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AnteayerEvidence-Based Nursing

Infertility and poor reproductive outcomes as potential predictors of early and premature menopause: lets act before it would be too late!

Por: Etrusco · A. · Lagana · A. S.

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.

Implications for practice and research

  • 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.

  • Context

    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...

    Gender differences found in fall-related factors among community-dwelling Korean older adults

    Por: Zhang · N. · Arunachalam · U.

    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.

    Implications for practice and research

  • 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

  • Context

    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...

    Supportive environment is key to self-determination for people with severe or profound intellectual disabilities

    Por: Desroches · M. L.

    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.

    Implications for practice and research

  • 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.

  • Context

    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.1 The United Nations’ Convention on the Rights of Persons with Disabilities recognises self-determination as a human right, in contrast to historic paternalisation in...

    Improving nutritional care for older adults: the role of massive open online courses and implementation science in enhancing health professional knowledge and attitudes

    Por: Bonetti · L. · Caruso · R.

    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.

    CommentaryImplications for practice and research

  • 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.

  • Context

    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.1 Providing adequate nutritional care...

    What is a process evaluation when used alongside a randomised controlled trial?

    Por: Bugge · C.
    Introduction

    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) guidance1 on developing and evaluating complex interventions has shifted the emphasis from a focus of solely understanding whether or not an intervention achieves its intended outcomes to additional considerations such as why and how an intervention may, or may not, have an effect. The complex nature of the intervention, and the context within which it is delivered, means that there are multiple other processes that may influence whether or not the intervention is effective in real-world clinical practice.2 Process evaluations are recommended...

    Early career nurse researchers: insights, challenges and strategies for success

    Por: Sisson · H.

    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.1 2 Length of time since the start or completion of doctoral training (or equivalent professional training) or a first academic appointment is often used by research councils such as the UK Research and Innovation (UKRI) (see Early career researchers–UKRI). Stage of career is also sometimes referred to with ECRs being a catch-all term for doctoral and immediately postdoctoral researchers as well as those making the transition to an independent research career (see Early career researchers–UKRI).

    Increasingly, the challenges associated with such time-bound definitions of ECRs are being acknowledged. Many bodies which offer funding for ECRs (eg, see Early career research fellowships–InterAct Hub (interact-hub.org) and Early career researchers: career and skills development–UKRI)...

    Engaging clinicians in research: barriers, benefits and building a blueprint

    Por: Mickan · S.

    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.

    Implications for practice and research

  • 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.

  • Context

    There is a growing body of international research evidence highlighting the benefits of clinicians’ research engagement and documenting associated barriers and facilitators.1 This study offers an insightful consolidation of clinicians’ perception of research alongside their barriers and facilitators to effective engagement.2 Full time clinicians in a specific healthcare system often do not see research as a core part of their...

    Strategies for supporting mental health nurses applications of trauma-informed care

    Por: Shah · R. B.

    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.

  • Context

    There is growing support for the delivery of trauma-informed care (TIC) in diverse clinical, organisational and community settings.1 TIC can be characterised by a realisation of the widespread impacts of trauma and recovery strategies; recognition of the potential signs of trauma;...

    Unravelling the complexities of nutritional behaviours in hospital nurses: a commentary on enablers and barriers to healthy eating

    Por: Abujaber · A. A. · Nashwan · A. J.

    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

    Implications for practice and research

  • 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.

  • Context

    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...

    Social prescribing integrated in primary care enhances access to type 2 diabetes preventative approaches among high-risk patient population

    Por: Fitzpatrick · S. L.

    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.

    CommentaryImplications for practice and research

  • 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.

  • Context

    Recent data suggest that 464 million adults worldwide have pre-diabetes and are at increased risk for type 2 diabetes (T2D).1 Social risks (eg, food insecurity, housing instability, financial strain) largely contribute to health inequities, particularly in diabetes incidence.2 SP, also referred to as navigation, involves connecting patients to community-based programmes and resources to address health and social needs. This study by Calderón-Larrañaga et al used...

    Ghost in the inbox: AI may help alleviate the burden of patient messages

    Por: Rose · C. · Preiksaitis · C.

    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.

    CommentaryImplications for practice and research

  • 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.

  • Context

    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...

    Low-quality evidence for medication errors reduction strategies in hospital paediatrics

    Por: Desforges · J. · Roumeliotis · N.

    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.

    Implications for practice and research

  • 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.

  • Context

    King et al conducted a systematic review of interventions aimed at reducing medication errors during inpatient rounds in children’s hospitals.1 Medication errors in hospitals may arise at many points in a complicated cascade of steps...

    How healthy dietary patterns have an impact on overall and cause-specific mortality?

    Por: Nguyen · N. T. H. · Duong · T. V.

    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.

    Implications for practice and research

  • 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.

  • Context

    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.1 2

    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...

    Scoping review suggests that reasons for choosing unassisted birth ('freebirth) vary depending on income, previous negative health care experiences and personal and cultural beliefs

    Por: Sperlich · M.

    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

    Implications for practice and research

    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.

    Context

    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...

    Clinicians signal the need to improve competency in the care of patients who identify as LGBTQ+

    Por: Ryan Schultz · T.

    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.

    Implications for practice and research

  • 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.

  • Context

    Individuals who identify as LGBTQ+ report discrimination in healthcare settings.1 Clinicians describe a lack of formal education in LGBTQ+ care needs.2 Adolescence is complex; adolescents who identify as LGBTQ+ are among our most vulnerable. International statistics illuminate that these youth are at exponentially higher risk for suicide.3 This study by Kelleher and...

    Scoping review of contributors to fatigue and medication administration errors among nurses

    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.

    CommentaryImplications for practice and research

  • 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.

  • Context

    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.1 In light of the fact that nurses allocate a substantial amount of their time to the administration of medications, Bell et al conducted this scoping review to analyse...

    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...

    Resources page

    Por: Wray · J.

    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 Vitae Research Development Framework.

  • Research funding bodies also provide a wealth of advice and resources see, for example, Early career researchers: career and skills development – UKRI, GROW 2024 now open for applications! – Mental Health Research and The Wellcome Trust Develop your research Career these offer information on funding and schemes for different career stages as well as tips, advice and resources for...

  • Evidence to support targeted investment in breastfeeding education among families of low socioeconomic status

    Por: Brockway · M. · Azad · M. B.

    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.

    Implications for practice and research

  • 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.

  • Context

    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 countries1—contribute significantly to socioeconomic health disparities across the lifespan. Breastfeeding intentions are an established predictor of breastfeeding outcomes, yet most...

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