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Commentary on: Ward-Stockham, Daniel C, Bujalka H, et al. Implementation and use of the Safewards model in healthcare services: A scoping review. Int J Ment Health Nurs. 2024;00:1–30.
Implications for practice and research Effective implementation of Safewards interventions could significantly reduce conflict and containment in healthcare services, resulting in a safer environment for patients and professionals. Research is needed on the sustainability and generalisability of Safewards interventions, particularly in non-mental health settings as the model expands to other healthcare contexts.
Conflict behaviours, such as aggression, along with containment practices like seclusion, adversely affect both patients’ well-being and staff safety.
Commentary on: Tahir, M., & Cobigo, V. (2024). "They helped me stand on my own two feet": Canadian parents with intellectual disabilities in child protection. Journal of Intellectual Disabilities, 17446295241296215.
Implications for practice and research Child protection agencies should enhance training on intellectual disabilities to reduce bias, ensure cognitive accessibility and promote tailored supports, fostering trusting relationships that improve parental outcomes. Future research should explore the intersection of intellectual disabilities with other identities, such as Indigeneity, to address systemic barriers and promote equitable child protection practices.
Parents with intellectual disabilities encounter substantial stigmatisation, marginalisation and systemic challenges, particularly within child protection systems. Empirical evidence indicates that they are disproportionately represented in child protection cases and exhibit a higher likelihood of losing custody of their children than parents without intellectual disabilities. Prejudicial attitudes often originate from preconceptions regarding parenting capacity, and systemic barriers,...
Commentary on: Roomaney et al. A scoping review of the psychosocial aspects of infertility in African countries.
Implications for practice and research Incorporate affordable, culturally and religiously sensitive psychosocial support and interventions, including assessment, education and abuse management, into infertility treatments in African contexts. Expand research on infertility across African countries, focusing on psychosocial interventional studies and the development of culturally appropriate assessment tools.
Infertility impacts approximately one in six people globally,
Roomaney et...
Commentary on: Taylor J, Hall R, Heathcote C, et al (2024). Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1)Archives of Disease in Childhood Published Online First: 09 April 2024. doi: 10.1136/archdischild-2023–3 26 499
Implications for practice and research Clinicians should exercise caution when following clinical guidelines for managing gender dysphoria in youth due to concerns about methodological issues and evidence quality. Research on long-term outcomes of interventions is urgently needed to inform robust and transparent guidelines, incorporating input from gender diverse youth and families.
The visibility and acceptance of transgender identities have increased, leading to more young individuals questioning their gender or identifying as transgender.
Understanding the quality of published research is essential for nurses, educators and healthcare researchers striving to implement evidence-based practice. However, ‘quality assessment’ can seem abstract or overly technical, primarily for those new to research appraisal. In an era where clinical decisions and policy recommendations are increasingly data-driven, evaluating the methodological rigour of quantitative studies is more critical than ever.
High-quality research provides trustworthy, valid and ethically sound conclusions. In contrast, poorly conducted studies can lead to misguided clinical decisions, suboptimal patient care and inefficient resource use.
Quality assessment involves evaluating a study’s design, methodology and reporting to determine its risk of bias and trustworthiness.
Commentary on: Jackson, J. Sinyor, J. & Trower, H. Umbrella review of hospital passports: Their use and improvements. British Journal of Learning Disabilities. 2024;1–9.
Implications for practice and research Strategic management support for hospital passports use can improve the health outcomes of hospitalised patients with intellectual disabilities and have a wider reach for any hospitalised patient with additional support needs. Future research should commit to equitable care that is accessible and person centred to ensure improved health outcomes.
People with intellectual disabilities are at a significantly greater risk of experiencing preventable, avoidable and premature death compared with the general population.
Commentary on: Borumandnia et al. The impact of vitamin D changes during pregnancy on the development of maternal adverse events: a random forest analysis. BMC Pregnancy and Childbirth 2024;24:125.
Implications for practice and research Data presented in this paper do not demonstrate a cause-effect relationship between maternal vitamin D deficiency during pregnancy and increased risk of maternal adverse events. Randomised controlled trials are needed to resolve uncertainty regarding the effects of vitamin D supplementation in pregnancy on maternal and fetal outcomes.
Sustainable Development Goal Target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by 2030. This remains elusive, with 223 maternal deaths per 100 000 live births reported worldwide in 2020.
Commentary on: Chuang C, Chen C: Effects of music intervention on quality of life, anxiety and fatigue among patients with breast cancer: a randomized controlled trial, Oncol Nurs Forum, 2024;51(5):467-482.
Implications for practice and research Music intervention may improve perceived quality of life in patients who have recently received a mastectomy for breast cancer. High-quality research is needed to determine whether and how music intervention can help patients during cancer treatment.
Music intervention is a complementary treatment that aims to ameliorate symptoms related to a medical condition. Music intervention is distinct from music therapy in that it is a solo listening experience rather than an active or therapist-guided session. Music intervention is thought to be a low-risk and convenient treatment with potentially positive effects on patients with breast cancer as measured by self-assessed symptom or quality of life scores or pain treatment...
Commentary on: Down L, Barlow M, Bailey SER, et al. Association between patient ethnicity and prostate cancer diagnosis following a prostate-specific antigen test: a cohort study of 730,000 men in primary care in the UK. BMC Med 2024 Mar 1;22(1):82.
Implications for practice and research Clinicians should consider ethnic differences when interpreting prostate-specific antigen test results, particularly for black men, to ensure timely prostate cancer diagnosis and avoid overtreatment or undertreatment. Further studies are needed to explore genetic, environmental and healthcare access factors that contribute to ethnic differences in prostate cancer incidence and progression.
Prostate cancer is a common cancer worldwide, with incidence and mortality varying significantly across ethnic groups.
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.
International guidelines on paediatric resuscitation support parental presence during resuscitation.
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.
People with autism, particularly those experiencing moderate-to-severe intellectual impairments, face an increased likelihood of developing anxiety disorders.
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.
Anxiety is a prevalent issue among healthcare professionals, particularly nurses, owing to the highly stressful nature of their work environments.
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.
Congenital heart disease (CHD) is the most prevalent birth defect that significantly affects infant and child mortality and morbidity.
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.
Type 2 diabetes mellitus (T2DM) is a significant public health issue, with diet playing a crucial role in its management.
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),:995-1003
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.
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.
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.
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...
As discussed in the accompanying editorial Nursing on the front foot,
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:
Every person...
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.
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...
For many decades, nurses have been expected to base their practice on up-to-date, research-derived evidence, melded with knowledge from nursing theory, experience—our own and others—and innovating in practice. This composite, complex evidence base is passed on through generations of nurses both formally, through educational opportunities and our own readings, and informally through the stories we tell of our practice. These nursing narratives encompass and connect the multiple levels at which nurses work—alongside a person and their families and carers, within the structures of healthcare and social-care organisations and in policymaking settings. Essentially, narratives enable compelling and memorable links to be drawn between research, theory and experience, creating the certainty and confidence we need to work effectively within our very different practice environments. Any turbulence in practice, deficiency in the evidence base or challenge to our ability to pass on our narratives is likely to cause ambiguity and anxiety and...
Commentary on: Le Lagadec MD, et al 2024, ‘Nurse by numbers: The impact of early warning systems on nurses’ higher-order thinking, a quantitative study.’ Journal of Advanced Nursing.
Implications for practice and research It is essential to ensure that early warning systems (EWS) are used in a balanced manner, enhancing clinical judgement without undermining the use and development of nurses’ critical thinking abilities. Research into the long-term effects of EWS on cognitive skills and the varying impacts across different levels of nursing experience could yield valuable insights for optimising their use in healthcare.
In modern healthcare, the use of tools such as early warning systems (EWS), has become integral to patient safety, particularly for detecting early signs of patient deterioration.
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