Journal of evaluation in clinical practice最新文献

{"title":"East Midlands Breast Pain Pathway: An Evaluation of Community Breast Pain Clinics Across the East Midlands Cancer Alliance","authors":"John F. R. Robertson,&nbsp;Thilan Bartholomeuz,&nbsp;Veronica Rogers,&nbsp;Kevin Clifton,&nbsp;Lucy Pirkle,&nbsp;Denise Stafford,&nbsp;Mike Ryan,&nbsp;D. Mark Sibbering","doi":"10.1111/jep.70150","DOIUrl":"https://doi.org/10.1111/jep.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Research indicates that breast pain as the sole symptom has no association with breast cancer. However, patients with breast pain only are often referred onto urgent breast cancer diagnostic pathways, leading to unnecessary anxiety and overutilisation of secondary health care services. The novel community breast pain clinic (CBPC) service in the UK aims to improve patient care while providing system-wide improvements for patients with breast pain, patients who have ‘red flag’ symptoms, as well as being cost-effective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim and Objectives</h3>\u0000 \u0000 <p>This study seeks to evaluate and assess the impact of the CBPC on patient care, experience, and healthcare system improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Quantitative and qualitative analysis of CBPC was undertaken using data from CBPC based on a core data set designed by the programme team, secondary care follow-up data, Patient Reported Outcomes Measure (PROMs) data and family history data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CBPC was well-received by patients with 98.5% recommending the service. Additionally, health economic analysis indicated a cost benefit ratio of 1.23 in year 1, indicating a positive return on investment. Breast cancer incidence within the cohort was estimated at 3.2 per 1000, in line with population estimates in the literature. For those with a breast cancer diagnosis, there is no evidence of care delays or missed diagnoses via the service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CBPC offers significant benefits in patient experience and value for money, with no evidence of reducing patient safety. The impacts of the clinics appear to be reproducible across all five centres in the East Midlands (a population of 5.5 million). Recommendations on further assessment on optimal staff mix and clinic cost mechanisms should be considered to maximise benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244915","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 Impact of Transtheoretical Model-Based Motivational Interviewing on Self-Efficacy and Adherence to Treatment in Hemodialysis Patients","authors":"Hüseyin Çapuk,&nbsp;Rukuye Aylaz","doi":"10.1111/jep.70152","DOIUrl":"https://doi.org/10.1111/jep.70152","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim(s)&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The aim of this study was to evaluate the impact of Transtheoretical Model-based Motivational Interviewing on self-efficacy and illness adjustment in hemodialysis patients.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Hemodialysis patients often face challenges in adhering to dietary, fluid, and medication guidelines due to the lengthy nature of the dialysis sessions and various associated restrictions.&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;This study was conducted between June 2022 and March 2023 at hemodialysis centers in eastern Turkey. It included 30 patients in the experimental group and 30 in the control group. The experimental group received six sessions of Transtheoretical Model-based motivational interviewing, while the control group received no intervention. This pretest-posttest randomized controlled trial was registered in the Clinical Trials Registry (NCT06706843).&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 results indicated a significant improvement in GSES scores. A significant difference was found between the groups in pre-test scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), and a statistically significant difference was also observed in Posttest scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Within-group comparisons revealed significant differences between pretest and posttest scores for the experimental group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). There was a significant difference between pre-test and Posttest scores in the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In the SDBM-NOS showed a significant difference between the experimental and control groups in the dietary adherence subscale at Posttest (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), but no significant difference was found in the other subscales. In the experimental group, a significant improvement was observed between pre-test and Posttest in terms of total ESRD-AS score, fluid compliance and dietary compliance (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In the control group, no significant difference was found for any variable (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). A significant negative correlation was found between GSES and ESRD-AS.&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;In conclusion, Transtheoretical Model-based Motivational Interviewing was found to significantly improve treatment adherence and self-efficacy in chronic hemodialysis patients, contributing to better illness adjustment.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;&lt;b&gt;Trial Registration:&lt;/b&gt; ClinicalTrials.gov identifier: NCT06706843.&lt;/p&gt;\u0000 &lt;/sectio","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244966","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":"Barriers and Facilitators to the Implementation of Advance Care Planning: A Qualitative Study at National and Organizational Levels","authors":"Linn Brøderud,&nbsp;Reidun Førde,&nbsp;Maria Romøren,&nbsp;Astrid Klopstad Wahl,&nbsp;Reidar Pedersen","doi":"10.1111/jep.70131","DOIUrl":"https://doi.org/10.1111/jep.70131","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;Aging population, enhanced medical opportunities, increased costs and emphasis on patient participation make advance care planning (ACP) important and it provides an evidence-based framework to ensure patient autonomy in future healthcare decisions. Despite the extensive international research literature supporting ACP, implementation seems challenging. Implementing complex interventions like ACP probably requires a system-wide approach. However, there is scarce research on the barriers and facilitators to ACP implementation as perceived at national and organizational levels.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To explore the barriers and facilitators affecting ACP implementation as perceived at national and organizational levels.&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;Fifteen in-depth individual interviews were conducted with stakeholders at national and organizational levels. A semi-structured interview guide was used, targeting overarching conditions and framework factors that could have an impact. Data was analysed using thematic analysis.&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;Barriers to ACP implementation described by participants included: Lack of prioritization of ACP at all levels; paradigms and culture of healthcare delivery, personal barriers and attitudes, and lack of competence; lack of collaboration and documentation between levels of healthcare; and lack of systems, routines, time and resources within healthcare services. Facilitators included: Cultural change; support in priority setting; national guideline and incentives; management commitment and support; systems, routines and local implementation efforts; ACP capacity building, implementation competence, and ethical reflection; dissemination of the benefits of ACP, including public education; and better collaboration and communication between levels of healthcare.&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;There appear to be significant barriers and facilitators to ACP implementation as perceived at the national and organizational levels of healthcare. Although ACP implementation appears to require a combination of top-down and bottom-up initiatives, national and organizational barriers and facilitators seem important in setting priorities in clinical practice, with an emphasis on financial incentives. An overarching cultural change of healthcare delivery that supports interventions such as ACP appears to be criti","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244911","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 Relationship Between Person-Organization Fit and Job Embeddedness in Nursing: The Mediating Role of Workplace Happiness","authors":"Ayşe Karadaş,&nbsp;Mehmet Gülşen,&nbsp;Nurşah Tatoğlu","doi":"10.1111/jep.70159","DOIUrl":"https://doi.org/10.1111/jep.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Person-organization fit and job embeddedness affect nurse performance and turnover intention, thus disrupting the functioning of the organization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to ascertain the mediating role of workplace happiness in the relationship between person-organization fit and job embeddedness in nursing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Conducted as a descriptive and cross-sectional study, this study included 240 nurses working at a public hospital between January 15 and March 15, 2024. Data were collected using a descriptive information form, the Person-Organization Fit Scale, the Global Job Embeddedness Scale, and the Happiness at Work Scale. Statistical analyses were undertaken using IBM SPSS Statistics version 26 and the PROCESS Makro v4.2 plug-in.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings revealed that person-organization fit significantly and positively affected workplace happiness and workplace happiness significantly and positively affected job embeddedness. Furthermore, the indirect effect of person-organization fit on job embeddedness was significant; therefore, workplace happiness mediated the relationship between person-organization fit and job embeddedness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study's results reveal that ensuring nurses' person-organization fit and increasing their workplace happiness levels contribute significantly to increasing their level of job embeddedness. Healthcare organizations and nurse managers play a crucial role in improving job embeddedness. Nurse managers can improve nurses' levels of job embeddedness by developing strategies to promote person-organization fit and increase workplace happiness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244910","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":"Children at Risk: A Cross-Sectional Study of Mothers' Awareness and Practices Regarding Chemical Product Labels at Home","authors":"Bahise Aydın,&nbsp;Nazan Çakırer Çalbayram","doi":"10.1111/jep.70163","DOIUrl":"https://doi.org/10.1111/jep.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Children's exposure to chemical products at home poses significant health risks, making mothers' awareness and label-reading practices crucial for ensuring household safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine the frequency of mothers reading labels on chemical products and their knowledge of label symbols.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive cross-sectional study included 352 mothers whose children were between the ages of 6–18 years. Data were collected through an online survey using the Sociodemographic and Descriptive Characteristics Data Form and the Chemical Label Symbols Information Questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>It was found that 65.6% of the mothers were interested in chemical product labels, 38.9% always read the information on the label, and 70.5% believed that the information on the label was useful. The label symbol that mothers knew the most was the symbol for airing the room after use (94.9%) and the least was the symbol for acute poisoning (50.6%). It was found that the frequency of label reading increased as the number of family members and the number of children decreased (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It was determined that although mothers were highly aware of the symbols on chemical product labels, the frequency of label reading was insufficient. Children's health is at risk due to the excessive use of chemical products at home.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244796","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":"Long Term Patient Experiences After Bariatric and Metabolic Surgery: A Phenomenological Study","authors":"Defne Dizlek Bayraktar,&nbsp;Emine Catal","doi":"10.1111/jep.70166","DOIUrl":"https://doi.org/10.1111/jep.70166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is important to know what individuals experience in the complex long-term process after bariatric and metabolic surgery, this information is now more sought after. It can be used to improve patient care management by better understanding individuals' long-term life experiences after bariatric and metabolic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This qualitative study aimed to determine the long-term experiences of patients who underwent bariatric and metabolic surgery using a phenomenological design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted as qualitative research. It included 16 volunteers who underwent bariatric and metabolic surgery at least 5 years ago. Its data was collected using a semi-structured in-depth interview method. The collected data were analysed through a content, descriptive, and thematic analysis process and supported by the participants' metaphors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the study, 10 of the participants were female and six were male. Only one of the participants underwent adjustable gastric band surgery, the others underwent sleeve gastrectomy. Content analysis of the data revealed four main themes. These were: ‘emotions and thoughts created by bariatric surgery’, ‘gains brought by the new body’, ‘difficulties brought by the new body’, ‘the point reached in the journey of process’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Long Term Patient Experiences after Bariatric and Metabolic Surgery, which were both positive and negative, provide information about the participant's postsurgical process and what can be done to improve it and help patients in their recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244841","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 Blind Call for More Research","authors":"Jacob Alexander de Ru","doi":"10.1111/jep.70155","DOIUrl":"https://doi.org/10.1111/jep.70155","url":null,"abstract":"&lt;p&gt;“&lt;i&gt;Fortunately I believe we have not yet gone so far as our friends in the USA where, I am told, some editors of journals will return an article because tests of significance have not been applied,&lt;/i&gt;” was written more than half a century ago in one of the most influential papers in medical history [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Unfortunately, recently an editor indeed returned a manuscript stating: “with that said, I urge you to conduct a more formal study of the usefulness of this maneuver in anesthetized patients and report your result.” Though at first glance this might not be a too strange remark, the ‘maneuver’ in this case is just a simple and harmless head-turn.&lt;/p&gt;&lt;p&gt;A can't oxygenate, can't ventilate, can't intubate situation means that a patient cannot breathe because he/she is under anesthesia, and doesn't get oxygen because the anesthesiologist cannot secure the airway. A can't oxygenate, can't ventilate, can't intubate situation may result in a life-threatening situation thus, a movement as simple as turning the patient's head can be worth every penny.&lt;/p&gt;&lt;p&gt;During Drug Induced Sleep Endoscopy (DISE), a diagnostic procedure used in case of obstructive sleep apnea syndrome (OSAS), we noticed that turning the head while the patient is under anesthesia can open the airway if it is obstructed by the base of the tongue. The head-turn is a routine part of the procedure as it might be an indicator of the effect of positional therapy for OSAS.&lt;/p&gt;&lt;p&gt;The ‘instructions for authors’ of the specific journal we had in mind states: ‘ “Freestanding” Letters to the Editor also may discuss matters of general interest to anesthesiologists, without specific linkage to recently published articles,’ and, “Letters to the Editor should be brief (250 to 750 words).”&lt;/p&gt;&lt;p&gt;Therefore, we wrote a 250 words letter to the editor with the advice for colleagues to try, based on our experience during DISE, a simple head-turn for non-traumatic cases of can't oxygenate, can't ventilate, can't intubate situation [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Even the editor found our “idea interesting and perhaps useful to many anesthesiologists.”&lt;/p&gt;&lt;p&gt;Unfortunately, since ‘evidence based’ became the magic words in medicine, the focus seems to have shifted from clear and logical thinking to an adopted creed for more and more research. However, in many cases we do not need more research to improve healthcare or to learn easy tips and tricks. To quote Hill concerning tests of significance: “&lt;i&gt;yet there are innumerable situations in which they are totally unnecessary – because the difference is grotesquely obvious, because it is negligible, or because, whether it be formally significant or not, it is too small to be of any practical importance&lt;/i&gt; [&lt;span&gt;1&lt;/span&gt;].”&lt;/p&gt;&lt;p&gt;Chalmers, Sackett and Silagy wrote: “&lt;i&gt;when care has such striking effects, (…) carefully controlled research is seldom necessary to identify whether the prescriptions and proscriptions of doctors and other health professio","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244913","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":"Optimised Hybrid Attention-Based Capsule Network Integrated Three-Pathway Network for Chronic Disease Detection in Retinal Images","authors":"M. Mohamed Yaseen,&nbsp;Thulasi Bai Vijayan","doi":"10.1111/jep.70126","DOIUrl":"https://doi.org/10.1111/jep.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Over the past 20 years, researchers have concentrated on generating retinal images as a means of detecting and classifying chronic diseases. Early diagnosis and treatment are essential to avoid chronic diseases. Manually grading retinal images is time-consuming, prone to errors, and lacks patient-friendliness. Various Deep Learning (DL) algorithms are employed to detect chronic diseases from retinal fundus images. Also, these methods have some disadvantages, such as overfitting, computational cost, and so on.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The proposed research aims to develop Optimized DL based system for detecting chronic diseases in retinal images and solving existing issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Initially, the retinal images are pre-processed to clean and organize the data. Normalization and HSI Colour Conversion are the techniques used for pre-processing. Inception-V3, ResNet-152 and a Convolutional Vision Transformer (Conv-ViT) are used to perform feature extraction. The classifier is an Optimized Hybrid Attention-based Capsule Network. An optimization is included in the proposed model to increase the classifier s performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proposed approach attains accuracies of 99.05 % and 99.15% using Diabetic Retinopathy 224 × 224 (2019 Data) and the APTOS-2019 dataset, respectively. The superior performance of the proposed technique highlights its effectiveness in this domain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The implementation of such automated methods can significantly improve the efficiency and accuracy of chronic disease diagnosis, benefiting both healthcare providers and patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135596","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 Assessment of Physiotherapy Practice on the Clinical Practice Performance of Physical Therapy Students in Pediatrics: A Comparative Study","authors":"Ting-Ting Ma,&nbsp;Qi Zhang,&nbsp;Hong-Xia Li","doi":"10.1111/jep.70128","DOIUrl":"https://doi.org/10.1111/jep.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate how Physical therapy (PT) students’ clinical practice performance is affected by the assessment of physiotherapy practice (APP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Students enroled at Capital Medical University's Rehabilitation School of Medicine between 2016 and 2019 were included in this study. Students enroled in 2018 and 2019 were assigned to the observation group, while those enroled in 2016 and 2017 were assigned to the control group. The clinical practice model handled by APP tools was given to students in the observation group, whereas the standard clinical practice model was given to students in the control group. Following the practice, students completed a questionnaire survey and took the graduation exam, which consisted of a theoretical examination and a practical examination. The two groups’ performances on these assessments were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The observation group outperformed the control group in both theoretical and practical assessment results (<i>p</i> &lt; 0.05). Following their internship, the observation group showed considerably higher improvements in the acquisition of theoretical knowledge, training in clinical thinking and the operation ability than the control group (<i>p</i> &lt; 0.05). However, no significant differences were found between the groups in communication skills, teamwork ability, and safety risk management (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The practice teaching model under APP management is superior to the traditional clinical practice model in improving students’ theoretical knowledge, clinical reasoning, and practical skills in pediatric PT. However, both models showed similar outcomes in developing communication skills, teamwork ability, and safety risk management. These findings suggest that APP can be an effective tool for enhancing specific aspects of clinical practice performance in PT education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135558","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 Internal Entrepreneurship on Patient-Centered Care Competence in Nursing Services","authors":"Mustafa Erdoğan,&nbsp;Harun Kirilmaz,&nbsp;Ali Arslanoğlu","doi":"10.1111/jep.70121","DOIUrl":"https://doi.org/10.1111/jep.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine the internal entrepreneurship levels and patient-centered care competencies of nurses and to examine the effect of internal entrepreneurship characteristics on nurses' patient-centered care competence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Internal entrepreneurship is defined as innovative activities within organizations. In the healthcare field, the transition from physician-centered care to patient-centered care has gained importance. It is thought that increasing nurses' internal entrepreneurship characteristics will positively contribute to improving the quality of patient-centered care practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This descriptive and cross-sectional study was conducted between October and November 2019 in a university hospital in Turkey. The sample consisted of 580 nurses who voluntarily agreed to participate in the study. Data were collected using the Nurse Information Form, the Internal Entrepreneurship Scale, and the Patient-Centered Care Competence Scale. Data were analyzed using independent sample t-test, one-way analysis of variance (ANOVA), correlation analysis, and regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that nurses had high levels of internal entrepreneurship and patient-centered care competence. There was a statistically significant and positive relationship between internal entrepreneurship and patient-centered care competence (<i>r</i> = 0.888, <i>p</i> &lt; 0.001). Regression analysis showed that internal entrepreneurship had a significant effect on patient-centered care competence (R² = 0.789, <i>p</i> &lt; 0.001). Among the sub-dimensions of internal entrepreneurship, risk-taking and proactivity were found to have the strongest impact on patient-centered care competence. In addition, socio-demographic characteristics such as age, marital status, education level, and years of experience caused significant differences in internal entrepreneurship and patient-centered care competence levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study concluded that increasing nurses' internal entrepreneurship characteristics positively contributes to enhancing their competence in providing patient-centered care. It is recommended to support and develop nurses' internal entrepreneurship characteristics to improve the quality of patient-centered care practices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135559","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}