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AnteayerEvidence-Based Nursing

Who gets to die at home? Race and disease-related cause of death impacts young adults place of death

Por: Sansom-Daly · U. M. · Mack · J. W.

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.

Implications for practice and research

  • 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.

  • Context

    Young adults (YAs) with serious illnesses report wanting choices in their end-of-life care.1–3 Where YAs would prefer to die is highly personal, though some studies have reported that many YAs prefer home-based palliative care and death.2 3 Yet, many YAs experience high-intensity, inpatient care at the end of their lives,4 with approximately half of YAs with cancer dying in hospital.4 Factors influencing these patterns of care—and the extent to...

    Digital assets should be included in advance care planning discussions for patients receiving palliative care

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

    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.

    Implications for practice and research

  • 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.

  • Context

    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.1 However, a study on healthcare professionals indicated that a significant majority...

    Patient-centered perspectives in diabetic retinopathy care: phenomenology and practice

    Por: Raman · R. · Kumar · S.

    Commentary on: Zhang M, Zhang C, Chen C, et al. The experience of diabetic retinopathy patients during hospital-to-home full-cycle care: a qualitative study. BMC Nurs. 2023 Mar 3;22(1):58. doi: 10.1186/s12912-023-01206-y.

    Implications for practice and research

  • Consideration of patients' life experiences, which aids in examining their feelings and patient’ experiences.

  • Future research should further investigate the phenomenological approach in diverse healthcare contexts.

  • Context

    The transition from hospital to home treatment for patients with diabetic retinopathy (DR) is the subject of a study by Zhang and colleagues. The authors attempt to comprehend the substance of this phenomenon a shift towards patient-centric healthcare research by using a phenomenological method.1 Such first-hand experiences may help to close the gap between patient demands and medical practise, laying the groundwork for personalised and emphathetic care strategies.

    Methods

    The descriptive phenomenology method was used to implement this...

    It is time for healthcare professionals to engage with social media

    Por: Hundley · V. · Marsh · A.

    Commentary on: Chee RM, Capper TS, Muurlink OT. The impact of social media influencers on pregnancy, birth, and early parenting experiences: A systematic review. Midwifery. 2023 May;120:103623. doi: 10.1016/j.midw.2023.103623. Epub 2023 Feb 19.

    Implications for practice and research

  • Social media is one of the fastest growing commercial determinants of health.

  • Healthcare professionals need a better understanding of social media and its impact.

  • Context

    Social media has rapidly become a key source of advice and support for women during childbirth. The growth of influencers, popular users credited with knowledge and expertise, can be seen in the numerous social posts, blogs, podcasts and videos about pregnancy, birth and parenting. Social media influencers provide responsive and relatable content to their network of followers; but there are concerns about the potential to spread misinformation.1

    Methods

    This systematic literature review2 sought to identify...

    Prolonged screen time in adolescence linked to higher cardiometabolic risk in adulthood

    Por: Nauman · J. · Omara · A.

    Commentary on: Nagata JM, Lee CM, Lin F, et al. Screen time from adolescence to adulthood and cardiometabolic disease: a prospective cohort study. J Gen Intern Med. 2023 Jan 10. doi: 10.1007/s11606-022-07984-6. Epub ahead of print.

    Implications for practice and research

  • Reducing screen time and promoting physical activity among children and adolescents could be a key strategy in preventing cardiometabolic diseases in adulthood.

  • Further research using objective measures of screen time is needed to advance knowledge of dose–response relationship between screen time and cardiometabolic disease risk and to inform future recommendations.

  • Context

    In an increasingly digital world, high prevalence of sedentary behaviour has become a significant concern for public health. It is ubiquitous in various environments, and WHO guidelines1 recommend reducing sedentary behaviour for substantial health benefits. The study by Nagata and colleagues2 investigating the relationship between screen time and...

    Home fall hazard assessments effective in high-risk fallers but more information needed on effects of assistive technologies

    Por: Sharma · Y. · Iaboni · A.

    Commentary on: Clemson L, Stark S, Pighills AC, Fairhall NJ, Lamb SE, Ali J, Sherrington C. Environmental interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2023 Mar 10;3(3):CD013258. doi: 10.1002/14651858.CD013258.pub2

    Implications for practice and research

  • Home fall hazard assessments are shown to be effective in fall prevention among community-dwelling older adults at higher risk of falls. Future work should investigate the feasibility of implementing these interventions in practice settings.

  • It is uncertain whether assistive technologies can prevent falls in community-dwelling older adults, thus further research is needed.

  • Context

    Nearly 30% of older adults aged 65 years and older fall each year.1 While falls are multifactorial and include both intrinsic and environmental factors, ‘accidental’ falls, such as trips and slips related to environmental hazards, are very common reasons provided for a fall.2 Identifying effective...

    Cultivating rapport in telehealth: insights from palliative care

    Por: Mazaheri · M.

    Commentary on: English W, Robinson J, Gott M. Health professionals' experiences of rapport during telehealth encounters in community palliative care: An interpretive description study. Palliat Med. 2023 Jul;37(7):975-983. doi: 10.1177/02692163231172243. Epub 2023 May 2

    Implications for practice and research

  • Continual training for health professionals is vital to improve their rapport building strategies during telehealth palliative care encounters.

  • Future studies should explore the perspectives of patients and families on rapport development during palliative care telehealth encounters.

  • Context

    Telehealth has gained prominence in palliative care, offering convenience and accessibility to patients with advanced illnesses, particularly in the backdrop of the COVID-19 pandemic.1 With the growing need for palliative care services, particularly in the context of an ageing population, the integration of telehealth into community palliative care has become increasingly relevant. This shift has raised important questions about the nuances of building and...

    Early rehabilitation of patients in the ICU may reduce long-term healthcare costs

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

    Commentary on: Murooka Y, Sasabuchi Y, Takazawa T, Matsui H, Yasunaga H, Saito S. Long-Term Prognosis Following Early Rehabilitation in the ICU: A Retrospective Cohort Study. Crit Care Med. 2023 Mar 29. doi: 10.1097/CCM.0000000000005862. Epub ahead of print.

    Implications for practice and research

  • Rehabilitation programmes if introduced early after admissions to intensive care unit could be beneficial to patients and healthcare systems.

  • Prospective studies are needed to confirm the long-term impacts of early introduction of rehabilitation programmes on healthcare outcomes in terms of, quality of life and physical functions, the optimal timing, duration, and intensity of rehabilitation.

  • Context

    Early rehabilitation is a promising treatment for postintensive care syndrome. Studies have demonstrated the benefits of rehabilitation, such as early exercise and mobilisation, which improve short-term physical and functional outcomes and reduce intensive care unit (ICU) and hospital stay durations for critically ill patients.1...

    A call to all nurses from transgender people: treat me as a whole person; I am more than my gender identity

    Por: Kuzma · E. K. · Yingling · C.

    Commentary on: Mikovits JC. "I don't feel like I'm a person": Nursing knowledge of transgender care through the lens of transgender people. J Adv Nurs. 2022 Sep;78(9):3012–3024. doi: 10.1111/jan.15308. Epub 2022 Jun 1.

    Implications for practice and research

  • Nurses have an ethical imperative to provide patient-centered care that honours all aspects of one’s identity, including gender identity.

  • Further research is needed to better understand the healthcare experiences of transgender people of intersecting identities and those with varying economic resources.

  • Context

    Transgender people experience numerous health inequities due to societal discrimination and stigma.1 Within healthcare, the oppression and discrimination that drive these inequities are reinforced by individuals with implicit and explicit biases and the system with structural barriers to accessible care. Nurses need to be able to provide patient-centred care to all patients. Yet, most nursing programmes do not fully prepare nurses to...

    What we can learn from paediatric ED visit changes during pandemics and epidemics

    Por: Rahman · N. · Pines · J. M.

    Commentary on: Roland D, Gardiner A, Razzaq D, Rose K, Bressan S, Honeyford K, Buonsenso D, Da Dalt L, De T, Farrugia R, Parri N, Oostenbrink R, Maconochie IK, Bognar Z, Moll HA, Titomanlio L, Nijman RGG; in association with the REPEM network (Research in European Paediatric Emergency Medicine) as part of the EPISODES Study. Influence of epidemics and pandemics on paediatric ED use: a systematic review. Arch Dis Child. 2023 Feb;108(2):115–122. doi: 10.1136/archdischild-2022-324108. Epub 2022 Sep 26.

    Implications for practice and research

  • Healthsystems must be prepared for paediatric emergency department (ED) volume shifts during epidemics and pandemics.

  • Two interventions to increase efficient paediatric ED use include: (1) parental education about home care and (2) real-time remote advice.

  • Context

    Epidemics and pandemics have major impacts on ED care. Studies examining the COVID-19 pandemic noted large early US ED visit declines.1 In some...

    People affected by dementia had mixed experiences of using technology during COVID-19

    Por: Pessoa Lima · D. · Rosa · I. D.

    Commentary on: Chirico I, Giebel C, Lion K, Mackowiak M, Chattat R, Cations M, Gabbay M, Moyle W, Pappadà A, Rymaszewska J, Senczyszyn A, Szczesniak D, Tetlow H, Trypka E, Valente M, Ottoboni G. Use of technology by people with dementia and informal carers during COVID-19: A cross-country comparison. Int J Geriatr Psychiatry. 2022 Sep;37(9). doi: 10.1002/gps.5801.

    Implications for practice and research

  • Consider patient and caregiver preferences for using technology.

  • Offer training on the use of technology.

  • Provide the most suitable schedule for caregivers.

  • More multicentre randomised controlled trials are needed to assess the feasibility of telehealth in different stages of dementia.

  • Context

    The COVID-19 pandemic brought to light the need to adopt technology in healthcare systems worldwide due to the need for physical distancing and isolation measures, especially in the older adult group.1 2 Several studies have...

    Efficacy of light intervention in improving mood and behaviour, but not sleep in intellectually disabled older adults

    Por: Annarumma · L. · De Gennaro · L.

    Commentary on: Böhmer MN, Oppewal A, Valstar MJ, Bindels PJE, van Someren EJW, Maes-Festen DAM. Light up: an intervention study of the effect of environmental dynamic lighting on sleep-wake rhythm, mood and behaviour in older adults with intellectual disabilities. J Intellect Disabil Res. 2022 Oct;66(10):756–781. doi: 10.1111/jir.12969. Epub 2022 Aug 25.

    CommentaryImplications for practice and research

  • Increasing light exposure in care facilities improves mood and behaviour in older adults with intellectual disability (ID).

  • Light exposure protocols should be implemented and investigated to determine the optimal intervention parameters.

  • Context

    Sleep problems are frequently experienced by older adults with ID living in residential care facilities1 due to instability and disruption of their sleep-wake rhythm.2 Light exposures protocols have been shown to improve sleep-wake rhythm, mood and behaviour in several clinical conditions, but literature in older adults with ID is still quite...

    Fathers with intellectual disabilities require support to successfully navigate fatherhood

    Por: Marsh · L. · Brown · M.

    Commentary on: Ćwirynkało K, Parchomiuk M. Support as described by fathers with intellectual disabilities. J Appl Res Intellect Disabil. 2023 Mar;36(2):320-332. doi: 10.1111/jar.13061. Epub 2022 Dec 9

    Implications for practice and research

  • Fathers with intellectual disabilities require informal and formal supports to successfully navigate parenthood.

  • The voices of fathers with intellectual disabilities should be prominent in future disability research.

  • Context

    Men with intellectual disabilities become good fathers with appropriate supports in place. Some fathers with intellectual disabilities were underestimated by partners, relatives and professionals, with their abilities to parent continually questioned. While formal and informal supports were viewed as helpful and necessary, there were differences between the support required and those provided. To develop their parenting skills and competence, fathers with intellectual disabilities require additional support.

    Methods

    This study explored the lived experiences of social support of 20 Polish fathers with intellectual...

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