FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerEvidence-Based Nursing

Mental health patients perceive observation as the least restrictive intervention

Por: Yesodharan · R. · Renjith · V.

Commentary on - Lindekilde CR, Pedersen ML, Birkeland SF, Hvidhjelm J, Baker J, Gildberg FA. Mental health patients' preferences regarding restrictive interventions: an integrative review. J Psychiatr Ment Health Nurs. 2024 May 2. doi: 10.1111/jpm.13057.

Implications for practice and research

  • Mental health patients perceive observation as the least restrictive intervention. Mental health professionals should consider environment, communication and duration that could influence patient preferences for restrictive interventions.

  • More research is needed on developing a global definition for restrictive interventions and also to understand patient preferences and views regarding various restrictive interventions.

  • Context

    Philippe Pinel has been honoured in history for his ‘humane treatment’ and ‘unchaining the mentally ill’.1 However, the use of restrictive interventions (RIs) in psychiatric hospitals continues in the 21st century. Ensuring safety for self and others is one of the major reasons for using these RIs.2...

    Older adults undergoing major elective surgery experience significant emotional distress: insights into the surgical patient experience

    Por: Dumon · K. R. · Rouhi · A. D. · Leon · S.

    Commentary on: Kata A, Dillon EC, Christina Keny RN, et al.‘There’s So Much That They're Enduring’: Experiences of Older Adults Undergoing Major Elective Surgery. Ann Surg. Published online April 9, 2024. doi:10.1097/SLA.0000000000006293

    Implications for practice and research

  • Routine psychosocial assessments for older adults may be implemented throughout the perioperative continuum to proactively identify emotional challenges and offer tailored support.

  • The effectiveness of integrated mental health and social support in improving surgical outcomes should be investigated in this vulnerable population, including longitudinal studies on mental health interventions.

  • Context

    Elderly patients, defined as adults aged 65 years and above, represent a growing segment of the surgical population.1 Despite numerous advances in surgical techniques and postoperative care, elderly patients face unique physical and psychological challenges that can exacerbate their risk of poor clinical outcomes.2 The recent study by Kata et al explores...

    Maintaining moderate to low blood pressure is a key element in improving clinical outcomes poststroke

    Por: Suner-Soler · R.

    Commentary on: Wang R, Liu Y, Zhang Q, et al. Twenty-4 hour blood pressure trajectories and clinical outcomes in patients who had an acute ischaemic stroke. Heart. 2024;110(11):768–774.

    Implications for practice and research

  • Blood pressure (BP) should be kept at moderate to low levels in the 24 hours after ischaemic stroke to reduce the risk of adverse outcomes.

  • Future studies need to determine the optimal BP that should be aimed for poststroke to avoid further vascular events.

  • Context

    Haemodynamic management, and particularly the management of blood pressure (BP), is critical to reduce mortality and preserve the functional capacity of people with cardiovascular disease.1 However, there is insufficient evidence to justify lower BP targets (≤135/85 mm Hg) in people with hypertension and established cardiovascular disease.1 Wang et al have undertaken a multicentre clinical trial in 26 hospitals across China to explore both...

    Key informants in qualitative research

    Por: Tabari-Khomeiran · R. · Barrett · D.
    Introduction

    Qualitative research methods allow investigators to gain a detailed understanding of phenomena, based on the collection and analysis of rich data. An important element of some qualitative studies is key informants (KIs)—those are a specific set of participants who are able to provide particularly valuable viewpoints and insights on the issues or questions being examined.1 2

    The concept of using KIs dates back to early anthropological studies, where researchers relied on local experts to help better understand cultural practices and social structures. Over time, this approach has evolved, with increasing recognition of the value that KIs bring to a wide array of fields, including public health, education, social sciences, medicine and nursing.3 This ‘Research Made Simple’ article explores what KIs are, how they can benefit nursing and healthcare research and what practical steps can be taken by researchers to optimise the...

    Vitamin D supplementation to reduce maternal adverse events: the jury is still out

    Por: Martineau · A. R. · Iliodromiti · S.

    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.

  • Context

    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 2020.1 Vitamin D plays pleiotropic physiological roles in maintaining calcium homeostasis, modulating the renin-angiotensin axis and regulating insulin secretion.2 Deficiency in...

    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...

    How disclosure of sexual violence affects mental health in older adults

    Por: Holmes · M. R. · Wei · W.

    Commentary on: Nobels A, Meersman C, Lemmens G, Keygnaert I. ‘Just something that happened?’: mental health impact of disclosure and framing of sexual violence in older victims. Int J Geriatr Psychiatry. 2023;38. https://doi.org/10.1002/gps.6036.

    Implications for practice and research

  • Healthcare professionals need training to provide supportive and effective responses to disclosures of sexual violence in older adults.

  • Further studies should explore the impact of positive responses to disclosures on the mental health outcomes of older victims.

  • Context

    Sexual violence (SV) remains a critical issue affecting mental health globally, defined as coerced sexual acts, unwanted advances or trafficking. Research indicates that an estimated 81% of women and 48% of men in Belgium have experienced SV in their lifetime.1 Actual rates might be higher among older adults due to under-reporting.2 While extensive research focuses on younger victims, there is growing...

    Parental experiences of congenital heart disease transition care highlight the need for family-centered approaches

    Por: Fox · K. R. · Garg · V.

    Commentary on: Lykkeberg B, Noergaard MW, Bjerrum M. Experiences and expectations of parents when young people with congenital heart disease transfer from pediatric to adult care: A qualitative systematic review. J Child Health Care. doi:10.1177/13674935241231024

    Implications for practice and research

  • To inform family-centred transition programmes, more high-quality qualitative research describing parental experiences should be conducted, particularly in non-European and low- and middle-income countries.

  • Congenital heart disease transition programmes should consider adopting a family-centred approach that incorporates informational and psychosocial support resources for parents.

  • Context

    A growing number of individuals born with congenital heart disease (CHD) are surviving well into adulthood, and a successful transition from paediatric to adult healthcare is essential for their long-term health. However, discontinuity in care is prevalent.1 Parents play an important role in the transition process and may impact transition-related outcomes,2 but their experiences and...

    While the preferences of older adults for community-based care are crucial, they must be considered alongside the challenges of staying in community dwellings

    Por: Heale · R.

    Commentary on: Understanding community-dwelling older adults' preferences for homeand community-based services: A conjoint analysis. - Chen, S et al.

    Implications for practice and research

  • Older adults prioritise caregivers’ attitudes in the delivery of service at home or in the community.

  • Health systems should consider the cost of home/community service to ensure that this care is feasible for all older adults.

  • Explore cultural influences on preferences for home and community services.

  • Examine the impact of preferences on service outcomes.

  • Context

    The study explored the preference for home-based and community-based services among older adults in China. As populations age globally, understanding these preferences becomes crucial for developing effective care models. The research focuses on identifying the preference structure of Chinese community-dwelling older adults for these services, with the aim of optimising the provision of services. Given the increasing scarcity of resources and the...

    Failure to rescue: optimising nursing assessment and surveillance has the potential to improve outcomes for deteriorating patients with multimorbidity

    Por: Elder · E. · Muir · R.

    Commentary on: Douglas C, Alexeev S, Middleton S, Gardner G, Kelly P, McInnes E, et al. Transforming nursing assessment in acute hospitals: A cluster randomised controlled trial of an evidence-based nursing core assessment (the ENCORE trial). International Journal of Nursing Studies. 2024. 2024;151:104690.

    Implications for practice and research

  • Introducing training to enhance manual nursing assessment and surveillance has the potential to improve outcomes for hospitalised patients with multimorbidity.

  • Further research is needed to establish which aspects of nursing assessment and surveillance are essential to improving recognition and response to clinical deterioration.

  • Context

    Failure to identify and respond to deteriorating patients is a significant and complex clinical safety issue. There is a growing body of international research evidence which has identified the importance of system and human factors in ‘failure to rescue’ events.1 Yet, despite the widespread adoption of rapid response and...

    Navigating the maze of self-management in primary glaucoma: insights from a qualitative study

    Por: Khurana · M. · Raman · R.

    Commentary on: Hua Y, Lu H, Dai J, et al. Self-management challenges and support needs among patients with primary glaucoma: a qualitative study. BMC nursing. 2023 Nov 14;22(1):426.

    Implications for practice and research

  • Healthcare professionals should provide personalised and comprehensive support, addressing the medical, emotional and social challenges faced by patients with primary glaucoma.

  • Further research is needed to explore the effectiveness of tailored self-management support programmes in improving the quality of life and treatment outcomes for patients with glaucoma.

  • Context

    Glaucoma is a chronic disease characterised by progressive visual field defects. It is the most common cause of irreversible blindness and is associated with a decrease in quality of life.1 Most studies in literature look at specific challenges faced by patients with glaucoma like adherence to medications, driving or depression.2–4 There is a paucity of...

    Lower levels of nursing staff are associated with delayed care and serious adverse outcomes for patients in emergency departments

    Por: Elder · E. · Muir · R.

    Commentary on: Drennan J, Murphey A, McCarthy VJC, Ball J, Duffield C, Crouch R, Kelly G, Loughnane C, Murphey A, Hegarty J, Brady N, Scott A & Griffiths P. The association between nurse staffing and quality of care in emergency departments: A systematic review. Int J Nurs Stud 2024 153, 104 706.

    Implications for practice and research

  • Healthcare leaders should place high importance on ensuring adequate levels of nursing staff in emergency departments to reduce serious adverse outcomes.

  • Further research is needed to ascertain safe nurse staffing levels in emergency departments.

  • Context

    There is a substantial body of international evidence, which demonstrates that inadequate nurse staffing is associated with increased mortality and poor patient outcomes in medical and surgical settings.1 However, there is less certainty about the link between nurse staffing levels, quality of care and patient outcomes in emergency departments (EDs)....

    Embedding racial diversity, in evidence-informed nursing practice

    Por: Moorley · C. · Crosby-Nwaobi · R.

    Nursing as a profession is deeply rooted in caring and advocating for the well-being of others, linking it to social justice praxis.1 Social justice refers to the fair and equitable distribution of resources, opportunities and upholding the rights of individuals within society, regardless of their characteristics such as race, gender, socioeconomic status, religious belief, age, disability and other protected characteristics. The tenets of social justice are diversity, equity and inclusion. In this editorial, we focus on racial diversity because it has a very important place in nursing and nurses should be continually taught how to embed racial diversity in practice.

    Embedding diversity, equity and inclusion (DEI) in evidence-informed nursing practice is crucial to ensuring that healthcare is accessible, culturally competent, socially just and addresses the unique needs of all individuals and communities. We hold the view that diversity is not and should not be a one-off showcase...

    Women exposed to intimate partner violence may experience barriers to help-seeking at the individual, interpersonal and institutional levels

    Por: Seymour · R.

    Commentary on: Shah, A., et al. Coping Strategies and Help-Seeking Behaviors among Survivors of Intimate Partner Violence: A Qualitative Study of Spouses of Men with Heavy Drinking in India. Health & Social Care in the community, 2024, 6839787, https://doi.org/10.1155/2024/6839787

    Implications for practice and research

  • Intimate partner violence (IPV) has wide-reaching impacts on exposed women and their children. Understanding the needs of women exposed to IPV enhances our ability to provide adequate support and sustainable local and systemic service provisions.

  • Future research should focus on embedding the cultural context into intervention design.

  • Context

    Global estimates indicate that approximately one in three women have experienced physical and/or sexual intimate partner violence (IPV), or non-partner violence across their lifespan.1 IPV can cause significant short-term and long-term consequences on women’s mental, physical, sexual and reproductive health, as well as their children’s welfare.2...

    Increased risk of dementia in older adults starting sulfonylurea: taking sulfonylurea off the list

    Por: Pessoa Lima · D. · Santos · L. T. R.

    Commentary on: Wu CY, Iskander C, Wang C, et al. Association of sulfonylureas with the risk of dementia: A population-based cohort study. J Am Geriatr Soc. 2023; 71:3059–70.

    Implications for practice and research

  • Unless contraindicated, dipeptidyl peptidase 4 inhibitors (DPP-4i) should be used as first-line choice in older adults with type 2 diabetes in preference to sulfonylurea due to increased risk of dementia.

  • Prospective studies are needed to ascertain if the use of sulfonylurea by older adult patients causes higher risk of developing dementia.

  • Context

    Diabetes is already known as a risk factor for developing dementia. Multiple factors contribute to this association: presence of microvascular and macrovascular complications, chronic inflammation, hyperglycaemia, hypoglycaemia and hyperinsulinemia.1

    Older adult patients often present with multimorbidities, polypharmacy, malnutrition, sarcopenia, longer duration of diabetes and renal and hepatic dysfunction. Furthermore, low education level, high blood pressure, dyslipidemia, obstructive...

    US public perceives abortion to be much riskier than it actually is

    Por: Arkell · R. · McCulloch · H.

    Commentary on: Chaiken, S.R., Darney, B.G., Schenck, M. and Han, L., 2023. Public perceptions of abortion complications. American journal of obstetrics and gynecology, 229(4), pp.421-e1.

    Implications for practice and research

  • Information provision, including clinical messaging and public health campaigns, needs to emphasise the safety of abortion, stressing accurate information on ‘true’ risks associated with respective procedures.

  • Further research should focus on exploring and tackling misinformation for all abortion methods, establishing which perceived risks are associated with which procedure type.

  • Context

    Despite firm evidence on the safety of abortion,1 a large number of myths concerning the risks associated with the treatment remain, particularly in the USA. The current political climate, which has seen increasing legal and regulatory restrictions placed on abortion, has encouraged the spread of misinformation. This has led to the perception that abortion has substantial physical and mental health risks....

    Enabling student nurses to meet the sexual health needs of young people: the perspective of a specialist community public health nurse

    Por: Baker · R.

    Commentary on: Russell JL, Chen HC, Jensen FB, Nichols ND. Nursing students' perceived attitudes toward addressing sexual health in their future profession: A longitudinal quantitative study. Nurse Educ Today. 2023 Nov;130:105953. doi: 10.1016/j.nedt.2023.105953. Epub 2023 Aug 25.

    Implications for practice and research

  • Nursing students have positive attitudes towards addressing sexual health in future practice and this should co-inside with educational opportunities to enable the development of competence and confidence.

  • Further research is required to establish the learning gaps between educational opportunities available to nursing students and that of sexual health-related competence within nursing practice.

  • Context

    Sexual health can be defined as one’s physical, emotional, mental and social well-being.1 Nurses often support and adopt a holistic approach to patient care, yet in practice, overlook a person’s sexual health.2 Both nationally and globally, disparities in sexual health are prevalent, even more so...

    Older patients have an increased risk of in-hospital death and adverse events following overnight stays in the emergency department

    Por: Muir · R. · Elder · E.

    Commentary on: Roussel M, Teissandier D, Yordanov Y, et al. Overnight stay in the emergency department and mortality in older patients. JAMA Intern Med. 2023 Dec 1;183(12):1378-1385.

    Implications for practice and research

  • Healthcare leaders should place high importance on organisational solutions to prioritise the admission of older patients from emergency departments (EDs) to wards to reduce risks associated with overnight stays.

  • Further evidence is needed to understand if increased risks to older patients in ED also occur at other times and to establish the most effective interventions to mitigate risks.

  • Context

    Crowding and access block in emergency departments (EDs) are pervasive problems of international concern.1 The demand on EDs has grown exponentially, particularly during the COVID-19 pandemic, where EDs served as the ‘safety net’ for rising numbers of high-acuity patients and emergencies. The study by Roussel et al 2 advances...

    ❌