Journal of evaluation in clinical practice最新文献

{"title":"Nurse-Led Triadic Synergy for Active Aging Intervention Among Migrant Older Adults With Children in China: Study Protocol for a Cluster Randomized Controlled Trial.","authors":"Ziying Chen, Yuhan Yang, Qinghua Zhang, Xinuo Yao, Danyan Lu, Xiaoxiao Hu, Chunyan Leng","doi":"10.1111/jep.70646","DOIUrl":"10.1111/jep.70646","url":null,"abstract":"<p><strong>Rationale: </strong>As the global population of older migrants grows, a unique subgroup of Migrant Older Adults with Children (MOAC) faces compounded challenges of migration and aging. Although relocating to join adult children may offer familial support, these individuals often encounter specific barriers to social integration and public health.</p><p><strong>Aims and objectives: </strong>To address these challenges, this study aims to evaluate the effectiveness of a nurse-led Triadic Synergy Intervention on Active Aging (TSAAIP-MOA) to promote healthy aging and further achieve the goal of active aging among the MOAC.</p><p><strong>Methods: </strong>A multicenter cluster randomized controlled trial will be conducted to recruit eligible MOAC. Communities will be randomly assigned to an immediate intervention group or the wait-list control group, which will receive the 22-day TSAAIP-MOA program, while the wait-list control group will receive the same program subsequently. The primary outcome is the level of active aging; secondary outcomes include changes in intrinsic capacity, health literacy, and social participation. Data will be collected at three time points: baseline (T0), post-intervention (T1), and the 1st month from the initial intervention (T2), and analyzed using repeated-measures ANOVA.</p><p><strong>Discussion: </strong>This protocol will be able to validate the effects of concurrently enhancing intrinsic capacity, health literacy, and social participation on the formation of healthy lifestyles and the improvement of health-related quality of life. This community-based TSAAIP-MOA program holds strong potential as a readily scalable model for real-world implementation to improve healthy aging outcomes and foster active aging among MOAC in migrant destinations.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70646"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137116","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":"Comparison of Natural Language Processing and Traditional Qualitative Analyses of Caregiver Feedback From a Community-Based Intervention for Children With Autism.","authors":"Carmen Caruthers, Samantha Hochheimer, Melanie Pellecchia, Amanda Gulsrud, Elizabeth McGhee Hassrick, David Mandell, Aubyn Stahmer, Connie Kasari, Suzannah Iadarola","doi":"10.1111/jep.70667","DOIUrl":"https://doi.org/10.1111/jep.70667","url":null,"abstract":"<p><strong>Background: </strong>Satisfaction data is a commonly used construct to evaluate programs, products, and experiences. This data is collected through forced choice (scales, surveys) and/or open-ended measures. While open-ended questions have the greatest potential for more useful and candid feedback, analysis of this data can be time-consuming.</p><p><strong>Objective: </strong>This paper compares two evaluation methods, traditional qualitative analysis (TQA) and Natural Language Processing (NLP), to analyze themes from open-ended satisfaction data of a caregiver-mediated intervention for families of autistic children, called 'Mind the Gap (MTG)'.</p><p><strong>Methods: </strong>This secondary analysis utilized existing survey data from 73 caregivers that participated in the MTG trial. To identify themes, TQA was performed using latent coding, and R statistical software was used for NLP, with strategies including term frequency and sentiment analysis. Methods were evaluated independently and in combination.</p><p><strong>Results and conclusion: </strong>Both methods are comparable in thoroughly analysing this type of data, with each method contributing both unique and overlapping themes. TQA and NLP showed parent satisfaction with materials and organization, as well as peer coach support. NLP may provide more thorough results while also reducing the time burden associated with TQA, although this strategy may also overlook important nuance in data. This clinical trial is registered as 'Mind the Gap (AIRB-3) (MTG)' at clinicaltrials.gov, registration number NCT03711799.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70667"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169656","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":"Change in Knowledge and Vaccine Hesitancy Following Immunization Training Among Family Health Workers: The Role of Experience and Cognitive Flexibility.","authors":"Yusuf Emre Bostan","doi":"10.1111/jep.70680","DOIUrl":"https://doi.org/10.1111/jep.70680","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Vaccine hesitancy is one of the principal barriers to immunization programs, and health workers are central to this process both in countering hesitancy and through their own attitudes. Although educational interventions targeting health workers are widespread, how the effect of such training differs according to individual characteristics-and which factors determine this variation-remains insufficiently understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;This study aimed to evaluate the effect of a 4 h immunization training program delivered to family health workers on vaccine knowledge and vaccine hesitancy, and to determine whether professional experience and cognitive flexibility predict knowledge gain and attitude change.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-group pre-test-post-test design was used in Trabzon in February 2026. Vaccine knowledge was measured with a 10-item test, vaccine hesitancy with the short form of the Vaccine Hesitancy Scale, and cognitive flexibility with the Cognitive Flexibility Inventory. Change scores were examined with baseline-adjusted multiple linear regression, and the experience × cognitive flexibility interaction with an exploratory moderated regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 272 participants, representing 95% of the source population, were analyzed. Immediate post-training knowledge recall increased substantially (from 6.77 to 8.76 out of 10; dz = 1.34; p &lt; 0.001); 84.9% of participants improved their score, and the proportion answering at least 8 of the 10 items correctly rose from 32.4% to 87.9%. The reduction in vaccine hesitancy was statistically significant but negligible in magnitude (Δ = -0.90; p = 0.033; dz = -0.13); this corresponds to 1.9% of the 48-point usable range of the scale, with 51.4% of participants scoring lower, 12.4% unchanged and 36.3% higher after the training. The only individual characteristic that predicted attitude change was the Control dimension of cognitive flexibility (β = -0.116; p = 0.026), whereas professional experience predicted neither knowledge gain nor attitude change. The exploratory experience × cognitive flexibility interaction did not survive heteroscedasticity-consistent estimation and is reported as hypothesis-generating only.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A brief, lecture-based training program substantially increased knowledge but produced no meaningful change in vaccine hesitancy in practice. This dissociation suggests that attitude change may require more than the transfer of information, and that cognitive flexibility-given the small and only partly robust associations observed here-is an individual factor whose role should be tested directly. Because of the uncontrolled design and the administration of the post-test immediately after the training, the findings describe short-term recall and immediate attitude reporting; any claim about causality or durability would require a controlled design w","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 7","pages":"e70680"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220422","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":"When Medicine Gets Irritating: Interactional and Structural Triggers of Uncertainty in Family Medicine Residency Training","authors":"Konrad Hierasimowicz,&nbsp;Laura Purkl,&nbsp;Norbert Donner-Banzhoff","doi":"10.1111/jep.70607","DOIUrl":"10.1111/jep.70607","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Uncertainty is part of everyday medical practice, especially in family medicine. Former studies have focused on how clinicians manage uncertainty, but its emotional experience has received less attention. This study looks at irritation as a distinct affective entry point through which family medicine residents first perceive disruptions in clinical, interactional or organisational issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2019 and 2021, we spoke with 15 residents in Hesse, Germany. In semi-structured interviews, they described situations where they felt uncertain, including the context, their emotions, and what they did next. We transcribed, pseudonymised and analysed the interviews using Kuckartz's qualitative content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In many cases irritation was the first emotional reaction when something in the consultation didn't feel right. We identified three common triggers: (1) a mismatch between intuition and medical findings, (2) irritation during patient interactions and (3) irritation caused by structural issues. The last two were our main focus, as they disrupt usual ways of working rather than pointing to hidden diagnoses. These moments of irritation could be confusing at first, but in some cases, they led residents to dig deeper into what shaped the patient's perspective, to ask colleagues for advice or pay more attention to systemic and organisational issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Irritation acts as a harbinger of uncertainty by embodying those small breaks in routines and expectations from which uncertainty first arises. At first, it might throw residents off balance, but if they take the time to reflect on it, irritation can help them see things differently, stay attentive and improve their clinical skills. Residency programmes should give residents room to talk about these experiences, helping them handle uncertainty more effectively in their daily work.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008618","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":"From Inference to Ritual: Why Frequentist Statistics Became Hard to Understand and Teach in Medicine","authors":"Jean-Christophe Lega,&nbsp;Sylvie Chevret","doi":"10.1111/jep.70608","DOIUrl":"10.1111/jep.70608","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Frequentist statistical tools still structure a large part of biomedical research, regulatory evaluation, and medical teaching, even though their correct interpretation remains uncertain among students, clinicians, and readers of the literature. This misunderstanding is usually attributed to pedagogical shortcomings or individual cognitive errors. This article examines the structural reasons for this persistent misunderstanding. It argues that it arises from a combination of historical, methodological, semantic, and institutional factors rather than from a direct lack of technical training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The paper uses a selective narrative and historical analysis of the Bayes–Fisher–Neyman trajectory, of the language used to describe major frequentist tools, of the critiques of their ritualized use, and of their institutionalization in editorial, regulatory, and curricular settings. Its purpose is synthetic and argumentative, with a focus on medical education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Findings</h3>\u0000 \u0000 <p>The article argues that, in Fisher's framework, the <i>p</i> value was not an isolated signal but one element within a dense experimental architecture based on study design, sufficient statistics, and exhaustive extraction of information. The later shift toward a procedural and decision-oriented meaning strengthened its widespread use as a simple decision tool but made its frequentist meaning less natural. This opacity is further reinforced by ambiguous terminology, by the separation between statistics and methodology in teaching, and by ritualization through editors, agencies, and curricula.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Misunderstanding of frequentism in biomedicine should be seen as a structural problem of intelligibility. A realistic educational response requires reconnecting calculation, study design, history, epistemology, and language, so that teaching moves away from ritual use of tools and toward a more robust understanding of their meaning and limits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008593","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":"Psychometric Evaluation of the Artificial Intelligence Perception Scale for Cancer Patients: A Structural Equation Modeling Approach","authors":"Dilek Yildirim,&nbsp;Vildan Kocatepe,&nbsp;Sevda Tüzün Özdemir,&nbsp;Ayşegül Türkmenoğlu,&nbsp;Ünal Önsüz","doi":"10.1111/jep.70606","DOIUrl":"10.1111/jep.70606","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Rationale, Aims and Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Artificial intelligence (AI) is increasingly integrated into oncology care, with oncology nurses playing a key role in patient education, communication, and trust in these technologies. Although artificial intelligence is increasingly integrated into healthcare, existing AI perception and technology acceptance scales have largely been developed for general healthcare settings and do not adequately capture the unique clinical, ethical, and workflow-related aspects of oncology practice. This study aimed to develop and psychometrically validate a scale measuring oncology patients' perceptions of artificial intelligence. The study focused on instrument development rather than testing a theoretical model of technology acceptance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A methodological, cross-sectional scale development study. The scale was developed according to established nursing research guidelines. An initial item pool was generated using the Technology Acceptance Model, literature review and expert opinions from oncology nursing and interdisciplinary healthcare professionals. Content validity was assessed using the Davis technique and Lawshe method. Data were collected from 382 adult cancer patients receiving nursing care. Construct validity was examined using exploratory and confirmatory factor analyses. Reliability was evaluated using Cronbach's &lt;i&gt;α&lt;/i&gt;, split-half reliability and composite reliability. Structural equation modeling with bootstrapping tested the theoretical model.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The final scale included 33 items across three factors: knowledge, awareness, and trust; perceived benefit; and acceptance and use tendencies. Exploratory factor analysis explained 82.37% of the total variance. Confirmatory factor analysis demonstrated good model fit (CFI = 0.99, RMSEA = 0.079, SRMR = 0.038). Internal consistency was excellent for the total scale (&lt;i&gt;α&lt;/i&gt; = 0.97) and subscales (&lt;i&gt;α&lt;/i&gt; = 0.97–0.98). Perceived benefit partially mediated the relationship between knowledge and acceptance, explaining 52% of the variance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The scale is a valid and reliable instrument for assessing cancer patients' perceptions and acceptance of AI in oncology nursing practice. This scale provides oncology nurses and nurse researchers with a standardized tool to support nursing-led patient education, shared decision-making and the integration of AI into patient-centred oncology nursing care.&lt;/p&gt;\u0000 &lt;/sec","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008574","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":"Generalist Medicine: Shifting the Focus From Knowledge to Knowledge-Work","authors":"Joanne Reeve,&nbsp;Molly Megson,&nbsp;Richard Boczko,&nbsp;Annabelle Machin,&nbsp;Myriam Dell Olio","doi":"10.1111/jep.70615","DOIUrl":"10.1111/jep.70615","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008660","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":"Statistical Complexity Is Outpacing Peer Review","authors":"Michal Ordak","doi":"10.1111/jep.70613","DOIUrl":"10.1111/jep.70613","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008666","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":"From Evidence to Value: Integrating Evidence-Based Medicine, Patient Safety, Quality Improvement, Learning Health Systems, and Value-Based Healthcare","authors":"Takehiro Okabayashi,&nbsp;Ryo Inada,&nbsp;Toshi Imai,&nbsp;Kazuhide Ozaki,&nbsp;Kazutoshi Hayashi","doi":"10.1111/jep.70605","DOIUrl":"10.1111/jep.70605","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Evidence-Based Medicine (EBM) has strengthened clinical decision-making, but evidence alone cannot ensure that care is delivered safely, consistently, or in a manner that produces outcomes meaningful to patients. Patient safety, Quality Improvement (QI), Learning Health Systems (LHS), and Value-Based Healthcare (VBHC) have emerged to address these limitations. Understanding their relationships is important for healthcare systems seeking improvement and patient-centred care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>To examine the historical development and conceptual relationships among EBM, patient safety, QI, LHS, and VBHC, and to propose an integrated framework for understanding their complementary roles in healthcare quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A narrative review was conducted using PubMed as a database, supplemented by reference-list searching. Literature published from approximately 1990 to June 2026 was considered. Searches combined terms related to EBM, patient safety, QI, LHS, VBHC, implementation science, systems thinking, shared decision-making, quality of care, and healthcare transformation. Landmark publications, conceptual papers, guidelines, consensus statements, systematic reviews, and original studies were narratively synthesized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review identifies a Five-Stage Evolution Framework: EBM establishes what works; patient safety addresses how effective care can be delivered safely; QI enables reliable and continuous improvement; LHS creates feedback loops that allow healthcare systems to learn from routine clinical practice; and VBHC evaluates whether these efforts generate outcomes that matter to patients relative to the resources required. These paradigms are complementary rather than competing approaches. Their integration also requires systems thinking, data literacy, interprofessional collaboration, shared decision-making, and attention to patient values and equity. Challenges include the evidence-to-practice gap, organizational barriers, data quality, algorithmic bias, privacy, and the difficulty of measuring individualized value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Modern healthcare should move beyond isolated quality initiatives toward an integrated system that generates evidence, delivers care safely, continuously learns and improves, and creates meaningful value for patients. The proposed framework is conceptual and requires empirical evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975876","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":"Analysis of Nursing Service Quality Gaps and Improvement Strategies in VIP General Wards Based on Patient-Reported Outcomes","authors":"Xueyan Luo,&nbsp;Jianying Li,&nbsp;Xi Liu,&nbsp;Jiaying Liang,&nbsp;Xiaoxian He","doi":"10.1111/jep.70599","DOIUrl":"10.1111/jep.70599","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In the context of patient-centered healthcare, VIP wards are becoming increasingly common due to their commitment to an excellent service experience. This study aimed to investigate the associations between nursing service quality, patient-reported health status, and patient satisfaction in VIP wards.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A single-center retrospective cross-sectional secondary analysis was conducted from January 2025 to March 2026, involving 266 discharged patients from the VIP general ward of a tertiary hospital in China. All primary study outcomes were patient-reported. The five-dimensional service quality (SERVQUAL) scale was used to assess nursing service quality gaps, the patient-reported outcomes measurement information system 29-item profile (PROMIS-29) scale was used to evaluate patient-reported outcomes (PROs), and overall satisfaction, along with socio-demographic information, was collected. Data were analyzed using descriptive statistics, analysis of variance, correlation analysis, and multiple linear regression.&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;Among 266 participants, a significant gap existed between patients' expectations and perceptions of nursing service (overall gap score: −0.45 ± 0.61), with the largest gap found in assurance (−0.63 ± 0.85; paired Cohen's &lt;i&gt;d&lt;/i&gt;_&lt;i&gt;z&lt;/i&gt; = −0.74), indicating a moderate-to-large standardized discrepancy. Patients reported lower physical function and higher anxiety, fatigue, and sleep disturbance than the general population reference. Patients who opted for the VIP payment package reported significantly smaller gaps in reliability, responsiveness, and assurance than patients using other payment methods, but no significant differences were found among the three payment groups across the seven PROMIS-29 domains or pain intensity. Multiple regression analysis revealed that the empathy deficit (&lt;i&gt;β&lt;/i&gt; = −0.447, 95% CI −0.562 to −0.333, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and anxiety level (&lt;i&gt;β&lt;/i&gt; = −0.299, 95% CI −0.424 to −0.174, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) had the largest standardized coefficients; the reliability deficit (&lt;i&gt;β&lt;/i&gt; = −0.226, 95% CI −0.347 to −0.106, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and sleep disturbance (&lt;i&gt;β&lt;/i&gt; = −0.124, 95% CI −0.223 to −0.024, &lt;i&gt;p&lt;/i&gt; = 0.015) were also significant, whereas the remaining candidate variables were not. Importance-performance analysis (IPA) identified four high-importance, low-performance items including ‘Individualized attention’, ‘Sufficient nursing knowledge’, ‘Nurses willingness to help’, and ‘Patient safety’, as priority areas for improvement.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977124","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}