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Commentary on: Kearns, RJ, Kyzayeva, A, Halliday, LO, et al. Epidural analgesia during labour and severe maternal morbidity: population based study. BMJ 2024;385.
Implications for practice and research Health research, policy and information should emphasise the advantages of intrapartum epidurals beyond pain relief, especially for women with pre-existing conditions and preterm labour. Health services must provide access to a 24-hour epidural service within their maternity care.
The use of intrapartum epidurals to manage pain during labour and birth has been globally accepted for decades.
Commentary on: Lykkeberg B, Noergaard MW, Bjerrum M. Experiences and expectations of parents when young people with congenital heart disease transfer from pediatric to adult care: A qualitative systematic review. J Child Health Care. doi:10.1177/13674935241231024
Implications for practice and research To inform family-centred transition programmes, more high-quality qualitative research describing parental experiences should be conducted, particularly in non-European and low- and middle-income countries. Congenital heart disease transition programmes should consider adopting a family-centred approach that incorporates informational and psychosocial support resources for parents.
A growing number of individuals born with congenital heart disease (CHD) are surviving well into adulthood, and a successful transition from paediatric to adult healthcare is essential for their long-term health. However, discontinuity in care is prevalent.
Commentary on: Reason M, Acton K, Foulds D. Working it out together: Lessons and insights into inclusive research in an arts context. British Journal of Learning Disabilities 2024:1–11.
Implications for practice and research Inclusive research places a strong emphasis on the active empowered participation, particularly in decision-making and agenda-setting, of marginalised/disadvantaged community members in every step of the research process. Implementation research needs to focus on how research methodologies can be democratised through a continuous commitment to allyship with marginalised/disadvantaged populations towards empowered involvement.
Research in the field of learning disabilities has been influenced by ableist practices, often excluding individuals with learning disabilities and autism from the research process. This exclusionary tradition, which also has been observed in research with other marginalised/disadvantaged groups, has diminished their capacity to drive change within their communities.
Commentary on: Skov SK, Hjorth S, Kirkegaard H et al. Mode of delivery and short-term maternal mental health: a follow-up study in the Danish national birth cohort. International Journal of Gynecology & Obstetrics. 2022 Nov;159(2):457-65.
Implications for practice and research Mode of delivery is associated with postpartum mental health, so mothers with emergency caesarean section (EmCS) need more support for their mental health. Therefore, healthcare providers should pay special attention to the increased risk of anxiety, depression and stress in these women and provide appropriate care and follow-up. Along with investing in technologies and clinical practice to minimise the number of EmCS, more research and education are needed to develop effective strategies to prepare and support women experiencing this delivery mode.
Caesarean section (CS) is a lifesaving intervention which can be used when complications arise during pregnancy or delivery. In the last...
Commentary on: Ren, LH., Wong, KLY., Wong, J., Kleiss, S., Berndt, A., Mann, J., Hussein, A., Hu, G., Wong, L., Khong, R., Fu, J., Ahmed, N., Nolte, J., Hung, L. (2024) Working with a robot in hospital and long-term care homes: staff experience BMC Nursing 23:317 https://doi.org/10.1186/s12912-024-01983-0
Implications for practice and research When implementing welfare technology, staff education needs to consider relational and cultural factors, including positivity in leadership, teamwork and staff-family relationships to facilitate use. As technological possibilities are increasing, while older populations are growing and working populations are decreasing, user-based research in implementation of welfare technology is urgently needed.
The interest of using digital technologies, robots etc in supporting old age care is growing, due to the fact that the technological possibilities are also increasing. The fact that older populations are growing while working populations are decreasing in...
Commentary on: Wen, F. H., Prigerson, H. G., Hu, T. H., Huang, C. C., Chou, W. C., Chuang, L. P., Chiang, M. C., & Tang, S. T. (2024). Associations Between Family-Assessed Quality-of-Dying-and-Death Latent Classes and Bereavement Outcomes for Family Surrogates of ICU Decedents. Crit Care Med. Published online February 1, 2024. doi:10.1097/CCM.0000000000006199.
Improving end-of-life (EoL) care in intensive care units is paramount for supporting patients and families. Supporting families with EoL decisions can impact their postbereavement health-related quality of life. Recognising and fostering spiritual self-awareness may enhance the bereavement experience.
Intensive care units (ICUs) exposes both patients and families to an unfamiliar/stressful environment, featuring the urgency for enhanced end-of-life (EoL) care within ICUs.
This article on realist reviews is the second in a four-part series on realist research.
Realist reviews (or realist evidence syntheses) are a theory-building, interpretative approach to evidence synthesis. Realist reviews aim to go beyond seeking whether interventions work (ie, are effective), to generating explanations as to...
This May, the World Health Assembly (WHA) will vote on re-establishing a mandate for the WHO to address the health consequences of nuclear weapons and war.
The first atomic bomb exploded in the New Mexico desert 80 years ago, in July 1945. Three weeks later, two relatively small (by today’s standards), tactical-size nuclear weapons unleashed a cataclysm of radioactive incineration on Hiroshima and Nagasaki. By the end of 1945, about 213 000 people were dead.
Last December, Nihon Hidankyo, a movement that brings together atomic bomb survivors, was awarded the Nobel Peace Prize for its ‘efforts to achieve a world free of nuclear weapons...
Commentary on: Kaldal, MH, Voldbjerg, SL, Gronkjaer, M, et al. Newly graduated nurses' commitment to the nursing profession and their workplace during their first year of employment: A focused ethnography. J Adv Nurs 2023:00:1-14.
Implications for practice and research Hospitals should have a structured support system for newly registered nurses (NRNs) to facilitate a positive and successful transition into professional practising nursing careers. A further qualitative research study exploring the nature of support NRNs require to facilitate a successful and committed nursing career.
The commitment of newly registered nurses (NRNs) mostly depends on their work environment and the support they receive from their first employment.
Commentary on: García-Hermoso A, López-Gil JF, Izquierdo M, et al. Exercise and insulin resistance markers in children and adolescents with excess weight: a systematic review and network meta-analysis. Jama Pediatrics. 2023;177(12):1276–84.
Resistance exercises with aerobic training and high-intensity interval training reduced insulin resistance markers in 5–18 years old children with excess weight if done at least two to three times/week. Low to moderate certainty of evidence in this meta-analysis
The prevalence of childhood excess weight continues to grow, adding to risk of metabolic syndrome and type II diabetes.
This article is the first in a series exploring realist research, a methodological approach well suited to the complexity of nursing practice. Unlike traditional approaches such as randomised controlled trials (RCTs) and systematic reviews, which focus on whether interventions work, realist research examines how and why interventions work when implemented in specific groups; reflecting the individualised care nurses provide. By introducing the key concepts of realist research, this article highlights its relevance to nursing and lays the groundwork for using realist research to drive meaningful improvements in healthcare.
Realist research offers a unique lens to examine the complexity of healthcare delivery. While traditional research methods often seek to determine if interventions work or not in controlled environments, realist research seeks to explain how, why, for whom and under what circumstances interventions succeed—or fail—in real-world settings.
Commentary on: Rooney, C, Pyer, M, & Campbell, J. Leaving it at the gate: A phenomenological exploration of resilience in mental health nursing staff in a high-secure personality disorder unit. J Adv Nurs, 00, 1–13. (2023) https://doi.org/10.1111/jan.15947
Implications for practice and research Organisational structures and systems of support such as clinical supervision can support resilience in mental health nursing staff who work in high-secure forensic settings. Future studies in different high-secure forensic settings and different countries are required to enhance the generalisability of the findings.
High-secure mental health hospitals, also known as high-secure forensic hospitals, are a specialism within mental healthcare.
Commentary on: Yoshimoto, H., Kawaida, K., Dobashi, S. et al. Effect of provision of non-alcoholic beverages on alcohol consumption: a randomized controlled study. BMC Med 2023; 21, 379. https://doi.org/10.1186/s12916-023-03085-1
Implications for practice and research There is scope for public health to consider non-alcoholic beverages as a potential strategy to reduce alcohol consumption in adults who drink excessively. Future research should explore whether non-alcoholic beverages can reduce alcohol consumption in a wider range of countries and in different population groups, such as individuals with a diagnosis of alcohol dependence.
Alcohol is a risk factor in over 200 health conditions, and 2016 data shows it accounts for 5.3% of overall deaths worldwide.
Commentary on: Pomeroy ML, Cudjoe TKM, Cuellar AE, et al. Association of social isolation with hospitalization and nursing home entry among community-dwelling older adults. JAMA Int Med. 2023; 183(9): 955–62. https://doi.org/10.1001/jamainternmed.2023.3064
Social isolation is a significant risk factor for nursing home placement for older adults, and public health interventions to improve social connections are urgently needed. Future research should address interventions across the lifespan and for those more vulnerable to isolation and loneliness, testing practical ways to improve social connectiveness.
The quality of our lives is the quality of our relationships. As we approach a challenging time of the year for loneliness and isolation, what do we know about social isolation and healthcare utilisation in older adults? Almost a quarter of community-dwelling older adults experience social isolation.
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