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AnteayerEvidence-Based Nursing

Characteristics and outcomes of pregnant Black and minority ethnic women admitted to hospital with confirmed SARS-CoV-2 infection in the UK

Por: Alcindor · M. L. · Alcindor · F. · Alcindor · M. A.

Commentary on: Knight M, Bunch K, Vousden N, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population-based cohort study. BMJ 2020;369:m2107. doi:10.1136bmj.m2107

Implications for practice and research

  • Providers managing obstetric patients will need to identify prevalent risk factors in minorities with SARS-CoV-2 and the outcomes.

  • This study can be used to launch a correlational study to investigate the relationship between health disparities and the spread of SARS-CoV-2 in the Black minority obstetric patients.

  • Context

    This national UK cohort study1 described 427 pregnant women admitted with confirmed SARS-CoV-2 infection,1 56% of whom were Black or ethnic minority patients. The study analysed risk factors such as advanced pregnancy and maternal age, obesity and cardiopulmonary comorbidities and their impact on the pregnancy and the newborn.1

    Methods

    The...

    Effect of grief on ageing populations physical and mental well-being

    Por: Dunham · M.

    Commentary on: Aoyama M, Sakaguchi Y, Fujisawa D, et al. Insomnia and changes in alcohol consumption: Relation between possible complicated grief and depression among bereaved family caregivers. Journal of Affective Disorders 2020;275:1-6. doi:10.1016/j.jad.2020.06.023.

    Implications for practice and research

  • Bereaved relatives are at greater risk of physical and psychological disorders and this should be considered as part of bereavement care and health assessment.

  • Longitudinal cohort data about the bereaved health status, across cultures and age groups, could inform better bereavement care and support.

  • Context

    Bereavement is distressing; the effects of grief, including distress and associated insomnia, are known.1 Complex grief2 is characterised by its severity and duration, it can limit normal activity and function. Alcohol consumption and insomnia are both known to be potentially damaging to mental and physical well-being.3 Exploration of the associations between bereavement, alcohol consumption and...

    Best practices to prevent delirium in hospitalised patients

    Por: Yerra · S. · Yarra · P.

    Commentary on: Ludolph P, Stoffers-Winterling J, Kunzler AM, et al. Non-Pharmacologic Multicomponent Interventions Preventing Delirium in Hospitalized People [published online ahead of print, 2020 Jun 12]. J Am Geriatr Soc. 2020;10.1111/jgs.16565. doi:10.1111/jgs.16565

    Implications for practice and research

  • Non-pharmacological multicomponent interventions like early mobilisation, reorientation, pain control and others reduce the incidence of delirium in hospitalised patients at-risk.

  • A positive association is noted with reduction in length of stay, delirium duration, mortality and institutionalisation, but further research is warranted.

  • Context

    In the USA, prevalence of delirium is 29%–64% among hospitalised elderly adults 65 years and older, and account for an estimated more than US$164 billion in annual healthcare expenditures.1 Delirium is frequently unrecognised and poorly understood with no clear evidence based pharmacological treatment. Delirium increases risk of falls, functional decline, dementia, prolonged length of stay and institutionalisation.2 Several non-pharmacological interventions have evolved...

    Inequities still exist in the use of digital health technology across different sociodemographic subgroups

    Por: Karri · K. · Yarra · P.

    Commentary on: Mahajan S, Lu Y, Spatz ES, Nasir K, Krumholz HM. Trends and predictors of use of digital health technology in the United States. Am J Med. 2020 Jul 24:S0002-9343(20)30617-3. doi: 10.1016/j.amjmed.2020.06.033.

    Implications for practice and research

  • Digital health technology (DHT) as a tool and means of communication in healthcare is increasing, thus understanding predictors and existing disparities of DHT is crucial for better health outcomes.

  • Focused strategies to improve reach and effectiveness of DHT use across all subgroups will provide an opportunity to decrease existing healthcare disparities.

  • Context

    In an increasingly internet world, use of DHT as an access and means of communication is becoming central to healthcare. Previous studies have demonstrated that DHT can improve health literacy, patient empowerment and engagement, and enable better self-management of care, especially for individuals with chronic conditions.1 DHT can be used as a...

    Diagnosis, gender and age predict context of care provision for older adults towards the end of life

    Por: Green · L.

    Commentary on: Teggi, D. Care homes as hospices for the prevalent form of dying: An analysis of long-term care provision towards the end of life in England. Soc Sci Med 2020;260:113150.

    Implications for practice and research

  • Current end-of-life care (EOLC) policy needs to recognise the predictors of long-term care (LTC) provision and address the central role of care homes for older people with non-malignant conditions.

  • Future research needs to focus on the development of public health models of LTC and EOLC.

  • Context

    For older people in the UK, death is often preceded by a protracted period of ill health.1 This study investigated patterns of LTC and EOLC provision in old age by examining the relationship between chronic health conditions, place of care and dying. Older adults who receive LTC in the period prior to death belonged to one of the five categories:...

    Impact of COVID-19 on nursing students mental health: a systematic review and meta-analysis

    Por: Barrett · D. · Twycross · A.
    Background and purpose

  • This is a summary of Mulyadi M et al, 2021, https://doi.org/10.1016/j.nepr.2021.103228.1

  • Since early 2020, the COVID-19 pandemic has impacted on all aspects of education and healthcare delivery.

  • Student nurses are in a position where they may be impacted by COVID-19 from both an educational perspective and in their role as learners in practice.

  • The purpose of this systematic review and meta-analysis was to gather, appraise and synthesise research on student nurses’ well-being during the COVID-19 pandemic, with a particular focus on mental health and sleep disturbances.

  • Methods

    Results and areas for future research

  • Seventeen studies—all cross-sectional design—were included, encompassing data from nine countries and 13 247 student nurses.

  • Eight studies including 8175 student nurses reported on depression levels; 52% of participants suffered depression during the COVID-19 pandemic.

  • Three studies (n=817)...

  • Clear, consistent and credible messages are needed for promoting compliance with COVID-19 public health measures

    Por: Hung · L. · Lin · M.

    Commentary on: Nivette, A., Ribeaud, D., Murray, A., Steinhoff, A., Bechtiger, L., Hepp, U., Shanahan, L., & Eisner, M. (2020). Non-compliance with COVID-19-related public health measures among young adults in Switzerland: Insights from a longitudinal cohort study. Social science & medicine

    Implications for practice and research

  • Clear, consistent and credible messages are essential for promoting compliance with COVID-19 public health measures in young adults.

  • Research should further investigate the role of communication science in motivating collective emotions and behaviours for future public health measures.

  • Context

    As COVID-19 spreads worldwide, implementation and compliance with public health measures during the pandemic have been the foremost concern globally. The WHO highlighted that young adults had been the primary drivers of the spread of the novel coronavirus in many countries.1 This study by Nivette et al describes patterns of non-compliance with COVID-19 19-related public health measures...

    Developing nurse-friendly digital technology can enhance its use in healthcare

    Por: Kapoor · S. · Acheson · L.

    Commentary on: Brown et al. Issues affecting nurses’ capability to use digital technology at work: An integrative review. J of Clin Nurs. 2020; 29:2801–2809

    Implications for practice and research

  • Technology experts, policy-makers and health managers should engage nurses while developing and implementing digital technology in healthcare.

  • Nurse-friendly digital technology and automation should be factored in future research.

  • Context

    Digital technology is increasingly used in healthcare for assessment, diagnosis, clinical decision-making, communications, care planning, and direct patient care.1 Nurses’ proficiency in the digital technology is critical in a dynamic healthcare environment.2 3 As a result, nurses are expected to adapt to new technology at an unprecedented pace.1 2 Brown et al’s integrative review illuminated factors that influence nurses’ ability to learn and use digital technology.3

    Methods

    Brown et al completed a...

    Understanding health disparities among LGBTQ populations and future needs

    Por: Yerra · S. · Yarra · P.

    Commentary on: Haviland KS, Swette S, Kelechi T, et al. Barriers and facilitators to cancer screening among LGBTQ individuals with cancer. Oncol Nurs Forum. 2020;47(1):44–55. doi:10.1188/20.ONF.44-55

    Implications for practice and research

  • Nurses have the potential to improve cancer screening among LGBTQ populations, thus addressing healthcare disparities with competency training, better communication and providing a non-judgemental welcoming environment.

  • LGBTQ-focused research, improved funding and national screening guidelines for cancer screening are needed to address existing healthcare disparities.

  • Context

    In the USA, the 2017 Gallup poll results show 11 million Americans or 4.5% of population identify themselves as LGBTQ1 (lesbian, gay, bisexual, transgender or queer). Significant health disparities like cancer screening are reported to be higher with LGBTQ when compared with heterosexual individuals. Lack of data collection regarding sexual orientation or gender identification (SOGI) by the National Cancer Databases or Centers for Disease Control augments the...

    Nurse identity: reality and media portrayal

    Por: Garcia · R. · Qureshi · I.
    Introduction

    The WHO, the International Council of Nurses and Nursing Now, had planned to raise the global public profile of nursing in 2020 as a consequence of Florence Nightingales 200th anniversary. However, with the unexpected arrival of the coronavirus pandemic in late 2019, nurses and the nursing profession found themselves having unexpected media attention. The degree and type of media attention that nursing achieved during this time were never anticipated. This article considers the reality of nursing, both the role and profession in the UK in 2021 compared with the public perception and temporal media portrayal.

    Stereotypes of nursing

    The media mediates public perception(s) through imagery and messaging. However, with reduced public understanding of healthcare services, inadequate understanding of healthcare professional roles and responsibilities, and reduced health literacy in the general population,1 there is ample opportunity for misinformation and psychological bias (such as confirmation...

    Home care environments are not adequately catered for by existing infection prevention guidelines

    Por: Haghgoshayie · E. · Ghorbani · Z. · Hasanpoor · E.

    Commentary on: Dowding D, Russell D, Trifilio M, et al. Home care nurses’ identification of patients at risk of infection and their risk mitigation strategies: a qualitative interview study. Int J Nurs Stud. 2020;8:103617.

    Implications for practice and research

  • One of the most important strategies for care of the elderly and people with chronic diseases is evidence-based infection control to improve quality of nursing care.

  • Further interventional studies needs to be conducted in order to create home-care focused guidelines based on the best evidence

  • Context

    Growing life expectancy, increasing number of elderly individuals with chronic disease, becoming at risk of antimicrobial drug resistance and hospital infection, increasing length and costs of hospitalisation are most important reasons for establishing home healthcare centres all over the world.1–3 The majority of posthospital discharge patients require home care. These patients are at...

    Hope is a crucial factor for patients facing cancer treatment

    Commentary on: Nierop-van Baalen C, Grypdonck M, Van Hecke A, et al. Associated factors of hope in cancer patients during treatment: a systematic literature review. J Adv Nurs 2020; 00:1–18.

    Implications for practice and research

  • In clinical practice, nurses need to focus on factors related to the management of hope levels in patients undergoing cancer treatment.

  • Cohort studies and clinical trials considering the implications of clinical characteristics and levels of hope, in advanced cancer as well as studies with children, are necessary.

  • Context

    Hope is a multidimensional and dynamic mental process; it consists of the relationship between motivational energy and strategies, visions, plans to achieve long-term goals. All of these components are necessary for the normal functioning of hope. One of the factors that should be considered in assisting patients who are undergoing cancer treatment involves emotional and spiritual aspects, among which hope stands...

    Malnutrition is a significant predictor of hospitalisation outcomes among older adults with sepsis

    Por: Vyasabattu · M. · Yarra · P.

    Commentary on: Abugroun A, Nayyar A, Abdel-Rahman M, Patel P. Impact of Malnutrition on Hospitalization Outcomes for Older Adults Admitted for Sepsis. Am J Med. 2020 Aug 15:S0002-9343(20)30695-1. doi: 10.1016/j.amjmed.2020.06.044. Epub ahead of print. PMID: 32810466.

    Implications for practice and research

  • Malnutrition is an independent predictor for increased odds of mortality, septic shock and need for intubation among older patients with sepsis during their hospitalisation.

  • Malnutrition is also associated with increased length of stay and higher hospitalisation costs among admitted older patients with sepsis.

  • Context

    Sepsis in older adults aged ≥65 years is detrimental and is a very important contributor to mortality and morbidity, including deconditioning and debility leading to significant health burden.1 Prevalence of malnutrition among older adults ranges from 29% to 61% and a significant determinant of health outcomes in this population.2 The complex inter-relatability of malnutrition and...

    Risk of aspirin among pregnant women

    Por: Jogu · H. R. · Yarra · P.

    Commentary on: Hastie R, Tong S, Wikström AK, et al. Aspirin use during pregnancy and the risk of bleeding complications: a Swedish population-based cohort study. Am J Obstet Gynecol. 2020 Jul 17:S0002-9378(20)30737-7. doi:10.1016/j.ajog.2020.07.023.

    Implications for practice and research

  • Using aspirin for prevention of pre-eclampsia is associated with increased risk of postpartum haemorrhage, postpartum hematoma and possibly neonatal intracranial haemorrhage.

  • More liberal or universal administration of aspirin may have more risk than benefits due to bleeding risk, but still strongly advised in high-risk pre-eclampsia pregnant women.

  • Future prospective studies are needed to determine bleeding risks with widespread use of aspirin in pregnancy.

  • Context

    Aspirin is widely offered to pregnant women at risk of developing pre-eclampsia, secondary to its anti-inflammatory and antiplatelet properties.1 There has been a trend towards increasing the use of aspirin universally to pregnant women, secondary to perceived safety of...

    Nurses awareness of diverse healthy diets may increase patients adherence improving cardiovascular disease risk management

    Por: Singh · S. · Eastwood · C. A.

    Commentary on: Shan Z, Li Y, Baden MY, et al. Association between healthy eating patterns and risk of cardiovascular disease. JAMA Intern Med 2020; 180:1090–100. doi: 10.1001/jamainternmed.2020.2176

    Implications for practice and research

  • Nurses should be aware and open to multiple healthy dietary patterns among diverse groups of people and how they might influence cardiovascular disease (CVD).

  • Further research is required to explore how to increase adherence to healthy diets for diverse population groups within their sociocultural and ecological contexts.

  • Context

    Historically, long-term risk management of CVD is composed of healthy dietary recommendations.1 2 A plethora of information about foods and nutrients occupy media and health research spaces,3 yet consumers often possess a suboptimal understanding of healthy dietary patterns.4 Information about isolated nutrients and foods is insufficient to manage CVD risks; instead, elevated public awareness of various...

    Dynamics of patient adherence with their cardiovascular treatment plans

    Por: Al ZadJali · S. · Lee · A. J.

    Commentary on: Rashidi, A., Kaistha, P., Whitehead, L. et al. (2020) Factors that influence adherence to treatment plans amongst people living with cardiovascular disease: A review of published qualitative research studies. International Journal of Nursing Studies, 110, 103727.

    Implications for practice and research

  • Following treatment plans is essential for best outcomes—nurses must understand how and why patients choose to conform with treatment so they can support adherence.

  • Further research is needed to highlight factors from both healthcare professional and patient/relatives’ perspectives to encourage concordance.

  • Context

    Adherence to cardioprotective treatment and lifestyle modification are crucial to reduce future cardiovascular complications, rehospitalisation and death; as well as to improve patient quality of life.1 Numerous studies have reviewed medication adherence, while research on factors that influence medication adherence and treatment plans is scarce. This systematic review collates evidence on factors which influence cardiovascular patient adherence...

    Enriching outcomes for persons with intellectual disabilities: choice, individuality and collaboration are key to effective eHealth

    Por: Fewings · H. · Lee · A. J.

    Commentary on: Oudshoorn CEM, Frielink N, Nijs SLP, Embregts PJCM. eHealth in the support of people with mild intellectual disability in daily life: a systematic review. J Appl Res Intellect Disabil 2019;00:1–22.

    Implications for practice and research

  • This review highlights a need for more individualised, planned and collaborative approaches when using eHealth to assist persons with mild intellectual disabilities.

  • Further research is required to tackle the significant lack of rigorous evidence on eHealth interventions for people with mild intellectual disabilities.

  • Context

    eHealth can be used to support daily functioning and independence for people with intellectual disabilities.1 Yet there is a distinct lack of evidence to support how we can use services most effectively. This is most important in today’s post COVID-19 environment, as healthcare increasingly needs to embrace technology to support our most vulnerable citizens, as we reduce onsite care provision. This...

    Trustworthiness sparks resilience in nursing education

    Por: Epstein · H.-A. B.

    Commentary on: Amsrud E, Lybergs A, Severinsson E. Development of resilience in nursing students: a systematic qualitative review and thematic synthesis. Nurs Educ Pract 2019;41:1–9. doi: 10.1016/j.nepr.2019.102621

    Implications for practice and research

  • Nursing schools should prioritise working more systematically to implement strategies for development of resilience in nursing students.

  • Future qualitative research could follow up on how nursing graduates are actually applying resilience in their patient care.

  • Context

    There is a growing body of evidence from studies conducted worldwide linking nursing education curriculum fostering growth of trustworthiness in students to building resilience that prepares them for academic success, self care and care of others. These programmes are crucial for nurses to face the worldwide continuing demand of changing ways healthcare is delivered, more informed patients and on a daily basis maintaining excellent professional standards. However in a 2020 report, 20% simple random sampling (n=155)...

    International nurses and midwives require individualised support for successful transition to work in the UK

    Por: Afriyie · D.

    Commentary on: Bond, F, Merriman, C, Walthall, H. The experiences of international nurses and midwives transitioning to work in the UK: A qualitative synthesis of the literature from 2010 to 2019. Int J Nurs Stud 110(2020): 103693.

    Implications for practice and research

  • International nurses and midwives (INM) require support to adapt socially, culturally and professionally to work in the UK.

  • Further primary research is required to understand the interventions that most successfully support transition of INM to working in the UK.

  • Context

    The recruitment of INM trained outside of the European Economic Area (EEA) has continued to grow in the UK, in an attempt the meet staff shortages.1 However, international recruitment processes are expensive and time-consuming for both applicants and recruiting agencies.1 This study by Bond et al examined the preparedness and support available to INMs to undertake the objective...

    Ineffectiveness and safety concerns of using aspirin and other NSAIDs in preventing dementia

    Por: Steele · D. · James · K. · Cadet · M.

    Commentary on:D. (2020). Aspirin and other non-steroidal anti-inflammatory drugs for the prevention of dementia. Cochrane Database of Systematic Reviews, (4).

    Implications for practice and research

  • Further studies of nonsteroidal anti-inflammatory drugs need to give due attention to the safety concerns arising from these existing studies.

  • Monitoring the risks of bleeding when prescribing aspirin or non-steroidal medications for patients with dementia in clinical practice is important.

  • Context

    According to the Centers for Disease Control and Prevention, 5 million adults were diagnosed with dementia in 2014; projected to rise to approximately 14 million by 2060.1 This is a significant health problem, as dementia prevalence is increasing. Therefore, practitioners need to understand how it can be prevented and treated effectively. To date, no available medication exists to prevent or delay the onset of dementia. It has been reported that the pathogenesis of dementia was associated with inflammation;...

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