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AnteayerEvidence-Based Nursing

Evidence-informed and targeted public health interventions are required to reduce the broader behavioural health impact of loneliness and social isolation due to the COVID-19 pandemic

Por: Ghassemi · A. E. · Azadeh Ranjbar · P.

Commentary on: Bu, F, Steptoe, A, Fancourt, D. Loneliness during a strict lockdown: Trajectories and predictors during the COVID-19 pandemic in 38,217 United Kingdom adults. Soc Sci Med., 2020; https://doi.org/10.1016/j.socscimed.2020.113521

Implications for practice and research

  • Developing targeted public health interventions to identify larger behavioural health impacts of loneliness due to COVID-19 lockdown are required, and these evidence-informed measures should help mitigate loneliness and improve mental health outcomes in high-risk populations during pandemics.

  • Future research should focus on developing loneliness scales using surveys tailored to assessing different dimensions of loneliness due to the COVID-19 pandemic.

  • Context

    The COVID-19 pandemic initiated a global lockdown and introduced social distancing policies limiting face-to-face activities and social interaction. With growing research on loneliness, and its associations with potential risk of mental illness, Bu et al examined the growth trajectories and predictors of loneliness during the pandemic lockdown.

    Increase disparities in breast cancer screening uptake for women with anxiety disorders

    Por: Alcindor · M. L.

    Commentary on: Ross E, Maguire A, Mairs A, et al. Disparities in breast cancer screening uptake for women with mental illness in the United Kingdom. Am J Prev Med 2021;60(3):e123-e130. https://doi.org/10.1016/j.amepre.2020.09.010.

    Implications for practice and research

  • Collaboration between primary care and psychiatry is needed for evidence-base practices addressing noncompliance rate in preventive care practice.

  • The use of a qualitative study would provide an opportunity to explore some of the modifiable factors contributing to the cancer mortality gap, like the stigmatisation of mental illness and individual’s ability to attend health clinics from the participant’s perspectives.

  • Context

    A study, from Northern Ireland involving 57,328, reports a relationship between women undergoing psychiatric treatments with a decline in attending breast screening centers.12 While the incidence rate of breast cancers in women diagnosed with psychiatric ailments receiving treatments was comparable to the...

    Researching sensitive topics in healthcare

    Por: Pinto · A. · Rodriguez · A. · Smith · J.
    Introduction

    Research about sensitive topics in healthcare is crucial because it is essential to give voice to the under-represented in research.1 If research is not undertaken on sensitive topics or with marginalised populations, our evidence base will be limited, lack significant knowledge or understanding of the individuals and community groups we support, with the potential for some areas and systems of care/interventions to lack an evidence-based, be ineffective or not inclusive. In this article, we will consider examples of research that could be deemed as sensitive before outlining key considerations when undertaking research within sensitive topic areas.

    Sensitive topics in healthcare

    The healthcare literature identifies a negative discourse when describing sensitive research topics or the participants of such studies, including words such as ‘difficult’, ‘emotive’ and ‘vulnerable’. The vulnerability narrative further involves the adjectives ‘fragile’, ‘emotional’, ‘controversial’, ‘delicate’, ‘weak’, ‘defenceless’ and ‘helpless’. Consequently, researchers...

    Meta-analysis exploring poststroke aphasia profiles and language recovery

    Por: Lawal · M.

    Commentary on: REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators. Predictors of poststroke aphasia recovery: a systematic review-informed individual participant data meta-analysis. Stroke 2021;52:1778–87.

    Implications for practice and research

  • Poststroke aphasia may symbolise a temporary or a significant life-changing communication problem.

  • The severity of aphasia on stroke patients has implications for functional capacity, discharge destination and potential to return to employment.

  • The sooner a person receives treatment for apoststroke aphasia, the lesser the impact and the better the prognosis.

  • Context

    Stroke is one of the leading causes of disability worldwide and almost 350 000 stroke survivors have aphasia in the UK.1 Depending on the severity, aphasia may affect oral communication, auditory, writing, reading comprehension and everyday communication.2 3 Long-term communication impairment of up to a year affects almost three quarters of stroke patients and there...

    In the room where it happens: in-person or remote data collection in qualitative research?

    Por: Wray · J. · Barrett · D.
    Introduction

    Qualitative research is founded on the collection of rich data through methods such as one-to-one interviews and focus groups, and usually with all parties together in the same place (referred to thereafter as the ‘in-person’ approach). However, since the onset of the COVID-19 pandemic in early 2020, access to health and social care settings has been restricted and many researchers have been subjected to ‘work-at-home’ orders. Consequently, there has been a rapid transition to many interactions and meetings taking place remotely, using technologies such as videoconferencing platforms. This has impacted substantially on opportunities for in-person data collection. But has the pandemic damaged the ability to gather rich qualitative data, or has it served as a catalyst for more effective, efficient and pragmatic approach to qualitative data collection? In this paper, we explore the arguments for and against remote data collection in qualitative research, focusing specifically on the...

    Non-infectious complications of peripheral venous catheters are common

    Por: Vyasabattu · M. · Yarra · P.

    Commentary on: Marsh N, Webster J, Ullman AJ, et al. Peripheral intravenous catheter non-infectious complications in adults: A systematic review and meta-analysis. J Adv Nurs 2020 Dec;76(12):3346–3362. DOI: 10.1111/jan.14565

    Implications for practice and research

  • Peripheral venous catheters are associated with non-infectious complications such as phlebitis and infiltration/extravasation.

  • Future research and guidelines should focus on identifying evidence-based interventions to reduce the incidence of these complications

  • Context

    Peripheral intravenous catheters (PIVCs) are the most commonly used vascular access devices among hospitalised patients, but little is known about the impact of non-infectious complications associated with them. Current guidelines from multiple nations, including England and USA, focus primarily on infection prevention.1 These guidelines lacked a concerted effort to recognise and address non-infectious complications. Failure of PIVCs lead to extra burden on healthcare resources, delay in treatments and increased the need for central line catheters.2...

    Simple preoperative frailty screening may identify older people with increased needs for discharge planning post surgery

    Por: Booth · J.

    Commentary on: Sokas CM, Cowan J, Dalton MK, et al. Association Between Patient-Reported Frailty and Non-Home Discharge Among Older Adults Undergoing Surgery. J Am Geriatr Soc 00:1-5, 2020.

    Implications for practice and research

  • Results highlight the potential for use of items from the FRAIL tool to screen older people prior to surgery to identify increased needs for discharge planning and predict the likelihood of not being discharged home.

  • Further investigation of the use of items from the FRAIL screening tool in the preoperative assessment of older patients is warranted to identify the ability to predict post surgery discharge outcomes.

  • Context

    Almost half of older adults need postacute care or rehabilitation following surgery1 and delays in discharge to home or other facilities are common, with implications for patient recovery as well as financial and organisational consequences. Preoperative screening for frailty is recommended for...

    Resources page

    Por: Heale · R.
    Long COVIDPrimary Care Nursing’s 'huge role' in long Covid, by Kate Oxtoby, Nursing in Practice, 22 December 2021

    https://www.nursinginpractice.com/community-nursing/primary-care-nursings-huge-role-in-long-covid/

    Primary care and community nurses have an important role in supporting patients with long COVID and can use their existing knowledge and skills in relation to long-term conditions to help individuals with this new condition.

    Long Covid Kids

    https://www.longcovidkids.org/

    The vision of this organisation is to achieve recognition, support and recovery for long COVID and related illnesses in children and young people.

    SOM: Supporting occupational health and wellbeing professionals

    https://www.som.org.uk/coronavirus-resources.php

    This website hosts a list of coronavirus resources with a focus on the specific needs of healthcare providers and the difficulties of returning to work after a COVID-19 diagnosis.

    British Journal of General Practice 2021; 71 (712): e815-e825. DOI: https://doi.org/10.3399/BJGP.2021.0265. Recommendations for the recognition,...

    Evidenced-based and targeted interventions are required to enhance compliance with COVID-19 public health measures

    Por: Ghassemi · A. E. · Azadeh Ranjbar · P.

    Commentary on: Nivette, A, Ribeaud, D, Murray, A, et al. Non-compliance with COVID-19 related public health measures among young adults in Switzerland: Insight from longitudinal cohort study. Soc Sci Med 2020; https://doi.org/10.1016/j.socscimed.2020.113370.

    Implications for practice and research

  • Developing targeted, evidence-based public health measures is necessary to increase compliance with COVID-19 public health measures

  • Future research should focus on analysis of targeted interventions on mitigating non-compliance attitudes in high-risk populations.

  • Context

    Compliance with public health guidelines has become increased in global importance since the COVID-19 pandemic began. While a growing body of research on how personality and individual differences predict compliance with health guidelines during the pandemic,1 Nivette and colleagues examined prior social and psychological factors linked to non-compliance in adolescents and young adults during the pandemic.

    Methods

    Using a prospective-longitudinal cohort study with data before and during the...

    Correction: What are sensitivity and specificity?

    Swift A, Heale R, Twycross A. What are sensitivity and specificity? Evid Based Nurs 2020;23:2–4. doi:10.1136/ebnurs-2019-103225

    In this article, ‘There is a risk that a test with high specificity will capture some people who do not have Disease D (figure 3). The screening test in figure 2 will capture all those who have the disease but also many who do not. This will cause anxiety and unnecessary follow-up for well people’ should read ‘There is a risk that a test with high sensitivity will capture some people who do not have Disease D (figure 3). The screening test in figure 3 will capture all those who have the disease but also many who do not. This will cause anxiety and unnecessary follow-up for well people.’

    Figure 3 should be labelled High sensitivity.

    The sentence that reads ‘The gold standard test, when compared with other options, is most likely to...

    Multidisciplinary intervention highly effective in decreasing restraint use in paediatric acute care

    Por: Bowen · F. R. · Chinnis · S.

    Commentary on: Dalton EM, Herndon AC, Cunliff A, et al. Decreasing the use of restraints on children admitted for behavioral health conditions. Pediatrics 2021;1481:e2020003939.

    Implications for practice and research

  • Standardised protocols for de-escalation can decrease agitation and the need for physical restraints in children with behaviour health disorders.

  • Research is needed to determine ways to mitigate the use of restraints in paediatric behavioural health patients with medical comorbidities.

  • Context

    The increased number of children diagnosed with mental health conditions has resulted in increased admissions to children’s hospitals where staff are ill prepared to care for children with mental health conditions.1 2 Dalton et al3 discovered four key drivers that informed a multidisciplinary intervention to decrease the use of physical restraints in children (1) de-escalating agitated patients, (2) use of medications and timing of administration, (3) communication and (4)...

    Targeting personalised leadership factors based on the organisational needs of nurses may cultivate and improve their nursing leadership

    Por: Singh · S. · Kapoor · S.

    Commentary on: Cummings GG, Lee S, Tate K, et al. The essentials of nursing leadership: a systematic review of factors and educational interventions influencing nursing leadership. Int J Nurs Stud 2020;115:103842.

    Implications for both practice and research

  • Implementation programmes to improve nursing leadership should attend to the needs of nursing leaders in their specific organisational contexts.

  • Innovative theoretical frameworks of nursing leadership should be developed to guide interventions and their implementation in a wide range of healthcare settings.

  • Context

    Nursing leadership transpires clinical, administrative and executive roles and responsibilities of nurses across various settings such as academic institutions, community and hospitals.1 Yet, what factors constitute nursing leadership and how to practically institute and improve the leadership practices in healthcare settings are persistent scholarly questions,2 which Cummings et al strove to explore by systematically and analytically reviewing the existing literature.

    Qualitative synthesis of research on healthcare providers perceptions of the transition from in-patient to community palliative care

    Por: McPherson · C. J.

    Commentary on: Killackey, T, Lovrics, E, Saunders, S. et al (2020). Palliative care transitions from acute care to community-based care: Qualitative systematic review of the experiences and perspectives of healthcare providers. Palliative Medicine; 34(10):316–31. https://doi.org/10.1177/0269216320947601

    Implications for practice and research

  • The findings reveal the challenges experienced by healthcare professionals managing patients’ transition from acute to community palliative care.

  • Further qualitative research is needed to increase understanding of transitional care in palliative care to better inform practices and policies across care sectors.

  • Context

    People with life-limiting conditions and their families face multiple transitions in care as they navigate the trajectory of illness; including the level, goals and place of care.1Transfers within and across care settings are not uncommon when care becomes complex or is difficult to manage.1 Of significant is the transition from inpatient to home, as a home...

    Depression and age groups in the UK population: implications for public health preventive strategies

    Por: Twining · F.

    Commentary on: Arias de la Torre J, Vilagut G, Ronaldson A, et al. Prevalence and age patterns of depression in the United Kingdom. A population-based study. J Affect Disord 2021;279:164–72

    Implications for practice and research

  • Findings indicated a higher prevalence of depression in middle-aged adults which suggests that targeted strategies can be valuable to improve the monitoring and prevention of depression.

  • Future research should include a wider range of socioeconomic variables which is essential to understand the factors which may contribute to depressive symptoms.

  • Context

    Depression is a worldwide public health concern, it is the major contributor to global disability and suicide.1 In Europe, depression is highly prevalent with huge economic consequences.2 In the UK, it is therefore critical to examine the prevalence of this condition in order for healthcare professionals to develop a better understanding which will improve public...

    Psychological trauma in postpartum women who experienced maternity care during the stringent COVID-19 pandemic restrictions

    Por: Alcindor · M. L.

    Commentary on: Sanders J and Blaylock R. "Anxious and traumatized": Users’ experiences of maternity care in the UK during the COVID-19 pandemic. Midwifery 2021;102. doi: 10.1016/j.midw.2021.103069.

    Implications for practice and research

  • Clinicians can use these findings to prioritise the return to visitor’s access in organisation of maternity services in the ‘new normal’ post pandemic.

  • Evidence-based research are needed to discover the findings of short-term and long-term impact from visitor restrictions on families.

  • Context

    There is a growing body of evidence supporting the emotional, psychological and physical trauma inflicted on women who experienced visitor restrictions while receiving maternity care after 11 March 2020 during the COVID-19 pandemic.1 The study employed the quantitative and qualitative format to demonstrate the number of women who experienced this trauma from the implementation of visitor’s restrictions in the UK maternity ward.1

    Methods

    The researchers...

    Teenage pregnancy strategy in England: new perspective on effectiveness: a commentary

    Por: Lawther · L. · Gillespie · M.

    Commentary on: Baxter AJ, Dundas R, Popham F, et al. How effective was England's teenage pregnancy strategy? A comparative analysis of high-income countries. Soc Sci Med 2021;270:113685

    Implications for practice and research

  • Individual experiences of the autonomous reproductive choices and pregnancy outcomes of teenagers should be heard

  • It is morally and economically justified to analyse the effectiveness of public health interventions.

  • Whole country public health interventions should be scrutinised to minimise repetition of costly mistakes.

  • A range of measures and a whole systems perspective is required in the analysis and evaluation of effect.

  • Context

    Teenage pregnancy is a global issue in low-income, middle-income and high-income countries, and is associated with suboptimal health outcomes for both the mother, baby and family. Social deprivation, health inequality and educational disadvantage are considered among causative factors and outcomes; therefore, targeting the teenage pregnancy rate is a...

    Effectiveness of flipped classroom techniques in nurse education

    Por: Milne · P. · Twycross · A.
    Background and purpose

  • This is a summary of Ozbay O and Cinar S. Effectiveness of flipped classroom teaching models in nursing education: a systematic review. Nurs Educ Today 2021. (102)

  • The flipped classroom is an alternative approach to traditional classroom-based learning where the learner passively listens to a lecturer.

  • The flipped classroom method is a student-centred approach to learning that can be undertaken online or face to face.

  • The purpose of this systematic review was to gain an insight into the effectiveness of the flipped classroom in nurse education.

  • Methods

    Results and areas for future research

  • Overall, 24 studies were included encompassing data from 2059 participants with 11 of the studies originating in the USA.

  • Twenty-one studies focused on undergraduate nurse education, three on postgraduate education.

  • Twelve of the studies compared traditional teaching methods...

  • Specialist services for people with young-onset dementia (YOD) are associated with better postdiagnostic care quality and satisfaction

    Por: Booth · J.

    Commentary on: Stamou V, La Fontaine J, Gage H, et al. Services for people with young onset dementia: the ‘Angela’ project national UK survey of service use and satisfaction. Int J Geriatr Psychiatry. 2020;1–12.

    Implications for practice and research

  • Results highlight improved performance on quality indicators of specialist services for people with young- onset dementia (YOD) over generic dementia services and neurology, indicating commissioners should configure future dementia services to include YOD specialist teams.

  • Reasons for reported regional variation in UK service provision is needed in future research to explore potential cultural and geographical influences on care and support pathways for people with YOD and their families and improve knowledge about optimum service delivery.

  • Context

    People with YOD, onset 1 which particularly affect processes of diagnosis and ongoing...

    Intensive care nurses should seek to identify those patients at risk of developing post-traumatic stress syndrome

    Por: Hughes · L. · McPeake · J. M.

    Commentary on: Wawer, E. Viprey, M. Floccard, B. Saoud, et al. (2020) Early detection of patients at risk of developing a post-traumatic disorder after an ICU stay. Critical Care Medicine 487(11):1572–9.

    Implications for practice and research

  • Assessment of post-traumatic stress disorder (PTSD) in the immediate post-intensive care unit discharge period may help identify those at risk of developing psychological sequelae.

  • More research is needed into the prevention and identification of PTSD in this population, alongside evaluation of potential interventions.

  • Context

    The long-term consequences of a critical care admission are well established in the literature.1 A common psychological sequelae is post-traumatic stress disorder (PTSD), a process triggered by a significant trauma or event in a person’s life, such as critical illness. The documented prevalence of PTSD in critical care survivors varies widely; however, as many as 62% of patients could experience PTSD in...

    Sleeping-related distress in a palliative care population: influence of symptom clusters

    Commentary on: Currow DC, Davis W, Connolly A, et al. Sleeping related distress in a palliative care population: A national, prospective, consecutive cohort. Palliat Med 2021. doi: 10.1177/026921631998558

    Implications for practice and research

  • Sleeping-related distress is highly prevalent in patients in both inpatient and community palliative care settings.

  • Good sleep can improve other symptoms that are in identified clusters, such as pain and fatigue.

  • Understanding a person’s sleep history and their personal objectives in any intervention should be explored within an assessment.

  • Context

    Sleep is essential for optimal mental and physical health.1 Poor sleep quality can have a negative impact and is associated with (among other things), a reduction in a person’s sense of well-being and quality of life.1 Patients in the palliative care stages of a progressive incurable disease’, with limited response to treatments, can often...

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