Reputation is of fundamental importance in science. It translates into the consideration, trust, and credibility that the scientific community exudes with the public. A growing number of events that undermine the quality and integrity of scientific research undermine the trust people place in it, facilitate the spread of an anti-scientific culture, and, above all, affect the development of new generations of scientists.
Methods
Major categories of research integrity issues that emerged over the past decade were analysed, including citation rate, conflict of interest, predation, quality, reproducibility, translation, and transparency.
Results
Many scientists downplay the problem of declining ethics in biomedical research, confident that errors and fraud in scientific research will be exposed and eliminated sooner or later. They forget that this self-correcting process of science almost invariably takes years, during which costly and potentially serious consequences can arise. Furthermore, the intense competition that has always driven scientific research progress prevents many from undertaking clean-up efforts that could prove detrimental under current research evaluation systems.
Conclusion
The time has come to adopt practical measures to mitigate the negative consequences of the deterioration of ethics in biomedical research. We outline possible interventions to address the main ethical issues that have emerged over the past decade.
{"title":"Dealing With Worsening Ethics in Biomedical Research, a Loose Cannon in the Growth of New Generations of Scientists","authors":"Guido Frosina","doi":"10.1111/jep.70366","DOIUrl":"10.1111/jep.70366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Reputation is of fundamental importance in science. It translates into the consideration, trust, and credibility that the scientific community exudes with the public. A growing number of events that undermine the quality and integrity of scientific research undermine the trust people place in it, facilitate the spread of an anti-scientific culture, and, above all, affect the development of new generations of scientists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Major categories of research integrity issues that emerged over the past decade were analysed, including citation rate, conflict of interest, predation, quality, reproducibility, translation, and transparency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Many scientists downplay the problem of declining ethics in biomedical research, confident that errors and fraud in scientific research will be exposed and eliminated sooner or later. They forget that this self-correcting process of science almost invariably takes years, during which costly and potentially serious consequences can arise. Furthermore, the intense competition that has always driven scientific research progress prevents many from undertaking clean-up efforts that could prove detrimental under current research evaluation systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The time has come to adopt practical measures to mitigate the negative consequences of the deterioration of ethics in biomedical research. We outline possible interventions to address the main ethical issues that have emerged over the past decade.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029596","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}
Sarah R. Prowse, Miriam Brazzelli, Hanne Bruhn, Shaun Treweek
Background
Trials are often poorly designed, address unimportant questions, or are conducted in ways that limit their usefulness. This contributes to research waste and undermines evidence-based healthcare. We examined whether guidance from funders, regulators, and ethics review bodies supports the planning and approval of informative trials, with a focus on resources available to investigators and the role of oversight organizations.
Methods
We conducted a directed qualitative content analysis of guidance documents from funders, regulators, and ethics review bodies across 13 countries and three multinational organizations. Documents were analysed using a coding framework based on the five conditions for trial informativeness identified by Zarin and colleagues: Importance, Design, Feasibility, Integrity, and Reporting.
Results
The final content analysis contains 37 guiding documents, including 13 documents from funders, 14 from regulators, and 10 addressing the ethics of trials. While contextual examples varied, many of the recommended processes or actions to improve trial informativeness were consistent across global guidance from funders, regulators, and those with ethical oversight. The aspects of Design and Integrity were particularly well represented, whereas guidance on improving Feasibility was limited.
Conclusion
The five key aspects of trial informativeness were reasonably described in some capacity across all forms of guidance, but may benefit from further examples or elaboration. Further research is needed to explore how trial guidelines and other supporting documents might incorporate more flexible, context-sensitive approaches that reduce bureaucratic burden without compromising ethical and scientific rigour.
{"title":"Do Funders, Regulators, and Ethics Bodies Support Informative Trials? A Content Analysis of Global Guidance Documents","authors":"Sarah R. Prowse, Miriam Brazzelli, Hanne Bruhn, Shaun Treweek","doi":"10.1111/jep.70356","DOIUrl":"10.1111/jep.70356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trials are often poorly designed, address unimportant questions, or are conducted in ways that limit their usefulness. This contributes to research waste and undermines evidence-based healthcare. We examined whether guidance from funders, regulators, and ethics review bodies supports the planning and approval of informative trials, with a focus on resources available to investigators and the role of oversight organizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a directed qualitative content analysis of guidance documents from funders, regulators, and ethics review bodies across 13 countries and three multinational organizations. Documents were analysed using a coding framework based on the five conditions for trial informativeness identified by Zarin and colleagues: <i>Importance</i>, <i>Design</i>, <i>Feasibility</i>, <i>Integrity</i>, and <i>Reporting</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final content analysis contains 37 guiding documents, including 13 documents from funders, 14 from regulators, and 10 addressing the ethics of trials. While contextual examples varied, many of the recommended processes or actions to improve trial informativeness were consistent across global guidance from funders, regulators, and those with ethical oversight. The aspects of <i>Design</i> and <i>Integrity</i> were particularly well represented, whereas guidance on improving <i>Feasibility</i> was limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The five key aspects of trial informativeness were reasonably described in some capacity across all forms of guidance, but may benefit from further examples or elaboration. Further research is needed to explore how trial guidelines and other supporting documents might incorporate more flexible, context-sensitive approaches that reduce bureaucratic burden without compromising ethical and scientific rigour.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029614","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}
Selda Mert, Önder Topbaş, Canan Baydemir, Tayfun Şahin, Hanefi Özbek
Background
Music is recognised as a holistic therapeutic intervention that enhances evidence-based, person-centred, and humanised nursing care, thereby facilitating patient recovery. This study examined the effects of a structured music intervention on patient recovery and nursing care in individuals undergoing percutaneous coronary intervention (PCI).
Method
The study is a randomised controlled trial. The sample comprised 210 patients, including 105 in the music group (MG) and 105 in the control group (CG), all of whom were scheduled to undergo PCI at a university hospital located in northwestern Türkiye. Data were collected using a Patient Information Form, the Vital Signs Assessment Form, the Numerical Rating Scale, the State-Trait Anxiety Inventory, the Perianesthesia Comfort Scale, and the Patient Satisfaction with Nursing Care Quality Questionnaire. Participants in the MG listened to instrumental pieces in the Rast, Acemashiran, and Hüseyni modes of Classical Turkish Music, whereas those in the CG received routine care only. In both groups, vital signs, pain, anxiety, comfort, and satisfaction with the quality of nursing care were measured before and after the procedure.
Results
Following PCI, patients who received music therapy experienced fewer complications, demonstrated greater physiological stability (lower respiratory and heart rates, reduced systolic and diastolic blood pressure, and increased oxygen saturation levels), had decreased pain intensity, reduced analgesic requirements, lower state anxiety levels, and higher satisfaction with nursing care. Overall, music exerted beneficial effects on the care process for both patients and nurses.
Conclusion
The findings indicate that music can be safely and effectively integrated into routine nursing care as a humane and person-centred intervention. By supporting both physiological and psychological recovery, music contributes to improved patient outcomes and enhances nursing practice. These results highlight its potential applicability beyond PCI, suggesting that music therapy may be valuable across various clinical and interdisciplinary healthcare settings.
{"title":"Impact of a Structured Music Intervention on Patient Recovery and Nursing Care in Percutaneous Coronary Intervention: A Randomised Controlled Trial","authors":"Selda Mert, Önder Topbaş, Canan Baydemir, Tayfun Şahin, Hanefi Özbek","doi":"10.1111/jep.70363","DOIUrl":"10.1111/jep.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Music is recognised as a holistic therapeutic intervention that enhances evidence-based, person-centred, and humanised nursing care, thereby facilitating patient recovery. This study examined the effects of a structured music intervention on patient recovery and nursing care in individuals undergoing percutaneous coronary intervention (PCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study is a randomised controlled trial. The sample comprised 210 patients, including 105 in the music group (MG) and 105 in the control group (CG), all of whom were scheduled to undergo PCI at a university hospital located in northwestern Türkiye. Data were collected using a Patient Information Form, the Vital Signs Assessment Form, the Numerical Rating Scale, the State-Trait Anxiety Inventory, the Perianesthesia Comfort Scale, and the Patient Satisfaction with Nursing Care Quality Questionnaire. Participants in the MG listened to instrumental pieces in the Rast, Acemashiran, and Hüseyni modes of Classical Turkish Music, whereas those in the CG received routine care only. In both groups, vital signs, pain, anxiety, comfort, and satisfaction with the quality of nursing care were measured before and after the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following PCI, patients who received music therapy experienced fewer complications, demonstrated greater physiological stability (lower respiratory and heart rates, reduced systolic and diastolic blood pressure, and increased oxygen saturation levels), had decreased pain intensity, reduced analgesic requirements, lower state anxiety levels, and higher satisfaction with nursing care. Overall, music exerted beneficial effects on the care process for both patients and nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings indicate that music can be safely and effectively integrated into routine nursing care as a humane and person-centred intervention. By supporting both physiological and psychological recovery, music contributes to improved patient outcomes and enhances nursing practice. These results highlight its potential applicability beyond PCI, suggesting that music therapy may be valuable across various clinical and interdisciplinary healthcare settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965936","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}
Samuel Atiku, Olufisayo Olakotan, Kehinde Owolanke
Background
Clinical documentation is a major contributor to physician burnout, and artificial intelligence (AI) scribes are increasingly being adopted to help reduce the burden of documentation. These tools automatically generate clinical notes from patient–provider conversations using speech recognition and natural language processing. However, their usability and effectiveness still remain an issue.
Aim
To synthesise the existing evidence on usability-related barriers and facilitators influencing the adoption and use of AI scribes for clinical documentation in healthcare settings.
Method
The scoping review employed the methodology developed by Arksey and O'Malley in 2005 and further expanded by Levac and Colquhoun in 2010. We searched PubMed, Scopus, Ovid MEDLINE, and Web of Science to identify relevant studies published in English between 2015 and 2025. All findings were reported according to PRISMA guidelines for scoping reviews.
Results
Of 4588 identified records, 14 studies met the inclusion criteria and employed qualitative, quantitative, and mixed-methods. AI scribes were consistently associated with reduced cognitive load, faster documentation, improved work–life balance, and positive user experience. However, common barriers included frequent errors, excessive note length, limited formatting options, and poor integration with electronic health records (EHR). Editing demands varied by clinician experience, with some finding that time savings were lost when substantial corrections were needed. Overall, usability was rated more favourably in routine or protocol-driven visits, with mixed outcomes reported on long-term burnout and workflow impact.
Conclusion
AI scribes show promise in reducing documentation burden and improving clinical workflow, but important usability challenges remain. Enhancing accuracy, streamlining integration, and allowing greater customization will be essential to support broader adoption and sustained use in clinical practice.
背景：临床文件是医生职业倦怠的主要原因，越来越多的人采用人工智能（AI）抄写员来帮助减轻文件的负担。这些工具使用语音识别和自然语言处理，从患者与提供者的对话中自动生成临床记录。然而，它们的可用性和有效性仍然是一个问题。目的：综合现有的关于可用性相关障碍和促进因素的证据，这些障碍和促进因素影响了在医疗保健环境中采用和使用人工智能抄写器进行临床记录。方法：范围评估采用Arksey和O'Malley于2005年开发的方法，并由Levac和Colquhoun于2010年进一步扩展。我们检索了PubMed、Scopus、Ovid MEDLINE和Web of Science，以确定2015年至2025年间发表的相关英文研究。所有发现均根据PRISMA范围审查指南进行报告。结果：在鉴定的4588份记录中，14项研究符合纳入标准，采用定性、定量和混合方法。人工智能抄写员始终与减少认知负荷、加快文档编制速度、改善工作与生活的平衡以及积极的用户体验有关。然而，常见的障碍包括频繁的错误、过多的注释长度、有限的格式化选项以及与电子健康记录（EHR）的集成不良。编辑要求因临床医生的经验而异，一些人发现，当需要进行大量修改时，节省的时间就会浪费掉。总体而言，在常规或协议驱动的访问中，可用性被评为更有利，报告的长期倦怠和工作流程影响的结果不一。结论：人工智能抄写员在减轻文档负担和改善临床工作流程方面表现出希望，但重要的可用性挑战仍然存在。提高准确性、简化集成和允许更大程度的定制，对于支持临床实践中更广泛的采用和持续使用至关重要。
{"title":"Usability-Related Barriers and Facilitators Influencing the Adoption and Use of AI Scribes in Healthcare: A Scoping Review","authors":"Samuel Atiku, Olufisayo Olakotan, Kehinde Owolanke","doi":"10.1111/jep.70365","DOIUrl":"10.1111/jep.70365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical documentation is a major contributor to physician burnout, and artificial intelligence (AI) scribes are increasingly being adopted to help reduce the burden of documentation. These tools automatically generate clinical notes from patient–provider conversations using speech recognition and natural language processing. However, their usability and effectiveness still remain an issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To synthesise the existing evidence on usability-related barriers and facilitators influencing the adoption and use of AI scribes for clinical documentation in healthcare settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The scoping review employed the methodology developed by Arksey and O'Malley in 2005 and further expanded by Levac and Colquhoun in 2010. We searched PubMed, Scopus, Ovid MEDLINE, and Web of Science to identify relevant studies published in English between 2015 and 2025. All findings were reported according to PRISMA guidelines for scoping reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4588 identified records, 14 studies met the inclusion criteria and employed qualitative, quantitative, and mixed-methods. AI scribes were consistently associated with reduced cognitive load, faster documentation, improved work–life balance, and positive user experience. However, common barriers included frequent errors, excessive note length, limited formatting options, and poor integration with electronic health records (EHR). Editing demands varied by clinician experience, with some finding that time savings were lost when substantial corrections were needed. Overall, usability was rated more favourably in routine or protocol-driven visits, with mixed outcomes reported on long-term burnout and workflow impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI scribes show promise in reducing documentation burden and improving clinical workflow, but important usability challenges remain. Enhancing accuracy, streamlining integration, and allowing greater customization will be essential to support broader adoption and sustained use in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965994","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}
Ke Tang, Yueping Li, Lingli Yang, Jin Yao, Ruixue Yin, Xianhong Chen, Yu Liu, Shuijuan Deng, Ya Jiang, Chunlan Zhou
Objectives
Pre-frail older adults are at high risk for adverse health outcomes. Enhancing their proactive health behaviours is crucial for healthy ageing. This study aimed to develop and establish the content validity of a theory-driven Proactive Health Intention Scale for this population.
Methods
A two-round Delphi study was conducted. Of the 36 experts invited, 16 completed the first round. Fifteen experts proceeded to complete the second round. The study was grounded in the Theory of Planned Behaviour (TPB). Content validity was assessed using the expert consensus criterion, defined as an item receiving a rating of 4 (relevant) or 5 (very relevant) from ≥ 70% of the panel.
Results
The expert panel demonstrated strong engagement (a 44.4% response rate in Round 1 and a 93.8% retention rate in Round 2) and high authority (Cr = 0.88). After two rounds, a high consensus was achieved, with 49 out of 52 assessed items (94.2%) meeting the predefined validity criterion. The final scale encompasses five TPB dimensions: past behaviour, behavioural intention, attitude, subjective norms and perceived behavioural control.
Conclusions
The Delphi process resulted in a 50-item Proactive Health Intention Scale with excellent content validity. This study provides a robust, theory-informed scale for measuring proactive health intentions in pre-frail older adults.
Practice Implications
The scale can be used by researchers and clinicians to assess intentions, identify barriers and facilitators, and inform the development of targeted interventions to promote proactive health behaviours in this vulnerable group.
{"title":"Content Validation of the Proactive Health Intentions Scale for Pre-Frailty Older Adults: A Delphi Study","authors":"Ke Tang, Yueping Li, Lingli Yang, Jin Yao, Ruixue Yin, Xianhong Chen, Yu Liu, Shuijuan Deng, Ya Jiang, Chunlan Zhou","doi":"10.1111/jep.70359","DOIUrl":"10.1111/jep.70359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Pre-frail older adults are at high risk for adverse health outcomes. Enhancing their proactive health behaviours is crucial for healthy ageing. This study aimed to develop and establish the content validity of a theory-driven Proactive Health Intention Scale for this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A two-round Delphi study was conducted. Of the 36 experts invited, 16 completed the first round. Fifteen experts proceeded to complete the second round. The study was grounded in the Theory of Planned Behaviour (TPB). Content validity was assessed using the expert consensus criterion, defined as an item receiving a rating of 4 (<i>relevant</i>) or 5 (<i>very relevant</i>) from ≥ 70% of the panel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The expert panel demonstrated strong engagement (a 44.4% response rate in Round 1 and a 93.8% retention rate in Round 2) and high authority (Cr = 0.88). After two rounds, a high consensus was achieved, with 49 out of 52 assessed items (94.2%) meeting the predefined validity criterion. The final scale encompasses five TPB dimensions: past behaviour, behavioural intention, attitude, subjective norms and perceived behavioural control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Delphi process resulted in a 50-item Proactive Health Intention Scale with excellent content validity. This study provides a robust, theory-informed scale for measuring proactive health intentions in pre-frail older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>The scale can be used by researchers and clinicians to assess intentions, identify barriers and facilitators, and inform the development of targeted interventions to promote proactive health behaviours in this vulnerable group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965938","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}
Princess Nash, Emma Quach, Valerie Clark, Shibei Zhao, A. Lynn Snow, Christine W. Hartmann
Aims
The Veterans Health Administration (VA) is the largest healthcare entity in the United States dedicated to serving Veterans. The VA has focused on improving resident-centered care through increased communication and strengthened relationships among staff who work in Community Living Centers (CLCs). This study employed the Relational Coordination (RC) survey to assess communication and relationships among nurses and nursing assistants in CLCs.
Methods
The study is a secondary analysis of relational coordination data as reported by nurses and nursing assistants from 8 VA CLCs. As part of a parent study of person-centered care implementation, these CLCs were selected from the national population of 134 CLCs for high resident-level quality indicators and artifacts of culture change. The Relational Coordination Survey was administered to assess dimensions of communication (timeliness, frequency, accuracy, and problem-solving vs. blaming) and relationship (shared goals, shared knowledge, and mutual respect). A total of 153 nurses and 133 nursing assistants responded (25% response rate). Within-group and between-group mean ratings for each dimension were computed and classified via the survey benchmarks as ‘weak,’ ‘medium,’ or ‘strong.’
Results
Nursing assistant ratings met benchmarks for ‘strong’ when assessing the frequency of communication with both fellow nursing assistants and with nurses. Nurse ratings also met benchmarks for ‘strong’ when assessing communication frequency with fellow nurses, though ‘moderate’ when assessing communication frequency with nursing assistants. For domains of timely, accurate, and problem-solving communication, ratings by nurses and nursing assistants were ‘weak.’ Shared goals and mutual respect fell into the weak category for within-role and across-role relationships for nurses and nursing assistants. Nursing assistant ratings for shared knowledge with nurses fell into the moderate rating category.
Conclusions
High frequency of communication may co-exist with low quality of communication and relationships.
{"title":"Examining Relational Coordination Among Nurses and Nursing Assistants in VA Community Living Centers","authors":"Princess Nash, Emma Quach, Valerie Clark, Shibei Zhao, A. Lynn Snow, Christine W. Hartmann","doi":"10.1111/jep.70360","DOIUrl":"10.1111/jep.70360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The Veterans Health Administration (VA) is the largest healthcare entity in the United States dedicated to serving Veterans. The VA has focused on improving resident-centered care through increased communication and strengthened relationships among staff who work in Community Living Centers (CLCs). This study employed the Relational Coordination (RC) survey to assess communication and relationships among nurses and nursing assistants in CLCs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study is a secondary analysis of relational coordination data as reported by nurses and nursing assistants from 8 VA CLCs. As part of a parent study of person-centered care implementation, these CLCs were selected from the national population of 134 CLCs for high resident-level quality indicators and artifacts of culture change. The Relational Coordination Survey was administered to assess dimensions of communication (timeliness, frequency, accuracy, and problem-solving <i>vs.</i> blaming) and relationship (shared goals, shared knowledge, and mutual respect). A total of 153 nurses and 133 nursing assistants responded (25% response rate). Within-group and between-group mean ratings for each dimension were computed and classified via the survey benchmarks as ‘weak,’ ‘medium,’ or ‘strong.’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nursing assistant ratings met benchmarks for ‘strong’ when assessing the frequency of communication with both fellow nursing assistants and with nurses. Nurse ratings also met benchmarks for ‘strong’ when assessing communication frequency with fellow nurses, though ‘moderate’ when assessing communication frequency with nursing assistants. For domains of timely, accurate, and problem-solving communication, ratings by nurses and nursing assistants were ‘weak.’ Shared goals and mutual respect fell into the weak category for within-role and across-role relationships for nurses and nursing assistants. Nursing assistant ratings for shared knowledge with nurses fell into the moderate rating category.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High frequency of communication may co-exist with low quality of communication and relationships.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952162","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}
Effective management of the operating room serves as a connector between patients and healthcare teams and institutions. This study monitored the surgical process of patients between the periods when they left their clinic to undergo a surgical operation and when they came back to their clinic after the surgery, to identify the waiting times spent in the waiting areas and to determine the reasons that cause patients to wait.
Methods
This is a longitudinal follow-up study. Surgical operations related to the clinics of general surgery, otorhinolaryngology, orthopaedics and traumatology conducted in a university hospital and within the business hours were followed up for 30 business days. Data were collected from 416 patients who underwent elective surgical operations between May and October 2019. Descriptive statistics and covariance analysis were used to analyse the data.
Results
The patients waited in nine areas during the surgical operation. The operating room occupancy rate was 62.01 ± 21.47%. The mean preoperative waiting time was 41.36 ± 28.86 min, the mean postoperative waiting time was 27.30 ± 16.07 min and the mean total waiting time was 65.84 ± 34.17 min. The most common reasons for waiting were the delay in completing the previous surgery (33.8%), preparation of the team (23.8%), preparation of the tables and equipment (16.1%), the reasons related to the personnel (13%) and cleaning of the operating room (9.2%). They had to wait in the T3 (31.68 ± 24.04 min), T4 (10.37 ± 16.68 min) and T8 (25.00 ± 15.79 min) areas for the longest period. Delay in completing the previous surgery (51.5%), which accounted for the largest portion of waiting time in area T3, preparation of the tables and equipment (44.8%) in area T4 and personnel-related factors (23.8%) in area T8 were the primary reasons for prolonged patient waiting times.
Conclusion
This study found that patients experienced long waiting times due to various factors, which can be reduced through organizational improvements. Planning of the operating room and effective communication among team members are key factors in these arrangements.
{"title":"Patients' Waiting Times in Operating Rooms and Relevant Reasons","authors":"Çağla Islatti Mutlu, Manar Aslan","doi":"10.1111/jep.70361","DOIUrl":"10.1111/jep.70361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective management of the operating room serves as a connector between patients and healthcare teams and institutions. This study monitored the surgical process of patients between the periods when they left their clinic to undergo a surgical operation and when they came back to their clinic after the surgery, to identify the waiting times spent in the waiting areas and to determine the reasons that cause patients to wait.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a longitudinal follow-up study. Surgical operations related to the clinics of general surgery, otorhinolaryngology, orthopaedics and traumatology conducted in a university hospital and within the business hours were followed up for 30 business days. Data were collected from 416 patients who underwent elective surgical operations between May and October 2019. Descriptive statistics and covariance analysis were used to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients waited in nine areas during the surgical operation. The operating room occupancy rate was 62.01 ± 21.47%. The mean preoperative waiting time was 41.36 ± 28.86 min, the mean postoperative waiting time was 27.30 ± 16.07 min and the mean total waiting time was 65.84 ± 34.17 min. The most common reasons for waiting were the delay in completing the previous surgery (33.8%), preparation of the team (23.8%), preparation of the tables and equipment (16.1%), the reasons related to the personnel (13%) and cleaning of the operating room (9.2%). They had to wait in the T3 (31.68 ± 24.04 min), T4 (10.37 ± 16.68 min) and T8 (25.00 ± 15.79 min) areas for the longest period. Delay in completing the previous surgery (51.5%), which accounted for the largest portion of waiting time in area T3, preparation of the tables and equipment (44.8%) in area T4 and personnel-related factors (23.8%) in area T8 were the primary reasons for prolonged patient waiting times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found that patients experienced long waiting times due to various factors, which can be reduced through organizational improvements. Planning of the operating room and effective communication among team members are key factors in these arrangements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952209","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}
<div> <section> <h3> Objective</h3> <p>Adolescent pregnancy is a global issue. In adolescent pregnant women, health practices which are the activities that positively influence maternal, foetal, and neonatal health can be associated with various socio-demographic, psychological, and environmental factors. These can impact the outcomes of the pregnancy and the well-being of both mother and foetal. This study aims to identify health practices and associated factors among adolescent pregnant women.</p> </section> <section> <h3> Methods</h3> <p>A cross-sectional study was conducted at a tertiary-care hospital. The sample of the study was calculated using a known population sample equation. A total of 128 pregnant women participated including 55 adolescents and 73 adult pregnant women. Data were collected using the ‘Participant Description Questionnaire’ and the ‘Health Practice Questionnaire-II (HPQ-II)’. The research data analysed in this study were obtained from pregnant women who attended an antenatal follow-up clinic and who obtained informed consent to participate in this study. Data analysis was performed using SPSS for Windows Version 22.0 (IBM Corporation, Armonk, New York, USA). Comparative statistical analyses employed the independent sample <i>t</i>-test and the one-way analysis of variance (ANOVA) test; kwhen a difference was detected by ANOVA, the source of this difference was identified using the Tukey test. The Pearson correlation test was used to identify relationships between pairs of continuous variables.</p> </section> <section> <h3> Results</h3> <p>The average total HPQ-II score among adolescent pregnant women was 110.6 ± 14.3 compared to 121.3 ± 12.2 among adult pregnant women. Average total HPQ-II scores differed significantly between adolescent and adult pregnant women (<i>p</i> < 0.001). Average total HPQ-II scores among adolescent pregnant women differed significantly according to income level (<i>p</i> < 0.05) and prenatal care status (<i>p</i> < 0.001) while it was significant differences between HPQ-II scores and education level (<i>p</i> < 0.05), health insurance status (<i>p</i> < 0.001), and employment status (<i>p</i> < 0.05) in adult pregnant women.</p> </section> <section> <h3> Conclusions</h3> <p>The reported health practices among adolescent pregnant women were poor than those among adult pregnant women in this study. Additionally, as income level increased, health practices among adolescent pregnant women also improved. Moreover, adolescent pregnant women who regularly attended antenatal follow-ups maintained better health practices. Additionally, adult pregnant women who had comp
目的：青少年怀孕是一个全球性问题。在青春期怀孕妇女中，对产妇、胎儿和新生儿健康产生积极影响的保健做法可能与各种社会人口、心理和环境因素有关。这些都会影响怀孕的结果以及母亲和胎儿的健康。本研究旨在确定青春期怀孕妇女的保健习惯和相关因素。方法：在某三级医院进行横断面研究。该研究的样本是使用已知的总体样本方程计算的。共有128名孕妇参与，其中包括55名少女和73名成年孕妇。使用“参与者描述问卷”和“健康实践问卷- ii （HPQ-II）”收集数据。本研究分析的研究数据来自于参加产前随访诊所并获得知情同意参加本研究的孕妇。数据分析使用SPSS for Windows Version 22.0 （IBM Corporation, Armonk, New York， USA）。比较统计分析采用独立样本t检验和单因素方差分析（ANOVA）检验；当方差分析检测到差异时，使用Tukey检验确定差异的来源。使用Pearson相关检验来确定连续变量对之间的关系。结果：青少年孕妇的平均总HPQ-II评分为110.6±14.3，成年孕妇的平均总HPQ-II评分为121.3±12.2。青少年孕妇和成年孕妇的平均总HPQ-II得分差异显著(p)。结论：本研究中青少年孕妇报告的健康习惯较成年孕妇差。此外，随着收入水平的提高，怀孕少女的保健做法也有所改善。此外，定期参加产前随访的少女孕妇保持了较好的保健习惯。此外，完成高中或高等教育、有工作并有健康保险的成年孕妇表现出更好的保健习惯。因此，建议增加对怀孕少女的后续随访，评价她们的保健做法，并根据她们的需要提供教育和咨询服务。在研究范围内，少女孕妇获得保健服务的机会少于成年孕妇。
{"title":"Factors Affecting Health Practices in Adolescent Pregnant Women: A Cross-Sectional Study","authors":"Gonul Kurt, Hamide Arslan Tarus, Zekiye Turan","doi":"10.1111/jep.70358","DOIUrl":"10.1111/jep.70358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Adolescent pregnancy is a global issue. In adolescent pregnant women, health practices which are the activities that positively influence maternal, foetal, and neonatal health can be associated with various socio-demographic, psychological, and environmental factors. These can impact the outcomes of the pregnancy and the well-being of both mother and foetal. This study aims to identify health practices and associated factors among adolescent pregnant women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted at a tertiary-care hospital. The sample of the study was calculated using a known population sample equation. A total of 128 pregnant women participated including 55 adolescents and 73 adult pregnant women. Data were collected using the ‘Participant Description Questionnaire’ and the ‘Health Practice Questionnaire-II (HPQ-II)’. The research data analysed in this study were obtained from pregnant women who attended an antenatal follow-up clinic and who obtained informed consent to participate in this study. Data analysis was performed using SPSS for Windows Version 22.0 (IBM Corporation, Armonk, New York, USA). Comparative statistical analyses employed the independent sample <i>t</i>-test and the one-way analysis of variance (ANOVA) test; kwhen a difference was detected by ANOVA, the source of this difference was identified using the Tukey test. The Pearson correlation test was used to identify relationships between pairs of continuous variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average total HPQ-II score among adolescent pregnant women was 110.6 ± 14.3 compared to 121.3 ± 12.2 among adult pregnant women. Average total HPQ-II scores differed significantly between adolescent and adult pregnant women (<i>p</i> < 0.001). Average total HPQ-II scores among adolescent pregnant women differed significantly according to income level (<i>p</i> < 0.05) and prenatal care status (<i>p</i> < 0.001) while it was significant differences between HPQ-II scores and education level (<i>p</i> < 0.05), health insurance status (<i>p</i> < 0.001), and employment status (<i>p</i> < 0.05) in adult pregnant women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The reported health practices among adolescent pregnant women were poor than those among adult pregnant women in this study. Additionally, as income level increased, health practices among adolescent pregnant women also improved. Moreover, adolescent pregnant women who regularly attended antenatal follow-ups maintained better health practices. Additionally, adult pregnant women who had comp","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952139","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}
Jie Xiao, Shuting Huang, Lei Chen, Qing Wang, Ying Wang, Wenzheng Xie, Ting Liu, Ke Sai, Ping Xu
Introduction
Clinical pharmacy services comprise a range of patient-centered, systematic care activities delivered by pharmacists, aiming to optimize medication use and improve patient outcomes. Despite growing recognition of the role of clinical pharmacy in medication safety, there is limited comprehensive analysis of barriers or actionable strategies, especially in under-resourced areas. This study aims to explore the state of implementation of clinical pharmacy practice, to elucidate the influencing factors and associated strategies.
Methods
Data were collected through quantitative surveys, participant observation, and semi-structured interviews. Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Directed content analysis was used to code the data and identify factors influencing clinical pharmacy services. Implementation strategies were developed using the CFIR-ERIC matching tool.
Results
Case studies were conducted in six county hospitals, with a total of 64 interviewees. We identified 25 facilitators and 21 barriers across five CFIR domains, with 15 distinguishing constructs between well and poorly performing centers. Our findings highlighted the critical role of local condition, policies and laws, external support, standardized appraisal systems, leadership, available resources, staffing and performance-linked incentives in sustaining service quality. Our analysis also proposed 8 tailored strategies to support sustainable implementation. The main distinguishing constructs between well and poorly performing implementation centers included outer setting, inner setting, individuals and implementation process.
Conclusions
The implementation and sustainability of clinical pharmacy services are still limited by factors such as inadequate resources, inappropriate regulatory frameworks, lack of leadership, and insufficient competency of pharmacists. Corresponding implementation strategies should be adopted to promote the development of clinical pharmacy services, and the professional development of clinical pharmacists, especially in under-resourced areas.
{"title":"Facilitators and Barriers of Implementation of Clinical Pharmacy Services in County Hospitals Based on CFIR: A Qualitative Study","authors":"Jie Xiao, Shuting Huang, Lei Chen, Qing Wang, Ying Wang, Wenzheng Xie, Ting Liu, Ke Sai, Ping Xu","doi":"10.1111/jep.70357","DOIUrl":"10.1111/jep.70357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Clinical pharmacy services comprise a range of patient-centered, systematic care activities delivered by pharmacists, aiming to optimize medication use and improve patient outcomes. Despite growing recognition of the role of clinical pharmacy in medication safety, there is limited comprehensive analysis of barriers or actionable strategies, especially in under-resourced areas. This study aims to explore the state of implementation of clinical pharmacy practice, to elucidate the influencing factors and associated strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected through quantitative surveys, participant observation, and semi-structured interviews. Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Directed content analysis was used to code the data and identify factors influencing clinical pharmacy services. Implementation strategies were developed using the CFIR-ERIC matching tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Case studies were conducted in six county hospitals, with a total of 64 interviewees. We identified 25 facilitators and 21 barriers across five CFIR domains, with 15 distinguishing constructs between well and poorly performing centers. Our findings highlighted the critical role of local condition, policies and laws, external support, standardized appraisal systems, leadership, available resources, staffing and performance-linked incentives in sustaining service quality. Our analysis also proposed 8 tailored strategies to support sustainable implementation. The main distinguishing constructs between well and poorly performing implementation centers included outer setting, inner setting, individuals and implementation process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The implementation and sustainability of clinical pharmacy services are still limited by factors such as inadequate resources, inappropriate regulatory frameworks, lack of leadership, and insufficient competency of pharmacists. Corresponding implementation strategies should be adopted to promote the development of clinical pharmacy services, and the professional development of clinical pharmacists, especially in under-resourced areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944589","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}
Ecological anxiety related to climate change is thought to be a risk factor for premenstrual syndrome (PMS). Regular physical activity can effectively reduce both physical and psychological symptoms associated with PMS. This study was conducted to examine the moderating effect of physical activity on the relationship between climate change-related eco-anxiety and PMS.
Methods
This cross-sectional and correlational study was conducted between February and March 2025 on 635 female students studying in health-related departments of a university. Personal information form, PMS scale, eco-anxiety scale and International Physical Activity Questionnaire-Short form were used to collect data.
Results
The prevalence of PMS was 87.7% and the median score on the Eco-anxiety scale was 13. The direct effect of eco-anxiety on PMS was positive and statistically significant (β = 0.606, p < 0.001). The direct effect of physical activity on PMS was negative and statistically significant (β = −0.067, p = 0.029).
Conclusion
The results of this study suggest that eco-anxiety levels affect PMS symptoms and that physical activity has a modulatory effect on the relationship between eco-anxiety and PMS. Psychosocial interventions aimed at reducing eco-anxiety and lifestyle changes that promote physical activity should be considered in interventions to manage premenstrual syndrome. It is important that women's health nurses and midwives, who have an important role in protecting and promoting women's health, consider eco-anxiety in their interventions.
{"title":"The Moderating Effect of Physical Activity in the Relationship Between Eco-Anxiety and Premenstrual Syndrome","authors":"Ayça Balmumcu, Hakan Öztürk, Nazan Öztürk, Ayden Çoban","doi":"10.1111/jep.70364","DOIUrl":"10.1111/jep.70364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ecological anxiety related to climate change is thought to be a risk factor for premenstrual syndrome (PMS). Regular physical activity can effectively reduce both physical and psychological symptoms associated with PMS. This study was conducted to examine the moderating effect of physical activity on the relationship between climate change-related eco-anxiety and PMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional and correlational study was conducted between February and March 2025 on 635 female students studying in health-related departments of a university. Personal information form, PMS scale, eco-anxiety scale and International Physical Activity Questionnaire-Short form were used to collect data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of PMS was 87.7% and the median score on the Eco-anxiety scale was 13. The direct effect of eco-anxiety on PMS was positive and statistically significant (<i>β</i> = 0.606, <i>p</i> < 0.001). The direct effect of physical activity on PMS was negative and statistically significant (<i>β</i> = −0.067, <i>p</i> = 0.029).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this study suggest that eco-anxiety levels affect PMS symptoms and that physical activity has a modulatory effect on the relationship between eco-anxiety and PMS. Psychosocial interventions aimed at reducing eco-anxiety and lifestyle changes that promote physical activity should be considered in interventions to manage premenstrual syndrome. It is important that women's health nurses and midwives, who have an important role in protecting and promoting women's health, consider eco-anxiety in their interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933743","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}
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