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Although the UK is a multicultural society, racially minoritised populations are often under-represented in healthcare research owing to the significant barriers to participation they experience.
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.
This is a perspective on Ridgway et al ‘Creative health a joke or valuable learning experience’. Creative health encompasses creative and arts activities that benefit health and well-being. The article evaluates a creative health placement designed to facilitate students’ learning about creative health and social prescribing, with opportunities to take part in arts activities.
Take home messages Creative health placements equip future nurses with knowledge about social prescribing initiatives to offer holistic person-centred care. The article provides valuable insights into placements that future-proof registrants’ knowledge and skills with the shift towards prevention and a neighbourhood health service. Building creative health placements into the curriculum in other institutions will improve access to this valuable learning opportunity.
A pilot creative health placement for undergraduate student nurses at a UK...
Commentary on: Er S, Murat M, Ata EE, Kose S, Buzlu S. Nursing student’s mental health: How does eco-anxiety effect? Int J Mental Health Nurs. 2024;00:1-12.
Implications for practice and research Nurse educators should be aware of eco-anxiety and think about the impact of climate change on nursing students. Nurse researchers should investigate ways of supporting nursing students affected by eco-anxiety and develop strategies to promote student learning during a climate emergency.
Climate change is causing a global climate emergency, which is increasingly seen as a major problem for global health concern.
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: Taylor SP, Kowalkowski MA, Skewes S, Chou SH. Real-world implications of updated surviving sepsis campaign antibiotic timing recommendations. Crit Care Med. 2024 doi: 10.1097/CCM.0000000000006240.
Implications for practice and research Antibiotic delivery in suspected sepsis must be prioritised within the clinical context emphasising the need to individualise antibiotic timing according to patient profiles. In the absence of shock, a more lenient approach to antibiotic timing could support the rational use of antibiotics.
Sepsis is a life-threatening response to infection and remains a critical challenge with high morbidity and mortality rates. The Surviving Sepsis Campaign (SSC) guidelines serve as a cornerstone for sepsis management and are pivotal in standardising care. Taylor et al’s article
Commentary on:Michelson KA, Rees CA, Florin TA, et al. Emergency department volume and delayed diagnosis of serious pediatric conditions. JAMA Pediatr. 2024;178:362–8. doi:10.1001/jamapediatrics.2023.6672
Implications for practice and research Low-paediatric-volume emergency departments (EDs) can increase paediatric readiness by improving diagnostic tools, expanding paediatric expertise (eg teleconsultation) and using electronic clinical decision support. Further research is needed to examine the costs and effectiveness of specific interventions to improve readiness in low-volume paediatric EDs.
Children sometimes have subtle illness presentations and symptom overlap with non-serious conditions.
Commentary: Luque-Alcaraz OM, Aparico-Martinez P, Gomera A, Vaquero-Abellan. The environmental awareness of nurse as environmentally sustainable healthcare leaders: a mixed method analysis. BMC Nursing 2024;23:229.
Implications for practice and research Healthcare emissions contribute to climate change and threaten human health; therefore, nurses have a professional obligation to become environmentally informed, take action to reduce healthcare emissions and support green solutions. Future research must understand and modify workplace barriers to promote environmentally sustainable staff behaviour and facilitate the green transformation of healthcare systems.
Climate change is increasingly harming human health. Extreme weather events cause devastation, low crop yields and failure, contributing to food insecurity, economic hardship and resource shortages. Rising temperatures also increase the spread of infectious diseases and epidemics. Globally, countries are using healthcare services as an initial method of addressing these challenges.
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.
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.
Health research aims to improve people’s health by understanding the best ways to diagnose and treat conditions, and understand people’s responses to health problems and health promotion initiatives. Quantitative research, and more specifically randomised controlled trials (RCTs), aims to establish if an intervention works, for example testing the effectiveness of a new drug, using statistical analysis. In contrast, qualitative research focuses on understanding a situation, for example people’s experiences, perspectives and behaviours. Qualitative research can enhance RCTs by ensuring a more complete understanding of the factors that influence the acceptability of a new intervention and how it might be implemented in practice. A previous article in this series outlined how process evaluation embedded within RCTs can help understand how and why an intervention works.
Commentary on: Chauhan A, Newman B, Manias E, et al. Creating safer cancer care with ethnic minority patients: A qualitative analysis of the experiences of cancer service staff. Health Expect. 2024 Jan 30;27(1):e13979.
Implementing culturally competent communication strategies, including interpreters and culturally adapted materials, can enhance patient safety and engagement. Further studies are needed to evaluate the effectiveness of communication tools and strategies in improving safety outcomes for ethnic minority patients with cancer.
This qualitative study explores the experiences of healthcare staff in creating safer cancer care environments for ethnic minority patients. People from ethnic minority groups, who face an increased risk of safety events, often encounter barriers such as language and cultural differences.
Commentary on: Lee IO, Wolstencroft J, Housby H, et al. The inequity of education, health and care plan provision for children and young people with intellectual and developmental disabilities. J Intellect Disabil Res. Published online 22 May 2024.
Implications for practice and research Children and young people with intellectual and developmental disabilities (IDD) living in deprived areas are less likely to receive education, health and care plans in the UK. Future research should aim to identify interventions that have the potential to reduce such inequities for individuals with IDD.
The findings from this study by Lee et al
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
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...
Interpretative phenomenological analysis (IPA) is a widely recognised and well-established method of qualitative inquiry designed to explore personal experience in detail, focusing on participants’ understandings and sense-making.
IPA was developed in the mid-1990s by Jonathan Smith and emerged out of health psychology, and since the early 2000s has increasingly been adopted by nursing and health researchers more generally. At the time of writing, a Google Scholar search of the terms ‘interpretative phenomenological analysis’ and ‘nursing’ yielded more than 35 000 results. IPA is primarily interested in undertaking...
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: 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.
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.
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