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Commentary on: Yıldız E, Yıldırım Ö. The mediating role of psychological flexibility in the relationship between psychotic symptom severity and depression in individuals diagnosed with schizophrenia. J Psychiatr Ment Health Nurs. 2024. (in press) doi: 10.1111/jpm.13040.
Implications for practice and research Mental health nurses’ training could be more focused on clinical skills and knowledge in enhancing psychological flexibility to minimize the impact of psychotic symptoms on comorbid depression in people with schizophrenia. Further development of the intervention of building psychological flexibility is of research interest for the clinical management of people with schizophrenia.
Schizophrenia is a mental disorder affecting approximately 23.9 million people worldwide, significantly contributing to the global disease burden, revealing 14.8 (10.9–19.1) million years lived with disability in 2021.
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: Zhao et al. The impact of education/training on nurses caring for patients with stroke: a scoping review. BMC Nurs 23:90
Implications for practice and research Nurses working in clinical stroke care could benefit from leadership and management strategies that encourage empowerment and time and space to reflect on current evidence, training and practice. Comprehensive evaluation strategies are needed to assess the impact and effectiveness of empowerment-based stroke education and training on patient outcomes.
Stroke nursing is widely recognised for its significant role across the whole multidisciplinary stroke care pathway.
Commentary on: Demerci AD, Oruc M, Kabukcuoglu K. "I need to make sense of my birth experience": A descriptive qualitative study of postnatal women’s opinions, and expectations about postnatal debriefing. Midwifery 2024;131;103955. https://doi.org/10.1016/j.midw.2024.103955
Implications for practice and research Healthcare professionals should prioritise and establish routines for postnatal debriefing, with a goal of averting problematic parenting adaptation and development of post-traumatic stress symptoms. More research is needed to determine the ideal format (structured or unstructured) and to consider whether either or both formats might influence subsequent reproductive decision making.
Previous investigations into postnatal debriefing have had mixed results regarding its effectiveness and have not established best practices for its usage.
Commentary on: Spurlock EJ, Pickler RH. Birth Experience Among Black Women in the United States: A Qualitative Meta-Synthesis. J Midwifery Womens Health. 2024; https://doi.org/10.1111/jmwh.13628
Implications for practice and research There is a need to understand and measure how black women can feel known and seen within their healthcare relationships, to improve their experiences of maternity care. Research around ‘seeing and knowing’ the identities of black women and mothers, from their own perspectives, could inform midwives and obstetricians to achieve racially concordant care.
The WHO recommendations around intrapartum care aim that a positive experience of childbirth should be the outcome of labour for each woman.
Commentary on: Velthuijs ELM, Jacod BC, Videler-Sinke L, et al. Outcome of induction of labour at 41 weeks with Foley catheter in midwifery-led care. Midwifery 2024 Aug;135:104026. doi: 10.1016/j.midw.2024.104026. Epub 9 May 2024. PMID: 38781793.
Implications for practice and research Performing induction of labour with a Foley catheter and subsequent amniotomy in midwife-led care is associated with worse neonatal outcomes and equivalent maternal outcomes compared with consultant-led care. Future research should further explore the cost-effectiveness, feasibility and neonatal outcomes associated with midwife-led care in different patient populations.
Although care for low-risk births in the Netherlands is primarily conducted by midwives, the use of consultant-led care has been increasing for a variety of indications, leading to a high patient burden for consultants. The induction of labour (IOL) of late-term pregnancies has historically been an indication for consultant-led care. This study by Velthuijs et...
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.
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: Kearns, RJ, Kyzayeva, A, Halliday, LO, et al. Epidural analgesia during labour and severe maternal morbidity: population based study. BMJ 2024;385.
Implications for practice and research Health research, policy and information should emphasise the advantages of intrapartum epidurals beyond pain relief, especially for women with pre-existing conditions and preterm labour. Health services must provide access to a 24-hour epidural service within their maternity care.
The use of intrapartum epidurals to manage pain during labour and birth has been globally accepted for decades.
Commentary on: Hunt K, Davies A, Fraser A, Burden C, Howell A, Buckley K, Harding S, Bakhbakhi D. Exposure to microplastics and human reproductive outcomes: A systematic review. BJOG. 2024 Apr;131(5):675-683. doi: 10.1111/1471-0528.17756. Epub 2024 Jan 29. PMID: 38287142.
Implications for practice and research Plastic exposure may be associated with increased deposition of microplastics in reproductive tissues, and the quantity of microplastics in these tissues may lead to adverse clinical outcomes. Future research should aim to provide high-quality, generalisable evidence to further demonstrate the impact of plastic exposure and microplastics on reproductive outcomes in humans.
As a result of the mass scale of production of plastics since the 1950s, microplastics, defined as particles 1 Microplastics have been linked to reproductive toxicity in both cell culture...
Commentary on: Jackson, I., Dagnan, D., Golding, L., & Rayner-Smith, K. (2024). How do people with intellectual disabilities understand friendship? A systematic meta-synthesis. JARID, 37(4), e13244.
Implications for practice and research People with intellectual disabilities value friendship and actively engage in reciprocal exchanges. People with intellectual disabilities seek and use opportunities for structured support and organised activities to access and manage friendships.
A previous study
Nursing is a profession that has always worked with diverse people and communities and has taken a social justice approach to care. Nursing has also undertaken research that includes diverse groups and communities. However, nurse researchers working with and undertaking research with diverse groups and communities may encounter problems in executing the research. This may be for reasons such as poor understanding of cultural and racial difference, not having an inclusive research team, for example, LGBTQIA+ researchers to help conduct LGBTQIA+ focused research or using an ableist approach, all of which can lead to exclusion, diminished trust and credibility. In this commentary, we draw on Hollowood’s doctoral journey and Moorley’s research experience, where both work with and research diverse communities’ health. Nurse researchers need to apply methodologies and approaches that are culturally sensitive and inclusive and here we offer essential tips, which have helped us by drawing on culturally specific...
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: Family caregivers’ burden, patients’ resourcefulness, and health-related quality of life in patients with colorectal cancer.
Practice: Treat the patient, and also treat the family and caregiver; help patients build or activate their resourcefulness, as resourcefulness can be a learnt skill. Research: Additional work should identify targets for improving patient resourcefulness.
Patients with colorectal cancer face treatments that can bring significant financial burden, physical strain and relationship changes which can affect quality of life. These stressors may be mitigated by coping ability, particularly resourcefulness, which reflects the ability of the patient to independently perform daily tasks and seek help when needed. The patient experience and need for care can affect caregivers as well, leading to caregiver burden: an accumulation of the negative responses to the caregiver that result from providing care, including disrupted schedules, financial and...
Commentary on: Women’s caesarean section preferences: a multicounty cross-sectional survey in low- and middle-income countries by Etcheverry et al. 2024;132.
Implications for practice and research Pregnant women in low- and middle-income countries should be counselled about the benefits and risks of both caesarean sections and vaginal deliveries to facilitate informed choices, the most suitable opportunity being antenatal clinic visits. Further studies are needed to explore decision aids in order to help women and doctors make informed shared decisions regarding the mode of delivery.
Caesarean section (CS) rates are rising globally from 7% in 1990 to 21% in 2018.
Commentary on: MacGregor KA, Ho FK, Celis-Morales CA, et al. Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease. BMC Med. 2023;21:488.
Implications for practice and research Fat mass, physical activity level and cardiorespiratory fitness were identified as factors that influence the relationship between the menstrual cycle and levels of glucose, triglycerides, the triglyceride-to-glucose index, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol and the total-to-HDL cholesterol ratio. Future studies should investigate whether these relationships indicate a causal mechanism responsible for the variations in metabolic control throughout the menstrual cycle.
The rate of impaired metabolic regulation is rising among premenopausal women, characterised by decreased insulin sensitivity, increased fasting blood sugar levels and abnormal lipid profiles.
Commentary on: Alanazi N, Gu F, Li CS, et al.Lorenz RA, Hong CC. Sleep Quality and Associated Factors Among Survivors of Breast Cancer: From Diagnosis to One Year Postdiagnosis. Oncol Nurs Forum. 2024 Feb 19;51(2):163-–174. doi: 10.1188/24.ONF.163-–174. PMID: 38442284.
Implications for practice and research Sleeping disorders are common in breast cancer patients and increase in the first year after diagnosis. Nurses should be aware of the high frequency of these disturbances, which persist after the conclusion of most therapies. The determinants of worsening sleeping quality in breast cancer survivors need to be understood, including the role of treatments, the type of surgery and psycho-social or contextual factors.
Breast cancer is the most common cancer in women worldwide. While research in recent decades has focused on minimising treatment, the disease still impacts women’s lives in many ways. Because increased sleep disturbances affect approximately...
Commentary on: Van Hecke A, et al. Development of a competency framework for advanced practice nurses: a co-design process. J Adv Nurs 2024; 1-13. doi.org/10.1111/jan.16174
Implications for practice and research A CanMEDS-derived APN (Advanced Practice Nurse) competency framework informs APNs’ personal and professional development and guides APNs’ practices within educational and healthcare settings in Belgium. Further research is required to validate this competency framework and determine its usability in education and practice.
Advanced practice nursing (APN) refers to an expanded scope of practice beyond the generalist level to provide direct healthcare services, including prevention, diagnosis, therapeutics and illness management.
Commentary on: Turk F, Sweetman J, Chew-Graham CA, et al. Accessing care for long covid from the perspectives of patients and healthcare practitioners: a qualitative study. Health Expect 2024;27:e14008. doi.org/10.1111/hex.14008
Training to enhance healthcare providers’ knowledge about Long Covid and tailored, equitable and timely access to integrated healthcare suitable for diverse and complex needs is required in the management of Long Covid. Future research is needed to address misinformation and the provision and effectiveness of reliable online resources for Long Covid patients along with an understanding of the effectiveness of integrated models of Long Covid care across diverse clinical settings.
Long Covid is an emerging long-term condition resulting from SARS-CoV-2 infection, characterised by a wide array of persistent symptoms, it is heterogenous in nature with fluctuations and experiences of relapse.
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