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Commentary on: Reddy M, Rolnik DL, Harris K, et al. Challenging the definition of hypertension in pregnancy: a retrospective cohort study. Am J Obstet Gynecol 2020, Jan 16. doi:10.1016/j.ajog.2019.12.272. [Epub ahead of print].
Evidence-based hypertensive thresholds need to be clear and consistent to ensure effective management of hypertension in pregnancy. Further research is paramount in determining whether lowering the thresholds of blood pressures in pregnancy, in line with the American College of Cardiology guidelines, would improve detection and outcomes for mother and baby.
Throughout routine antenatal care, blood pressure is used as a screening tool for preeclampsia and its associated adverse outcomes.
Commentary on: Seon HL, Soyoung Yu. Effectiveness of multifactorial interventions in preventing falls among older adults in the community: a systematic review and meta-analysis. Int J Nurs Stud 2020;106:103564. doi: 10.1016/j.ijnurstu.2020.103564.
Multifaceted falls prevention is effective in reducing fall rates for high-risk and healthy community-dwelling older adults. Exercise or an environmental modification component are important moderating factors in the effectiveness of multifaceted falls prevention in community-dwelling older adults. Further high-quality research is required in the exploration of important mediating factors in the effectiveness of multifactorial interventions for falls prevention in community-dwelling older adults.
A fall is defined as an event that causes a person to, unintentionally, rest on the ground and is not a result of a major intrinsic event or hazard.
Commentary on: Coffey MJ, Garg M, Homaira N, et al. Probiotics for people with cystic fibrosis. Cochrane Database Syst Rev 2020;1:CD012949. doi:10.1002/14651858.CD012949.pub2.
Probiotics may be considered for children and adults with cystic fibrosis (CF) and might have some limited health benefits. Further research is required on the effects of varying duration, dose and type of probiotics on children and adults with CF.
Cystic fibrosis (CF) is an autosomal recessive genetic disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene
Commentary on: Gillet N, Huyghebaert-Zouaghi T, Reveillere C, et al. The effects of job demands on nurses’ burnout and presenteeism through sleep quality and relaxation. J Clin Nurs 2020;29(3–4):583–592. doi: 10.1111/jocn.15116. Epub 2019 Dec 9.
Work shifts have to consider the role of sleep quality in recovering from workload and emotional dissonance as a way to prevent emotional exhaustion and presenteeism. Further research into interventions that can enhance nurses’ recovery processes is required.
The role of work stress (high demand coupled with low control) in burn-out and health impairment is well known from the scientific evidence, including in nursing.
Commentary on: Perry A, Lawrence V, Henderson C. Stigmatisation of those with mental health conditions in the acute general hospital setting. A qualitative framework synthesis. Soc Sci Med 2020; 255:112974. doi: 10.1016/j.socscimed.2020.112974.
The framework for categorising stigmatisation patterns in patients with mental health conditions may be useful in practice to facilitate stigma reduction in acutecare settings. There is a need for highquality review, including quantitative and qualitative observational and interventional studies, to further explore stigmatisation patterns and reduction interventions.
Stigmatisation is the action of devaluing individuals due to some factor identified as a mark of shame or ‘stigma’. Stigma has been associated with ethnic features and certain health conditions such as HIV and mental illness
Commentary on: Chen YJ, Cheng SF, Lee PC, Lai CH, Hou IC, Chen CW. Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial. J Clin Nurs. 2020 Feb;29(3-4):503-510. doi: 10.1111/jocn.15088. Epub 2019 Dec 4.
Virtual reality (VR) head-mounted sets are a valuable tool to help reduce pain and anxiety for intravenous cannulation in children and caregivers. Further studies should focus on comparison of the range of VR devices, their use in different age groups, and their use in the preparation prior to procedures.
Virtual Reality (VR) head-mounted displays (HMDs) are now affordable, and the latest ‘techno’ gadget for home entertainment. Research studies are increasingly focused on this new technology and the use of VR in the hospital setting. The use of VR headsets has great potential as a tool for use...
Commentary on: Burry L, Hutton B, Williamson DR et al. Pharmacological interventions for the treatment of delirium in critically ill adults. Cochrane Database Syst Rev 2019:CD011749. DOI: 10.1002/14651858.
Alpha2 agonist dexmedetomidine may reduce duration of delirium while Cholinesterase inhibitor rivastigmine may prolong the duration of delirium and length of intensive care. Future research should ensure that important clinical outcomes are reported such as symptom management.
Delirium is a multifaceted neurocognitive indication of an underlying medical condition.
It frequently occurs in critically ill patients and can have substantial negative consequences with increased mortality and intensive care unit (ICU) length of stay.
Commentary on: Howarth EJ, O’Connor DB, Panagioti M, et al. Are stressful life events prospectively associated with increased suicidal ideation and behaviour? A systematic review and meta-analysis. J Affect Disord. 2020;266:731–42. doi: 10.1016/j.jad.2020.01.171.
Practitioners need to explore non-traumatic stressful life events in order to identify ways to enhance individual resilience and coping strategies. Future narrative research is required to explore the different types of stressful life events and how these impact on individuals and wider society.
Suicide is a leading cause of death worldwide, and it has devastating effects on families, friends and the professionals who work with suicide victims.
Commentary on: Schichtel M, Wee B, Perera R, Onakpoya I. The effect of advance care planning on heart failure: a systematic review and meta-analysis. J Gen Internal Med 2019. Epub ahead of print 12 November. https://doi.org/10.1007/s11606-019-05482-w.
Nurses are well equipped to have key roles in facilitating advanced care planning (ACP) for patients and families. Future research of ACP in heart failure (HF) should encompass multiple key components and multidisciplinary teams emphasising ethnic preferences to shift the paradigm of HF end-of-life care.
Heart failure (HF) is a chronic, progressive condition with tremendous burden on healthcare, patients and families. Six million Americans live with HF, projected to be eight million by 2030.¹ Despite medical developments, HF mortality remains 50% 5 years after diagnosis.² As HF progresses, patients, providers and families experience more suffering and symptom burden, impairing quality of...
Commentary on: Heo S, Moser DK, Lennie TA, et al. Prediction of Heart Failure Symptoms and Health-Related Quality of Life at 12 Months From Baseline Modifiable Factors in Patients With Heart Failure. J Cardiovasc Nurs 2020;35(2),116–125.doi: 10.1097/JCN.0000000000000642.
Heart failure (HF) management, which targets multidimensional, modifiable predictors such as New York Heart Association class, depressive symptoms and self-care, may improve HF symptoms and health-related quality of life in the long term. Further longitudinal studies are required in order to establish the nature of the relationship between the modifiable predictors of HF symptoms and how they change over time.
Heart failure (HF) is a chronic condition which is associated with high morbidity and mortality rates, with patients experiencing a major symptom burden and negative effect on their quality of life (QOL).
Commentary on: Li Z, Lin F, Thalib L, et al. Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis. Int J Nurs Stud 2020;105:103546. doi: 10.1016/j.ijnurstu.2020.103546. [Epub ahead of print 31 Jan 2020].
The estimated worldwide pressure injury (PI) prevalence is 12.8% in hospitalised adults. Hospitals should continue to see PIs as a priority. Future PI prevalence studies should ensure appropriate sampling methods and training for data collectors.
A pressure injury (PI) or pressure ulcer is localised skin and/or tissue damage which results from sustained pressure and/or shear.
Commentary on: Puente-Fernández D, Lozano-Romero MM, Montoya-Juárez R, et al. Nursing professionals’ attitudes, strategies and care practices towards death: a systematic review of qualitative studies. J Nurs Scholarsh 2020;52:301–10.
Nurses can use the explanatory model to help them understand their emotions and the importance of self-care when providing end of life care (EoLC) to patients, and families. Future research should focus on qualitative methods, allowing for better understanding of the relationship between nurses’ attitudes and their EoLC.
Nurses have a pivotal role in providing EoLC to patients and their families. The care individual nurses provide can be influenced by their own attitudes to death and dying, and their perceptions of the quality of care provided at end of life. A review
Commentary on: Sims S, Leamy M, Levenson R, et al. The delivery of compassionate nursing care in a tick-box culture: Qualitative perspectives from a realist evaluation of intentional rounding. Int J Nurs Stud 2020;107:103580.
Prescriptive ‘intentional rounding’ to systematically assert clinical nursing interactions does not facilitate ‘compassionate care’. Nursing research must interrogate implementation of strategies which assert ‘tick box cultures’, and ensure that such initiatives are evidence based.
Compassion sits at the heart of nursing as one of the fundamental characteristics of the profession.
Commentary on: Guo B, Zuo X, Li Z, et al. Improving the quality of bowel preparation through an app for inpatients undergoing colonoscopy: a randomized controlled trial. J Adv Nurs 2019. doi: 10.1111/jan.14295
Healthcare professionals should recognise and utilise newer technology to improve the quality of bowel preparation for patients undergoing colonoscopy. App-based instructions which are user friendly, personalised and interactive can result in better quality of healthcare delivery.
Colonoscopy is the standard method for screening, diagnostic evaluation and treatment of colorectal lesions.
Interpretative phenomenological analysis (IPA) was originally developed in 1995 by Johnathan Smith as a method to undertake experiential research in psychology and has gained prominence across health and social sciences as a way to understand and interpret topics that are complex and emotionally laden, such as chronic illness experiences.
Commentary on: Abu Khait, A Shellman, J, Sabo K. Metasynthesis of Patients’ Perspectives about Reminiscence in Dementia Care. West J Nurs Res 2020;1–15. https://doi.org/10.1177/0193945919897927
Understanding reminiscence therapy from the perspectives of people with dementia can assist nurses to deliver reminiscence sessions which reduce negative emotions and improve self-esteem. The inclusion of patient perspectives can enhance further theoretical development of a middle-range theory relating to reminiscence therapy in dementia care. Research methods should be inclusive in their design so as not to exclude people in the later stages of dementia.
Reminiscence is a therapeutic intervention used to support people with dementia. It involves sharing life experiences, memories and stories from the past. While it is suggested that people with dementia can benefit from the principles of reminiscence, there is a lack of supporting evidence from the...
Commentary on: Baghdadi JD, Wong MD, Uslan DZ et al. Adherence to the SEP-1 Sepsis Bundle in Hospital-Onset v. Community-Onset Sepsis: a Multicenter Retrospective Cohort Study. J Gen Intern Med 2020; Feb 10. doi: 10.1007/s11606-020-05653-0. [Epub ahead of print]
Patients with hospital-onset sepsis are less likely to receive sepsis bundle adherent care compared with community-onset sepsis, reasons for which are multifactorial. High-quality prospective cohort studies are needed to explore disparities in adherence, factors affecting non-adherence and its effect on mortality.
Adherence to sepsis bundles is associated with good outcomes in community-onset sepsis.
Commentary on: Datla S, Verberkt CA, Hoye A, et al. Multi-disciplinary palliative care is effective in people with symptomatic heart failure: a systematic review and narrative synthesis. Palliat Med 2019;338:1003–16.
Heart failure management which includes tailored multidisciplinary palliative care (PC) interventions improve patient outcomes, reduces acute hospitalisations and decreases costs. Large multicentre trials need to be conducted to ensure generalisability of the findings with consensus needed regarding the key elements of the PC intervention and study population.
Heart failure (HF) is a chronic condition which is associated with high morbidity and mortality rates with patients experiencing a major symptom burden and negative effect on their quality of life (QOL).
Commentary on: Østergaard B, Clausen AM, Agerskov H, et al. Nurses’ attitudes regarding the importance of families in nursing care: a cross-sectional study. J Clin Nurs 2020;297-8:1290–1301. DOI 10.1111/jocn.15196.
Nurses developing a positive attitude towards patient’s families can help create a culture of inclusivity that can be beneficial to support quality nursing care, family cohesiveness and patient safety. Correlational studies are required to explore if relationships exist between the quality of nursing care and family engagement in patients’ care.
There is a growing body of evidence concerning the importance of family involvement in patient care. The evidence base suggests that engaging families in the care of patients supports quality nursing care and patient concordance with treatment
Employing a cross-sectional study, 1720 (79%) out of 2177 nurses completed a survey questionaire.
Commentary on: Flateland SM, Pryce-Miller M, Skisland AVS, et al. Exploring the experiences of being an ethnic minority student within undergraduate nurse education: a qualitative study. BMC Nursing, 18:63. https://doi.org/10.1186/s12912-019-0389-0
Diversity training is needed for nurse educators; the numbers of nursing faculty from ethnic minority groups should be increased. Research is needed to identify best practices for equitable academic opportunities for ethnic and cultural minority nursing students.
There is a growing body of evidence suggesting that ethnic and cultural minority students face multiple, unique challenges in completing an undergraduate degree in nursing. The challenges include discrimination, language barriers, social and cultural marginalisation and a lack of culturally sensitive academic support.
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