What is known about how the level of social support, which is among the factors affecting medication adherence, affects medication adherence is limited.
Objectives
This study investigated the relationship between perceived social support and immunosuppressive medication adherence among kidney recipients.
Design
This study was conducted using a descriptive correlational research method.
Participants
The study conducted research with 168 kidney transplant recipients who agreed to participate between April and June 2021. Participants completed the Immunosuppressive Medication Adherence Scale (IMAS) and the Multidimensional Scale of Perceived Social Support (MSPSS).
Measurements and Results
Participants had a mean IMAS and MSPSS score of 50.24 ± 3.71 and 57.21 ± 13.96, respectively. Participants' MSPSS total (r = 0.209, p = 0.006) and ‘family’ (r = 0.248, p = 0.001) and ‘friends’ (r = 0.226, p = 0.003) subscale scores were weakly and positively correlated with their IMAS total score.
Conclusion
Understanding the effect of perceived social support on immunosuppressive medication adherence is important for designing future interventions to increase immunosuppressive medication adherence.
{"title":"Determining the Relationship Between Perceived Social Support and Immunosuppressive Medication Adherence After Kidney Transplantation: A Descriptive Correlational Study","authors":"Ebru Karazeybek","doi":"10.1111/jep.70021","DOIUrl":"https://doi.org/10.1111/jep.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>What is known about how the level of social support, which is among the factors affecting medication adherence, affects medication adherence is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigated the relationship between perceived social support and immunosuppressive medication adherence among kidney recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study was conducted using a descriptive correlational research method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The study conducted research with 168 kidney transplant recipients who agreed to participate between April and June 2021. Participants completed the Immunosuppressive Medication Adherence Scale (IMAS) and the Multidimensional Scale of Perceived Social Support (MSPSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Results</h3>\u0000 \u0000 <p>Participants had a mean IMAS and MSPSS score of 50.24 ± 3.71 and 57.21 ± 13.96, respectively. Participants' MSPSS total (<i>r</i> = 0.209, <i>p</i> = 0.006) and ‘family’ (<i>r</i> = 0.248, <i>p</i> = 0.001) and ‘friends’ (<i>r</i> = 0.226, <i>p</i> = 0.003) subscale scores were weakly and positively correlated with their IMAS total score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Understanding the effect of perceived social support on immunosuppressive medication adherence is important for designing future interventions to increase immunosuppressive medication adherence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380303","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}
Antibiotic overuse is highly reported among dentists worldwide. An antibiotic stewardship programme has been shown to be effective for decreasing the number of unappropriated antibiotic prescriptions. The goal of this survey was to assess dentists' awareness of antibiotic stewardship and their willingness to implement changes accordingly.
Methods
A structured questionnaire was developed and distributed to dentists at a university hospital with different levels of experience. It included questions regarding antibiotic prescription habits, antibiotic stewardship knowledge and willingness to implement changes in such a programme.
Results
Overall, 256 dentists participated in the survey. Among them, 16.4% (95% confidence interval: 12.1%–21.5%) reported awareness regarding antibiotic stewardship. Awareness levels were higher among specialists (28.3%) and increased with experience. Most dentists in this study reported willingness to improve their antibiotic prescribing practices. The mean willingness score was 8.78 (standard deviation: 1.81).
Conclusions
Awareness of antibiotic stewardship was low among dentists with different levels of experience. However, dentists were willing to change their antibiotic prescription habits if policies were implemented as part of a stewardship programme at the school.
{"title":"Dentists' Awareness of Antibiotic Stewardship and Their Willingness to Support Its Implementation: A Cross-Sectional Survey in a Dental School","authors":"Arwa A. Banjar","doi":"10.1111/jep.70023","DOIUrl":"https://doi.org/10.1111/jep.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Antibiotic overuse is highly reported among dentists worldwide. An antibiotic stewardship programme has been shown to be effective for decreasing the number of unappropriated antibiotic prescriptions. The goal of this survey was to assess dentists' awareness of antibiotic stewardship and their willingness to implement changes accordingly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A structured questionnaire was developed and distributed to dentists at a university hospital with different levels of experience. It included questions regarding antibiotic prescription habits, antibiotic stewardship knowledge and willingness to implement changes in such a programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 256 dentists participated in the survey. Among them, 16.4% (95% confidence interval: 12.1%–21.5%) reported awareness regarding antibiotic stewardship. Awareness levels were higher among specialists (28.3%) and increased with experience. Most dentists in this study reported willingness to improve their antibiotic prescribing practices. The mean willingness score was 8.78 (standard deviation: 1.81).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Awareness of antibiotic stewardship was low among dentists with different levels of experience. However, dentists were willing to change their antibiotic prescription habits if policies were implemented as part of a stewardship programme at the school.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380877","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}
Implementing standardised outcome measures (SOMs) in stroke rehabilitation practices enhances patient care, communication, and overall clinical effectiveness. However, the implementation of Arabic-validated SOMs in stroke rehabilitation practices among Arabic-speaking patients has not been fully explored.
Aims
To examine the use, facilitators, and barriers of implementing Arabic-validated SOMs for chronic stroke rehabilitation among physical therapists.
Methods
A cross-sectional survey was conducted among 262 physical therapists managing patients with chronic stroke. The survey evaluated the use, facilitators, and barriers to implementing Arabic-validated SOMs. Descriptive statistics summarised demographic and professional characteristics, while multivariate logistic regression identified independent predictors of SOM use, with adjusted odds ratios and 95% confidence intervals calculated.
Results
The use of Arabic-validated SOMs in chronic stroke rehabilitation was reported by 54% of therapists within the first week of physical therapy services and 64% at discharge. The Berg Balance Scale and the Timed Up and Go test were the two most commonly employed scales. Facilitators for implementing SOMs included facilitating adherence to clinical practice guidelines, providing valuable patient insights, and supporting balanced assessments. Barriers included time constraints, financial limitations, and time demands on both patients and therapists. Familiarity with clinical practice guidelines was significantly associated with increased use of Arabic-validated SOMs.
Conclusions
Implementing Arabic-validated SOMs is essential to ensure culturally appropriate and linguistically accurate evaluations that support evidence-based decision-making and enhance patient management in stroke rehabilitation among Arabic-speaking patients. Enhancing familiarity with clinical practice guidelines and addressing barriers such as time constraints and financial challenges can further promote the implementation of Arabic-validated SOMs into routine practice, ultimately improving patient outcomes.
{"title":"Barriers and Facilitators of Implementing Arabic-Validated Standardised Outcome Measures for Chronic Stroke Rehabilitation Among Physical Therapists","authors":"Maha Almarwani, Reham Alhamyani","doi":"10.1111/jep.70018","DOIUrl":"https://doi.org/10.1111/jep.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Implementing standardised outcome measures (SOMs) in stroke rehabilitation practices enhances patient care, communication, and overall clinical effectiveness. However, the implementation of Arabic-validated SOMs in stroke rehabilitation practices among Arabic-speaking patients has not been fully explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine the use, facilitators, and barriers of implementing Arabic-validated SOMs for chronic stroke rehabilitation among physical therapists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was conducted among 262 physical therapists managing patients with chronic stroke. The survey evaluated the use, facilitators, and barriers to implementing Arabic-validated SOMs. Descriptive statistics summarised demographic and professional characteristics, while multivariate logistic regression identified independent predictors of SOM use, with adjusted odds ratios and 95% confidence intervals calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The use of Arabic-validated SOMs in chronic stroke rehabilitation was reported by 54% of therapists within the first week of physical therapy services and 64% at discharge. The Berg Balance Scale and the Timed Up and Go test were the two most commonly employed scales. Facilitators for implementing SOMs included facilitating adherence to clinical practice guidelines, providing valuable patient insights, and supporting balanced assessments. Barriers included time constraints, financial limitations, and time demands on both patients and therapists. Familiarity with clinical practice guidelines was significantly associated with increased use of Arabic-validated SOMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Implementing Arabic-validated SOMs is essential to ensure culturally appropriate and linguistically accurate evaluations that support evidence-based decision-making and enhance patient management in stroke rehabilitation among Arabic-speaking patients. Enhancing familiarity with clinical practice guidelines and addressing barriers such as time constraints and financial challenges can further promote the implementation of Arabic-validated SOMs into routine practice, ultimately improving patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380147","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}
NICE guidelines recommend offering computerised Cognitive Behavioural Therapy (cCBT) to young people with mild mental health issues to ensure early treatment access and reduce service demand. Emerging evidence suggests cCBT reduces symptoms, but further evaluation is needed. SilverCloud is a recommended digital CBT programme.
Aims
Evaluate a pilot trial of SilverCloud in CAMHS at a local NHS Foundation Trust.
Objectives
(1) Symptomology: Is there a change in depression or anxiety symptoms after using the intervention? (measured by outcome scores); (2) Adoption: What was young people's engagement with SilverCloud? (measured by time spent on the platform and uptake); (3) Satisfaction: How satisfied were young people with SilverCloud? (measured by module feedback ratings and a questionnaire).
Methods
The SilverCloud intervention for young people was evaluated over 9 months. Reductions in symptoms of generalised anxiety disorder (GAD) and low mood were measured using the Revised Children's Anxiety and Depression Scale (RCADS), GAD, and Major Depressive Disorder (MDD) subscales. Adoption was measured by time spent on SilverCloud and intervention uptake. Satisfaction was measured by module feedback ratings and a questionnaire.
Results
Ninety-one people were offered SilverCloud, 77% started, 46% completed it and 27% disengaged. Thirty-two participants completed SilverCloud during the evaluation (12 CYP and 20 parents). No statistically significant reduction was found in any subscale. Satisfaction was varied; 94% rated the intervention favourably, but no participants reported behaviour changes due to the intervention.
Conclusion
This evaluation suggests tentative pessimism regarding SilverCloud's benefits. However, due to significant challenges and limitations, further analysis is recommended. Recommendations were given for local services.
{"title":"Evaluation of a Trial of Computerised Cognitive Behavioural Therapy Programme Within Local Child and Adolescent Mental Health Services","authors":"Deborah Bell","doi":"10.1111/jep.70022","DOIUrl":"https://doi.org/10.1111/jep.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>NICE guidelines recommend offering computerised Cognitive Behavioural Therapy (cCBT) to young people with mild mental health issues to ensure early treatment access and reduce service demand. Emerging evidence suggests cCBT reduces symptoms, but further evaluation is needed. SilverCloud is a recommended digital CBT programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Evaluate a pilot trial of SilverCloud in CAMHS at a local NHS Foundation Trust.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>(1) Symptomology: Is there a change in depression or anxiety symptoms after using the intervention? (measured by outcome scores); (2) Adoption: What was young people's engagement with SilverCloud? (measured by time spent on the platform and uptake); (3) Satisfaction: How satisfied were young people with SilverCloud? (measured by module feedback ratings and a questionnaire).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SilverCloud intervention for young people was evaluated over 9 months. Reductions in symptoms of generalised anxiety disorder (GAD) and low mood were measured using the Revised Children's Anxiety and Depression Scale (RCADS), GAD, and Major Depressive Disorder (MDD) subscales. Adoption was measured by time spent on SilverCloud and intervention uptake. Satisfaction was measured by module feedback ratings and a questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-one people were offered SilverCloud, 77% started, 46% completed it and 27% disengaged. Thirty-two participants completed SilverCloud during the evaluation (12 CYP and 20 parents). No statistically significant reduction was found in any subscale. Satisfaction was varied; 94% rated the intervention favourably, but no participants reported behaviour changes due to the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This evaluation suggests tentative pessimism regarding SilverCloud's benefits. However, due to significant challenges and limitations, further analysis is recommended. Recommendations were given for local services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380150","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":"We Certainly Need Real Life Research—But What Is Real Life?","authors":"John P. A. Ioannidis","doi":"10.1111/jep.70027","DOIUrl":"https://doi.org/10.1111/jep.70027","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379952","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}
Ilkin Seda Can Caglayan, Gulbahtiyar Demirel, Ceren Eda Can
Objective
The present study was conducted to determine the relationship between prolonged complaints of women who had COVID-19 infection and whose symptoms persisted and their vaccination status against COVID-19.
Methods
This prospective observational study consisted of three groups [The Unvaccinated Group (Control Group: 89), the BioNTech Vaccine Group (114 people), and the Sinovac Vaccine Group (84 people)]. In this study, which included 287 women, prolonged COVID-19 symptoms in their spouses were also questioned. Information was obtained from the participants in the form of questions and answers under outpatient clinical conditions 2 months after their recovery. Women between the ages of 18–45 who had regular menstrual periods in the last 6 months before the pandemic, those whose COVID-19 test was negative and those who received a single dose of vaccine in the vaccinated group were included in the study.
Results
The rates of loss of taste and prolonged symptoms of high fever in Sinovac-vaccinated participants were lower than in the other groups in the present study (p < 0.05). A total of 40.5% of those who were vaccinated with Sinovac after COVID-19 had a menstrual cycle length of every 28–40 days, which was higher than the percentage of participants in other groups, and 40.5% of those in this group did not have menstrual pain. Additionally, the menstrual period length of 62.3% of the participants who received the BioNTech vaccine increased (p < 0.05). This increase is higher than the participants in the other group.
Conclusion
The study indicated that certain prolonged symptoms of COVID-19 infection were less common among participants vaccinated with Sinovac. In this group, the menstrual cycle length increased, while menstrual pain decreased.
{"title":"Associations Between COVID-19 Vaccination Status and Persistent Symptoms: A Prospective Study of Reproductive-Age Women","authors":"Ilkin Seda Can Caglayan, Gulbahtiyar Demirel, Ceren Eda Can","doi":"10.1111/jep.70005","DOIUrl":"https://doi.org/10.1111/jep.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The present study was conducted to determine the relationship between prolonged complaints of women who had COVID-19 infection and whose symptoms persisted and their vaccination status against COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study consisted of three groups [The Unvaccinated Group (Control Group: 89), the BioNTech Vaccine Group (114 people), and the Sinovac Vaccine Group (84 people)]. In this study, which included 287 women, prolonged COVID-19 symptoms in their spouses were also questioned. Information was obtained from the participants in the form of questions and answers under outpatient clinical conditions 2 months after their recovery. Women between the ages of 18–45 who had regular menstrual periods in the last 6 months before the pandemic, those whose COVID-19 test was negative and those who received a single dose of vaccine in the vaccinated group were included in the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rates of loss of taste and prolonged symptoms of high fever in Sinovac-vaccinated participants were lower than in the other groups in the present study (<i>p</i> < 0.05). A total of 40.5% of those who were vaccinated with Sinovac after COVID-19 had a menstrual cycle length of every 28–40 days, which was higher than the percentage of participants in other groups, and 40.5% of those in this group did not have menstrual pain. Additionally, the menstrual period length of 62.3% of the participants who received the BioNTech vaccine increased (<i>p</i> < 0.05). This increase is higher than the participants in the other group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study indicated that certain prolonged symptoms of COVID-19 infection were less common among participants vaccinated with Sinovac. In this group, the menstrual cycle length increased, while menstrual pain decreased.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362506","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}
Saloni Kumar, Jude K. des Bordes, Raia Khan, Rachel Jantea, Sunyang Fu, Min Ji Kwak, Nahid J. Rianon
Rationale
The FRAIL scale is a self-administered tool used to screen for frailty in clinical, community and long-term nursing settings. Patient's self-reporting of fatigue in the FRAIL scale may raise concerns of subjectivity and accuracy in frailty assessment.
Objective
To assess the performance of the patient-reported fatigue measure in the FRAIL scale in comparison to a validated fatigue measure, the Fatigue Severity Scale (FSS).
Methods
We conducted a cross-sectional study involving interviews and medical records review. Participants were 55 years and older seen at an ambulatory geriatric osteoporosis clinic. Participants were administered the FRAIL scale and the FSS over the phone or in person. Patient self-reported fatigue was derived from the first item (Are you fatigued?) on the FRAIL scale while the FSS provided a validated fatigue measure. Clinical and demographic data were obtained by review of medical records. Sensitivity, specificity, negative and positive predictive values, and AUC were estimated for patient self-reported fatigue from the FRAIL scale using the FSS as the gold standard. Logistic regression analysis was used to investigate independent associations between the items on the FRAIL scale and fatigue assessed by the FSS, adjusting for demographic and clinical characteristics.
Results
We interviewed 126 participants, mean age was 77.2 ± 8.5 years, 91.3% (116) were female and 69.3% (88) were Caucasian/White. The prevalence of fatigue assessed by the FSS and the FRAIL scale were 24% and 34.6%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of patient-reported fatigue were 0.67, 0.75, 0.45, and 0.88, respectively. The AUC was 0.71. Depression (OR = 2.41, 95% CI = 1.14–10.25) and patient self-reported fatigue (OR = 4.74, 95% CI = 1.74–12.9) were significantly associated with FSS fatigue measure.
Conclusion
Patient-reported fatigue largely reflects validated measure of fatigue. Physicians should therefore be encouraged to use the FRAIL scale to assess frailty.
{"title":"A Comparison of Patient Self-Reported Fatigue in the FRAIL Scale With a Validated Fatigue Measure","authors":"Saloni Kumar, Jude K. des Bordes, Raia Khan, Rachel Jantea, Sunyang Fu, Min Ji Kwak, Nahid J. Rianon","doi":"10.1111/jep.70016","DOIUrl":"https://doi.org/10.1111/jep.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>The FRAIL scale is a self-administered tool used to screen for frailty in clinical, community and long-term nursing settings. Patient's self-reporting of fatigue in the FRAIL scale may raise concerns of subjectivity and accuracy in frailty assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the performance of the patient-reported fatigue measure in the FRAIL scale in comparison to a validated fatigue measure, the Fatigue Severity Scale (FSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study involving interviews and medical records review. Participants were 55 years and older seen at an ambulatory geriatric osteoporosis clinic. Participants were administered the FRAIL scale and the FSS over the phone or in person. Patient self-reported fatigue was derived from the first item (Are you fatigued?) on the FRAIL scale while the FSS provided a validated fatigue measure. Clinical and demographic data were obtained by review of medical records. Sensitivity, specificity, negative and positive predictive values, and AUC were estimated for patient self-reported fatigue from the FRAIL scale using the FSS as the gold standard. Logistic regression analysis was used to investigate independent associations between the items on the FRAIL scale and fatigue assessed by the FSS, adjusting for demographic and clinical characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We interviewed 126 participants, mean age was 77.2 ± 8.5 years, 91.3% (116) were female and 69.3% (88) were Caucasian/White. The prevalence of fatigue assessed by the FSS and the FRAIL scale were 24% and 34.6%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of patient-reported fatigue were 0.67, 0.75, 0.45, and 0.88, respectively. The AUC was 0.71. Depression (OR = 2.41, 95% CI = 1.14–10.25) and patient self-reported fatigue (OR = 4.74, 95% CI = 1.74–12.9) were significantly associated with FSS fatigue measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patient-reported fatigue largely reflects validated measure of fatigue. Physicians should therefore be encouraged to use the FRAIL scale to assess frailty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362928","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}
Equating health with complete physical, mental and social well-being, as defined by the WHO, has played an important role in the development of healthcare systems in Western countries. However, this definition has contributed to the rise of the myth of well-being, increasing the demand on healthcare systems and raising the risk of medicalizing all aspects of life. Additionally, equating health with complete well-being is conceptually flawed for two important reasons.
Aim
The aim of this article is to move beyond this utopian vision, which has led to negative consequences for both individual health and the sustainability of healthcare systems.
Methods
This article analyses the most relevant definitions of health proposed in the scientific literature over the last 50 years.
Findings
There have been some attempts within the WHO itself to reduce the utopian content of its definition, but these efforts have not yielded significant results. Outside the WHO, many different proposals have emerged, including those that incorporate malaise into the concept of health. Nevertheless, none of the definitions proposed in the last 50 years have achieved widespread consensus.
Discussion and Implications for Practice
While there are various approaches to defining health, the crucial issue is that each definition should include states of unwell-being. Incorporating this perspective would represent a paradigm shift in the field of health, fostering more realistic expectations and reducing the risk of medicalization.
{"title":"Overcoming the Utopian Perspectives on Health: Health Must Also Include States of Unwell-Being","authors":"Fabio Leonardi","doi":"10.1111/jep.70008","DOIUrl":"https://doi.org/10.1111/jep.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Equating health with complete physical, mental and social well-being, as defined by the WHO, has played an important role in the development of healthcare systems in Western countries. However, this definition has contributed to the rise of the myth of well-being, increasing the demand on healthcare systems and raising the risk of medicalizing all aspects of life. Additionally, equating health with complete well-being is conceptually flawed for two important reasons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this article is to move beyond this utopian vision, which has led to negative consequences for both individual health and the sustainability of healthcare systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This article analyses the most relevant definitions of health proposed in the scientific literature over the last 50 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>There have been some attempts within the WHO itself to reduce the utopian content of its definition, but these efforts have not yielded significant results. Outside the WHO, many different proposals have emerged, including those that incorporate malaise into the concept of health. Nevertheless, none of the definitions proposed in the last 50 years have achieved widespread consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Implications for Practice</h3>\u0000 \u0000 <p>While there are various approaches to defining health, the crucial issue is that each definition should include states of unwell-being. Incorporating this perspective would represent a paradigm shift in the field of health, fostering more realistic expectations and reducing the risk of medicalization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362505","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}
To explore the trajectory of self-management behaviour and its influencing factors in patients with knee osteoarthritis.
Design
This is a prospective, longitudinal observational study.
Methods
From January 2024 to April 2024, 126 patients with knee osteoarthritis who were hospitalized in two tertiary-level hospitals in Hunan Province were selected to be surveyed on the day of discharge, 1 month after discharge and 3 months after discharge using the Chinese version of the Chronic Disease Self-Management Research Measurement Scale. The trajectories of self-management behaviours were performed using latent category growth analysis. The influencing factors were performed using Lasso regression.
Results
Two classes were identified, including ‘slow decline class’ (37.1%) and ‘significant decline class’ (62.9%). Age, education, history of knee surgery and number of other chronic diseases combined were significant factors. Finally, older patients were more likely to be in the ‘significant decline group’ and patients with a history of knee surgery were more likely to be in the ‘slow decline group’.
Conclusion
We reported the existence of heterogeneity in self-management trajectories in patients with KOA and found that younger age and history of knee surgery were significantly associated with slow decline class trajectories. Further studies are needed to test the generalizability of these identified self-management trajectories in patients with KOA and their association with psychosocial aspects.
Implications for the Profession and Patient Care
To identify the trajectory of self-management behaviours of patients with KOA and explore their influencing factors, to provide reference for healthcare professionals to formulate targeted intervention programmes, so as to prevent the recurrence of knee osteoarthritis and delay the course of the disease.
Reporting Method
STROBE checklist was followed.
Patient or Public Contribution
The authors would specially thank all the participants in this study.
{"title":"Trajectories and Influencing Factors of Self-Management Behaviour in Patients With Knee Osteoarthritis: A Longitudinal Study","authors":"Lingjia Li, Xiangzhou Lan, Weike Zeng, Miao Chen, Ke Xue, Qing Chen","doi":"10.1111/jep.70007","DOIUrl":"https://doi.org/10.1111/jep.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore the trajectory of self-management behaviour and its influencing factors in patients with knee osteoarthritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This is a prospective, longitudinal observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From January 2024 to April 2024, 126 patients with knee osteoarthritis who were hospitalized in two tertiary-level hospitals in Hunan Province were selected to be surveyed on the day of discharge, 1 month after discharge and 3 months after discharge using the Chinese version of the Chronic Disease Self-Management Research Measurement Scale. The trajectories of self-management behaviours were performed using latent category growth analysis. The influencing factors were performed using Lasso regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two classes were identified, including ‘slow decline class’ (37.1%) and ‘significant decline class’ (62.9%). Age, education, history of knee surgery and number of other chronic diseases combined were significant factors. Finally, older patients were more likely to be in the ‘significant decline group’ and patients with a history of knee surgery were more likely to be in the ‘slow decline group’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We reported the existence of heterogeneity in self-management trajectories in patients with KOA and found that younger age and history of knee surgery were significantly associated with slow decline class trajectories. Further studies are needed to test the generalizability of these identified self-management trajectories in patients with KOA and their association with psychosocial aspects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for the Profession and Patient Care</h3>\u0000 \u0000 <p>To identify the trajectory of self-management behaviours of patients with KOA and explore their influencing factors, to provide reference for healthcare professionals to formulate targeted intervention programmes, so as to prevent the recurrence of knee osteoarthritis and delay the course of the disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Reporting Method</h3>\u0000 \u0000 <p>STROBE checklist was followed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The authors would specially thank all the participants in this study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362330","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}
Emma Bertilsson, Victoria Östman, Henrik Cam, Kristin Franzon, Ulrika Gillespie
Rationale
Transitions of care are periods of heightened risk of medication management errors. Poor-quality discharge documentation has been linked to incorrect or suboptimal medication use and unplanned hospital visits. Despite regulations defining essential components of medication-related discharge documentation, deficiencies persist, highlighting the need for a method to assess whether current clinical practice meets these standards.
Aims
To conduct an initial validation of a newly developed instrument, the Complete Medication Documentation at Discharge – Measure (CMDD-M), assessing the quality and completeness of medication-related discharge documentation in a Swedish clinical setting.
Methods
The instrument was developed and refined in multiple stages. In this study, two clinical pharmacists and one geriatrician independently applied the final instrument to discharge documentation from 50 patients. Inter-rater reliability (IRR) was evaluated using linear and quadratic weighted Cohen's κ (κWlinear and κWquadratic).
Results
The average CMDD-M score, based on the consensus of the three raters, was 3.40 (SD ± 2.50) out of nine possible points across the patients' discharge documentation. The IRR between the pharmacists' individual assessments demonstrated almost perfect agreement, with κWlinear and κWquadratic values of 0.92 (95% CI: 0.80–1.00) and 0.97 (95% CI: 0.85–1.00), respectively. Moreover, the IRR between the pharmacists' consolidated score and the geriatrician's assessment displayed a moderate to strong agreement, with κWlinear and κWquadratic values of 0.64 (95% CI: 0.48–0.80) and 0.80 (95% CI: 0.64–0.97), respectively.
Conclusion
The CMDD-M demonstrated robust IRR confirming its ability to consistently and accurately measure the quality and completeness of medication-related discharge documentation in an easy-to-use form. Further research is recommended to ensure validity, generalisability and association with clinically relevant outcomes supporting the instrument's potential usefulness for evaluating and improving clinical practice and research.
{"title":"Development and Validation of an Instrument to Assess Quality and Completeness of Medication-Related Discharge Documentation","authors":"Emma Bertilsson, Victoria Östman, Henrik Cam, Kristin Franzon, Ulrika Gillespie","doi":"10.1111/jep.70006","DOIUrl":"https://doi.org/10.1111/jep.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Transitions of care are periods of heightened risk of medication management errors. Poor-quality discharge documentation has been linked to incorrect or suboptimal medication use and unplanned hospital visits. Despite regulations defining essential components of medication-related discharge documentation, deficiencies persist, highlighting the need for a method to assess whether current clinical practice meets these standards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To conduct an initial validation of a newly developed instrument, the Complete Medication Documentation at Discharge – Measure (CMDD-M), assessing the quality and completeness of medication-related discharge documentation in a Swedish clinical setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The instrument was developed and refined in multiple stages. In this study, two clinical pharmacists and one geriatrician independently applied the final instrument to discharge documentation from 50 patients. Inter-rater reliability (IRR) was evaluated using linear and quadratic weighted Cohen's <i>κ</i> (<i>κ</i><sub>W</sub><sup>linear</sup> and <i>κ</i><sub>W</sub><sup>quadratic</sup>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average CMDD-M score, based on the consensus of the three raters, was 3.40 (SD ± 2.50) out of nine possible points across the patients' discharge documentation. The IRR between the pharmacists' individual assessments demonstrated almost perfect agreement, with <i>κ</i><sub>W</sub><sup>linear</sup> and <i>κ</i><sub>W</sub><sup>quadratic</sup> values of 0.92 (95% CI: 0.80–1.00) and 0.97 (95% CI: 0.85–1.00), respectively. Moreover, the IRR between the pharmacists' consolidated score and the geriatrician's assessment displayed a moderate to strong agreement, with <i>κ</i><sub>W</sub><sup>linear</sup> and <i>κ</i><sub>W</sub><sup>quadratic</sup> values of 0.64 (95% CI: 0.48–0.80) and 0.80 (95% CI: 0.64–0.97), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CMDD-M demonstrated robust IRR confirming its ability to consistently and accurately measure the quality and completeness of medication-related discharge documentation in an easy-to-use form. Further research is recommended to ensure validity, generalisability and association with clinically relevant outcomes supporting the instrument's potential usefulness for evaluating and improving clinical practice and research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362504","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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