Journal of evaluation in clinical practice最新文献

{"title":"‘Am I not Talking to any Medical Doctors Today?’—Evaluation of Effective and Ineffective Interactional Practices in Spinal Pain Clinic Consultations","authors":"Christina Emborg,&nbsp;Camilla Blach Rossen,&nbsp;Lise Hestbæk","doi":"10.1111/jep.70134","DOIUrl":"https://doi.org/10.1111/jep.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evaluating communication in clinical settings is essential for enhancing patient satisfaction and improving treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examined the quality of consultations and communication practices used at a hospital-based Danish Medical Spine Clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data included audio-taped consultations with patients suffering from low back pain and subsequent patient interviews. The methodological approach to analysing consultation recordings was Conversation Analysis, while interviews were openly coded and analysed thematically. By comparing the services delivered by the healthcare professionals and the patients' reflections, effective and less effective practices were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analyses showed that (1) diagnostic and prognostic information provided, partly based on MR imaging, was generally perceived as satisfactory by patients, and (2) treatment plans were meaningful to patients and developed through a collaborative process. Moreover, (3) healthcare professionals' communication was clear and displayed an orientation towards achieving mutual understanding with patients. Finally, (4) an initial outline of the consultation facilitated alignment of expectations. However, the analyses also demonstrated discrepancies between patient expectations and the actual consultation experience concerning (1) the occupational background of the clinician, (2) the purpose of the consultation, and (3) the kind of help offered by the clinic. These mismatches contributed to lower patient satisfaction and prompted negotiations around epistemic authority and legitimation of professional identity during consultations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Improved alignment of patients' expectations could facilitate more effective consultations. Furthermore, despite the patients' satisfaction, the routine practice of explaining MR findings should be reconsidered based on recent evidence from prognostic research, which questions their relevance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615156","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":"Developing Standards for Rapid Evaluation and Appraisal Methods (STREAM): An e-Delphi Consensus Study","authors":"Sigrún Eyrúnardóttir Clark,&nbsp;Norha Vera San Juan,&nbsp;Cecilia Vindrola-Padros","doi":"10.1111/jep.70207","DOIUrl":"https://doi.org/10.1111/jep.70207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Timeliness is key to influencing the utility of evaluation and research findings and has given rise to a range of rapid evaluation and appraisal approaches. However, issues in the design, implementation and transparency in their reporting has led to concerns around their rigour and validity. To address this, we have developed the Standards for Rapid Evaluation and Appraisal Methods (STREAM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We followed a four-stage consensus process, starting with a (1) steering group consultation; (2) three-stage e-Delphi study; (3) stakeholder consensus workshop; and (4) piloting exercise. The stakeholders invited to participate in the consensus process had experience in conducting, being part of, or commissioning rapid evaluations or appraisals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-eight standards were developed with the purpose of guiding the design and implementation of rapid evaluations and appraisals and supporting the reporting of methods used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Rapid evaluations and appraisals can be useful in time and resource limited contexts and in the response to new or changing services, but close attention needs to be paid to their rigour and other factors that might influence the production of knowledge and validity of the findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614989","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":"Screening for Atrial Fibrillation: A Perspective From Critical Appraisal of the Guidelines","authors":"Peng Wang,&nbsp;Jing Zhang,&nbsp;Tong Liu,&nbsp;Yangsheng He,&nbsp;Menghui Liu,&nbsp;Xinxue Liao,&nbsp;Xiaodong Zhuang,&nbsp;Li Feng","doi":"10.1111/jep.70157","DOIUrl":"https://doi.org/10.1111/jep.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Current guidelines involving screening for atrial fibrillation (AF) have some discrepancies in the recommendations for AF screening, which might confuse clinicians. Therefore, it is necessary to appraise the quality of the guidelines and summarize the consensus and discrepancies regarding AF screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted for guidelines containing recommendations for AF screening between 2012 and 2024. Two reviewers appraised the quality of the included guidelines with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven guidelines met the inclusion criteria, with AGREE II scores ranging from 42% to 80%, of which 4 guidelines were defined as ‘strongly recommended’ guidelines. Most current guidelines reach consensus that AF screening should be performed in individuals aged ≥ 65 years and patients with stroke or cardiac implantable electronic devices (CIED). However, there was no consensus on whether to perform systematic ECG screening in patients ≥ 75 years of age and the optimal method of prolonged ECG monitoring in patients with stroke. Moreover, the recommendation regarding AF screening in other subgroups was limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The guidelines from European and American regions had higher AGREE II scores. Most of the current guidelines reached consensus that the elderly population (≥ 65 years) and patients with stroke or CIED need AF screening, but there was no consensus on the methods or intensity of screening for specific subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615424","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":"Google Scholar as a Resource for Systematic Reviews in Clinical Medicine","authors":"Matthew E. Falagas,&nbsp;Paraskevi Maria Paliogianni,&nbsp;Dimitrios S. Kontogiannis,&nbsp;Dimitrios Ragias,&nbsp;Elizabeth Johnson","doi":"10.1111/jep.70206","DOIUrl":"https://doi.org/10.1111/jep.70206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Authors of systematic reviews must select, among several options, the databases for searching articles for inclusion in their analyses. Google Scholar is readily available, easy to use, and widely accepted for everyday information searches, including scientific research. However, there is no consensus for its use as a resource in systematic reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study assessed the proportion of systematic reviews that used Google Scholar as a resource, the search strategies used, and the number of potentially missed articles if the search in Google Scholar was omitted and focused on PubMed, Cochrane Library, and Scopus. We also analyzed data from the most recent systematic reviews in clinical medicine indexed in PubMed that listed Google Scholar as one of the resources used for literature searches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The term ‘Google Scholar’ was included in the title and/or abstract of 6.1% of systematic reviews archived by PubMed, compared to 37.5%, 36.1%, 31.8%, 18.5%, and 14.1% for the terms ‘PubMed’, ‘Embase’, ‘Cochrane’, ‘Web of Science’, and ‘Scopus’, respectively. Almost all (1029/1030) articles in the results section of the evaluated systematic reviews could be found in Google Scholar searches. If Google Scholar was omitted as a resource, the missed articles were 5% (53/1029). Twenty-one of 50 (42%) of the evaluated systematic reviews did not mention the number of articles identified from Google Scholar searches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Google Scholar, as the most inclusive resource, should be used along with other established resources for systematic reviews. Advances in artificial intelligence may facilitate its use for this scientific purpose.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615425","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 Testing of Powerlessness Assessment Scale for Patients","authors":"Betul Bal,&nbsp;Havva Ozturk","doi":"10.1111/jep.70194","DOIUrl":"https://doi.org/10.1111/jep.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Powerlessness is a negative perception that can affect all people throughout their lives. Individuals are particularly vulnerable in times of illness and are prone to experience powerlessness. It is therefore important to learn about powerlessness, recognize the symptoms and take action.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aimed to develop a measurement tool that can evaluate the powerlessness of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this methodological study, face and content validity, construct validity and reliability analyses were examined to develop the scale and determine its psychometric properties. The scale's psychometric properties were tested with 1044 nurses and patients in different sample groups. Data were collected between 22 November 2022 and 2 December 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The content validity index of the scale is 0.75. According to principal components analysis, the scale consisted of 24 items and four sub-dimensions. The total variance of the scale was 64.62%, and the factor loading values were in the range of 0.649−0.882. In confirmatory factor analysis, fit indices were acceptable or good. According to the reliability analysis, the scale's reliability is high. Test−retest showed that the scale made stable measurements over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, the patient powerlessness assessment scale is a valid and reliable measurement tool for patients and nurses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615420","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":"Evaluation and Strategy Provision to Promote the Indicators of Integrated Geriatric Care Program in an Iranian Community: Protocol for a Participatory Action Research","authors":"Neda Sadat Nazaripanah,&nbsp;Haidar Nadrian,&nbsp;Mina Hashemiparast,&nbsp;Neda Gilani,&nbsp;Hassan Rezaeipandari","doi":"10.1111/jep.70199","DOIUrl":"https://doi.org/10.1111/jep.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The presence of an effective primary healthcare system can serve as a pivotal factor in promoting and fostering a state of well-being conducive to healthy aging in older adults. The objective of this investigation was to evaluate and strategy provisions to promote the indicators of the Integrated Geriatric Care Program (IGCP) for community-dwelling older adults in Yazd, Iran.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The current study is a quantitative-qualitative study with a Participatory Action Research (PAR) approach. One of the healthcare centers that has recently obtained the weakest health indicators of the IGCP will be selected as the center for the PAR. The present study aims to enhance the health indicators of IGCP in the designated healthcare center. The principles of this PAR study are based on a cyclical approach including problem identification, planning, implementation, feedback, and evaluation. The study participants comprise the healthcare providers and the older adults covered by this healthcare center. The data will be collected in two phases quantitative and qualitative. The quantitative data will be obtained through Electronic Health Records (EHRs) and a researcher-made questionnaire. The qualitative data will be collected via semi-structured interviews using conventional content analysis design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PAR studies can be used to empower and create innovative recommendations for the health promotion of older persons. Through the PAR methodology, this investigation seeks to evaluate and promote the health indicators of IGCP in a healthcare center of a developing country. The findings will offer valuable insights for healthcare settings serving older adults, enabling them to conduct similar assessments aligned with their organizational goals to improve the quality of care for older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614988","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":"Improving Clarity and Interpretability of Items in a Bilingual Index of Propensity to Integrate Research Evidence Into Clinical Decision-Making in Rehabilitation","authors":"Jacqueline Roberge-Dao,&nbsp;Nancy Mayo,&nbsp;Annie Rochette,&nbsp;Keiko Shikako,&nbsp;Aliki Thomas","doi":"10.1111/jep.70196","DOIUrl":"https://doi.org/10.1111/jep.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Clear, interpretable measures that account for linguistic differences are critical to accurately assess rehabilitation clinicians' propensity to integrate research evidence into clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>To contribute evidence for the clarity and interpretability of a new five-item bilingual multidimensional index of a rehabilitation clinician's propensity to integrate research evidence into clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted in three sequential steps: (1) We conducted a focus group with occupational therapists, physical therapists, and researchers to review the items and response options for clarity, consistency, and interval properties and agree on equivalency in English and French. (2) We conducted cognitive interviews whereby clinicians elaborated on their interpretation of the item, comprehensibility of items, and appropriateness of response options. Accepted modifications were integrated and tested with subsequent participants. (3) We conducted an online survey to validate the English and French equivalency of response options on a 0–100 scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the qualitative revision process (one focus group with seven participants followed by 27 interviews), the index was revised 12 times with substantial modifications to the <i>use of research evidence</i> and <i>attitudes</i> items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study increases the clinical relevance and reduces measurement error of this brief index which can inform on individual or organizational factors influencing a clinician's propensity of integrating research evidence into decision-making and ultimately improve rehabilitation outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582207","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":"Preschool Aggression Across Cultures: A Clinician-Informed Framework for Diagnosis and Early Intervention","authors":"Momina Yahya,&nbsp;Tehreem Arshad","doi":"10.1111/jep.70183","DOIUrl":"https://doi.org/10.1111/jep.70183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>: Preschool aggression is a critical public health issue linked to juvenile delinquency, academic failure, and long-term psychopathology. Despite its widespread impact, clinical definitions and intervention strategies remain inconsistent, in Pakistan, cultural norms such as collectivist family structures, acceptance of hierarchical discipline, and the normalization of harsh parenting significantly shape the understanding and response to aggressive behaviors in young children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study captures clinicians' interpretations of preschool aggression, their critiques of existing Western-based models, and their culturally grounded intervention strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Using Reflexive Thematic Analysis (RTA) within a social constructivist framework, this study analyzed data from 35 senior child psychologists and psychiatrists. Participants were recruited from government hospitals, private clinics, academic institutions, and special education centers in Pakistan. Semi-structured interviews (60–90 min) were transcribed and analyzed using NVivo software, following Braun &amp; Clarke's (2019) six-phase framework. Methodological rigor was ensured through member checking, intercoder reliability (<i>κ</i> = 0.82), and cultural validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings indicate that parenting styles, insecure attachment, and sociocultural stressors shape preschool aggression. Experts identified significant diagnostic inconsistencies, emphasizing the need for culturally adaptive intervention models beyond Western-centric approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Practical recommendations include clinician training modules rooted in cultural responsiveness, parent-centered therapeutic programs, and policy reforms that address the normalization of corporal punishment. While the study offers a meaningful contribution to culturally informed mental health care, limitations include reliance on expert opinion, the qualitative nature of the data, and potential biases in interpretation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581900","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":"Community Based Healthcare Services Satisfaction Scale Among Older Adults Development and Psychometric Evaluation","authors":"Ji-Peng Yang,&nbsp;Xu-Miao Li,&nbsp;Zhuo-Lin Liang,&nbsp;Rong-Sai Wei,&nbsp;Jing-Ying Liu","doi":"10.1111/jep.70201","DOIUrl":"https://doi.org/10.1111/jep.70201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Community home-based elderly healthcare services play a crucial role in combating the aging trend. However, China's community home-based elderly healthcare is still in its infancy, and the quality of these services must be enhanced. The satisfaction of older adults as a significant indicator of older adults healthcare services quality is crucial for promoting the enhancement of service quality. Currently, an appropriate instrument to assess community home-based elderly healthcare services satisfaction is limited. The present study aimed to develop and examine the community home-based elderly healthcare services satisfaction scale (CHEHSSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Developing and assessing the scale was carried out in two phases: Phase I involved a literature review and Delphi to explore the themes of satisfaction for community home-based elderly healthcare services and instrument development; Phase II established construct validity of the scale using a sample of 439 elderly in Tianjin. Data from the questionnaire were analysed using Item analysis, exploratory factor analysis, confirmatory factor analysis, and internal consistency. Analysis results were used to determine the reliability and validity of the developed scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The scale was developed and validated in two phases. Phase I involved a literature review and Delphi expert consultation (<i>n</i> = 15) to identify satisfaction domains and generate items. Phase II evaluated psychometric properties using a cross-sectional sample of 439 older adults in Tianjin, China. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability tests (Cronbach's <i>α</i>, split-half reliability) were conducted. The results showed seven factors including diagnosis and treatment capacity, professional skills, preventive care, care and respect, transitional care, medical circumstances, and service attitude were generated by exploratory factor analysis, and these factors explained 78.463% of the total variance. Cronbach's <i>α</i> of the community home-based elderly healthcare services satisfaction scale was 0.896.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The establishment of the tool will help to accurately assess the satisfaction of older adults with community home-based healthcare services, which can inform the construction of policies aimed at promoting the quality improvement of community home-based elderly healthcare services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581929","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":"Subtle Differences in Physician Communication and Substantial Impacts on Patient Decision-Making About Low-Value Care: An Experimental Vignette Study","authors":"Ji Sun Park,&nbsp;Ji-Su Lee,&nbsp;Young Kyung Do","doi":"10.1111/jep.70208","DOIUrl":"https://doi.org/10.1111/jep.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rational, Aims and Objectives</h3>\u0000 \u0000 <p>While low-value care may have multiple contributing factors, it ultimately arises within patient-physician interactions, often influenced by communication. This study examines whether and the extent to which physician communication factors influence patients' willingness to undergo low-value care using hypothetical vignettes in South Korea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilised data from a total of 1229 South Korean adults that included hypothetical vignettes on low-value care. Participants were presented with vignettes involving minor head injury and the potential use of computed tomography (CT). We assessed changes in the proportion of individuals willing to undergo low-value CT based on three physician communication factors: explicit recommendation, communication regarding test benefits and risks, and expressions indicative of defensive medicine, such as warning about missed problems and stating no legal responsibility. We also examined participant characteristics associated with their willingness to use low-value CT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Decisions regarding low-value care were significantly influenced by physician communication factors. For instance, while 68.5% of participants were willing to use low-value CT without explicit recommendation, 76.6% were willing when an explicit recommendation was made. Among those initially willing to use low-value CT without an explicit recommendation, 54.6% changed their decision and chose not to undergo the CT when presented with information on the risks and benefits. However, 69% of these individuals reversed their decision and opted for the CT when the vignette included elements indicative of defensive medicine. The willingness to use low-value care was not associated with most participant characteristics, except for supplementary private health insurance and individual preferences for health care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Physician communication plays a pivotal role in patient decision-making regarding low-value care. To reduce low-value care, improving physician communication should be prioritised and considered a crucial leverage point in quality improvement initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582226","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}