Commentary on: Liang C, Chung HF, Dobson AJ, Cade JE, Greenwood DC, Hayashi K, Hardy R, Kuh D, Schouw YTV, Sandin S, Weiderpass E, Mishra GD. Is there a link between infertility, miscarriage, stillbirth, and premature or early menopause? Results from pooled analyses of 9 cohort studies. Am J Obstet Gynecol. 2023 Jul;229(1):47.e1-47.e9. doi: 10.1016/j.ajog.2023.04.009. Epub 2023 Apr 13.
Women with a history of recurrent miscarriages, infertility, or stillbirths should be informed of their increased risk of early or premature or menopause. Future studies should aim to evaluate whether a tailored counselling and management strategies considering this risk can improve patient outcomes and overall quality of care.
Menopause is a significant milestone for women, marking the permanent cessation of menstruation after 12 months of amenorrhoea. The onset of menopause is influenced by various factors, including genetics, lifestyle and...
Commentary on: Suh M, Kim DH, Cho I, Ham OK. Age and gender differences in fall-related factors affecting community-dwelling older adults. J Nurs Res. 2023 Apr 1;31(2):e270. doi: 10.1097/jnr.0000000000000545.
Future research could explore and test the efficacy of gender-specific fall prevention protocols. In practice, understanding that there are gender-based risk factors for falls would assist and prompt nurses and health professionals to perform assessments or interventions to specifically mitigate those risks
Falls are an incredibly common issue among older adults, with potentially serious downstream consequences. Suh et al (2023) aimed to explore not only the prevalence of falls but also the factors relating to age, gender and falls. It is well established that there are gender differences in the prevalence of falls, however, the reasoning is not fully understood. This study was conducted to address the paucity in...
Commentary on: Kuld PB, Frielink N, Zijlmans M, et al. . Promoting self-determination of persons with severe or profound intellectual disabilities: a systematic review and meta-analysis. J Intellect Disabil Res. 2023 Jul;67(7):589–629. doi: 10.1111/jir.13036. Epub 2023 May 11.
Nurses can promote self-determination of people with severe and profound intellectual disabilities through relationship building and learning to read a person’s communication cues to determine their preferences. Future research should use an ecological approach to optimise environments for self-determination and consistent measures to strengthen the evidence base.
Self-determination is a key dimension of quality of life for people with intellectual disabilities, that is, acting freely and willfully to make things happen in one’s own life.
Commentary on: Eglseer D. Development and evaluation of a Massive Open Online Course (MOOC) for healthcare professionals on malnutrition in older adults. Nurse Educ Today. 2023 Apr;123:105741. doi: 10.1016/j.nedt.2023.105741. Epub 2023 Feb 4.
Massive open online course (MOOCs) can improve health professionals (HPs)’ knowledge and nutritional care skills for malnutrition in older adults efficiently. Implementation science studies are necessary to effectively change HPs’ behaviours and attitudes towards malnutrition by considering organisational, cultural and self-efficacy aspects. Future research should focus on identifying effective strategies for implementing evidence-based nutritional care for older adults, emphasising HPs’ attitudes and self-efficacy.
Malnutrition is a prevalent condition among older adults in acute hospital settings that can result in adverse clinical outcomes such as increased pressure ulcer development, reduced wound healing, increased infections and higher mortality rates.
Nursing research often tests complex interventions. For example, the intervention may be delivered by different nurses, with varying levels of seniority and expertise and in diverse geographical locations. The efficacy (can it work) or effectiveness (does it work in the real world) of complex interventions is often evaluated within randomised controlled trials (RCTs). The most recent UK Medical Research Council (MRC) guidance
The term early career researcher (ECR) is commonly used, although its meaning is expressed by a wide range of definitions which vary globally, and may be institutionally determined.
Increasingly, the challenges associated with such time-bound definitions of ECRs are being acknowledged. Many bodies which offer funding for ECRs (eg, see
Commentary on: Boucher NA, Tucker MC, White BS, et al. Frontline clinician appraisement of research engagement: "I feel out of touch with research". J Gen Intern Med 2023:1–7. doi: 10.1007/s11606-023-08200-9.
Leadership action by prioritising clinical research activities and introducing a range of clinician engagement strategies for research can lead to better staff retention and patient care. Implementation of clinician engagement strategies needs further research to clarify and enhance key benefits for staff and patients.
There is a growing body of international research evidence highlighting the benefits of clinicians’ research engagement and documenting associated barriers and facilitators.
Commentary on: Wilson A, Hurley J, Hutchinson M, Lakeman R. Trauma-informed care in acute mental health units through the lifeworld of mental health nurses: A phenomenological study. Int J Ment Health Nurs. 2023 Jun;32(3):829–838. doi: 10.1111/inm.13120. Epub 2023 Jan 27.
Implications for practice and research
Clients’ medical data and trauma histories should be supplemented with information on their strengths to promote a holistic and integrated understanding of their lived experiences. Research is needed to better understand the extent to which trauma-informed care (TIC) principles are taught to nursing students so that they understand how to apply TIC in different healthcare settings.
There is growing support for the delivery of trauma-informed care (TIC) in diverse clinical, organisational and community settings.
Commentary on: Marko S, Wylie S, Utter J. Enablers and barriers to healthy eating among hospital nurses: a systematic review. Int J Nurs Stud. 2023 Feb;138:104412. doi: 10.1016/j.ijnurstu.2022.104412. Epub 2022 Dec 5
Multi-faceted interventions are key in addressing various influences on nurses’ healthy eating beyond individual choices. Rigorous studies are needed to assess multi-level socio-ecological interventions’ effectiveness on nurses’ eating habits.
Nurses, despite playing a significant role in healthcare, have been found to possess poor dietary habits and face elevated rates of chronic illnesses. A recent systematic review by Marko and colleagues explored factors influencing healthy eating among nurses in hospital settings. Barriers included high accessibility of unhealthy foods, high costs and lack of storage/preparation facilities. Enablers included proximity to healthy options, roster planning and structured workplace programmes. Supportive networks were an interpersonal enabler, while work culture and...
Commentary on: Calderón-Larrañaga S, Greenhalgh T, Clinch M, Robson J, Dostal I, Eto F, Finer S. Unravelling the potential of social prescribing in individual-level type 2 diabetes prevention: a mixed-methods realist evaluation. BMC Med. 2023 Mar 13;21(1):91. doi: 10.1186/s12916-023-02796-9.
Integrating social prescribing (SP) in primary care increases opportunities to deliver holistic care and facilitate clinic-community partnerships. Research examining the effect of SP on prediabetes-related clinical outcomes is needed.
Recent data suggest that 464 million adults worldwide have pre-diabetes and are at increased risk for type 2 diabetes (T2D).
Commentary on: Ayers JW, Poliak A, Dredze M, Leas EC, Zhu Z, Kelley JB, Faix DJ, Goodman AM, Longhurst CA, Hogarth M, Smith DM. Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum. JAMA Intern Med. 2023 Jun 1;183(6):589-596. doi: 10.1001/jamainternmed.2023.1838.
AI assistants could be used to draft responses for physicians and nurses, potentially addressing a key element of burn-out. Further research is needed to assess the impact of communication on healthcare outcomes and should incorporate patient evaluations and feedback.
In the setting of increasing adoption of virtual healthcare and the surge in electronic patient messages, there has been a higher workload for physicians and nurses, contributing to burnout and potentially terse, unanswered or unhelpful patient messages. Given these challenges, there is a need to explore innovative solutions...
Commentary on: King C, Dudley J, Mee A, Tomlin S, Tse Y, Trivedi A, Hawcutt DB; Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacist Group Joint Standing Committee on Medicines. For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review. Arch Dis Child. 2023 Jul;108(7):583–588. doi: 10.1136/archdischild-2022-324772. Epub 2023 Feb 15. PMID: 36792347.
Medication errors can occur throughout many complex steps. Children are exposed to a higher risk of harm than adults when it comes to medication errors. High-quality evidence for interventions that reduce medication errors in children on rounds is lacking.
King et al conducted a systematic review of interventions aimed at reducing medication errors during inpatient rounds in children’s hospitals.
Commentary on: Shan Z, Wang F, Li Y, Baden MY, Bhupathiraju SN, Wang DD, Sun Q, Rexrode KM, Rimm EB, Qi L, Tabung FK, Giovannucci EL, Willett WC, Manson JE, Qi Q, Hu FB. Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality. JAMA Intern Med. 2023 Feb 1;183(2):142-153. doi: 10.1001/jamainternmed.2022.6117. Erratum in: JAMA Intern Med. 2023 Jun 1;183(6):627.
Wholesome eating diets can be customised to align with person’s culinary traditions and tastes in accordance with the Dietary Guidelines for Americans to decrease the mortality risk. Provide updated scientific evidences on the benefits of maintaining a healthy diet throughout the life course to take appropriate strategies and policies.
Healthy eating patterns play a prominent role in preserving public health. The association between dietary patterns with the mortality risk has been investigated in numerous countries.
Commentary on: Gustafson CM, Higgins M, Wood KA, Song MK. Place of death for young adults with chronic illness. Nurs Res. 2023 Jul 11. doi: 10.1097/NNR.0000000000000681. Epub ahead of print.
Clinicians must communicate with young adults (YAs) throughout their disease course about end-of-life care preferences, including place-of-death. Future research must explore YAs’ preferences for place-of-death.
Young adults (YAs) with serious illnesses report wanting choices in their end-of-life care.
Commentary on: Shorey S, Jarašiūnaite-Fedosejeva G, Akik BK, Holopainen A, Isbir GG, Chua JS, Wayt C, Downe S, Lalor J. Trends and motivations for freebirth: A scoping review. Birth. 2023 Mar;50(1):16-31. doi: 10.1111/birt.12702. Epub 2023 Jan 4.Commentary
Providing maternity care that is trauma informed, respectful, supportive and promotes patient autonomy, agency and cultural beliefs may encourage lower rates of freebirth.
More research is needed to articulate motivations for freebirth among diverse populations and translate trauma informed and respectful maternity care principles across systems and service providers.
Unassisted childbirth (outside a hospital facility with no professional attendant) is common in low-income and middle-income countries (LMICs), where barriers to access and poverty delimit engagement in maternity healthcare services. However, even in high-income countries (HICs) where maternity healthcare services are more attainable, a small percentage of birthing people are choosing unassisted birth, a...
Commentary on: Kelleher ST, Barrett MJ, Durnin S, Fitzpatrick P, Higgins A, Hall D. Staff competence in caring for LGBTQ+ patients in the paediatric emergency department. Arch Dis Child. 2023 Jul;108(7):525–529. doi: 10.1136/archdischild-2022-325151. Epub 2023 Apr 24.
Emergency department staff self-identified the need for training in the care of youth who identify as LGBTQ+ to close a gap in knowledge and clinical preparedness. Intervention studies, using evidence-based science, are needed to improve competency and advance health equity for LGBTQ+ youth.
Individuals who identify as LGBTQ+ report discrimination in healthcare settings.
Commentary on: Bell T, Sprajcer M, Flenady T, Sahay A. Fatigue in nurses and medication administration errors: A scoping review. J Clin Nurs. 2023 Sep;3217-18,:5445-5460. doi: 10.1111/jocn.16620. Epub 2023 Jan 27.
Revising the ‘safe working hours policy’, limiting overtime, and developing fatigue management systems are vital approaches for managing nurses’ fatigue and reducing medication administration errors (MAEs). Future research should use large-scale studies and diverse approaches of data collection to better report registered nurses’ (RNs) fatigue’s impact on MAEs.
Preventing MAEs is a top priority to ensure patient safety. The presence of fatigue among RNs has been recognised as a growing factor in the occurrence of MAEs.
Commentary on: Stanley S, Higginbotham K, Finucane A, Nwosu AC. A grounded theory study exploring palliative care healthcare professionals’ experiences of managing digital legacy as part of advance care planning for people receiving palliative care. Palliat Med. 2023 Oct;37(9):1424–1433. doi: 10.1177/02692163231194198. Epub 2023 Aug 23.
Digital legacy could be incorporated into advance care planning policies in practice, with explicit inclusion in advance care planning documents. Further research is required to explore the diverse facets of digital legacies within various patient populations and cultural backgrounds.
The rapid growth of technology, including increased internet access and smartphone usage, has made digital legacy management an important aspect of end-of-life care. Digital legacy refers to the digital assets and online presence that individuals leave behind after they pass away.
In this edition of our resources page, we include information on guidance for early career researchers (ECRs) and this builds on our recent editorial from Dr Helen Sisson, a registered Children’s Nurse and Health Visitor and Lecturer.
For ECRs, there is some excellent information available to help guide you in your careers.
There are free and accessible resources available such as Concordat to Support the Career Development of Researchers and the Research funding bodies also provide a wealth of advice and resources see, for example,
Commentary on: Kopp SJ, Kelly EA, DeFranco EA. Influence of social determinants of health on breastfeeding intent in the USA. Birth. 2023 Jul 3. doi: 10.1111/birt.12740. Epub ahead of print.
Healthcare providers should focus on improving knowledge around breastfeeding guidelines and the benefits of breast feeding for mothers in low socioeconomic status (SES) groups. Focusing research on breastfeeding intention (rather than rates) in low SES groups may help to improve breastfeeding outcomes as breastfeeding intentions are a significant predictor of breastfeeding initiation.
Breastfeeding sets the foundation for healthy growth and development, with many recognised benefits for both infant and maternal health. Thus, socioeconomic disparities in breastfeeding—which are widely reported in the USA and many other Western countries