Evaluation & the Health Professions最新文献

We normalized, harmonized, and pooled 344,429 surveys collected from 106,470 research participants from 25 research studies that assessed past 30-day alcohol use, drunkenness, smoking cigarettes, using marijuana, and a host of psychosocial variables. After normalizing and harmonizing psychosocial measures, we completed analyses to examine the ability of psychosocial variables to serve as proxy indicators of use. Intentionality, peer descriptive normative beliefs, and age emerged as being of primary importance in indicating use. Additional variables - peer injunctive norms, beliefs about the positive and negative consequences of use, and attitudes - were also demonstrated to have the potential to serve as proxies in the assessment of substance use risk. There were developmental patterns in how intentionality and descriptive normative beliefs changed with age. Young adolescents had scores that are protective; they have positive intentionality and do not see the prevalence of alcohol and other drug use as widespread. These and other psychosocial variable's mean scores generally erode with age while the distribution of scores widens as youth grow older. The goal of analyses was to define age-related psychosocial profiles that can be used prospectively to estimate substance use risk. These profiles are useful in creating virtual control cases for evaluating disseminated prevention programs.

One of the most challenging aspects of writing multiple-choice test questions is identifying plausible incorrect response options-i.e., distractors. To help with this task, a procedure is introduced that can mine existing item banks for potential distractors by considering the similarities between a new item's stem and answer and the stems and response options for items in the bank. This approach uses natural language processing to measure similarity and requires a substantial pool of items for constructing the generating model. The procedure is demonstrated with data from the United States Medical Licensing Examination (USMLE®). For about half the items in the study, at least one of the top three system-produced candidates matched a human-produced distractor exactly; and for about one quarter of the items, two of the top three candidates matched human-produced distractors. A study was conducted in which a sample of system-produced candidates were shown to 10 experienced item writers. Overall, participants thought about 81% of the candidates were on topic and 56% would help human item writers with the task of writing distractors.

Self-generated identification codes (SGICs) are strings of information based on stable participant characteristics. They are often used in longitudinal research to match data between time points while protecting participant anonymity. However, the use of SGICs with military personnel has been infrequent, even though military personnel do not have the same privacy protections as civilians. The current paper reports results from two studies that tested the feasibility, reliability, and validity of using a SGIC to collect sensitive longitudinal data among military personnel. In study one, a team of 105 participants was tracked three times over a period of 12 weeks. The 10-item SGIC produced optimal matching over the 12-weeks. In study two, 1,844 participants were randomly assigned to a SGIC group or an anonymous control group, and then were asked to provide information about their alcohol use. Although match rates declined over time, there were no observed differences between study groups in participants' beliefs about the use of a SGIC. However, differences were identified in reported alcohol use behaviors between the groups, with controls reporting significantly more drinks per week and higher AUDIT-10 scores. While these findings raise potential concerns about using SGICs for epidemiological assessments of highly sensitive problem behaviors, these codes may still be useful in determining group differences in behavior change in randomized studies.

Intensive care unit (ICU) nurses are expected to facilitate effective day-to-day communication with patients and family members at the bedside. To date, communication training for ICU health care professionals has targeted mainly intensivists-in-training, but there is limited data on communication experience and needs to be evaluated among ICU nurses. This qualitative study used focus group interviews to explore daily communication experiences with patients' families and communication training needs and preferences among ICU nurses in South Korea. Five focus group interviews were conducted with 27 ICU nurses (4-6 nurses per group). The results of inductive qualitative content analysis highlighted four main categories: "Perceived difficulties during communication," "burden from working conditions," "endeavors to promote communication skills," and "strategies for cultivating effective communication." Regarding suggestions for future communication training, nurses preferred interactive learning with peer-support over traditional methods (e.g., lectures). Nurses also suggested that communication training for ICU nurses should include learning skills appropriate for difficult situations (e.g., angry family members). Findings from this study can serve as a framework for stakeholders in ICU care and healthcare education (e.g., hospital and nursing administrators, nurse educators) when designing communication training to support ICU nurses with their practical knowledge and communication skills.

Evidence-based program registries (EBPRs) are web-based compilations of behavioral healthcare programs/interventions that rely on research-based criteria to rate program efficacy or effectiveness for support of programmatic decision-making. The objective was to determine the extent to which behavioral health decision-makers access EBPRs and to understand whether and exactly how they use the information obtained from EPBRs. Single State Authorities (SSAs) and service provider agencies in the areas of behavioral health and child welfare were recruited nationally. Senior staff (n = 375) responsible for the selection and implementation of programs and/or policies were interviewed by telephone concerning their visits (if any) to 28 relevant EBPRs, the types of information they were seeking, whether they found it, and how they may have used that information to effect changes in their organizations. At least one EBPR was visited by 80% of the respondents, with a median of three different registers being visited. Most visitors (55%) found all the information they were seeking; those who did not desired more guidance or tools for individual program implementation or were unable to locate the program or practice that they were seeking. Most visitors (65%) related using the information obtained to make changes in their organizations, in particular to select, start or change a program, or to support the adoption or improvement of evidence-based clinical practices. EBPRs were shown to be important resources for dissemination of research-based program effectiveness data, leading to increased use of evidence-based practices in the field, but the study also identified needs for greater awareness of EBPRs generally and for more attention to implementation of specific recommended programs and practices.

Handball is a high-intensity contact sports activity characterized by repetitive movements, leading to sport-specific muscle patterns. However, at some stage, this pattern may turn into imbalance, predisposing athletes for injuries. The complexity of muscular interactions often makes it difficult to see a whole picture of an athlete's postural disorders and assess them within the framework of his stereotyped movements. We attempted to find an association between the muscle pattern and the number of injuries in a limited group of handball players by constructing a static logistical model. The constructed decision table of the static logistical model included seven conditional attributes of the muscle imbalance as preconditions for injury development and one decision attribute representing the number of experienced injuries of 25 university handball players. The findings displayed a sport-specific pattern of muscle alignment in athletes without or only one injury. However, all players with repetitive injuries had unilateral m. gluteus maximus weakness. In the latter case, impaired core body musculature can lead to increased share forces and stress for the gluteus maximus muscle leading to weakness of this crucial dynamic stabilizer. The logistical model allowed defining muscle imbalance associated with sports-related injuries in a limited group of athletes.

The Core Cardiology Training Symposium (COCATS) standards are recommendations endorsed by the American College of Cardiology to assist cardiology fellowship program training directors in curricular design. In addition to seeking COCATS standards as evidence of proficiency in cardiovascular skills, Fellows-In-Training (FITs) often pursue board certifications to maximize their hiring potential. The costs and barriers with COCATS standards and board certification processes are not insignificant, however the degree to which the job marketplace demands them has not been well characterized. The intent of this investigation study was to estimate the demand for COCATS standards and board certification in cardiology job advertisements. We conducted a cross-sectional survey of job listings on the American College of Cardiology's "Cardiology Careers" page, to establish how often advanced COCATS standards and certifications are requested. Of a total of 314 total cardiology job postings (including 133 academic positions), only eight (2.5%) job postings explicitly noted COCATS standards. Aside from American Board of Internal Medicine subspecialty certification, only 8.60% required certification in another cardiology related board certification. Despite the perception that COCATS standards and subspecialty certifications are vital to the cardiology job application process, our analysis suggests that few job postings require them. Concern regarding COCATS standards and subspecialty certification of FITs may be out of proportion to the relevance of these achievements on the current job market.

Drawing on the Conservation of Resources theory, this study analyzes whether resilience could be related to healthcare providers' wellbeing and professional self-efficacy, both directly and indirectly, as mediated by ethical vision of patient care and moderated by managerial support in dealing with ethical issues. Overall, 315 Italian healthcare professionals employed in neuro-rehabilitation medicine or palliative care specialties participated in this multi-centered cross-sectional study. The following variables were investigated: resilience (Connor-Davidson Resilience Scale), wellbeing (Maugeri Stress Index-Reduced), professional self-efficacy (Maslach Burnout Inventory-General Survey), ethical vision of patient care and managerial support in dealing with ethical issues (Italian version of the Hospital Ethical Climate Survey). Overall, resilience was positively associated with healthcare providers' wellbeing and professional self-efficacy, directly and indirectly, as mediated by ethical vision of patient care. Highly resilient healthcare professionals who perceived the presence of a positive ethical vision of patient care in their workplace were more likely to experience greater wellbeing when managerial support in dealing with ethical issues was high (vs. low). Thus, these findings provide suggestions for tailored interventions sustaining healthcare professionals along their daily activity characterized by high-demanding and challenging situations.

The Nursing Quality of Life Scale (NQOLS) is a 28-item self-report measure evaluating the four dimensions of nurses' quality of life, namely, the physical, emotional, working, and social dimensions. The purpose of this study is to assess the psychometric properties, including validity and reliability, of the NQOLS. The study enrolled 1105 nurses who provided direct assistance to patients. The NQOLS factorial structure was tested using a cross-validation approach via Exploratory Structural Equational Modeling, which confirmed the instrument's four-dimension structure. Reliability was assessed using omega coefficients, proving excellent for all factors. Cluster analysis identified five distinct groups, each composed of participants sharing a substantial similarity with respect to their profile in the NQOLS. These five identifiable clusters presented significant differences not only in the NQOLS but also in the risk of work-related stress, emotional labor, and burnout. The results show that NQOLS is a simple, reliable, lean tool for measuring nurses' overall QoL, whose various parts can additionally be used to answer specific research questions.

COVID-19 rapidly spread across the world, constituting a public health disaster unlike any other experienced in decades. The impact exerted on workplaces and their employees was dramatic, and an immense burden fell on healthcare provision globally. Along with "front-line" healthcare staff, sanitation workers at hospitals also had to cope with additional workloads, making them vulnerable to psychological trauma and affecting their quality of life at establishments. This study investigated how the factors of occupational stress, self-efficacy (belief in the capacity to carry out a task well) and mental health altered the WRQoL (Work-Related Quality of Life) of employees carrying out sanitation duties at hospitals in Malaysia. To this end, a survey translated into the Malay language was conducted among 449 such workers during a so-called "recovery movement control order", i.e. quarantine and control measures pertaining to an outbreak of Coronavirus disease. Research involved co-variance-based structural equation modeling, performed in IBM-AMOS-26 software, in order to discern the causal relationship of the aforementioned factors on WRQoL. Results revealed a high level of occupational stress, diminished self-efficacy and poor mental health among the employees surveyed. Such stress directly impacted the WRQoL of the second factor alongside an indirect effect on that of the third, i.e. anxiety stemming from potentially catching the virus and the experience of having to disinfect facilities for treating patients, undertake cleaning duties, and move corpses.