Journal of evaluation in clinical practice最新文献

{"title":"Characterizing Personal Clinical Cognitive Uncertainty and Its Association With Clinical Judgment","authors":"Philippe Simard-Sauriol,&nbsp;Andréanne Wassef,&nbsp;Eric Peters,&nbsp;Jean-Pascal Costa,&nbsp;Nicolas Fernandez,&nbsp;Quoc Dinh Nguyen","doi":"10.1111/jep.70124","DOIUrl":"https://doi.org/10.1111/jep.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Clinical uncertainty has been studied mostly in relation to clinical scenarios or as a personal characteristic. The intersection between clinical context and personal characteristics remains underexplored. Specific forms of personal and cognitive clinical uncertainty may exist at different layers of cognitive processes, and impact clinical judgment and training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and objectives</h3>\u0000 \u0000 <p>We aimed to characterize and quantify facets of personal clinical cognitive uncertainty, and examine associations with clinical judgment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 120 learners and 24 supervisors at the <i>Centre hospitalier de l'Université de Montréal</i>. Learners completed 15 multiple-choice vignettes and recorded their level of uncertainty for each. Learners' characteristics and supervisor-rated clinical judgment were compiled. We quantified five uncertainty measures: self-reported general uncertainty, degree of clinical uncertainty, relative, absolute, and objective calibrations of uncertainty. Correlations between demographic characteristics, test scores, and uncertainty measures were computed. We examined adjusted linear regressions of clinical judgment on uncertainty measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age of learners was 24.9 years (SD = 3.5), 80 (68%) were women, 52 (44%) had undergraduate education. Mean test score was 61% (13) and supervisor-rated clinical judgment was 40 (10) over 60. Higher degree of clinical uncertainty correlated with lower scores, lower training levels, and being a woman. Higher self-reported general uncertainty was associated with higher degree of clinical uncertainty but lower relative and absolute calibrations. Higher test score was correlated with higher absolute and objective calibrations. Lower self-reported general uncertainty (standardized β = −0.27, <i>p</i> = 0.003), lower degree of uncertainty (<i>β</i> = −0.27, <i>p</i> = 0.01), higher relative (<i>β</i> = 0.16, <i>p</i> = 0.09) and absolute calibrations (<i>β</i> = 0.18, <i>p</i> = 0.06) were associated with clinical judgment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We identified five measures of personal clinical cognitive uncertainty with differential associations with clinical judgment and knowledge. Greater focus on understanding and teaching of personal clinical cognitive uncertainty may enhance clinicians' tolerance to uncertainty and improve clinical judgment and outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systems Thinking in Mental Health Patient Safety: A Narrative Review of Complex Adaptive Systems","authors":"Alexander Challinor,&nbsp;Oladayo Bifarin,&nbsp;Esmaeil Khedmati Morasae,&nbsp;Pooja Saini,&nbsp;Kathryn Berzins,&nbsp;Rajan Nathan","doi":"10.1111/jep.70080","DOIUrl":"https://doi.org/10.1111/jep.70080","url":null,"abstract":"<p>Despite the growth of knowledge and interest into safety and quality in healthcare more generally, the exploration in mental healthcare has been deemed to be in a narrow isolated ‘world of its own’. It is possible that relatively little attention is being paid to the processes and interdependencies within the mental health patient safety system. This may result in simplistic static measures of what the system/organisation <i>has</i>, not what it does (or doesn't do). This can limit the potential for learning and affecting change. To investigate systems thinking in mental health patient safety, we conducted a narrative review into the extent of evidence streams supporting systems and complexity thinking approaches. We sourced a total of 89 reports for analysis with six themes identified. These themes included studies evaluating patient safety events that have occurred within mental healthcare, research that has investigated components of the safety system, and studies that have investigated how patient safety incidents are responded to, investigated, and learned from. The review evaluated the use of systems thinking and complexity research in patient safety, and research encapsulating patient and carer involvement. Most research has focused on the analysis of historic approaches to incident investigation and on system-based factors of patient safety, with little attention being paid to systems and complexity thinking approaches. The relationships between components were often ignored in the non-systemic studies sourced, with relationships between components not investigated and unknown. With policymakers recommending changes in patient safety practice through system-based approaches, it is important that its implementation is evaluated robustly with consideration of the multiple levels of the healthcare system. Future research should aim to incorporate systems-thinking approaches to model the safety system, and to improve our understanding of the highly interconnected technical and social entities that dynamically produce emergent behaviour across the system.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Is Evidence-Based Pharmacy?","authors":"Jennifer Maria Alexa,&nbsp;Katja Suter-Zimmermann,&nbsp;Thilo Bertsche,&nbsp;Samuel S. Allemann","doi":"10.1111/jep.70114","DOIUrl":"https://doi.org/10.1111/jep.70114","url":null,"abstract":"&lt;p&gt;&lt;i&gt;Evidence-based pharmacy (EBPharm)&lt;/i&gt; appears to be a vague term. This term has been used interchangeably and with overlapping meanings [&lt;span&gt;1-13&lt;/span&gt;]. Furthermore, it remains underrepresented in the literature and seems to be mostly unknown [&lt;span&gt;14, 15&lt;/span&gt;]. EBPharm has a great potential to contribute to an individualized, safe and effective pharmaceutical care and consequently to a reduced burden on healthcare systems. However, a successful implementation of EBPharm into practice requires a clear understanding of what it embodies. To date, a widely accepted definition of EBPharm is lacking. The purpose of this commentary is to propose a definition for EBPharm in alignment with existing terminology.&lt;/p&gt;&lt;p&gt;EBPharm emerged in recent years based on &lt;i&gt;evidence-based medicine (EBM)&lt;/i&gt;. The most commonly used definition of EBM was coined in 1996 by D.L. Sackett and his colleagues [&lt;span&gt;16&lt;/span&gt;]. They defined EBM as the ‘conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.’ Within the same editorial the authors also stated that ‘integrating individual clinical expertise’ and the ‘patient's choice’ [&lt;span&gt;16&lt;/span&gt;] are of great importance in EBM. Furthermore, according to Sackett et al. ‘good doctors use both individual clinical expertise and the best available external evidence,’ because ‘neither alone is enough [&lt;span&gt;16&lt;/span&gt;].’&lt;/p&gt;&lt;p&gt;Despite the frequent use of this definition, some confusion and disagreement still seem to exist.&lt;/p&gt;&lt;p&gt;Many authors cited only the first part of the definition when referring to EBM. Therefore, EBM was mistakenly accused of neglecting health professionals' practical experiences and of being too focused on clinical data [&lt;span&gt;17, 18&lt;/span&gt;]. However, it is well-established that EBM integrates the following three factors equally: 1) external evidence as well as 2) a patient's preferences and 3) a healthcare professional's practical experience. This constitutes the core of EBM and other evidence-based health disciplines. One could argue that the most commonly used sentence of the definition indirectly implies the consideration of all three factors. Misunderstandings may, nonetheless, be due to the fact, that Sackett et al. did not clearly mention all three key factors of EBM within their most prominent line of the editorial and subheading.&lt;/p&gt;&lt;p&gt;Another cause for uncertainty and confusion is the ambiguous use of the term &lt;i&gt;evidence-based practice (EBP)&lt;/i&gt;. Some authors utilize EBP and EBM synonymously. Sackett et al. stated that ‘the practice of evidence-based medicine’ requires ‘integrating individual clinical expertise with the best available external clinical evidence from systematic research’ [&lt;span&gt;16&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Based on the Sicily statement on evidence-based practice [&lt;span&gt;19&lt;/span&gt;], however, EBP refers to the process of considering the three key factors in practice. EBP comprises 5 main steps, which are also of","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Integrated Health Management in Hospital Administration: A Systematic Literature Review Applying the ProKnow-C Methodology","authors":"Damián Encalada Avila,&nbsp;David Naranjo Gil","doi":"10.1111/jep.70125","DOIUrl":"https://doi.org/10.1111/jep.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale, Aims and Objectives</h3>\u0000 \u0000 <p>Integrated health management represents a pivotal strategy for enhancing both operational efficiency and the quality of care in hospital environments. This study undertakes a systematic literature review to examine the influence of integrated health management on hospital administration. The principal aim is to synthesise a structured body of knowledge capable of informing strategic clinical decision-making and shaping future research trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This investigation employed the Constructivist Knowledge Development Process (ProKnow-C), a methodological framework implemented in four sequential stages: (i) the selection of pertinent peer-reviewed literature to construct a representative portfolio; (ii) bibliometric analysis to evaluate the impact and consistency of sources; (iii) systemic analysis to categorise thematic dimensions; and (iv) the identification of research gaps and prospective avenues for investigation. A total of 20 scholarly articles were scrutinised using both quantitative and qualitative criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three principal approaches to integrated hospital management were identified: (1) the utilisation of management tools—such as the Balanced Scorecard and performance indicators—to improve service delivery efficiency; (2) strategies for performance enhancement, underpinned by strategic planning, detailed operational analysis, and robust internal controls; and (3) financial management approaches, grounded in hospital information systems and evidence-based decision-making. Bibliometric findings confirmed the internal coherence of the selected portfolio, while the systemic analysis demonstrated the presence of shared conceptual frameworks throughout the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This systematic review contributed to the consolidation of a structured knowledge base concerning integrated hospital management and highlighted critical areas for future research. Further enquiry is warranted into models for clinical risk mitigation, the optimisation of resource allocation, and the development of financially viable management practices. The ProKnow-C methodology proved robust and suitable for guiding research within the domains of clinical evaluation and healthcare management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do GPs Want Large Language Models to be Applied in Primary Care, and What Are Their Concerns? A Cross-Sectional Survey","authors":"Richard C. Armitage","doi":"10.1111/jep.70129","DOIUrl":"https://doi.org/10.1111/jep.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although the potential utility of large language models (LLMs) in medicine and healthcare is substantial, no assessment has been made to date of how GPs want LLMs to be applied in primary care, or of which issues GPs are most concerned about regarding the implementation of LLMs into their clinical practice. This study's objective was to generate preliminary evidence that answers these questions, which are relevant because GPs themselves will ultimately harness the power of LLMs in primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Non-probability sampling was utilised: GPs practicing in the UK and who were members of one of two Facebook groups (one containing a community of UK primary care staff, the other containing a community of GMC-registered doctors in the UK) were invited to complete an online survey, which ran from 06 to 13 November 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The survey received 113 responses, 107 of which were from GPs practicing in the UK. When LLM accuracy and safety were assumed to be guaranteed, broad enthusiasm for LLMs carrying out various nonclinical and clinical tasks in primary care was reported. The single nonclinical task and clinical task that respondents were most supportive of were the LLM listening to the consultation and writing notes in real-time for the GP to review, edit, and save (44.0%), and the LLM identifying outstanding clinical tasks and actioning them (51.0%), respectively. Respondents were concerned with a range of issues regarding LLMs being embedded into clinical systems, with patient safety being the most commonly reported single issue of concern (36.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study has generated preliminary evidence that is of potential utility to those developing LLMs for use in primary care. Further research is required to expand this evidence base to further inform the development of these technologies, and to ensure they are acceptable to the GPs who will use them.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Alarm Management Training on Adult ICU Nurses' Knowledge, Behaviour, and Fatigue: A Quasi-Experimental Study","authors":"Dilanur Kibar,&nbsp;Aysel Özsaban","doi":"10.1111/jep.70127","DOIUrl":"https://doi.org/10.1111/jep.70127","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Teaching effective alarm management behaviours to intensive care nurses and preventing alarm fatigue is essential for patient safety. In this context, demonstrating the effectiveness of training activities for nurses on effective alarm management can significantly contribute to ensuring patient safety. However, studies demonstrating the effectiveness of alarm management training activities are limited. Therefore, there is an emerging need to examine the effects of training interventions that can help nurses gain effective alarm management behaviours. The study aimed to assess the effect of alarm management training on the knowledge, behaviours and fatigue levels of ICU nurses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This is a pretest- posttest, single-group, quasi-experimental study. The sample size was 19 nurses from two ICUs in a state hospital. Data were collected between 1 November 2021 and 20 March 2022 with the “Nurse Information Form,” “Monitor Alarms Management Monitoring Form,” “Monitor Alarm Management Knowledge Test,” and “Alarm Fatigue Scale.” Monitor alarm management training was given by presentation, case studies and reminder cards. The researcher monitored 322 alarms in the pretest and 199 in the posttest.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;At post- training, nurses' alarm response times (&lt;i&gt;p&lt;/i&gt; = 0.008) and crisis alarms (&lt;i&gt;p&lt;/i&gt; = 0.032) decreased statistically significantly compared to the pre-training. Post-training, nurses' customization of alarm ranges based on patients' clinical condition (&lt;i&gt;p&lt;/i&gt; = 0.001) and performing skin cleaning (&lt;i&gt;p&lt;/i&gt; = 0.001) increased statistically significantly compared to pre-training. The inappropriate behaviour of “silencing and muting the alarm” was never exhibited post-training. “No response to the alarm” behaviour decreased statistically significantly, and the rate of effective alarm management behaviours increased statistically significantly (&lt;i&gt;p&lt;/i&gt; = 0.016). Nurses' monitor alarm management knowledge increased significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), while alarm fatigue scores decreased statistically significantly at posttest (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The alarm management training intervention was significantly increased nurses' knowledge regarding effective alarm management, improved their behaviours and alarm fatigue scores, and patients' monitor alarm outputs. In conclusion, it can be suggested that training activities be focused on to teach intensive care nurses effective alarm man","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Trends and Research Hotspots of Remote Ischemic Preconditioning in Cardiac Surgery: A Bibliometric Analysis","authors":"Linlin Chen,&nbsp;Yuntai Yao,&nbsp;Evidence in Cardiovascular Anesthesia (EICA) Group","doi":"10.1111/jep.70111","DOIUrl":"https://doi.org/10.1111/jep.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Remote ischemic preconditioning (RIPC) is a key area in cardiovascular research, but inconsistent findings have made it hard to fully understand. Bibliometrics, using mathematics and statistics, can track trends and progress in research over time. This study uses bibliometrics to assess RIPC trends and hotspots in cardiac surgery, aiming to better understand future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Studies on RIPC were retrieved from the Web of Science Core Collection, with 104 studies included contributing countries, collaborative countries, institutions, authors, journals, keywords, research topics, citation patterns, and the current state of research. in this field were visually analyzed by using R platform, VOS viewer, and Microsoft Excel. These publications mainly came from 29 countries and 65 institutions. All experiments were clinical studies, and the type of surgery involved was cardiac surgery. A significant percentage of publications occurred during the period from 2010 to 2020 (75; 72.11%). Germany made the most significant contribution to this field with 27 (25.96%) papers and had the highest total citation count (2314). <i>J Thorac Cardiovasc Surg</i> published the most studies (<i>n</i> = 6), followed by <i>Basic Res Cardiol</i> (<i>n</i> = 5). We identified 89 authors, among which Patrick Meybohm, Juergen Peters, and Matthias Thielmann had the most studies (<i>n</i> = 10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RIPC has significant research value and potential in cardiac surgery, mainly focusing on organ protection during adult heart surgeries, especially myocardial protection. Although Germany and China are leading, more international cooperation is needed. Large-scale, standardized randomized controlled trials on RIPC are essential to provide higher-level evidence-based medical research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Aging and Ageism Among Nursing Students at a Public Institution","authors":"Juliana Bernardo Machado,&nbsp;Márcia Matos Souza,&nbsp;Alice Regina Felipe Silva Djinan,&nbsp;Jack Roberto Silva Fhon","doi":"10.1111/jep.70119","DOIUrl":"https://doi.org/10.1111/jep.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To analyze nursing students' perceptions of the aging process and ageism at a public institution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A descriptive qualitative study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 29 nursing students were recruited from March to June 2024. The interviews were recorded and lasted an average of 40 min, being analyzed using a text database consisting of a full transcript of the interviews. The text corpus was analyzed using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires 0.6 alpha 3 software, Brazilian version, which produced a dendrogram.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The dendrogram showed six classes, based on the participants' statements: Class 4—Aging: a natural and complex process; Class 3—Resignification and wisdom in old age; Class 5—Positive and negative perspectives on aging; Class 2—Prejudice towards the social role of women in caregiving; Class 1—Infantilization of elderly people; and Class 6—Ageism in daily life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Encourage undergraduate students, during their training, to get closer to elderly people—either by increasing the number of classes covering current topics in the field of gerontology, seminars, or home visitations—consequently reducing the ageist aspects during their training as nurses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Promotion of Preventive Behaviours in Healthcare Services: A Quantitative Study Among Older Adults in Spain","authors":"Rosaura Puga García,&nbsp;Ana Suárez Vázquez,&nbsp;Ana Belén del Río Lanza","doi":"10.1111/jep.70108","DOIUrl":"https://doi.org/10.1111/jep.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Preventive health is an emerging area of growing interest that not only influences the well-being and health of the population but also has effects on the economy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This work analyzes the ‘buttons’ that can be pushed to influence preventive health behaviours. The aim is to study how the perception of severity and risk of a disease influence preventive behaviours. In addition, the possible limitations associated with this type of action, in the form of rejection of imposed preventive health behaviours, are assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data come from a quantitative cross-sectional study in which information was gathered from a sample of adults over the age of 65 with a chronic disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>When actions that restrict the freedom of older adults are imposed, their adoption of preventive health behaviours is not impaired by the lack of freedom per se, nor by the anger elicited by this situation. However, the negative thoughts provoked by the lack of freedom decrease preventive behaviour compliance. In addition, preventive health behaviours can be incentivized by convincing older adults of the negative consequences of the health threat which is to be avoided. On the contrary, the susceptibility, or possibility of experiencing the health threat, does not influence their motivation to engage in preventive health behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>According to the results, information on preventive health behaviours should be aimed at improving the perception of autonomy, reducing negative cognitions, and communication campaigns should prioritize risks associated with the severity of the threat over those associated with vulnerability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of an Outreach Educational Workshop for Pediatricians to Manage Newborns With Birth-Related Neurological Illness","authors":"Jocelyne Bukeyeneza,&nbsp;Medha Goyal,&nbsp;Elif Bilgic,&nbsp;Katelyn MacKenzie,&nbsp;Mohammad Omar Aziz,&nbsp;Kamal El Tobgy,&nbsp;Ipsita Goswami","doi":"10.1111/jep.70112","DOIUrl":"https://doi.org/10.1111/jep.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neonatal encephalopathy (NE), particularly due to hypoxia/ischemia at birth, is a perinatal emergency. Timely diagnosis and initiation of therapeutic hypothermia within a 6-h window from birth are challenging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We aimed to explore the challenges community physicians face in the management of NE in our region and to test the feasibility of co-designing and implementing an educational program that addresses their needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This mixed-method study started with a 1 h semi-structured interview with community pediatricians through an audio-recorded virtual platform. Subsequently, an outreach training workshop was designed and pilot-tested at each participating center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Analysis</h3>\u0000 \u0000 <p>Qualitative analysis included the following steps: data familiarization, code and theme generation, and report writing. Descriptive statistics were used to summarize the impact of the curriculum on participants’ knowledge and experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Key themes included lack of experience with detailed neurological examination due to infrequent exposure, lack of standardization in management guidelines, and limited access to brain monitoring devices. Diagnosing NE was challenging due to the natural variability in presentation, progression and time-sensitiveness of interventions. Focused skill development workshops were found to be feasible and significantly improved participants’ knowledge of NE. Almost 75% of the participants perceived that the workshop enhanced their comfort levels with the neonatal neurological assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Outreach training education adapted to the local context is feasible and essential for the skill maintenance of community pediatricians who infrequently encounter NE. Future studies will have to study the impact of such workshops on physician behavior and patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}