Journal of evaluation in clinical practice最新文献

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Investigation of the Factors Affecting the Quality of Life of Family Members Caring for Hospitalized Adults With Cancer: A Cross-Sectional Study 影响住院成人癌症患者家属生活质量的因素调查:横断面研究
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-21 DOI: 10.1111/jep.70184
Arzu Demircioğlu-Karagöz, Zeynep Güven, Vesile Yıldız-Kabak, Osman Dağ, Tülin Düger, Songül Atasavun-Uysal
{"title":"Investigation of the Factors Affecting the Quality of Life of Family Members Caring for Hospitalized Adults With Cancer: A Cross-Sectional Study","authors":"Arzu Demircioğlu-Karagöz,&nbsp;Zeynep Güven,&nbsp;Vesile Yıldız-Kabak,&nbsp;Osman Dağ,&nbsp;Tülin Düger,&nbsp;Songül Atasavun-Uysal","doi":"10.1111/jep.70184","DOIUrl":"https://doi.org/10.1111/jep.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>The caregiving burden is defined as problems experienced by caregivers related with the care of patient and may have some impacts on caregiver's quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study was aimed to determine caregiving burden and quality of life in caregivers of adults with cancer, and to investigate associations with sociodemographic characteristics of patient and caregiver, and clinical information and functional level of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, a total of 322 participants were included, comprising 161 hospitalized adult cancer patients and 161 caregivers. Patients’ comorbidities were assessed with the Modified Charlson Comorbidity Index, functional impairments were evaluated with Karnofsky Performance Scale, participation of daily life activities were assessed with the Barthel Index, and functional mobility were assessed with Rivermead Mobility Index. In addition, Pittsburgh Sleep Questionnaire was used to assess sleep experience in caregiver. Zarit Caregiver Burden Scale was used to evaluate caregiver burden, and City of Hope-Quality of Life-Family Version was used to assess quality of life of the caregiver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Caregivers reported moderate level care burden. Caregiver's quality of life was negatively associated with cancer duration (<i>p</i> = 0.048) and caregiver burden (<i>p</i> &lt; 0.001). In addition, it was positively associated with male gender (<i>p</i> = 0.001), sleep quality (<i>p</i> &lt; 0.001) and functional mobility (<i>p</i> &lt; 0.001) of the patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that male gender, increased sleep quality and functional mobility of the patient affect the caregiver's quality of life positively, while prolonged cancer duration and higher level of care burden affect negatively. Considering these factors may be important to reduce the burden and increase the quality of life of caregiver family members.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881525","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}
引用次数: 0
Nonpharmacological Methods and Pain Measurement Tools Used by Nurses Working in Surgical Clinics for Postoperative Pain Management 外科诊所护士术后疼痛管理的非药物方法和疼痛测量工具
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-21 DOI: 10.1111/jep.70236
Dilek Çeçen Çamlı
{"title":"Nonpharmacological Methods and Pain Measurement Tools Used by Nurses Working in Surgical Clinics for Postoperative Pain Management","authors":"Dilek Çeçen Çamlı","doi":"10.1111/jep.70236","DOIUrl":"https://doi.org/10.1111/jep.70236","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study was conducted to determine the nonpharmacological methods and pain measurement tools used by nurses working in surgical clinics for postoperative pain management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this cross-sectional and descriptive study, <i>n</i> = 107 nurses working in the surgical clinics of a university hospital in western Turkey between March and June 2024 were included.</p>\u0000 \u0000 <p>A ‘Questionnaire for Postoperative Pain Management’ consisting of 26 questions which was created by the researcher in line with the information in the relevant literature was used to determine the practices of nurses working in surgical clinics regarding pain management and the scales they use. Frequency, percentage, mean, and standard deviation values, Chi-Squared tests, <i>t</i>-tests, and ANOVA were used to analyze the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>It was determined that 49.1% of the participants were in the 18–29 age group, the mean age of all participants was 30.72 ± 6.79 years, and 67.3% of the participants had bachelor's or master's degrees. The participants had a mean professional experience of 9.75 ± 7.32 years, 56.1% of them did not educate their patients about pain relief methods in the preoperative period, 81.3% used scales during pain assessment, the most commonly used scale (61.9%) was the ‘Numerical Rating Scale,’ 63.6% used nonpharmacological pain relief or reduction methods, and the participants who received training on pain applied nonpharmacological methods more frequently than those who did not receive training. It was found that the participants who provided education to preoperative patients used scales more frequently during pain assessment than those who did not provide education to preoperative patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this study showed that nurses who had more professional experience and those who received training on pain during their professional education and after their graduation had more knowledge and favorable practices regarding pain and the management of pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881527","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}
引用次数: 0
Process & Outcome Evaluation of a Rural Health Network to Assess Effectiveness 农村卫生网络有效性评估的过程与结果评价
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70249
Sarah Mollman, Kelly Boyd, Charlene Berke, Mari Perrenoud, Vonda Reed, Carol Stewart
{"title":"Process & Outcome Evaluation of a Rural Health Network to Assess Effectiveness","authors":"Sarah Mollman,&nbsp;Kelly Boyd,&nbsp;Charlene Berke,&nbsp;Mari Perrenoud,&nbsp;Vonda Reed,&nbsp;Carol Stewart","doi":"10.1111/jep.70249","DOIUrl":"https://doi.org/10.1111/jep.70249","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rural residents face many health disparities and challenges. Rural health networks form to address the specific needs of a community by bringing together multiple individuals and organisations; however, there is limited literature on the evaluation of these networks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate a network's effectiveness in three areas: (1) capacity to achieve change in palliative care education, (2) key results of collaborative efforts, and (3) extent to which grant activities were implemented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Grant required evaluation measures were used to answer area one and three: key sector representation, network organisational assessment, external environmental scan, and SWOT analysis. To answer area two, knowledge and commitment to change were evaluated after a palliative care symposium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The network was proficient or excelling in all 15 areas of a Network Organisational Assessment and represented all 38 key sectors representing the focus of network (palliative care). Through repeated external environment scans and analysis of the strategic plan, the network continually evaluated the landscape in which it operated enabling the network to adapt and capitalise on opportunities. The outcome evaluation of the network's symposium revealed that most participants reported improvement in their ability to impact patient outcomes (59%), overall confidence and performance (65%), and knowledge of palliative care (78%). Nearly all participants reported better communication and collaboration with a multidisciplinary team (96% and 97% respectively) and intent to apply what they learned in their team (97%). Practice changes included commitment to improving their patient education, communication, and teamwork.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The network's evaluation demonstrated its effectiveness in three areas. This article adds to the limited literature on network evaluation by presenting practical tools to grow, engage, and evaluate a network so other rural health networks can replicate these evaluations to assess their effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869998","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}
引用次数: 0
Converting Evidence-Based Summary of Findings Evidence Tables Into Decision Analytical, Quality Adjusted Life Years (QALY) and Life Expectancies Metrics: A Tutorial 将基于证据的结论总结证据表转化为决策分析、质量调整生命年(QALY)和预期寿命指标:教程
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70254
Iztok Hozo, Gordon Guyatt, Benjamin Djulbegovic
{"title":"Converting Evidence-Based Summary of Findings Evidence Tables Into Decision Analytical, Quality Adjusted Life Years (QALY) and Life Expectancies Metrics: A Tutorial","authors":"Iztok Hozo,&nbsp;Gordon Guyatt,&nbsp;Benjamin Djulbegovic","doi":"10.1111/jep.70254","DOIUrl":"https://doi.org/10.1111/jep.70254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale, Aims, and Objectives</h3>\u0000 \u0000 <p>We have recently succeeded in integrating evidence estimation with decision-analytical frameworks, thereby addressing a major challenge in advancing the science of evidence-based medicine (EBM) and clinical practice guidelines. However, the primary output of our analysis was expressed as net differences in expected utility (ΔEU) between competing treatment interventions. Although expected utility is a standard decision-analytic metric, it is not intuitively understood by most clinicians. Here, we demonstrate how ΔEU can be converted into gains in quality-adjusted life years (QALYs) and life expectancy (LE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We begin with GRADE (Grading of Recommendations Assessment, Development, and Evaluation) Summary of Findings (SoF) tables—the primary outputs of systematic reviews that underpin guideline recommendations—to generate ΔEU, which we subsequently convert into QALY and LE gains using the DEALE (Declining Exponential Approximation of Life Expectancy) method. We also integrate patients’ values and preferences by relating minimal important differences (MIDs)—the smallest change in an outcome that patients perceive as important enough to justify a change in management—to relative values, which reflect the preference (or weight) assigned to avoiding a specific health outcome compared to the worst outcome (mortality).</p>\u0000 \u0000 <p>To convert a deterministic ΔEU model into a probabilistic one, we employ Monte Carlo simulation to assess the credibility of recommendations under the evidentiary uncertainty included in the SoF tables. We also provide a method to assess the impact of the certainty of evidence (CoE) on the robustness of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We developed a user-friendly, Excel-based calculator for converting evidence-based SoF tables into ΔEU, and subsequently into QALY and LE gains. We illustrate our methods by comparing the effects of short-term versus indefinite anticoagulation for the prevention of recurrent venous thromboembolism. The complete analysis can be performed in approximately 5–10 min.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We extend our methods to link estimation metrics commonly used in the EBM field with decision-analytic metrics such as expected utility, QALY, and LE. We present a user-friendly calculator that integrates all key domains underpinning contemporary guideline development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869999","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}
引用次数: 0
Improving Clinical Reasoning Skills With Machine Learning K-Means Algorithm 用机器学习K-Means算法提高临床推理能力
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70250
Nadia Hachoumi, Mohamed Eddabbah, Ahmed Rhassane El Adib
{"title":"Improving Clinical Reasoning Skills With Machine Learning K-Means Algorithm","authors":"Nadia Hachoumi,&nbsp;Mohamed Eddabbah,&nbsp;Ahmed Rhassane El Adib","doi":"10.1111/jep.70250","DOIUrl":"https://doi.org/10.1111/jep.70250","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The enhancement of clinical reasoning is crucial in health sciences education for producing skilled practitioners. This study explores whether machine learning, particularly the K-means clustering algorithm, can detect technical and conceptual errors occurring while students are engaged in problem-solving. The study's main questions ask to what extent machine learning provides opportunities for a personalized approach towards educational interventions aimed at certain types of reasoning deficits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A new method was proposed to classify students on clinical reasoning skills by integrating K-means clustering with Bloom's taxonomy. The approach gathered learners in clusters at different levels of cognition, starting from very basic cognitive processes of recalling factual knowledge to fully advanced clinical problematization. It was these reverse-engineered clusters that allowed the design of pedagogy that targeted the specific cognitive needs of the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clustering using the K-means method provides valuable insights into performance patterns in student behaviour that extend beyond the limitations of conventional assessments. By placing students on a continuum of reasoning abilities, educators were able to take action to respond to individual learning paths. Such interventions could be applied in real time at the scale necessary for effective targeted instruction, which is essential for closing reasoning gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of machine learning, especially K-means clustering, and educational theory, such as Bloom's taxonomy, results in electronic-high-scale, multi-evidence, personalized clinical training. This is another theorem on how machine learning enables teaching and individual learning by a student in various cognitive domains.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869953","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}
引用次数: 0
Process Evaluation of Drug Supply Management in Public Health Centres of Gondar City, Northwest Ethiopia: A Case Study Evaluation Design 埃塞俄比亚西北部贡达尔市公共卫生中心药品供应管理过程评价:一个案例研究评价设计
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70246
Kaleb Assegid Demissie, Tadele Biresaw Belachew, Melak Jejaw, Getachew Teshale, Misganaw Guadie Tiruneh, Ayal Debie
{"title":"Process Evaluation of Drug Supply Management in Public Health Centres of Gondar City, Northwest Ethiopia: A Case Study Evaluation Design","authors":"Kaleb Assegid Demissie,&nbsp;Tadele Biresaw Belachew,&nbsp;Melak Jejaw,&nbsp;Getachew Teshale,&nbsp;Misganaw Guadie Tiruneh,&nbsp;Ayal Debie","doi":"10.1111/jep.70246","DOIUrl":"https://doi.org/10.1111/jep.70246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Drug supply management is the cornerstone of any meaningful health service. There are, however, serious problems with pharmaceutical supply systems in many developing countries. Therefore, this study aimed to evaluate the process of drug supply management of health centres in Gondar town, northwest Ethiopia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A case study evaluation design with a mixed method was employed from 1 May to 31, 2022. A total of 414 clients were interviewed. Six hundred prescriptions were reviewed, and nine KII were conducted. The quantitative data were entered into EpiData version 4.6 and exported to STATA version 14.0 for analysis. In the multivariable logistic regression analysis, variables with <i>p</i> &lt; 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to declare factors associated with client satisfaction. The qualitative data were transcribed, translated, coded and analysed using a thematic analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall implementation status of the DSM programme was 66.3%, with client acceptability, availability, accommodation and compliance contributing 67.85%, 68.9%, 63.15% and 65%, respectively. Procaine and paracetamol were out of stock. Visiting the health centres twice (AOR 4.10, 95% CI: 1.61−10.45), more than twice (AOR 4.12, 95% CI: 1.64−10.34) and living in rural areas (AOR 2.32, 95% CI: 1.26−4.03) were factors associated with client acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The overall implementation status of the DSM programme was judged fair. Visiting health centres twice or more than twice, and living in rural areas were factors associated with patients' satisfaction. Therefore, the programme needs great improvement to enhance the implementation of the DSM programme by giving attention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870000","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}
引用次数: 0
A Mixed Methods Assessment of the Effect of Organizational Characteristics on Intervention Scale-Up Success in 42 HIV Testing Clinics in Vietnam 越南42家HIV检测诊所组织特征对干预扩大成功影响的混合方法评估
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70243
Sophia M. Bartels, Hong Linh T. Dang, Jane S. Chen, Ha T. T. Nong, Van Anh T. Cao, Ha V. Tran, Teerada Sripaipan, Byron J. Powell, Clare Barrington, Luz M. Reyes, Le Minh Giang, Huong T. T. Phan, William C. Miller, Vivian F. Go
{"title":"A Mixed Methods Assessment of the Effect of Organizational Characteristics on Intervention Scale-Up Success in 42 HIV Testing Clinics in Vietnam","authors":"Sophia M. Bartels,&nbsp;Hong Linh T. Dang,&nbsp;Jane S. Chen,&nbsp;Ha T. T. Nong,&nbsp;Van Anh T. Cao,&nbsp;Ha V. Tran,&nbsp;Teerada Sripaipan,&nbsp;Byron J. Powell,&nbsp;Clare Barrington,&nbsp;Luz M. Reyes,&nbsp;Le Minh Giang,&nbsp;Huong T. T. Phan,&nbsp;William C. Miller,&nbsp;Vivian F. Go","doi":"10.1111/jep.70243","DOIUrl":"https://doi.org/10.1111/jep.70243","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Organizational characteristics, including structures, culture, and climate, are important determinants of intervention scale-up success. Little is known about which characteristics are most important for HIV intervention scale-up success in low and middle-income countries (LMICs), and how they influence implementation in these contexts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>We sought to examine the relationship between organizational characteristics and scale-up success within an implementation trial testing strategies to scale up Systems Navigation and Psychosocial Counselling (SNaP) for people who inject drugs (PWID) with HIV in Vietnam.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted in 42 HIV testing clinics in Vietnam. Informed by the Exploration, Preparation, Implementation, and Sustainment Framework, we assessed the association between five organizational characteristics and SNaP scale-up success: (1) implementation leadership; (2) staff workload; (3) percent PWID; (4) implementation climate; and (5) organizational readiness. We conducted a mixed methods study including surveys at baseline and endline with clinic staff and PWID participants in all clinics and interviews with clinic staff (<i>n</i> = 48) in six high and six low-performing clinics. To develop a context-driven scale-up success index for our outcome measure, we undertook a modified Delphi process with 14 experts in HIV, PWID, and implementation science. We assessed the relationship between our organizational characteristics and scale-up success using thematic and multiple linear regression analyses and explored the convergence of results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Conclusion</h3>\u0000 \u0000 <p>Greater implementation leadership (<i>ß</i> = 12.20, <i>p</i> = 0.004), high staff workload (<i>ß</i> = 4.71, <i>p</i> = 0.008), and lower implementation climate scores (<i>ß </i>= −6.23, <i>p</i> = 0.046) were significantly associated with scale-up success. Qualitatively, participants described the importance of implementation leadership, particularly during COVID-19, and, to a lesser extent, implementation climate and organizational readiness for scale-up success. Some also described how more time spent on SNaP delivery improved fidelity but exacerbated workload. These findings demonstrate that prioritizing implementation leadership-focused strategies for the scale-up of HIV interventions like SNaP could improve implementation outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869993","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}
引用次数: 0
Midwifery Practices for the Conversion of Foetus With Breech Presentation: A Qualitative Study 臀位胎儿转化的助产实践:一项定性研究
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70245
Menekşe Nazlı Aker, Ilknur Münevver Gönenç
{"title":"Midwifery Practices for the Conversion of Foetus With Breech Presentation: A Qualitative Study","authors":"Menekşe Nazlı Aker,&nbsp;Ilknur Münevver Gönenç","doi":"10.1111/jep.70245","DOIUrl":"https://doi.org/10.1111/jep.70245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although the conversion of the foetus with breech presentation to cephalic presentation is well-supported in the literature in terms of its benefits for maternal and neonatal health, there is insufficient knowledge regarding the specific midwifery practices involved in this process. The purpose of this study is to identify the methods used by midwives to convert fetuses with breech presentation to cephalic presentation and how they feel about performing these methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study employs a descriptive exploratory qualitative design. Individual in-depth interviews were conducted with 10 midwives who had previously performed interventions to convert the foetus from breech presentation to cephalic presentation. The ʻthematic analysisʼ method was used to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The data were categorised under five themes; methods used, common care elements, concerns, barriers, and outcomes of the midwifery practices. Midwives use external versions, mental practices, and physical practices for the conversion of the foetus with a breech presentation. Despite the reporting of some barriers and concerns, the midwives also reported positive outcomes such as increased chances of vaginal birth, positive birth perception, bonding, professional satisfaction, and maternal sense of satisfaction/adequacy with the use of methods. The study findings will provide guidance for midwives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Midwives employ different methods for the conversion of the breech presentation. Despite encountering some barriers and concerns regarding the utilisation of methods, they reported positive outcomes. It is recommended to strengthen the evidence base regarding these practices, and that midwives and nurses provide necessary information to pregnant women with breech presentation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869997","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}
引用次数: 0
Quality Indicators for the Pharmacological Management of Chronic Non-Cancer Pain in Older Adult Patients: An Integrative Review 老年患者慢性非癌性疼痛药理管理的质量指标:一项综合评价
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70253
Aljoscha Noël Goetschi, Henk Verloo, Nicole Schönenberger, Ursina Wernli, Carla Meyer-Massetti
{"title":"Quality Indicators for the Pharmacological Management of Chronic Non-Cancer Pain in Older Adult Patients: An Integrative Review","authors":"Aljoscha Noël Goetschi,&nbsp;Henk Verloo,&nbsp;Nicole Schönenberger,&nbsp;Ursina Wernli,&nbsp;Carla Meyer-Massetti","doi":"10.1111/jep.70253","DOIUrl":"https://doi.org/10.1111/jep.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Chronic non-cancer pain (CNCP) affects 28%–88% of older adults. They also experience more medication-related problems and are more likely to receive insufficient pain therapy, impacting their quality of care. Quality indicators (QIs) can be used to assess and improve the quality of their care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This integrative review aimed to consolidate the scientific evidence on existing QIs for the pharmacological care of older adult patients with CNCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched Medline and Embase via Ovid, CINAHL via EBSCO, the SCOPUS databases and Google Scholar. We used backward citation searching to identify additional studies. We included studies reporting validated QIs and studies reporting quality-related factors associated with reduced medication safety caused by pain-related medication therapy. Two reviewers independently screened the titles, abstracts and full texts. One extracted and charted the data and assessed the risk of bias; the second validated this.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We screened 4068 articles identified through the systematic search of databases and 2774 articles identified via citation searching. Seventy-eight articles met our inclusion criteria and were retained for analysis. We extracted 11 validated QIs and developed a further 243 based on quality criteria reported in the literature. QIs covered different levels, from pharmacotherapy in general to particular substance groups and individual active substances. The risk of bias in the included studies was judged to be very high in the majority of studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This integrative review established a scientific basis for developing QIs for the pharmacological management of older adult patients with CNCP. The high risk of bias present in the included studies, highlights the need for expert validation and input from patients. These indicators could help improve the quality of care provided to older adult patients with CNCP and help focus specific interventions on vulnerable patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869996","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}
引用次数: 0
Women Affected by Endometriosis: Their Anxieties and Coping Methods 受子宫内膜异位症影响的女性:她们的焦虑和应对方法
IF 2.1 4区 医学
Journal of evaluation in clinical practice Pub Date : 2025-08-19 DOI: 10.1111/jep.70198
Handan Özcan, Dilek Bilgiç, Enzel Köksaldi
{"title":"Women Affected by Endometriosis: Their Anxieties and Coping Methods","authors":"Handan Özcan,&nbsp;Dilek Bilgiç,&nbsp;Enzel Köksaldi","doi":"10.1111/jep.70198","DOIUrl":"https://doi.org/10.1111/jep.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine the anxieties and coping methods of women diagnosed with endometriosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This qualitative study was conducted using a phenomenological approach. Sixteen women diagnosed with endometriosis were selected through criterion sampling. Data were analyzed using inductive analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the participants was 32.62 ± 7.42 years, the mean age at diagnosis was 27.50 ± 6.87 years, and the mean age at symptom onset was 22.37 ± 8.13 years. Only four women had heard of endometriosis prior to diagnosis. All married participants who wished to conceive (<i>n</i> = 7) were diagnosed with infertility. Three main themes and nine sub-themes were identified: i. Emotions at the time of diagnosis (fear, anxiety, sadness, feeling bad, surprise, relief, numbness, feeling incomplete, and depression); ii. Anxieties related to endometriosis (pregnancy, chronic pain, inability to cope, ovarian damage, medication side effects, delayed diagnosis, lack of information, cyst rupture, and fear of inheritance by children); iii. Coping strategies (researching, avoidance, changing physicians, psychological support, regular check-ups, acceptance/giving up, family support, positive thinking, and oocyte freezing).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Due to the long-term nature of endometriosis treatment and follow-up, it is essential to closely monitor women and provide social and psychological support. Increasing awareness among the general public and health professionals, organizing educational activities, and promoting interinstitutional cooperation are recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869506","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}
引用次数: 0
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