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Commentary on: Freedman B, Li WW, Liang Z, Hartin P, Biedermann N. The prevalence of incivility in hospitals and the effects of incivility on patient safety culture and outcomes: A systematic review and meta-analysis. J Adv Nurs. Published online March 21, 2024. doi:10.1111/jan.16111
Practice: Implement anti-incivility programmes, including training and policies, to improve teamwork, communication and management support, thereby enhancing patient safety culture (PSC). Research: Investigate mediating factors such as conflict handling, psychological resilience and self-efficacy to understand their impact on the relationship between incivility and patient safety, guiding effective intervention development.
Workplace incivility, characterised by low-intensity deviant behaviour, undermines mutual respect,
Commentary on: Lyon, M. E., Fraser, J. L., Thompkins, J. D., et al (2024). Advance Care Planning for Children With Rare Diseases: A Pilot RCT. Pediatrics, 153(6), e2023064557. https://doi.org/10.1542/peds.2023-064557.
Implications for research and practice Having access to advance care planning, despite social and financial constraints is imperative. It is evident that in the population included in this study, advance care planning was invaluable for those below the 2021 financial poverty line. Further research is required to determine if the current medical model in the USA is meeting the requirements of caregivers and children with rare diseases.
Rare diseases in babies, children and young people (children) are often life-shortening, and children can require constant caregiving. Bösch et al
Commentary on: Impact of Crisis Care on Psychiatric Admission in Adults with Intellectual Disability and Mental Illness and/or Challenging Behavior: A Systematic Review—Tai et al.
Implications for practice and research Crisis care should be integrated into community care for this vulnerable and difficult-to-treat population to improve community tenure and reduce healthcare costs. Crisis care versus intensive community care needs to be defined, and standardised models compared, to optimise outcomes in different healthcare jurisdictions.
There is a high prevalence of psychiatric disorders among individuals with intellectual disability. In keeping with deinstitutionalisation, this population has also been moved from hospital to community but not necessarily accompanied by the specialised resources required. Consequently, there are high admission rates, however, this has been associated with traumatic experience (for patients and caregivers), potential neglect and abuse. Community crisis care has been studied for other patient groups but...
Commentary on: Ali MR, Lam CSP, Strömberg A, et al. Symptoms and signs in patients with heart failure: association with 3-month hospitalisation and mortality. Heart. 2023 Dec 1. doi: 10.1136/heartjnl-2023-323295.
Implications for practice and research In primary care consultations, symptoms reported by patients with heart failure (HF) could be valuable in identifying patients at risk of hospitalisation or death. Further research needs to investigate how best can support patients to monitor and report symptoms and test new patient-centred prognostic models including HF signs and symptoms.
Hospitalisation in patients with HF is associated with impaired quality of life, increased mortality and excessive medical costs.
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...
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.
Commentary on: Kim MR, Chae SM. Experiences of trust in mothers of hospitalized children toward pediatric nurses. J Child Health Care. 2023 Oct 17:13674935231206214. doi: 10.1177/13674935231206214. Epub ahead of print.
The ability to develop a trusting relationship with families and carers of hospitalised children is an important skill for paediatric nurses as it can facilitate emotional support and parental empowerment Future research in this area requires the development of tools which can objectively measure trust; these must be culturally sensitive and acknowledge the culturally diverse experiences of parents, caregivers and healthcare professionals
Developing a trusting relationship with parents and caregivers is an essential component of paediatric nursing. Previous studies in this area have been largely conducted in western cultures and as such, the experiences of other cultures are not well understood. This study
Commentary on: Wyss C, Inauen J, Cignacco E, Raio L, Aubry EM. Mediating processes underlying the associations between maternal obesity and the likelihood of cesarean birth. Birth. 2024 Mar;51(1):52-62. doi: 10.1111/birt.12751. Epub 2023 Aug 24.
It is important for future clinical practice to understand the risks of Caesarean Section (CS) to properly counsel pregnant patients, even if the patient is obese. It would be crucial to have CS delivery indications that are accepted at national and international levels, even in in obese women.
According to the literature, it appears that obese pregnant women are more likely to undergo a caesarean section than non-obese women. However, the mechanisms underlying these data have not yet been clarified.
The aim of the study of Wyss et al
Commentary on: Yeji Hwang, Miranda V. McPhillips, Liming Huang, G. Adriana Perez and Nancy A. Hodgson, Better caregiver mastery is associated with less anxiety in individuals with cognitive impairment, BMC Nursing. 2023; 22:307.
Implications for practice and research Anxiety is one of the common neuropsychiatric symptoms (NPs) in individuals with cognitive impairment. Considering the fluctuating and variable course of NPs in dementia, studies with longer follow-up periods are required to understand the relationship between caregiver mastery and anxiety in patients with dementia. Dementia, an umbrella condition, encompasses various neurogenerative diseases that can cause behavioural problems, movement problems, autonomic dysfunction, gait and balance problems, as well as cognitive impairment. Hence, it is important to develop caregiver skills with different strategies for each type of dementia.
As the population ages, the prevalence of dementia has increased.
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