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AnteayerEvidence-Based Nursing

Characteristics and role of the parental supporter during paediatric resuscitation: an opportunity for paediatric nurses to improve parental experience

Por: Chapman · S. M.

Commentary on: Ghavi A, Hassankhani H, Meert KL. Parental supporter in pediatric resuscitation: A mixed-method study with Delphi and analytic hierarchy process. J Nurs Scholarsh. 2023 Nov 29. doi: 10.1111/jnu.12947. Epub ahead of print. PMID: 38031298.

Implications for practice and research

  • Parental presence during resuscitation is widely recommended, despite a lack of empirical evidence to guide its implementation.

  • This study explores the characteristics and role of the parental supporter and provides an evidence-based foundation to develop this role in clinical practice.

  • Context

    International guidelines on paediatric resuscitation support parental presence during resuscitation.1 To ensure their needs are met, parents need dedicated support during their child’s resuscitation, whether they are present or not. Resuscitation is a stressful and potentially life-changing time for parents; however, there is little empirical evidence on who and how parental support should be provided. The aim of this...

    Behavioural interventions adapted for autistic adults with moderate-to-severe intellectual disabilities are feasible and acceptable for reducing anxiety

    Por: Al Qadire · M. · Abdelrahman · H.

    Commentary on: Langdon, P.E., Apanasionok, M.M., Scripps, E., Barrowcliff, A., Biswas, A., Bunning, K., Burbidge, C., Byron-Daniel, K., Cookson, A., Croom, S. and Filipczuk, M.2024. Behavioural interventions to treat anxiety in adults with autism and moderate to severe intellectual disabilities: The BEAMS-ID feasibility study. Journal of Applied Research in Intellectual Disabilities, 375, p.e13282.

    Implications for practice and research

  • The BEAMS-ID study demonstrates that behavioural interventions, when properly adapted, are both feasible and acceptable for adults with autism and moderate-to-severe intellectual disabilities.

  • A larger randomised controlled trial is warranted to evaluate the efficacy of these adapted interventions in reducing anxiety in this population.

  • Context

    People with autism, particularly those experiencing moderate-to-severe intellectual impairments, face an increased likelihood of developing anxiety disorders.1 2 Although anxiety is common among this group, there is limited research demonstrating the effectiveness of psychological treatments for...

    Importance of training and education for nurses delivering stroke care

    Por: McLoughlin · A. · Kidd · L.

    Commentary on: Zhao et al. The impact of education/training on nurses caring for patients with stroke: a scoping review. BMC Nurs 23:90

    Implications for practice and research

  • Nurses working in clinical stroke care could benefit from leadership and management strategies that encourage empowerment and time and space to reflect on current evidence, training and practice.

  • Comprehensive evaluation strategies are needed to assess the impact and effectiveness of empowerment-based stroke education and training on patient outcomes.

  • Context

    Stroke nursing is widely recognised for its significant role across the whole multidisciplinary stroke care pathway.1 Ensuring that stroke nurses are equipped with the latest stroke specialist knowledge and skills is fundamental in providing high-quality and safe stroke care.1 2 However, in spite of the provision of nationally-recognised, quality-assured training and education programmes, for example, the Stroke-Specific Education Framework in the...

    Association between eco-anxiety and mental health difficulties among student nurses has implications for nurse education during a climate emergency

    Por: Parkinson · B. · Johnston · M.

    Commentary on: Er S, Murat M, Ata EE, Kose S, Buzlu S. Nursing student’s mental health: How does eco-anxiety effect? Int J Mental Health Nurs. 2024;00:1-12.

    Implications for practice and research

  • Nurse educators should be aware of eco-anxiety and think about the impact of climate change on nursing students.

  • Nurse researchers should investigate ways of supporting nursing students affected by eco-anxiety and develop strategies to promote student learning during a climate emergency.

  • Context

    Climate change is causing a global climate emergency, which is increasingly seen as a major problem for global health concern.1 Climate change has far-reaching consequences for society and can impact our mental health.2 Eco-anxiety is the fear of an environmental catastrophe and is associated with symptoms of stress, anxiety, depression, insomnia and trauma.3 Nurses are exposed to the negative impact of climate change through...

    Qualitative study with postnatal women in Turkey provides perspectives on the practice of postnatal debriefing as a desired practice that promotes processing of birth experiences and provides benefits for health and well-being

    Por: Sperlich · M.

    Commentary on: Demerci AD, Oruc M, Kabukcuoglu K. "I need to make sense of my birth experience": A descriptive qualitative study of postnatal women’s opinions, and expectations about postnatal debriefing. Midwifery 2024;131;103955. https://doi.org/10.1016/j.midw.2024.103955

    Implications for practice and research

  • Healthcare professionals should prioritise and establish routines for postnatal debriefing, with a goal of averting problematic parenting adaptation and development of post-traumatic stress symptoms.

  • More research is needed to determine the ideal format (structured or unstructured) and to consider whether either or both formats might influence subsequent reproductive decision making.

  • Context

    Previous investigations into postnatal debriefing have had mixed results regarding its effectiveness and have not established best practices for its usage.1 Shortcomings of prior studies included the heterogeneity of types of debriefing delivery, which varied across contexts (format, setting, provider type), and varying inclusion and exclusion criteria.1 Importantly,...

    How can we improve low-volume paediatric emergency departments to enhance readiness?

    Por: Goparaju · N. · Pines · J. M.

    Commentary on:Michelson KA, Rees CA, Florin TA, et al. Emergency department volume and delayed diagnosis of serious pediatric conditions. JAMA Pediatr. 2024;178:362–8. doi:10.1001/jamapediatrics.2023.6672

    Implications for practice and research

  • Low-paediatric-volume emergency departments (EDs) can increase paediatric readiness by improving diagnostic tools, expanding paediatric expertise (eg teleconsultation) and using electronic clinical decision support.

  • Further research is needed to examine the costs and effectiveness of specific interventions to improve readiness in low-volume paediatric EDs.

  • Context

    Children sometimes have subtle illness presentations and symptom overlap with non-serious conditions.1 Young age also presents a communication barrier. The combination of these factors can lead to diagnostic delays and sometimes misdiagnosis, particularly in emergency department (EDs) that do not see high volumes of children. In the USA, one in three EDs sees fewer than five children daily. A prior study linked low-paediatric ED volume to diagnostic delays in...

    Mindfulness-based interventions effectively reduced anxiety among nurses

    Por: Al Qadire · M. · Abdelrahman · H.

    Commentary on: Alkhawaldeh JFM, Khawaldeh MA, Mrayyan MT, et al. The efficacy of mindfulness-based programs in reducing anxiety among nurses in hospital settings: a systematic review. Worldviews Ev Based Nurs 2024. doi.org/10.1111/wvn.12722

    Implications for practice and research

  • Implementing mindfulness-based programmes in healthcare settings can significantly reduce anxiety among nurses.

  • Further longitudinal and well-designed randomised controlled trials are necessary to establish the long-term efficacy and optimal programme characteristics.

  • Context

    Anxiety is a prevalent issue among healthcare professionals, particularly nurses, owing to the highly stressful nature of their work environments.1 Increasing workload, emotional demands and critical responsibilities contribute to elevated anxiety levels, which can affect well-being and job performance.2 Mindfulness-based programmes have gained attention as potential interventions for alleviating anxiety by promoting mental well-being and resilience. This systematic review aimed to assess the effectiveness of these programmes in reducing anxiety among...

    Developing a green nursing workforce to mitigate healthcare emissions and improve human health

    Por: Mills · A.

    Commentary: Luque-Alcaraz OM, Aparico-Martinez P, Gomera A, Vaquero-Abellan. The environmental awareness of nurse as environmentally sustainable healthcare leaders: a mixed method analysis. BMC Nursing 2024;23:229.1

    Implications for practice and research

  • Healthcare emissions contribute to climate change and threaten human health; therefore, nurses have a professional obligation to become environmentally informed, take action to reduce healthcare emissions and support green solutions.

  • Future research must understand and modify workplace barriers to promote environmentally sustainable staff behaviour and facilitate the green transformation of healthcare systems.

  • Context

    Climate change is increasingly harming human health. Extreme weather events cause devastation, low crop yields and failure, contributing to food insecurity, economic hardship and resource shortages. Rising temperatures also increase the spread of infectious diseases and epidemics. Globally, countries are using healthcare services as an initial method of addressing these challenges.2 However, healthcare systems are major...

    Midwife-led care for the induction of labour with a Foley catheter and subsequent amniotomy is associated with equivalent maternal outcomes but worse neonatal outcomes

    Por: Phillipi · M. · Caughey · A. B.

    Commentary on: Velthuijs ELM, Jacod BC, Videler-Sinke L, et al. Outcome of induction of labour at 41 weeks with Foley catheter in midwifery-led care. Midwifery 2024 Aug;135:104026. doi: 10.1016/j.midw.2024.104026. Epub 9 May 2024. PMID: 38781793.

    Implications for practice and research

  • Performing induction of labour with a Foley catheter and subsequent amniotomy in midwife-led care is associated with worse neonatal outcomes and equivalent maternal outcomes compared with consultant-led care.

  • Future research should further explore the cost-effectiveness, feasibility and neonatal outcomes associated with midwife-led care in different patient populations.

  • Context

    Although care for low-risk births in the Netherlands is primarily conducted by midwives, the use of consultant-led care has been increasing for a variety of indications, leading to a high patient burden for consultants. The induction of labour (IOL) of late-term pregnancies has historically been an indication for consultant-led care. This study by Velthuijs et...

    Parents of children with congenital heart disease face substantial financial hardships

    Por: Abdelrahman · H. · Al Qadire · M.

    Commentary on: Delaney, A. E., Fu, M. R., Conway, C., Marshall, A. C., Lindberg, J., Thiagarajan, R. R., Glazer, S.2024. Financial Stressors for Parents of Children and Emerging Adults with Congenital Heart Disease: A Qualitative Study. Journal of Pediatric Health Care.

    Implications for practice and research

  • Enhanced financial counselling and support services, coupled with strong advocacy for policy reforms, are essential to alleviate the financial burden on families of children with congenital heart disease.

  • Future research should explore long-term financial impacts and effective interventions to alleviate economic stress.

  • Context

    Congenital heart disease (CHD) is the most prevalent birth defect that significantly affects infant and child mortality and morbidity.1 2 While medical advancements have extended the survival of children with CHD into adulthood, the financial burden on parents remains a growing concern. Indirect evidence links this to stress and family...

    Can an intensive food-as-medicine programme enhance preventive care engagement without improving glycaemic control in patients with T2DM?

    Por: Magon · A. · Caruso · R.

    Commentary on: Doyle J, Alsan M, Skelley N, et al. Effect of an intensive food-as-medicine programme on health and healthcare use: a randomized clinical trial. JAMA Intern Med. 2024;184(2):154–163. doi:10.1001/jamainternmed.2023.667

    Implications for practice and research

  • Food-as-medicine programmes could enhance patient engagement with preventive healthcare.

  • Further adjustments are needed within these programmes to improve glycaemic control significantly.

  • Food-as-medicine programmes interest nurses, as these programmes are sensitive to nursing interventions.

  • Context

    Type 2 diabetes mellitus (T2DM) is a significant public health issue, with diet playing a crucial role in its management.1 Food insecurity, defined as the lack of consistent access to enough food for an active, healthy life, exacerbates this condition, making effective dietary interventions critical.2 Food-as-medicine programmes, which provide medically tailored meals and nutritional education, aim to improve health outcomes for individuals with chronic diseases.2 The study...

    Impact of missed insulin doses on glycaemic parameters in people with diabetes using smart insulin pens

    Por: Varma · M. · Campbell · D. J. T.

    Commentary on: Danne et al. Association Between Treatment Adherence and Continuous Glucose Monitoring Outcomes in People With Diabetes Using Smart Insulin Pens in a Real-World Setting. Diabetes Care. 2024.47 (6),:995-10031

    Implications for practice and research

  • Healthcare providers should emphasise consistent insulin adherence for people with diabetes, as even a few missed doses can worsen overall glycaemia.

  • Future research should identify barriers to consistent usage of insulin and develop strategies to enable patients’ adherence, such as increasing patient engagement with smart insulin pens and continuous glucose monitoring systems.

  • Context

    Diabetes is a widespread chronic disease, with steadily rising prevalence in most countries. In 2019, the global prevalence of diabetes was estimated at 9.3%, affecting 463 million people. This figure is projected to rise to 10.2% by 2030 and 10.9% by 2045.2 All people with type 1 diabetes and many people...

    Virtual reality (VR) in practice and research: the mounting evidence supporting development and testing of VR applications to relieve pain during wound care and beyond

    Por: OMalley · P.

    Commentary on: Lou J, Li J, Fan Y, et al. Effects of virtual reality on analgesia in wound care and physical therapy for burn patients: a systematic review and meta-analysis. Pain Manag Nursing. 2024; 25(4):377–388.

    Implications for practice and research

  • Virtual reality (VR) is a promising distraction intervention for pain and anxiety. Which type of VR and most effective length of exposure to reduce symptom burden is unknown.

  • Future research must address this gap to discover best practices for the frequency, intensity and duration of VR therapy for analgesia.

  • Context

    Over the past 20 years, virtual reality (VR) has emerged in culture and healthcare providing a virtual world with audio and visual stimuli that can be immersive or non-immersive. Immersive VR has headsets with motion detectors that enable a multidimensional environmental experience with sensory feedback. Non-immersive VR provides a one-dimensional digital environment observed...

    Resources page: foundations of Nursing Care for People with Long Covid

    Por: Twycross · A. · le May · A. · McMahon · A. · Maxwell · E.

    As discussed in the accompanying editorial Nursing on the front foot,1 we have recently worked with a group of specialist nurses and the stories of three people with Long Covid to draw out the foundations of nursing care for people with Long Covid. Below is a list of the resources that have come out of this work, as well as some other useful resources.

    Supporting patients to navigate the health and social care systems

    People living with Long Covid often find the complexity of navigating health services difficult. The nurse’s role is to support patients in this context. This includes ensuring they are sufficiently informed about what Long Covid is. The specialist nurses recommended the British Heart Foundation’s online resource - Long Covid: Symptoms, tests and treatments: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/long-covid%23whatdoesfatiguefeel.

    Information about Long Covid is also available via Long Covid Physio: https://longcovid.physio/

    Every person...

    Plastic exposure may be associated with the deposition of microplastics in reproductive tissues and adverse clinical outcomes

    Por: Phillipi · M. · Caughey · A. B.

    Commentary on: Hunt K, Davies A, Fraser A, Burden C, Howell A, Buckley K, Harding S, Bakhbakhi D. Exposure to microplastics and human reproductive outcomes: A systematic review. BJOG. 2024 Apr;131(5):675-683. doi: 10.1111/1471-0528.17756. Epub 2024 Jan 29. PMID: 38287142.

    Implications for practice and research

  • Plastic exposure may be associated with increased deposition of microplastics in reproductive tissues, and the quantity of microplastics in these tissues may lead to adverse clinical outcomes.

  • Future research should aim to provide high-quality, generalisable evidence to further demonstrate the impact of plastic exposure and microplastics on reproductive outcomes in humans.

  • Context

    As a result of the mass scale of production of plastics since the 1950s, microplastics, defined as particles 1 Microplastics have been linked to reproductive toxicity in both cell culture...

    How can qualitative research enhance and strengthen randomised controlled trials undertaken with children and young people?

    Por: Thompson · J. · Smith · J. · Evans · J.

    Health research aims to improve people’s health by understanding the best ways to diagnose and treat conditions, and understand people’s responses to health problems and health promotion initiatives. Quantitative research, and more specifically randomised controlled trials (RCTs), aims to establish if an intervention works, for example testing the effectiveness of a new drug, using statistical analysis. In contrast, qualitative research focuses on understanding a situation, for example people’s experiences, perspectives and behaviours. Qualitative research can enhance RCTs by ensuring a more complete understanding of the factors that influence the acceptability of a new intervention and how it might be implemented in practice. A previous article in this series outlined how process evaluation embedded within RCTs can help understand how and why an intervention works.1 While process evaluation is important, we will outline the reasons qualitative research can enhance the design and procedures associated with RCTs, and the...

    Socioeconomic status remains largest predictor of special education provision in the UK

    Por: Misik · L. · Barnhardt · E.

    Commentary on: Lee IO, Wolstencroft J, Housby H, et al. The inequity of education, health and care plan provision for children and young people with intellectual and developmental disabilities. J Intellect Disabil Res. Published online 22 May 2024.

    Implications for practice and research

  • Children and young people with intellectual and developmental disabilities (IDD) living in deprived areas are less likely to receive education, health and care plans in the UK.

  • Future research should aim to identify interventions that have the potential to reduce such inequities for individuals with IDD.

  • Context

    The findings from this study by Lee et al1 mirror findings from similar studies across the world, reiterating that children with disabilities are receiving inadequate supports, particularly if they are living in a poor community or if they come from a minority background. The publishing of this article comes at a...

    Time to implement the strategies that work to address the health inequalities experienced by adults with intellectual disabilities

    Por: Brown · M. · Marsh · L.

    Commentary on: Heslop, P., Lauer, E. (2024). Strategies to prevent or reduce inequalities in specific avoidable causes of death for adults with intellectual disability: A systematic review. British Journal of Learning Disabilities, 52(2), pp.312-349.

    Implications for practice and research

  • Preventative interventions and reasonable adjustments are required to address health inequalities experienced by adults with intellectual disability.

  • Future research should focus on policy, population and individual interventions that reduce health inequalities and avoidable deaths.

  • Context

    There is well-established research evidence regarding the substantial health inequalities experienced by many adults with intellectual disabilities, with significant implications for their health, well-being and quality of life. Despite this evidence, many continue to die prematurely from conditions amenable to early interventions and preventative strategies. Limited knowledge, skills and confidence regarding the needs of adults with intellectual disabilities by some health professionals is evident. Reasonable adjustments can contribute positively...

    Embracing diversity in nursing research: essential tips

    Por: Hollowood · L. · Moorley · C.

    Nursing is a profession that has always worked with diverse people and communities and has taken a social justice approach to care. Nursing has also undertaken research that includes diverse groups and communities. However, nurse researchers working with and undertaking research with diverse groups and communities may encounter problems in executing the research. This may be for reasons such as poor understanding of cultural and racial difference, not having an inclusive research team, for example, LGBTQIA+ researchers to help conduct LGBTQIA+ focused research or using an ableist approach, all of which can lead to exclusion, diminished trust and credibility. In this commentary, we draw on Hollowood’s doctoral journey and Moorley’s research experience, where both work with and research diverse communities’ health. Nurse researchers need to apply methodologies and approaches that are culturally sensitive and inclusive and here we offer essential tips, which have helped us by drawing on culturally specific...

    What is an interpretative phenomenological analysis case study?

    Por: Rodger · D. · Smith · J. A.
    What is an interpretative phenomenological analysis case study?

    Interpretative phenomenological analysis (IPA) is a widely recognised and well-established method of qualitative inquiry designed to explore personal experience in detail, focusing on participants’ understandings and sense-making.1 In this article, we explain what distinguishes an IPA case study from a typical IPA study and highlight the strengths and limitations of this approach. While IPA is frequently used with small samples, single-participant IPA case studies can offer unique insights into deeply personal or rare experiences.

    An overview of IPA

    IPA was developed in the mid-1990s by Jonathan Smith and emerged out of health psychology, and since the early 2000s has increasingly been adopted by nursing and health researchers more generally. At the time of writing, a Google Scholar search of the terms ‘interpretative phenomenological analysis’ and ‘nursing’ yielded more than 35 000 results. IPA is primarily interested in undertaking...

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