Journal of evaluation in clinical practice最新文献

{"title":"The Declaration of Helsinki Must Address the Challenges of Artificial Intelligence","authors":"Richard C. Armitage","doi":"10.1111/jep.70065","DOIUrl":"https://doi.org/10.1111/jep.70065","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639259","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":"Lengthy Shifts and Decision Fatigue in Out-of-Hours Primary Care: A Qualitative Study","authors":"Mona Maier, Louisa Lawrie, Daniel Powell, Peter Murchie, Julia L. Allan","doi":"10.1111/jep.70050","DOIUrl":"https://doi.org/10.1111/jep.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Demands on healthcare workers are high: services are stretched, shifts are long and healthcare professionals (HCPs) regularly work lengthy periods without a break. Spending time continuously ‘on task’ changes decision-making in predictable ways, as described by the ‘decision fatigue’ phenomenon where decision-makers progressively shift towards making less cognitively effortful decisions as the time worked without a break increases. This phenomenon has been observed repeatedly in large quantitative observational studies, however, individual healthcare workers' experiences have not been explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This qualitative study aimed to explore general practitioners' (GPs) and advanced nurse practitioners' (ANPs) experiences of working for lengthy periods in an out-of-hours primary care service in the UK. This included exploration of self-perceived changes in decision-making throughout a work shift, and mitigating strategies used to avoid changes in decision-making over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted online. An inductive thematic analysis was carried out to identify salient issues articulated by participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting and Participants</h3>\u0000 \u0000 <p>The interview sample (<i>n</i> = 10) comprised ANPs (<i>n</i> = 5) and GPs (<i>n</i> = 5) who regularly worked within the out-of-hours primary care service across a regional National Health Service (NHS) health board.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HCPs (GPs and ANPs) provided insights into their experiences during lengthy shifts and the impact of prolonged periods of work on clinical decision-making. Four main themes were identified and developed: (1) HCPs are aware of decision fatigue effects over the course of a shift; (2) Multiple factors help and hinder stable decision-making quality; (3) HCPs deliberately use strategies to help keep the quality of their decision-making stable; and (4) HCPs are aware of contextual changes, likely related to the decision fatigue phenomenon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study underscore the intricate interplay of personal, social and systemic factors in decision-making quality and highlight HCPs' deliberate efforts to mitigate decision fatigue's effects in pr","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602747","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":"Comparing Medicaid Enrolment Death Data to State-Wide Death Records in Maine","authors":"Katherine A. Ahrens,&nbsp;Apsara Kumarage,&nbsp;Philip Dubois,&nbsp;David Jorgenson","doi":"10.1111/jep.70049","DOIUrl":"https://doi.org/10.1111/jep.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Death data available in Medicaid enrolment files may be incomplete and lack cause of death information. We sought to compare Medicaid enrolment death data to state-wide death records in Maine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>(1) To compare the date of death of Medicaid enrollees in Maine according to the Medicaid enrolment data to the date of death obtained through an ongoing quarterly death certificate-Medicaid linkage for 2016–2023; and (2) using the death certificate-Medicaid linkage data, to perform an analysis of the risk of drug overdose death in 2023 by opioid use disorder (OUD) status in 2023, as part of monitoring activities required for one of Maine's new approaches to delivering Medicaid services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used Maine Medicaid enrolment data 2010 through 2023 and claims data 2016 through 2023, and Maine final death certificate data 2016 through 2023 (plus Q1–Q2 2024 provisional data). We estimated the risk of drug overdose death in 2023 by OUD diagnosis among non-elderly adults in 2023 using underlying cause of death information from the death certificate-Medicaid linkage data file.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 124,510 deaths in Maine among Maine residents from 2016 to 2023. Among Medicaid enrollees each year, there was a slightly higher number of deaths when using the death certificate-Medicaid linkage data than when using current enrolment data (e.g. 12% vs. 11% among 2016 enrollees), but generally, death counts were consistent (90% found in both data sources). In our analysis of death certificate-Medicaid linkage data, we found the risk of drug overdose death in 2023 was 0.68% among those with OUD and 0.11% among those without OUD (risk ratio = 6.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Generally, there was good agreement between the two sources on the date of death. However, only ongoing death certificate-Medicaid linkage allows for examination of the cause of death, which is required for monitoring a new approach to delivering Medicaid services in Maine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Music Recital on Labor Anxiety and Satisfaction: A Randomized Controlled Study","authors":"Gülşen Kaya,&nbsp;Zümrüt Bilgin","doi":"10.1111/jep.70038","DOIUrl":"https://doi.org/10.1111/jep.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Music as a distraction is used in various areas of obstetrics and gynecology to reduce fear, pain and anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In this study, it was aimed to determine the effect of music recital on labor anxiety and satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted in a hospital between June 12 and November 30, 2019. A total of 80 primiparous pregnant women aged 18–35 years (40 music and 40 control) participated in this randomized controlled study. Data were collected using ‘Personal Information Form’, ‘Birth Follow-up Form’, ‘Visual Analog Scale’, ‘Oxford Worries about Labour Scale’ and ‘Birth Satisfaction Scale’. In the study, while routine care was given to all groups, in addition to the music group, music of their choice from Rehavi or Nihavend Maqam was played with MP3 player headphones for 30 min when their cervical openings were 4–5 cm and 6–7 cm, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean ages of the control and music groups were 23.67 ± 3.18 and 23.95 ± 3.32, respectively. Thirty-five percent of women are very anxious and 42.5% are very afraid of childbirth. Participants in the music group had lower Visual Analog Scale scores after listening to music and at the 1st and 2nd hours after delivery compared to the control group (<i>p</i> &lt; 0.05). In the study, the mean score of the Oxford Worries about Labour Scale was found to be (21.72 ± 3.76) in the control group and (31.42 ± 4.23) in the music group (<i>p</i> = 0.000); the mean score of the Birth Satisfaction Scale was (84.25 ± 11.83) in the control group and (116.72 ± 10.36) in the music group (<i>p</i> = 0.000) and a significant difference was found between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lower birth anxiety and higher birth satisfaction were observed in the music group compared to the control group, and it is recommended that music should be included in routine nursing and midwifery care in the birth process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594884","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":"Examining a Holistic Framework for Evaluating Clinical Outcomes in Parallel With Non-Clinical Outcomes","authors":"Robert G. Lingard,&nbsp;Louise Horstmanshof","doi":"10.1111/jep.70047","DOIUrl":"https://doi.org/10.1111/jep.70047","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Rationale&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;While clinical research seeks to evaluate outcomes of various types, no framework has been identified that permits a sufficiently broad approach to evaluating clinical outcomes, in parallel with non-clinical outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims and Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The objective of this paper is to examine a unifying framework for evaluating clinical outcomes in parallel with non-clinical outcomes by drawing on different understandings of the Common Good. The proposed framework must have broad application, accounting for the various types of outcomes that may emerge within different disciplinary approaches and identifying the benefits or harms that might be experienced by the clinical research participants.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Six different definitions of the Common Good originally described by Boltanski and Thévenot are presented. The six conceptions of the Common Good identify organising principles by which an outcome is evaluated as beneficial or harmful. It also identifies the various ways that the researched persons, and the researchers, are subjectified. Academic literature that reported outcomes for persons living with dementia was purposively sampled to demonstrate the application of the six definitions of the Common Good.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A wide range of outcomes from clinical research may be evaluated in parallel, based upon the assumption that the Common Good may be expressed as a plurality of perceived goods extending beyond purely clinical, technically measured outcomes.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Further, the subjects of interventions may be described in non-clinical language, thus respecting the many roles that may be important to them as human persons and agents.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Boltanski and Thévenot's Economies of Worth framework allows research outcomes to be evaluated consistently against the six definitions of the Common Good. The definitions of the Common Good inhere six different Worlds: Civic, Domestic, Industry, Inspiration, Market and Opinion (or Celebrity). Each World is structured around a Higher Common Principle by which the Common Good is defined within that specific world.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;The example of research amongst people living with dementia demonstrates the robustness of this framework by identifying a wide range of non-clinical outcomes. These ","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554568","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":"'I'm Not Sure Who to Refer You to': Experiences of Clinicians Accessing Allied Health for Their Patients With Parkinson's Disease","authors":"Cassandra Meishan Wong,&nbsp;Sarah May Dennis,&nbsp;Natalie Elizabeth Allen,&nbsp;Serene Sulyn Paul","doi":"10.1111/jep.70044","DOIUrl":"https://doi.org/10.1111/jep.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Allied health interventions have been shown to improve impairments and quality of life in people with Parkinson's disease (PwPD). However, globally allied health is underutilised, and referrals tend to be reactive and occur in moderate to advanced disease. Currently little is known about the referral patterns of PwPD to allied health in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study examined the allied health referral patterns of neurologists, general practice physicians (GP) and Parkinson's disease nurse specialists (PDNS) treating PwPD in New South Wales (NSW), Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four neurologists, three GPs and four PDNSs each completed a demographic questionnaire and a semi-structured interview. Interview data were analysed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All clinicians experienced difficulties locating approachable, available, affordable, and appropriate allied health services. Clinicians also perceived that patient ability to interact impacted their involvement in allied health therapies. Referrals were typically made in response to symptom progression. The most common individual disciplines referred to were physiotherapy and/or exercise physiology, followed by speech pathology and occupational therapy. Multidisciplinary teams (MDT) were generally not available, so referrals to MDTs occurred less frequently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clearer guidelines regarding when to refer to individual allied health disciplines and to MDTs are needed to facilitate more proactive referrals by clinicians treating PwPD. Establishing an MDT model for PwPD throughout Australia would improve the approachability, availability and appropriateness barriers, and could improve quality of life for PwPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Psychometric Properties of the Turkish Version of the Stress Scale for Siblings of Childhood Cancer Patients","authors":"Bahar Aksoy,&nbsp;Melike Demir Doğan,&nbsp;Edanur Tar Bolacali,&nbsp;Tuğba İnci","doi":"10.1111/jep.70045","DOIUrl":"https://doi.org/10.1111/jep.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate the psychometric characteristics of the Turkish version of the “Stress Scale for Siblings of Childhood Cancer Patients (SCCP)”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted with 273 siblings aged 11-16 of childhood cancer patients (SCCPs) who were treated in a hospital in the Black Sea Region of Türkiye between March 2022 and April 2024. Data were collected with “The Sociodemographic Information Form” and “SCCP”. The data were examined through descriptive statistics, as well as exploratory and confirmatory factor analyzes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The SCCP Turkish version is a valid and reliable scale consisting of 27 items and six sub-dimensions. The SCCP Turkish version explained 77.676% of the total variance. The SCCP Turkish version was found to be summable according to Tukey's test of additivity (<i>p</i> = 0.334), and the test-retest reliability of the scale was <i>r</i> = 0.864 (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicate that the Turkish version of the SCCP is a valid and reliable instrument for evaluating stress levels in siblings aged 11 to 16.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>With SCCP, nurses can determine the stress levels of SCCPs and contribute to the planning of necessary interventions to cope with stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554594","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":"Correction to “Reassurance for Patients—Essential Not Optional”","authors":"","doi":"10.1111/jep.70036","DOIUrl":"https://doi.org/10.1111/jep.70036","url":null,"abstract":"<p>Citation to article:</p><p>Marx R. Reassurance for Patients—Essential Not Optional. <i>J Eval Clin Pract</i>. 2025;31(1):e14287. https://doi.org/10.1111/jep.14287</p><p>Description of error:</p><p>In the References section, citation number 42 is incorrect:</p><p>42. R. F. Redberg, “Less Is More,” <i>Archives of Internal Medicine</i> 170, no. 7 (2010): 584, https://doi.org/10.1001/archinternmed.2010.48</p><p>The correct citation is:</p><p>42. R. F. Redberg, M. H. Katz, and D. Grady, “Diagnostic Tests: Another Frontier for Less Is More: Or Why Talking to Your Patient Is a Safe and Effective Method of Reassurance,” <i>Archives of Internal Medicine</i> 171, no. 7 (2011): 619, https://doi.org/10.1001/archinternmed.2010.465</p><p>We apologize for this error.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Out-of-Hospital Extended Care on the Prognosis of Patients With Chronic Obstructive Pulmonary Disease","authors":"Xiaoyan Gong,&nbsp;Yan Gong,&nbsp;Shuhua Peng,&nbsp;Qiaoying Huang,&nbsp;Wenting Luo,&nbsp;Man Jin,&nbsp;Ling Xiao,&nbsp;Liping Xiong","doi":"10.1111/jep.70025","DOIUrl":"https://doi.org/10.1111/jep.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Nursing services are crucial for the recovery and prognosis of patients with chronic obstructive pulmonary disease (COPD). This study is to evaluate the impact of out-of-hospital extended care services on patients with COPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 67 COPD patients were enroled in this study, divided into a control group and an intervention group. The intervention group was provided with out-of-hospital extended care services for 6 months, and at the end of the follow-up visit, the patients' psychological status, pulmonary function, and exercise endurance were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with the control group, patients in the intervention group showed significant improvement in pulmonary function, as reflected in FVC, FEV1, FEV1%, and FEV1/FVC. Meanwhile, after 6 months of extended care services, patients in the intervention group showed significant improvement in exercise endurance, with a significant increase in 6-min walking distance. In addition, patients in the intervention group experienced a significant reduction in anxiety and depression after extended care services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Extended care service as a new care model can significantly improve the prognosis of COPD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533247","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":"Transition and Life-Long Care for Adults With Cerebral Palsy: A Patient Group ‘Too Hard to Impact!’ Are We Still Sending Young People ‘Off a Cliff’?","authors":"Susie Turner,&nbsp;Charlotte Nash,&nbsp;Jane Goodwin,&nbsp;Johanna Smith,&nbsp;Charlie Fairhurst,&nbsp;Jill Cadwgan","doi":"10.1111/jep.70011","DOIUrl":"https://doi.org/10.1111/jep.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>At Evelina London Children's Hospital, tertiary care is provided for children with Cerebral Palsy (CP) across the South East of England. An increasing number of adults with CP remain under the care of the children's hospital due to a lack of appropriate adult neurodisability services. This quality improvement project as part of a gap analysis regarding transition pathways for young adults with CP, aimed to explore the lived experience of young adults within our service, with respect to transition and care in adulthood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a multi-methods design. Firstly, a bespoke questionnaire to young adults with CP and their families evaluated their experience of transition, access to services, challenges with care, and their needs from healthcare professionals (<i>n</i> = 46). Then, a focus group with parents of adults with CP (<i>n</i> = 4) and interviews with adults with CP (<i>n</i> = 5) informed design of an ideal transition pathway and adult service. The qualitative data were thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Framework analysis of the questionnaire data was mapped against the International Classification of Functioning (ICF) with the following themes identified: Body structure and function: pain and anxiety; Activity: equality; accessibility and relationships; Participation: need for friendship and social opportunities, employment and education; Environmental factors: health services and providers; home environment and wider community; Personal factors: independence. Analysis of the focus group and interviews identified five main themes: Gradual and co-ordinated transition process; Co-ordination of care in adult services; Knowledge, skills and experience of professionals; Communication; and Worrying about the future.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participants identified significant challenges with transition pathways and adult care. Annual reviews from healthcare professionals with expertise in CP should be offered to young adults to ensure early identification of health needs. Further research is needed to support business planning in development of appropriate adult services for adults with CP and ensure successful transition pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521768","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}