Virtual reality is an effective way to engage men with awareness, screening and intention to seek help for testicular disorders.

  • Extending this research to explore a wider diverse ethnic group is important

  • Context

    The health of men in the Western World is poorer than that of women, with increased mortality rates where men are less likely to utilise health services.1 When men fail to seek help, serious health problems can emerge, resulting in poorer outcomes and extra burden on healthcare systems.2

    Innovative ways to engage men in preventative health activities are required1 and virtual reality (VR) may improve engagement. Saab et al3 conducted a pre-test and...

    First-career and second-career nurses experiences of stress, presenteeism and burn-out during transition to practice

    Por: Mohamed · L. K.

    Commentary on: Rainbow JG, Steege LM. Transition to practice experiences of first and second career nurses: a mixed method study. J Clin Nurs 2018;00:1-12.

    Implications for practice and research

  • First-career and second-career nurses face stressors, presenteeism and burn-out during transition to nursing practice.

  • The nursing working environment is filled with different stressors and coping strategies that should be paid attention to in the development of transition to practice programmes.

  • Context

    There is very little research studying the experiences of traditional graduate nurses (TGNs) and secondary career graduate nurses (SCGNs) during the professional role transition to practice. Knowing more of their experiences will provide insight about the challenges facing them. Therefore, this study compared first-career and second-career nurses’ experiences of stress and coping, presenteeism and burn-out during transition to practice.


    The current study used a mixed-methods design that paired qualitative interviews (semistructured questions) with quantitative...

    Impact of stigma on the care of postpartum women with severe mental illness

    Por: Rodger · D.

    Commentary on: Ordan R, Shor R, Liebergall-Wischnitzer M, et al. Nurses’ professional stigma and attitudes towards postpartum women with severe mental illness. J Clin Nurs 2018;27:1543–51.

    Implications for practice and research

  • Healthcare professionals should provide person-centred care to postpartum women with severe mental illness (SMI), promoting their autonomy and the best outcomes for the woman and the child.

  • Stigma and negative attitudes towards individuals with SMI can have a detrimental effect on patient care.

  • Future research should evaluate interventions that decrease stigma in healthcare professionals caring for women with SMI.

  • Context

    Healthcare professionals can exhibit stigma and negative attitudes towards individuals with mental illness.1 These negative attitudes influence how they engage with patients with SMI, creating barriers to individualised care. The aim of the study by Ordan et al2 was to examine the professional stigma of nurses...

    Nurse-led cognitive behavioural group treatment intervention for insomnia successfully reduces daytime symptomatology

    Por: Scott · L. · Bawden · J.

    Commentary on: Sandlund C, et al. Impact of group treatment for insomnia on daytime symptomatology: Analyses from a randomized controlled trial in primary care. Int J Nurs Stud 2018;85:126–35

    Implications for practice and research

  • Nurse-led initiatives can be successfully applied to group treatment for insomnia in primary care settings.

  • Future research should continue to explore the impact of daytime symptomatology of insomnia (fatigue, mood, health related quality of life and daytime functioning) on subgroups of patients and should be considered when designing a treatment intervention.

  • Context

    The burden of insomnia is significant in primary care.1 Standard care often involves hypnotic medications. Previous research has focused on improvement in sleep outcomes. This article discusses how extensive daytime symptomatology is attributed to sleep difficulties and how these symptoms have a negative impact on quality of life and mental health. Cognitive processes contribute to developing...

    Patients and nurses have differing views of what is meant by 'compassion

    Por: Green · L.

    Commentary on: Durkin J, Usher K, Jackson D. Embodying compassion: A systematic review of the views of nurses and patients. J Clin Nurs. 2018 Nov 28. doi: 10.1111/jocn.14722.

    Implications for practice and research

  • There is ambiguity regarding how compassion is defined and experienced within nursing.

  • Patients and nurses hold different views on what constitutes compassionate care.

  • Understanding the concept of compassion can help nurses in their clinical practice.

  • Focusing on the nature of compassion—particularly from the point of view of patients—is an important direction in nursing education and research.

  • Context

    Compassion has always been a key concept in nursing.1 2 In the UK, several instances of poor care propelled compassion to the foreground and prompted a series of policy responses that impact directly on the nursing profession. Consequently, compassionate care is increasingly recognised as being just as vital...

    Student nurses gender role is a predictor of caring behaviours and critical thinking

    Por: Harrison · J.

    Commentary on: Liu N-Y, Hsu W-Y, Hung C-A, et al. The effect of gender role orientation on student nurses' caring behaviour and critical thinking. Int J Nurs Stud 2019;89:18–23.

    Implications for practice and research

  • Gender role orientation (masculine or feminine traits) rather than sex is a predictor for determining caring behaviour and critical thinking skills among student nurses.

  • Student nurses’ caring behaviour should be emphasised to cultivate students’ critical thinking skills.

  • Context

    Previous research on the relationship between nurses’ gender and perceptions of caring behaviours or critical thinking is inconsistent. Research has shown that gender does not significantly influence caring behaviour1 or critical thinking.2 However, earlier research did show a correlation between caring traits and gender.3 Furthermore, presentation of caring behaviour has been shown to predict critical thinking.4 5

    The aim of the study

    Expanding midwiferys role to improve perinatal mental healthcare access

    Por: Dennis · C.-L. · Vigod · S.

    Commentary on: Viveiros CJ, Darling EK. Perceptions of barriers to accessing perinatal mental healthcare in midwifery: a scoping review. Midwifery 2019;70:106–118.

    Implications for practice and research

  • Midwives increasingly provide important perinatal care but their role in the identification and management of mental illness, one of the most common complications of pregnancy, remains unclear.

  • Access to mental healthcare in midwifery is hampered by supply-side barriers and there are also barriers due to the clients’ inability to interact with midwives to optimise access to care

  • Research in innovative strategies to train midwives to provide psychosocial and psychological interventions to women with mild-to-moderate symptom severity is needed to ensure timely access to evidence-based treatment and appropriate follow-up.

  • Context

    Despite increased awareness of perinatal mental health issues, management remain suboptimal. Barriers are diverse and areas to target for greatest impact remain unknown. Midwives are playing an increasingly...

    Multidisciplinary disease management programme with or without exercise training may reduce heart failure-related rehospitalisation

    Por: Collier · L.

    Commentary on: Liu M, Wang C, Tung T, et al. Effects of a multidisciplinary disease management programme with or without exercise training for heart failure patients: secondary analysis of a randomized controlled trial. Int J Nursing 2018;8:94–102.

    Implications for practice and research

  • The inclusion of exercise training within a multidisciplinary disease management programme (MDP) may reduce rates of heart failure (HF)-related rehospitalisation.

  • When exercise is contraindicated, an MDP may reduce HF-related rehospitalisation rates for 12 months after discharge for an HF-related hospital stay.

  • Context

    Advances in the management of HF mean survival rates for patients with HF are increasing.1 While management of HF is focused around medicine regimens, lifestyle changes such as weight maintenance, smoking cessation and exercise are encouraged so patients may manage their symptoms more effectively.1 MDPs with structured patient education are effective in reducing HF-related rehospitalisation rates and mortality...

    Developmentally appropriate social and mental health support could improve quality of life for children receiving cancer treatment

    Por: Neilson · S.

    Commentary on: Jibb LA, Croal L, Wang J, et al. Children’s experiences of cancer care: A systematic review and thematic synthesis of qualitative studies. Oncology Nursing Forum 2018;45:527–44.

    Implications for practice and research

  • Developmentally appropriate conversations with children receiving cancer treatment can ensure timely referrals to the wider team through early identification and understanding of impact and needs.

  • The benefits of ongoing social support during cancer treatment while wide ranging may not be optimally facilitated or utilised in care settings and therefore is an area for future research.

  • Context

    As the overall long-term survival rate for children’s cancer increases,1 recognition of the wide-ranging (physical, psychological, emotional and social) impacts on the quality of life for these children and young people is important.2 3 The systematic review undertaken by Jibb et al4 focuses on the experiences of children receiving cancer treatment...

    Parenting intervention programmes during childhood can improve health outcomes for black and rural communities

    Por: Frazer · K.

    Commentary on: Brody H, et al. Preventive parenting intervention during childhood and young black adults' unhealthful behaviors: a randomised controlled trial. J Child Psychol Psychiatry. 2018 Sep 11. doi: 10.1111/jcpp.12968

    Implications for practice and research

  • Targeted improvements for reducing smoking, alcohol intake and drug use are required amongst disadvantaged groups to reduce rates of morbidity and mortality.

  • Future research needs to consider factors associated with engagement in supportive parenting programmes.

  • Context

    Supporting early childhood development across the life course is a fundamental component of the UN sustainable development goals framework.1–3 The impact of deprivation and discrimination results in poorer mental and physical health outcomes with increased negative health behaviours for those at risk.3 4 Black and rural communities in America experience negative living conditions. However, the challenging conditions do not always result in negative...