Journal of evaluation in clinical practice最新文献

{"title":"The Effectiveness of Positive Psychological Intervention Based on PERMA Model in Cancer Patients: A Systematic Review and Meta-Analysis","authors":"Qin Wang,&nbsp;Qiuying Wu,&nbsp;Yanyan Wang,&nbsp;Tao Yang,&nbsp;Qiaoling Chen,&nbsp;Kaidi Yang","doi":"10.1111/jep.70175","DOIUrl":"https://doi.org/10.1111/jep.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Happiness is a fundamental goal for all individuals. However, cancer patients often find themselves at risk of happiness deprivation owing to the psychological and physical challenges posed by their condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This systematic review aimed to evaluate the effectiveness of positive psychological interventions based on the PERMA model in enhancing happiness/well-being in cancer patients. A secondary objective was to assess their effects on anxiety, depression, fatigue, and fear of cancer recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were performed according to PRISMA guidelines. PubMed, EMBASE, CINAHL, Cochrane Library, PsycINFO, Scopus, and Web of Science databases were searched for experimental studies on PERMA-based positive psychological interventions for cancer patients (from inception to 15 May 2024). Two researchers independently performed data screening, extraction, and risk of bias assessments using Cochrane's Risk of Bias Tool (RoB 2). Meta-analysis techniques were applied, and evidence certainty was evaluated using the GRADE system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen studies involving 1200 cancer patients met the inclusion criteria, with thirteen included in the meta-analysis. PERMA model-based positive psychological interventions significantly improved happiness/well-being (standardized mean difference [SMD]: 1.19; 95% confidence interval [CI]: 0.68–1.70) and were associated with reductions in anxiety (MD: −2.98; 95% CI: −3.29 to −2.67), depression (MD: −2.08; 95% CI: −2.20 to −1.96), fatigue (MD: −2.14; 95% CI: −2.20 to −2.08) and fear of cancer recurrence (MD: −5.10; 95% CI: −6.27 to −3.94). The certainty of evidence for all outcomes was rated as low or very low.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This meta-analysis provides preliminary evidence that PERMA-based positive psychological interventions have the potential to enhance happiness/well-being in cancer patients while alleviating psychological distress. However, substantial heterogeneity and methodological limitations preclude definitive recommendations, highlighting the need for further high-quality research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514634","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":"Prediction Performance of Earlier Studies for Later Studies in Cochrane Reviews","authors":"Fahad M. Al Amer,&nbsp;Lifeng Lin","doi":"10.1111/jep.70172","DOIUrl":"https://doi.org/10.1111/jep.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Between-study heterogeneity poses challenges to the generalisability of meta-analytical results, which can influence their ability to predict outcomes in future studies. Prediction intervals have been proposed to account for both uncertainty and heterogeneity, yet their real-world performance in predicting future studies has not been systematically evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aims to assess the prediction performance of meta-analyses, focusing on how effectively they predict later study results based on meta-analyses of earlier studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This empirical study used a comprehensive collection of meta-analyses from the Cochrane Database of Systematic Reviews. Through in-sample evaluation, the success of predicting later study results was assessed based on meta-analyses of earlier studies in Cochrane reviews. The impact of factors such as the number of studies in the meta-analysis and uncertainties in heterogeneity estimation was also analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings reveal that prediction failures are common, particularly as the number of studies in the meta-analysis increases. This may be attributed to uncertainties in estimating between-study heterogeneity. Conversely, when the number of studies is small, the proportion of successful predictions is high. However, this is likely due to large uncertainties in predictions and the limited information provided by fewer studies, which may reduce their utility in providing valuable evidence for future studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results underscore the importance of cautious interpretation and further investigation when applying meta-analytical findings to future studies. Our findings suggest several potential strategies for predicting future study results through evidence synthesis, with particular emphasis on carefully considering between-study heterogeneity, the number of studies included in a meta-analysis, and the temporal trends in individual study results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482259","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 Mediating Effect of Distrust of the Health System on the Relationship Between Health Literacy and Anti-Vaccination","authors":"Şehriban Özdemir,&nbsp;Fatih Şantaş","doi":"10.1111/jep.70140","DOIUrl":"https://doi.org/10.1111/jep.70140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to determine whether distrust of the health system has a mediating role in the effect of health literacy on anti-vaccination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The universe of the study consists of people over the age of 18 who apply to the polyclinics of Yozgat Akdağmadeni Şehit Sinan Babacan Public Hospital in Turkey and the number of people reached in this study was 450.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>According to the Process Macro analysis result, the total effect of health literacy on anti-vaccination (c = −0.115, <i>p</i> &lt; 0.01) and its direct effect (c' = −0.073, <i>p</i> &lt; 0.01) were negative and statistically significant. It was determined that health literacy negatively and significantly affected distrust of the health system (a = −0.098, <i>p</i> &lt; 0.01) and distrust of the health system positively and significantly affected anti-vaccination (b = 0.432, <i>p</i> &lt; 0.01). It was determined that distrust of the health system mediated the effect of health literacy on anti-vaccination in a statistically significant way [= −0.042 95% CI (−0.076; −0.012)]. Similar results were found in the structural equation modeling, but higher standardized and unstandardized loads and explained variance were obtained according to the Process Macro analysis result.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>According to the research results, individuals' distrust of the health system and their anti-vaccination can be reduced by increasing their health literacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339466","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":"Shared Decision Making: The Prerequisite for Substantial Autonomy in Evidence-Based Practice","authors":"André Demambre Bacchi","doi":"10.1111/jep.70171","DOIUrl":"https://doi.org/10.1111/jep.70171","url":null,"abstract":"&lt;p&gt;Evidence-Based Practice (EBP) has been widely accepted as the dominant paradigm in contemporary healthcare, traditionally grounded in a triad of principles: the best available scientific evidence, the clinician's expertise, and the patient's values and preferences [&lt;span&gt;1&lt;/span&gt;]. However, a critical gap persists in the implementation of this model: the third pillar, patient values and preferences, often remains a theoretical ideal rather than a tangible component of routine care [&lt;span&gt;2&lt;/span&gt;]. To address this disconnection, EBP requires conceptual refinement. Shared decision making (SDM) must be understood not as a discretionary tool but as the fundamental mechanism through which substantial patient autonomy is operationalized, thereby transforming the third pillar from an aspirational statement into a clinical reality [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Contemporary bioethics positions autonomy as a foundational principle. However, it is crucial to distinguish between &lt;i&gt;formal autonomy&lt;/i&gt; - the abstract legal right to choose—and &lt;i&gt;substantial autonomy&lt;/i&gt;, the actual capacity to make informed, deliberate and value-congruent decisions [&lt;span&gt;4&lt;/span&gt;]. Although traditional informed consent satisfies the conditions of formal autonomy, it often falls short of enabling substantial autonomy. A patient may formally consent to a proposed intervention without genuinely understanding its implications or viable alternatives, ultimately making choices that do not authentically reflect their values [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Table 1 outlines the essential distinctions between formal and substantial autonomy within the EBP framework. Formal autonomy corresponds to the baseline recognition of patient rights, which is typically enacted through standard informed consent procedures. By contrast, substantial autonomy facilitated by SDM embodies the patient's effective ability to make informed, reflective and value-oriented decisions.&lt;/p&gt;&lt;p&gt;Within this framework, SDM emerges as the mechanism that truly operationalizes the third pillar of EBP, translating ‘values and preferences’ from abstract concepts into concrete elements of clinical decision-making. SDM entails a structured process comprising bidirectional communication about the clinical condition, presentation of evidence-based options, elicitation of patient values and preferences, collaborative deliberation and implementation of a consensual decision. This approach markedly transcends the conventional informed consent process, which is often reduced to unidirectional transfer of information followed by formal approval [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Despite the growing recognition of SDM's relevance, its implementation remains hindered by substantial challenges across multiple levels. At the individual level, barriers include limited communication skills among clinicians, reluctance to relinquish traditional medical paternalism and low health literacy among patients. At the organizational level, key obstacles include t","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367459","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":"Injection Errors Are Still Common in Insulin Therapy! Could It be a Solution?","authors":"Güneş Alkaya Feyizoğlu,&nbsp;Gülbeyaz Can","doi":"10.1111/jep.70156","DOIUrl":"https://doi.org/10.1111/jep.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study is to evaluate the impact of educational materials used to reduce insulin administration errors in patients with type 2 diabetes (educational brochure vs. educational video) on patients' knowledge and practical application of insulin injection techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This randomised controlled experimental study was conducted between December 2019 and January 2021 at a Training and Research Hospital in Istanbul. The study was completed with 52 patients who were given educational videos and 42 (<i>n</i> = 94) patients given educational brochures. In the first meeting, patients' insulin administration characteristics were evaluated, they were trained again with a video or brochure and were then handed the corresponding education material of the group. Their insulin administration characteristics were re-evaluated 1 week and 3 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Conclusion</h3>\u0000 \u0000 <p>The number of correct insulin administrations was higher in the group that received video-based education compared to the group that received brochure-based education. However, a significant increase in the number of correct administrations was also observed in the brochure-based education group. It was concluded that both educational methods are effective, practical, and feasible for reinforcing insulin administration training in patients using insulin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trials Act</h3>\u0000 \u0000 <p>Clinical trial registration: NCT05658744 (Approval date of registry; 20 December 2022).</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339601","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":"Prospective Evaluation of Missed Musculoskeletal Injuries in Trauma Prevent Study","authors":"Serena S. Hong,&nbsp;Elise Tcharkhedian,&nbsp;William O'Regan,&nbsp;Joseph Descallar,&nbsp;Scott D'Amours","doi":"10.1111/jep.70182","DOIUrl":"https://doi.org/10.1111/jep.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Physiotherapists are not routinely involved in tertiary survey of trauma patients but are well equipped to perform the musculoskeletal component of the tertiary survey (MSK tertiary survey) to detect any injuries that are missed during primary and secondary surveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To observe and evaluate MSK tertiary surveys completed by physiotherapists in the early identification of missed musculoskeletal injuries in trauma patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included a convenience sample of patients over 18 years old admitted under the Trauma team. Patients were allocated to P group if the physiotherapists conducted MSK tertiary survey before the trauma team. Patients were allocated to T group if the admitting Trauma team conducted a tertiary survey before the physiotherapists. McNemar's test was used to compare the discordance of new findings and missed injuries between the Trauma team's tertiary survey and the physiotherapists’ MSK tertiary survey within each of the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two-hundred twenty-four patients were enrolled into P group and 436 patients were enrolled into T group. In the T group, 26 patients (6%) were identified with new confirmed injuries, of which physiotherapists identified 8 patients (1.9%). In the P group, 8 patients (4%) were identified with confirmed injuries, of which, physiotherapists identified 3 patients (2.4%). The discrepancies of identifying missed injuries between the trauma teams and physiotherapists in T or P group were not significant (<i>p</i> = 0.81, <i>p</i> = 0.25 respectively). No adverse events were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Physiotherapists can conduct MSK tertiary surveys safely in the care of trauma patients as an adjunct to Trauma team-led tertiary survey to identify any missed musculoskeletal injuries in admitted trauma patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367394","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":"Symptom Bias: Definition, Identification and Avoidance","authors":"Austin Due","doi":"10.1111/jep.70176","DOIUrl":"https://doi.org/10.1111/jep.70176","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367461","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":"Determinants of Health-Related Quality of Life Among COPD Patients From a Clinical Practice Setting in Nigeria","authors":"Abiodun G. Tekobo,&nbsp;Tochukwu T. Ayo-Olagunju,&nbsp;Adewale Ogundare,&nbsp;Michelle G. Dania,&nbsp;Taofeek Oloyede,&nbsp;Akintayo T. Olaniyan,&nbsp;Olufemi O. Ojo,&nbsp;Temitope Fapohunda,&nbsp;Ogochukwu A. Ekete,&nbsp;Olufunke O. Adeyeye,&nbsp;Obianuju B. Ozoh","doi":"10.1111/jep.70178","DOIUrl":"https://doi.org/10.1111/jep.70178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous and multisystem disease with potential impact on health-related quality of life (HRQoL). Understanding the burden and determinants of poor HRQoL in COPD may highlight modifiable factors that could minimize disease impact among an already vulnerable population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the HRQoL and its determinants among COPD patients attending a tertiary care hospital in Lagos, Nigeria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study conducted at the Lagos University Teaching Hospital, Lagos, Nigeria. Participants with stable COPD were recruited and sociodemographic and clinical characteristics, current medications, and comorbidities were obtained. The HRQoL was assessed using the St. Georges Respiratory Questionnaire COPD version (SGRQ-C), functional status was assessed by the 6-min walk test (6MWT) and mortality risk assessed using the BODE index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-three participants were recruited and 47 (56.6%) were male. COPD assessment test (CAT) score was ≥ 10 in 81 (97.6%) participants and 47 (56.6%) had Modified Medical Research Council Dyspnea (mMRC) grading ≥ 2. The median 6-min walk distance (6MWD) was 256.0 meters (IQR = 93.0) and median BODE index was 4.0 (IQR = 3.0). Most of the participants (72) had 6MWD of &lt; 350 meters, 22 had a BODE index score of &gt; 5 and only 1 participant scored &gt; 7. The median total SGRQ score was 47.7 (39.6–52.8) and the symptoms domain had the worst score of 76.7 (65.9–88.3). Factors that independently worsened HRQoL are higher CAT and MRC scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HRQoL is substantially impaired in COPD in our practice setting. High symptoms burden and worsening dyspnea worsened HRQoL. Interventions that reduce the burden of dyspnea and other symptoms such as pulmonary rehabilitation is a potential high value intervention in our setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367460","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":"Sleep Quality, Depression, and Frailty in Atrial Fibrillation Patients: The Mediating and Interaction Effects","authors":"Hairong Lin,&nbsp;Xue Yang,&nbsp;Guirong Li,&nbsp;Dingce Sun","doi":"10.1111/jep.70133","DOIUrl":"https://doi.org/10.1111/jep.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Frailty, sleep disorders, and depression are common issues among patients with atrial fibrillation (AF) although the underlying mechanisms are not yet clear. This study aims to explore the mediating role of depression between sleep and frailty and the interactive effects of sleep and depression on frailty in patients with AF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study that enrolled 380 AF patients in Tianjin, China. The Mental Health Inventory-5, the Pittsburgh Sleep Quality Index, and the FRAIL scale were used to detect depression, sleep quality, and frailty. The Mediator and interaction effects were tested among them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sleep quality had a positive effect on depression (a = 0.135, <i>p</i> &lt; 0.001). Sleep quality had a positive effect on frailty (b = 0.089, <i>p</i> &lt; 0.001). Depression partially mediates the relationship between sleep quality and frailty with the mediating effect was 14.8%. Further, sleep disorders and depression have an additive interactive effect to synergistically increase the risk of frailty (OR = 8.94, 95% CI: 4.36–18.3, <i>p</i> &lt; 0.001) which is strongly indicated by the RERI = 5 (95% CI: 0.14–13.25), A<i>p</i> = 0.51 (95% CI: 0.07–1.63), and S = 3.13 (95% CI: 1.26–19.84).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Depression partially mediates between sleep and frailty in AF patients. AF patients exposed to both sleep disorders and depression have a superposed risk of frailty. In clinical practice, A variety of interventions should be considered to improve sleep quality and depression to reduce the risk of frailty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339602","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":"Qualitative Outcomes of Bariatric Surgery Patients: Reasons for Choosing Bariatric Surgery and the Impact of Bariatric Surgery on Patients' Lives","authors":"Pinar Yilmaz Eker,&nbsp;Ezgi Yildiz","doi":"10.1111/jep.70154","DOIUrl":"https://doi.org/10.1111/jep.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This qualitative study aimed to examine the reasons why morbidly obese people prefer bariatric surgery and the effect of bariatric surgery on the lives of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Interviews with the participants who underwent bariatric surgery were completed through a semi-structured interview form. The expressions of the participants were analyzed thematically using the MaxQDA20 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The participants were 52.9% were female. The study reached three main themes: ‘First Experiences After Surgery’, ‘Reasons for Choosing Bariatric Surgery’, and ‘The Effects of Bariatric Surgery on Patients' Lives’. It was found that the primary reason for participants to prefer bariatric surgery was ‘aesthetic appearance/to be liked’. It was determined that the most used code among the positive effects after surgery was ‘happiness’. The most used codes for negative effects were ‘hair loss’ and ‘weight regain’. The most repeated code in the first experiences after surgery was ‘nausea and vomiting’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The participants that revealed results are a significant guide for all morbidly obese people. However, it is recommended to conduct further qualitative and quantitative research on the preference for bariatric surgery and attitudes toward surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339600","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}