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AnteayerEvidence-Based Nursing

Time to treat the climate and nature crisis as one indivisible global health emergency

Over 200 health journals call on the United Nations (UN), political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency.

The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of the Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in Turkey in 2024. The research communities that provide the evidence for the two COPs are unfortunately largely separate, but they were brought together for a workshop in 2020 when they concluded that: ‘Only by considering climate and biodiversity as parts of the same...

Impact of the COVID-19 pandemic on eating disorder-related hospital and programme admissions in youth

Por: Devoe · D. J. · Holland · K. M. G.

Commentary on: Hartman-Munick SM, Lin JA, Milliren CE, et al. Association of the COVID-19 pandemic with adolescent and young adult eating disorder care volume. JAMA Pediatr. 2022 Dec 1;176(12):1225-1232. doi: 10.1001/jamapediatrics.2022.4346.

Implications for practice and research

  • The current research demonstrates the need to increase staffing and programme capacity for those working with patients with eating disorders (EDs) to ensure adequate care.

  • Future research into how the relationship between ED-related hospitalisations and individual external factors, such as social isolation are needed.

  • Context

    Research has shown that the pandemic greatly impacted worldwide mental health1 and disproportionality impacted those with EDs.2 Those with EDs such as anorexia nervosa, bulimia nervosa and binge ED have seen an increase in hospital admissions and programmes due to the COVID-19 pandemic.2 3 However, there is a lack of nationwide research investigating the increase...

    Sibling carers of adults with intellectual disabilities in Ireland report high levels of health but feel overwhelmed by care responsibilities

    Por: Leane · M.

    Commentary on: Brennan, D., D'Eath, M., McCallion, P., & McCarron, M. (2023). Health and well-being of sibling carers of adults with an intellectual disability in Ireland: Four waves of data. British Journal of Learning Disabilities, 1–10. https://doi.org/10.1111/bld.12532

    Implications for practice and research

  • Formal protocols for engaging with sibling carers of people with intellectual disability about their support needs are required.

  • Future research should explore the experiences of sibling carers and their support needs.

  • Context

    Increased life expectancy of people with intellectual disability (ID) means that sibling caring is more likely to occur. Planning around sibling carer roles is often absent and the needs of this cohort are not well documented.1

    Methods

    Family carers of people with ID aged 40 years and older were surveyed between 2011 and 2020.2 Four waves of data were collected through a...

    We need more evidence to inform community-based health services for women, and transgender and nonbinary people who experience incarceration

    Por: McLeod · K. · Kouyoumdjian · F. G.

    Commentary on: Paynter M, Heggie C, Low C, McKibbon S, Martin-Misener R. Community-based models of health care for women, trans and nonbinary people released from prisons: An international scoping review with implications for Canada. J Clin Nurs. 2023 Jul;32(13-14):3277-3294. doi: 10.1111/jocn.16464. Epub 2022 Aug 8.

    Implications for practice and research

  • Women, transgender and non-binary people who experience incarceration often have complex healthcare needs and require dynamic, trauma-informed care in the community.

  • Research is needed to understand how to address the diverse health needs of women, transgender and non-binary people leaving prison.

  • Context

    On any given day, approximately 740 000 women and girls1 and an unknown number of transgender, non-binary and gender diverse people are incarcerated globally. Intersecting social and structural factors impact incarceration and healthcare experiences, requiring community-based interventions that address the specific needs of women, transgender and non-binary people leaving prison.

    ...

    Step your way to a longer life: examining the relation between step counts, morbidity and mortality

    Por: Blond · K. · Grontved · A.

    Commentary on: del Pozo Cruz B, Ahmadi MN, Lee IM, Stamatakis E. Prospective Associations of Daily Step Counts and Intensity With Cancer and Cardiovascular Disease Incidence and Mortality and All-Cause Mortality. JAMA Intern Med. 2022 Nov 1;182(11):1139-1148. doi: 10.1001/jamainternmed.2022.4000.

    Implications for practice and research

  • Encouraging daily steps and increasing the daily time with high cadence steps may be important means to prevent morbidity and prolong lifespan.

  • Assessment of daily steps over a longer period may further elucidate the shape of the dose–response relationship and better quantify the benefits of increasing daily step counts.

  • Context

    Physical activity is widely recommended due to the extensive evidence supporting its numerous health benefits, including lower risks of morbidity and mortality. While current physical activity guidelines quantify their recommendations in terms of minutes of physical activity, step count has emerged as another popular metric for quantifying physical activity. However,...

    Evidence-informed and community-based strategies are essential to developing affordable and accessible technology-based interventions to prevent social isolation among older adults and promote their well-being and quality of life

    Por: Ghassemi · A. E.

    Commentary on: Umoh ME, Prichett L, Boyd CM, Cudjoe TKM. Impact of technology on social isolation: Longitudinal analysis from the National Health Aging Trends Study. J Am Geriatr Soc. 2023 Apr;71(4):1117–1123. doi: 10.1111/jgs.18179. Epub 2022 Dec 15.

    Implications for practice and research

  • Developing and implementing targeted and integrated community-based interventions that supports steady assessment of technology access and use are required to diminish social isolation among seniors and enhance their overall quality of life.

  • Future research should focus on assessing the efficacy of technology-based interventions and advancing digital technologies to reduce social isolation among older adults.

  • Context

    Social isolation is a fundamental public health problem, and it has significant negative effect on the healthcare system along with surge in ageing population.1–3 Furthermore, social isolation is linked with increased mortality rate, cognitive and functional decline among older adults.

    Increased prevalence of chronic medical conditions linked to higher rates of adverse perinatal outcomes in Dutch women

    Por: Melekoglu · R.

    Commentary on: Rosman AN, van der Vliet-Torij HWH, Hilberink SR. Trends in perinatal outcomes of women with chronic medical conditions: a 10-year population-based study in the Netherlands. Midwifery. 2023 Mar;118:103572. doi: 10.1016/j.midw.2022.103572. Epub 2022 Dec 13.

    Implications for practice and research

  • Due to the heightened risk of preterm birth, caesarean deliveries, NICU admission of neonates and increased perinatal mortality among pregnant women with chronic medical conditions, it is essential that midwives and nurses receive comprehensive training to deliver personalised care for these women.

  • To enhance perinatal outcomes among pregnant women with chronic medical conditions, future research should prioritise identifying the contributing factors to such outcomes and developing novel interventions targeted at optimising perinatal outcomes during both the prepregnancy and pregnancy periods.

  • Context

    Chronic diseases can impact pregnancy and lead to long-term consequences for women during and after childbirth, causing anxiety. However, medical advancements and...

    Strategies to improve and enhance satisfaction with learning among nursing students

    Background and purpose

  • This is a summary of Cant R, Gazula S, and Ryan C.1

  • Student satisfaction is important as it positively influences both student retention and institutional rankings.

  • The concept of student satisfaction with education is poorly understood, although some studies suggested its related elements such as learning environments; student motivation to learn; student and teacher accountability; classroom diversity, and assessment approaches.

  • By identifying factors that influence nursing students’ satisfaction, nurse educators will have the opportunity to further improve the curriculum and student education experiences.

  • This integrative review aims to discover basic conceptual elements that affect higher education students’ satisfaction, focusing on nursing education.

  • Methods

    Results and areas for future research

  • Twenty-two studies were included: 19 with an experimental, quasi-experimental design and three systematic reviews from 15 countries.

  • Service quality, institutional image and...

  • It is time for healthcare professionals to engage with social media

    Por: Hundley · V. · Marsh · A.

    Commentary on: Chee RM, Capper TS, Muurlink OT. The impact of social media influencers on pregnancy, birth, and early parenting experiences: A systematic review. Midwifery. 2023 May;120:103623. doi: 10.1016/j.midw.2023.103623. Epub 2023 Feb 19.

    Implications for practice and research

  • Social media is one of the fastest growing commercial determinants of health.

  • Healthcare professionals need a better understanding of social media and its impact.

  • Context

    Social media has rapidly become a key source of advice and support for women during childbirth. The growth of influencers, popular users credited with knowledge and expertise, can be seen in the numerous social posts, blogs, podcasts and videos about pregnancy, birth and parenting. Social media influencers provide responsive and relatable content to their network of followers; but there are concerns about the potential to spread misinformation.1

    Methods

    This systematic literature review2 sought to identify...

    Preoperative functional performance is the best predictor for loss of independence after major surgery among older adults

    Por: Johnson · C. E. · Brooke · B. S.

    Commentary on: Goeddel L, Murphy Z, Owodunni O, et al. Domains of Frailty Predict Loss of Independence in Older Adults after Non-Cardiac Surgery. Ann Surg. 2022 Sep 20. doi: 10.1097/SLA.0000000000005720. Epub ahead of print.

    Implications for practice and research

  • Frailty screening with the Edmonton Frailty Scale can be used to identify risk factors for loss of independence after surgery, including a patient’s functional performance, functional dependence, social support and urinary incontinence.

  • Prospective studies are needed to test whether risk factors can be modified before surgery to prevent loss of independence among frail patients.

  • Context

    Frailty is a common syndrome of physiological decline among older adults characterised by vulnerability to adverse outcomes and loss of functional independence after major surgery.1 The study by Goeddel et al2 examined 11 geriatric domains associated with frailty that were collected before surgery using the Edmonton...

    Diffusion of paediatric long-term ventilation as a reflection of changing clinical scenarios and practice

    Por: Meggiolaro · L. · Trevisanuto · D.

    Commentary on: Barker N, Sinha A, Jesson C, Doctor T, Narayan O, Elphick HE. Changes in UK paediatric long-term ventilation practice over 10 years. Arch Dis Child. 2023 Mar;108(3):218-224. doi: 10.1136/archdischild-2021-323562. Epub 2022 Nov 29.

    Implications for practice and research

  • Up-to-date information on the use of long-term ventilation (LTV) in the UK paediatric population helps LTV centres to plan services and support healthcare needs.

  • The future development of a national LTV children database could advise clinical guidelines and assist resource allocation planning.

  • Context

    LTV consists in the delivery of respiratory support provided on a daily basis for a minimum period of 3 months through various mechanical interventions.1 LTV, particularly long-term non-invasive ventilation (NIV), is an increasing practice in children as there has been evidence of improving survival and quality of life in several clinical scenarios characterised by respiratory failure. Moreover, it is...

    Cardiometabolic profile of young adults with intellectual disability

    Por: McKenna · N. · Brown · M.

    Commentary on: Zwack CC, McDonald R, Tursunalieva A, Lambert GW, Lambert EA. Exploration of diet, physical activity, health knowledge and the cardiometabolic profile of young adults with intellectual disability. J Intellect Disabil Res. 2022 Jun;66(6):517-532. doi: 10.1111/jir.12917. Epub 2022 Feb 9.

    Implications for practice and research

  • Adults with intellectual disabilities need education and additional support to increase daily physical activity and improve their diets.

  • Longitudinal studies are required to identify how adults with intellectual disabilities apply nutrition and activity-related knowledge and the supports that work to reduce cardiometabolic disease.

  • Context

    Research evidence details the significant health needs and inequalities experienced by many people with intellectual disabilities that contribute to their poor physical and mental health. While life expectancy has increased, many continue to die prematurely from avoidable and preventable conditions. Poor diet, obesity, low levels of physical activity, poor lipid profile and type 2...

    Understanding staff perceptions on adolescent seclusions

    Por: Vidal · C. · Reynolds · E. K.

    Commentary on: Yurtbasi MK, Melvin G, Pavlou C, Gordon M. Staff perspectives on the effects of seclusion in adolescent psychiatric inpatient care. Int J Ment Health Nurs. 2023 Apr;32(2):567–578. doi: 10.1111/inm.13102. Epub 2022 Dec 15.

    Implications for clinical practice and research

  • Nursing staff find adolescent seclusions necessary but also experience related guilt and self-doubt.

  • Seclusion protocols in adolescent psychiatric units should include alternatives to seclusion and debriefing processes.

  • Context

    Seclusions cause distress in patients and lead to negative outcomes, including death. Growing research demonstrates that seclusion rates vary by age, sex, race, diagnosis and personal history of adverse events.1 In fact, seclusion rates among youth are higher than among adults. While research involving staff in adult inpatient psychiatric units demonstrates that staff and patients experience negative reactions,2 more specific research is needed related to staff in adolescent inpatient units, given...

    Birth cohort study indicates the impact of COVID-19 pandemic on early child language development

    Por: Alvarenga · P.

    Commentary on: Byrne S, Sledge H, Franklin R, Boland F, Murray DM, Hourihane J; CORAL Study group. Social communication skill attainment in babies born during the COVID-19 pandemic: a birth cohort study. Arch Dis Child. 2023 Jan;108(1):20-24. doi: 10.1136/archdischild-2021-323441. Epub 2022 Oct 11.

    Implications for practice and research

  • Future research must explore contexts of crisis and disaster to investigate whether delays in acquiring the pointing gesture and the first meaningful words would result in cascading impairments in language development in early childhood.

  • During crises and disasters, caregivers must be encouraged to enhance verbal responsiveness following infants’ communicative and exploratory behaviours.

  • Context

    Several studies conducted during the COVID-19 pandemic have indicated deficits in different domains of infant development. This study by Byrne and colleagues compared early developmental milestones in two infant cohorts: babies born at the onset of the COVID-19 pandemic and babies born between...

    Extreme temperatures are associated with increased cardiovascular mortality

    Por: Barrett · D.

    Commentary on: Alahmad B, Khraishah H, Royé D, Vicedo-Cabrera AM, Guo Y, Papatheodorou SI, Achilleos S, Acquaotta F, Armstrong B, Bell ML, Pan SC, de Sousa Zanotti Stagliorio Coelho M, Colistro V, Dang TN, Van Dung D, De' Donato FK, Entezari A, Guo YL, Hashizume M, Honda Y, Indermitte E, Íñiguez C, Jaakkola JJK, Kim H, Lavigne E, Lee W, Li S, Madureira J, Mayvaneh F, Orru H, Overcenco A, Ragettli MS, Ryti NRI, Saldiva PHN, Scovronick N, Seposo X, Sera F, Silva SP, Stafoggia M, Tobias A, Garshick E, Bernstein AS, Zanobetti A, Schwartz J, Gasparrini A, Koutrakis P. Associations Between Extreme Temperatures and Cardiovascular Cause-Specific Mortality: Results From 27 Countries. Circulation. 2023 Jan 3;147(1):35-46. doi: 10.1161/CIRCULATIONAHA.122.061832. Epub 2022 Dec 12.

    Implications for practice and research

  • Nurses need to be aware that extreme temperatures—whether hot or cold—increase the likelihood of death from cardiovascular causes.

  • More...

  • Enhancing behavioural support through telehealth for family carers and professionals

    Por: Leyser · M.

    Commentary on: Tomlinson SRL, Gore N, McGill P. Family carer and professional perceptions of the potential use of telehealth for behavioural support. J Intellect Disabil Res. 2023;67:531–46. doi: 10.1111/jir.13026.

    Implications for practice and research

  • Telehealth is valuable for behavioural support, especially for family carers facing challenges in accessing in-person services.

  • Healthcare professionals need training to effectively use telehealth platforms for behavioural interventions.

  • Further research is required to explore diverse populations’ perspectives and experiences and evaluate technical barriers, long-term effectiveness and cost-effectiveness of telehealth for behavioural support.

  • Context

    Tomlinson et al1 explored the use of telehealth for behavioural support in individuals with intellectual and developmental disabilities (IDD). They examined the perspectives of family carers and professionals on this approach, considering the need for accessible interventions and the impact of the COVID-19 pandemic.2 3 Telehealth, using digital communication technologies...

    Nurse identity: the misrepresentation of nursing in the media

    Por: Garcia · R. · Qureshi · I.

    Since 2019, the nursing profession has been frequently represented in mainstream media in the UK through the lenses of the COVID-19 pandemic and more recently, industrial action. In 2020, during COVID, we saw the nursing profession praised, with weekly neighbourhood applause and thanks to the National Health Service (NHS) staff schemes. In 2023, when, for the first time in history nurses voted to strike (fair pay for nursing), nurses again received media attention. Conversely, the media chose to report how striking nurses (and other health professional staff) contributed to long waiting lists in the NHS and unhelpfully, demonstrated how 64% of poll voters (n=7955) did not think nurses should have a better pay deal.1 The reality is that nursing is central to the delivery of quality, evidence-based, and person-centred care in our health sector in the UK and represents the largest clinical professional group with approximately 334 690...

    Prolonged screen time in adolescence linked to higher cardiometabolic risk in adulthood

    Por: Nauman · J. · Omara · A.

    Commentary on: Nagata JM, Lee CM, Lin F, et al. Screen time from adolescence to adulthood and cardiometabolic disease: a prospective cohort study. J Gen Intern Med. 2023 Jan 10. doi: 10.1007/s11606-022-07984-6. Epub ahead of print.

    Implications for practice and research

  • Reducing screen time and promoting physical activity among children and adolescents could be a key strategy in preventing cardiometabolic diseases in adulthood.

  • Further research using objective measures of screen time is needed to advance knowledge of dose–response relationship between screen time and cardiometabolic disease risk and to inform future recommendations.

  • Context

    In an increasingly digital world, high prevalence of sedentary behaviour has become a significant concern for public health. It is ubiquitous in various environments, and WHO guidelines1 recommend reducing sedentary behaviour for substantial health benefits. The study by Nagata and colleagues2 investigating the relationship between screen time and...

    Induction, deduction and abduction

    Por: Barrett · D. · Younas · A.

    Researchers often refer to the type of ‘reasoning’ that they have used to support their analysis and reach conclusions within their study. For example, Krick and colleagues completed a study that supported the development of an outcome framework for measuring the effectiveness of digital nursing technologies.1 They reported completing the analysis through combining ‘an inductive and deductive approach’ (p1), but what do these terms mean? How can these methods of reasoning support nursing practice, and guide the development and appraisal of research evidence?

    This article will explore inductive and deductive reasoning and their place in nursing research. We will also explore a third approach to reasoning—abductive reasoning—which is arguably less well-known than induction and deduction, but just as prevalent and important in nursing practice and nursing research.

    Inductive reasoning

    Induction, or inductive reasoning, involves the identification of cues and the collection of data to develop general...

    Starting at the top: culture change has the potential to advance the patient participation agenda in Iranian hospitals

    Por: Tobiano · G. · Chaboyer · W.

    Commentary on: Sarkhosh S, Abdi Z, Ravaghi H. Engaging patients in patient safety: a qualitative study examining healthcare managers and providers' perspectives. BMC Nurs. 2022 Dec 29;211,:374. doi: 10.1186/s12912-022-01152-1.

    Implications for practice and research

  • Without a shift in organisational culture, patient participation in patient safety may continue to be haphazard in Iranian hospitals.

  • Researchers should consider and report the impact of gender when investigating patient participation in care.

  • Context

    Despite Iran’s economic crisis, brought on by sanctions, years of war and improper government resource management, Iranian healthcare is now considered among the finest in the Eastern Mediterranean region.1 There are satisfactory secondary and tertiary hospitals, and progress towards eradication of contagious, maternal and neonatal disorders has been made.1 Internationally, patient participation in hospital safety activities is advocated, such as patients detecting and reporting symptoms, side effects and hospital issues, to...

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