Journal of evaluation in clinical practice最新文献

{"title":"Evaluation of Future Nurses' Beliefs and Fears About Pain: A Descriptive and Correlational Study","authors":"Kamile Kırca,&nbsp;Hüsna Özveren,&nbsp;Tuba Karabey","doi":"10.1111/jep.70058","DOIUrl":"https://doi.org/10.1111/jep.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>How nurses manage pain and their decisions to treat it depend on their attitudes, beliefs, and misconceptions about pain. Therefore, the first step to promoting positive behaviour change in nurses is to determine their attitudes, beliefs, fears, knowledge, and behaviour towards pain management. Nurses with negative or false beliefs about pain are likely to provide inadequate pain management and care. Nursing students are the nurses of tomorrow who will play a key role in pain management and treatment. This study aimed to evaluate nursing students' beliefs and fears about pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive and correlational study was carried out on 342 nursing students of a university in Türkiye. Data were collected using an individual information form, the Fear of Pain Questionnaire-III (FPQ-III), and the Pain Beliefs Questionnaire (PBQ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean scores of the participants from FPQ-III, Severe Pain, Minor Pain, Medical Pain subscales were 83.71 ± 19.14, 32.54 ± 7.97, 24.48 ± 6.89 and 26.68 ± 7.92, respectively. The participants' mean scores on the Organic Beliefs and Psychological Beliefs subscales were 3.50 ± 0.72 and 4.60 ± 0.96, respectively. There was a positive correlation between FPQ-III and PBQ scores. The psychological belief subscale explained only 2.1% of the total change in the fear of pain score (<i>R</i>² = 0.021, <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participants had high ‘psychological beliefs’ and ‘severe pain’ scores. It may be recommended to use interactive education methods such as case-based teaching for students to learn effective methods of coping with pain and realise their own beliefs and attitudes. Establishing simulation laboratories where students can experience all pain-related processes is also important in gaining knowledge and skills on pain management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914248","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":"Incorporating Real-World Variability in Clinical IBD Research","authors":"Anje A. te Velde","doi":"10.1111/jep.70117","DOIUrl":"https://doi.org/10.1111/jep.70117","url":null,"abstract":"&lt;p&gt;Every problem is embedded in a greater whole and should not be oversimplified by selectively focusing on only the variables that are easily identified and measured.&lt;/p&gt;&lt;p&gt;This statement highlights the interconnectedness and complexity of problems within larger systems. It suggests that problems cannot be fully understood or addressed by focusing solely on the variables that are most apparent or easiest to identify. To truly grasp a problem, one must consider it within the context of the broader system or environment in which it exists, acknowledging all relevant factors—even those that may be harder to observe or measure.&lt;/p&gt;&lt;p&gt;In other words, simplifying a problem by overlooking less obvious variables can lead to incomplete or inaccurate solutions. This perspective aligns with systems thinking, which emphasizes the importance of considering the entire system, recognizing the interplay between various elements, and understanding how changes to one part can affect the whole.&lt;/p&gt;&lt;p&gt;For my own understanding, I needed to search the internet for further clarity. I came across explanations from several sources that distinguish between ‘doing things right’ and ‘doing the right things’. ‘Doing things right’ refers to following rules, policies, procedures, and norms, while ‘doing the right things’ involves aligning with our values and moral compass in pursuit of something greater. This immediately reminded me of a topic I discussed in a previous paper on current practices in clinical research related to inflammatory bowel diseases (IBD) [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Therefore, I would like to expand on the broad impacts of environmental context on patient care and health outcomes for the conditions analyzed in this paper—diabetes, coronary heart disease, and cancer—by including thoughts on IBD, which I consider a prototype of complex disease. Due to its anatomical localization and our current understanding of immune reactions, this intestinal inflammation can be likened to a fire, manifesting as an enormous, uncontrolled adjuvant reaction. To extinguish this fire, it is essential to address the disease's complexity by simultaneously targeting all modifiable aspects: innate immunity, cytokines, microbiota, adaptive immunity cells, cytokines, and factors related to the (micro)environment [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The latter is particularly important, as IBD can also be considered a Western disease, with lifestyle factors playing a central role in its initiation. One of the main environmental factors associated with the onset and progression of IBD is the patient's diet [&lt;span&gt;3, 4&lt;/span&gt;]. While the exact causative role remains unclear, diet is a key factor in shaping the composition and function of the microbiota, which in turn directly influences immune function [&lt;span&gt;5, 6&lt;/span&gt;]. The Western pro-inflammatory diet, which is high in fat, sugar, salt, and additives such as emulsifiers, while low in fiber (vegetables and fruits), contributes to the development ","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.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914506","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 Relationship Between Parent-Adolescent Relationships and Emotional Abuse","authors":"Melike Yavas Celik,&nbsp;Leyla Kaya","doi":"10.1111/jep.70122","DOIUrl":"https://doi.org/10.1111/jep.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the relationship between parent-adolescent relationships and emotional abuse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The research was conducted with 400 adolescents between 25.11.2023 and 25.03.2024. Adolescents in one school were included in the study by simple random sampling method. Data were collected with AMFRI and EAQ and a questionnaire regarding the demographic structure of adolescents. ANOVA, <i>t</i>-test and correlation analysis were used to analyze the data of the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average score of the adolescents from the Emotional Abuse Questionnaire was 30.43 ± 23.11 and the total average score received from the Adolescent-Mother, Father Relationship Inventory was 126.22 ± 24.57 for their mothers and 133.38 ± 32.36 for their fathers. It was determined that there was a moderate negative relationship between EAQ and its sub-scales and AMFRI (mother) score averages. It was determined that there was a weak negative relationship between EAQ and its sub-scales and AMFRI (father) score averages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Emotional abuse scores of adolescents were found to be high and parental relationships were evaluated as inadequate. Adolescents' experiences of emotional abuse and parental relationships were found to be related to each other.</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":"143914247","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 Impact of Improving Clinical Patient Handover Interventions on Patient Outcomes and Handover Practices: A Complex Nursing Intervention Study","authors":"Serap Gungor,&nbsp;Betul Tosun","doi":"10.1111/jep.70087","DOIUrl":"https://doi.org/10.1111/jep.70087","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In the context of patient handovers, there is a consensus on the importance of utilizing standardized forms, yet comprehensive evidence on the effectiveness of complex nursing interventions in post-use evaluations is lacking, especially regarding their impact on short-term, long-term and patient outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aims to assess the feasibility, implementation and impact of interventions designed to enhance the effectiveness of patient handovers among 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 quasi-experimental, complex nursing intervention development study investigated patient handover practices in general surgery intensive care units, internal medicine and general surgery clinics. The study utilized the Handoff CEX, standard patient handover form to categorize effectiveness, Newcastle Satisfaction with Nursing Care Scale and Trust in Nurses Scale.&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;Analysis of the Handoff CEX total and Newcastle Nursing Care Satisfaction Scale and the Trust in Nurses Scale mean scores, showed a statistically significant increase.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nurses and educators can adopt complex nursing intervention practices for patient handovers in both current practice and future research. Standardizing patient handovers will contribute to increased patient safety and satisfaction.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Implications for the Profession and/or Patient Care&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;From a professional standpoint, this study emphasizes how crucial it is to use standardized interventions during patient handovers since they've the ability to improve patient outcomes, nursing practices and serve as guidelines for future research.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Impact&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;It is widely acknowledged that the establishment of standardization is crucial for attaining improvement in patient handover. The results of this study revealed that non-standardized handovers lead to limited transfer of information. The research findings show the use of intricate nursing interventions during patient turnover can augment the efficacy of permanent handover, so causing better patient outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Reporting Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The guidance for CReDECI 2 was followe","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905245","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":"Development and Psychometric Properties Evaluation of the Patient-Reported Outcome Measure for People With Schizophrenia in Day Rehabilitation Centres","authors":"Yang Fei,&nbsp;Yafang Liu,&nbsp;Yueheng Yin,&nbsp;Jing Wang,&nbsp;Ying Xing,&nbsp;Enfang Shan,&nbsp;Shuzhen Niu,&nbsp;Haining Liu,&nbsp;Xianwen Li","doi":"10.1111/jep.70115","DOIUrl":"https://doi.org/10.1111/jep.70115","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Given the paucity of appropriate patient-reported outcome measure (PROM) to assess the multidimensional rehabilitation status of people with schizophrenia in day rehabilitation centres (DRCs) in China, the present study aimed to develop a PROM specifically designed for people with schizophrenia in DRCs (SDRC-PROM) and evaluate its psychometric properties.&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;The development process of the SDRC-PROM was in accordance with the guideline established by the US Food and Drug Administration and the guideline outlined in the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. Participants with schizophrenia were recruited from six DRCs in Nanjing, China. The conceptual framework and item pool were determined through literature review, semistructured interview with 14 participants, and two rounds of Delphi method with 16 experts. The comprehensibility and feasibility of the measure were assessed through a pilot test with another 12 participants. Psychometric properties of the SDRC-PROM were evaluated in a formal survey containing 127 participants. The discrimination ability of items was estimated through the item analysis with the critical ratio, item-total correlation, corrected item-total correlation, Cronbach's α if item deleted, communality and factor loading. The construct validity was assessed through exploratory factor analysis (EFA). The internal consistency reliability, the test–retest reliability, measurement error and responsiveness were used to evaluate the reliability of the measure.&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;The final SDRC-PROM comprised four domains with 40 items. Delphi consultations showed acceptable degree of concentration and coordination of experts' opinions. There were 10 ineligible items deleted during the item analysis. EFA supported a four-domain construct related to the psychological, physiological, social and therapeutic domain, and four domains explained 70.7% of the total variance. The Cronbach's α coefficient of the overall measure was 0.911, which of the four domains ranged from 0.814 to 0.907. The intraclass correlation coefficient (ICC) of the measure was 0.902, that of four domains varied from 0.853 to 0.913. The SDRC-PROM also indicated acceptable measurement error based on the illustration of standard error of measure (SEM), and smallest detectable change (SDC). Meanwhile, the responsiveness was also confirmed by the less SDC than the minimum important change (MIC).&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 SDRC-PROM is a reliable and vali","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905323","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 Wicked Problem of Context in Clinical Practice and Implementation Research","authors":"David C. Aron","doi":"10.1111/jep.70120","DOIUrl":"https://doi.org/10.1111/jep.70120","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905041","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 Effect of Community Care on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis","authors":"Jing Zhang,&nbsp;Ting Luo,&nbsp;Jiao Wang,&nbsp;Mingmin Zhang,&nbsp;Hong Wang,&nbsp;Wei Wu","doi":"10.1111/jep.70106","DOIUrl":"https://doi.org/10.1111/jep.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Cardiovascular disease (CVD) remains a leading global cause of morbidity and mortality, with hypertension, dyslipidemia, and smoking as key modifiable risk factors. While pharmacological interventions are effective, their accessibility in resource-limited settings highlights the need for scalable nonpharmacological strategies. Community care has emerged as a potential solution, yet evidence on its efficacy in reducing CVD risk factors remains fragmented and inconsistent due to heterogeneity in intervention designs and population characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the effectiveness of community care in reducing CVD risk factors (blood pressure, lipids, smoking) and explore geographical heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifteen RCTs (<i>n</i> = 10,749) from PubMed, Embase, Cochrane Library, and Web of Science (up to January 2025) were included. Participants had ≥ 1 CVD risk factor and received community nursing (health education, follow-up) versus routine care. Random-effects models in Stata 17.0 analysed outcomes (SBP, DBP, HDL, LDL, TG, smoking). Subgroups assessed sample size, region, duration, and quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Community care significantly reduced SBP (WMD = − 3.54 mmHg, 95% CI: − 4.73 to −2.35; <i>p</i> &lt; 0.001), DBP (WMD = − 1.47 mmHg, −1.94 to −0.99; <i>p</i> &lt; 0.001), LDL ( − 5.11 mg/dL; <i>p</i> &lt; 0.001), and TG ( − 4.21 mg/dL; <i>p</i> = 0.024), with lower smoking persistence (RR = 0.949; <i>p</i> = 0.033). No HDL improvement was observed (WMD = 1.26 mg/dL; <i>p</i> = 0.323). Subgroups showed stronger TG reduction in developing countries (P_interaction = 0.010) and greater smoking cessation efficacy in developed nations (P_interaction = 0.085).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Community care effectively lowers blood pressure, LDL, TG, and smoking persistence, supporting its role in primary CVD prevention. Limited HDL impact and regional variations necessitate tailored interventions and further research on HDL functionality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905087","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":"A Qualitative Study to Explore Global Trends in Clinical Pharmacy Practice","authors":"Laura Alexandra Moura Gomes,&nbsp;Adriano Miguel Gomes Costa,&nbsp;Stephane Marc Richard Steurbaut,&nbsp;Helder Dias Mota Filipe,&nbsp;Silvana Nair Leite,&nbsp;Filipa da Palma Carlos Alves da Costa Azevedo e Silva","doi":"10.1111/jep.70104","DOIUrl":"https://doi.org/10.1111/jep.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Pharmacists' clinical responsibilities have been on a progressive rise, adopting a more person-centered approach, and experiencing increased involvement in healthcare teams across all settings. The development and evolution of clinical pharmacy practice in each country depends on the existing facilitators and barriers, which are variable and highly context-related.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>To investigate the perspectives of global experts regarding the advancement of clinical pharmacy practice, with a specific focus on examining the factors contributing to success and their outlook on the future of clinical pharmacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with academia and practice experts from 13 countries. Each expert was asked what they considered to be the future of clinical pharmacy education and practice, as well as what should be improved in the clinical pharmacy learning path to ensure that it keeps pace with the evolution of pharmacists' clinical responsibilities in practice. Success factors for change in clinical pharmacy practice were also explored. Interviews were transcribed verbatim and analyzed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Success factors for advancing clinical pharmacy practice included elements related to the healthcare and political landscape, such as remuneration, leadership, as well as willingness and readiness for change. Other success factors identified are directly related to the pharmacist, such as the use of reflective practice or the pharmacist's motivation.</p>\u0000 \u0000 <p>Perceived future directions include the existence of a multidisciplinary approach in practice, the expansion of clinical pharmacy services, as well as the delivery of clinical pharmacy services at the primary care level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The development of clinical pharmacy practice relies on a wide range of factors. The analysis carried out in this study of the success factors as well as the potential future directions of clinical pharmacy can serve as catalysts for the development of this pharmacy field at the country, regional, and global levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905246","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":"Risk Mitigation Measures Captured by a Tertiary Hospital's Disaster Simulation: An Observational Study","authors":"Faran Shoaib Naru,&nbsp;Janet C. Long,&nbsp;Kate Churruca,&nbsp;Mitchell Sarkies,&nbsp;Jeffrey Braithwaite","doi":"10.1111/jep.70113","DOIUrl":"https://doi.org/10.1111/jep.70113","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To document the challenges experienced and adaptations made during a simulated hospital disaster, and consider the implications of the observations for hospital disaster preparedness.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nonparticipant observational assessment.&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;Nonparticipant observations of an exercise simulating a disaster were undertaken by two researchers. The researchers shadowed triage team members, complementing this with observations of the Hospital-Emergency-Operations-Centre, theaters, wards, and Emergency Department subsections such as Resuscitation, Acute, Minor-Injuries-Clinic, Children's emergency, and Mental health. Field notes were coded line-by-line through an inductive thematic analysis, which synthesized both challenges and observed adaptations to those challenges.&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;The major challenges observed were deaths due to lack of critical care equipment, management of high number of minor injuries, lack of situational awareness, shortage of orderlies, and difficulties in patient tracking and bed allocations. Observed adaptations included pediatricians' treatment of adult patients with minor injuries, fast-tracking triage through ranking, manual ventilation during transfers, and batching of patients requiring imaging to utilize limited orderlies for transfers.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This observational study distills both challenges that clinicians may face in real disasters, and the improvisations that they can make to manage mass casualties.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Implications for Clinical Professions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Research findings hold promising potential in enhancing clinicians' disaster preparedness by articulating specific interventions on mass-casualty management within limited resources.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Impact&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Unforeseen challenges arise when clinicians are confronted with disaster casualties. This study addresses that problem by not only preempting such challenges, but by also discussing practical solutions. The findings can enable a positive impact on clinicians' readiness for mass casualty influx.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 ","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905293","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":"Effectiveness of Functional Resistance Training in Hospital to Prevent Deconditioning and Improve Discharge Pathways: A Service Evaluation","authors":"William Carey,&nbsp;Hannah Warwick,&nbsp;Shaun Burnham,&nbsp;Fionn Wall,&nbsp;Mohammed Raja,&nbsp;Victoria Dickens,&nbsp;Helen Hurst,&nbsp;Lindsey Darley,&nbsp;Emma Elliott,&nbsp;Daniel Rowbotham","doi":"10.1111/jep.70116","DOIUrl":"https://doi.org/10.1111/jep.70116","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Deconditioning is a complex process of physiological change following a period of inactivity. This can be observed in a clinical setting when hospital patients have prolonged periods of bed rest. Prolonged bed rest negatively affects health-related outcomes such as cardiovascular, respiratory and musculoskeletal function, and is linked to increased mortality. To combat deconditioning in patients, a functional resistance exercise intervention may be suitable to employ. Exercise interventions can successfully prevent and reverse muscle loss and functional decline, the main component of deconditioning.&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 service evaluation investigates functional resistance training (FRT) as a preventive measure against inpatient deconditioning, conducted from September 2023 to January 2024 with 146 inpatients admitted to medical or orthopaedic wards. Inclusion criteria were age 65 years or older, ability to follow instructions, no baseline hoisting, and sufficient medical fitness. FRT was delivered by sport and exercise professionals. Outcome measures were strength and function-based and were completed pre- and post-intervention. Statistical analysis was conducted using IBM SPSS Statistics 29 (Windows). Normality was assessed via the Shapiro–Wilk test, with statistical significance set at &lt;i&gt;p&lt;/i&gt; ≤ 0.05. Paired &lt;i&gt;t&lt;/i&gt;-tests compared admission and discharge outcomes to evaluate the intervention's effectiveness. Spearman's &lt;i&gt;ρ&lt;/i&gt; was used to assess correlations between engagement rate and each outcome measure. As this is an evaluation of a current service, with no additional interventions carried out, or additional data collected, ethics approval was not required.&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;Preliminary findings reveal high engagement (average 80%) and significant improvements (&lt;i&gt;p&lt;/i&gt; ≤ 0.001) in muscle strength, grip strength, 30-s sit-to-stand test (30STS), and DeMorton's Mobility Index (DEMMI) post-FRT. Handheld dynamometry indicates a notable 30%–50% increase in muscle strength, while grip strength improved by 11%. However, a 20% reduction occurred in patients with &lt; 50% engagement, suggesting deconditioning without FRT. The 30STS observed a 100% increase in repetitions, indicating improved lower limb strength. DEMMI scores showed a statistically significant enhancement in overall mobility post-intervention. Notably, 26 pathways were downgraded with over 80% engagement, suggesting FRT-engaged patients are more likely to downgrade.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The positive effects on muscle and grip strength, lo","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883989","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}