Journal of evaluation in clinical practice最新文献_第4页

Why Desirable Difficulties ‘Work’: A Review of the Evidence From Cognitive and Educational Psychology and Some Caveats for the Health Professions Education Field 为什么理想的困难“起作用”：来自认知和教育心理学的证据综述以及卫生专业教育领域的一些注意事项。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2026-01-08 DOI: 10.1111/jep.70349

Sally Binks

Background

‘Desirable difficulties’, a concept that originated in the cognitive psychology literature, are practices that tend to impede initial learning but that promote long-term retention and transfer of knowledge and skills. Educators in the health professions have been enjoined to employ and integrate desirable difficulties in their classroom and clinical teaching practice, with assurances that they ‘work’. But how do they work? Insights into the mechanisms of desirably difficult practices may enrich the practice of educators and provide impetus for further research into how and when such practices might be effectively deployed in health professions education.

Aim

In this paper, I review the evidence from the cognitive psychology and educational literatures not only for evidence of the effectiveness and boundary conditions of the desirable difficulties, but for their proposed mechanisms. I also review reports on how these practices have been deployed and investigated within health professions education.

Results

Desirable difficulties for which there is ample robust evidence across fields and disciplines are formative testing, or assessment-for-learning as opposed to assessment-of-learning, interleaved or mixed practice, or problem-solving, distributed or spaced practice, and various productive failure approaches. These practices are hypothesised to have various cognitive, meta-cognitive, motivational and affective mechanisms at the level of the individual. Within the health professions education literature, there is some evidence of lack of clarity as to how these practices are defined and as to their theoretical underpinnings.

Conclusions

While there is ample evidence supporting the efficacy of desirable difficulties, it is crucial to approach their implementation with caution. Greater perceived difficulty or disfluency should not be conflated uncritically with greater educational benefit. Lack of clarity as to what is, and what is not, a desirably difficult practice has been evident in published health professions education literature. Educators and researchers alike should have a clear understanding of the definitions and theoretical bases of desirable difficulties to advance practice and theory.

背景：“理想困难”是一个起源于认知心理学文献的概念，指的是那些倾向于阻碍初始学习，但却能促进知识和技能长期保留和转移的实践。已要求卫生专业的教育工作者在课堂和临床教学实践中使用和整合适当的困难，并保证这些困难“有效”。但它们是如何工作的呢？对困难做法机制的深入了解可以丰富教育工作者的实践，并为进一步研究如何以及何时在卫生专业教育中有效地采用这些做法提供动力。目的：在本文中，我回顾了认知心理学和教育文献的证据，不仅为证据的有效性和边界条件的理想困难，而且为他们提出的机制。我还审查了关于如何在卫生专业教育中部署和调查这些做法的报告。结果：在各个领域和学科中，有足够的有力证据表明，理想的困难是形成性测试，或与学习评估相对的学习评估，交错或混合实践，或解决问题，分布或间隔实践，以及各种生产性失败方法。这些实践被假设在个体层面上具有各种认知、元认知、动机和情感机制。在卫生专业教育文献中，有一些证据表明，这些实践是如何定义的，以及它们的理论基础是缺乏明确的。结论：虽然有充分的证据支持理想困难的有效性，但谨慎对待其实施至关重要。更大的感知困难或不流利不应该不加批判地与更大的教育效益混为一谈。在已出版的卫生专业教育文献中，缺乏对什么是什么不是的明确认识，这是一种令人满意的困难实践。教育工作者和研究人员都应该对理想困难的定义和理论基础有一个清晰的认识，以推动实践和理论的发展。

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引用次数: 0

Patient Expectations as Predictors: Understanding Patient-Reported Outcomes in Musculoskeletal Conditions 患者期望作为预测因素：了解肌肉骨骼疾病患者报告的结果。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-29 DOI: 10.1111/jep.70343

Sebastian Sabadis, Roswell F. Childs, Jodi L. Young, Chad E. Cook

Rationale

Patient expectations are a key component of the shared decision-making process and have been found to be associated with treatment outcomes. However, there are concerns about the published research on patient expectations, including heterogeneity of the studies, variability, ceiling effect, and lack of validity of the measuring tools.

Aims and Objectives

This prospective, longitudinal cohort study investigated whether initial patient expectations for physical therapy, measured by the Expectation for Treatment Scale (ETS), could predict PROMIS physical function (PF) and pain interference (PI) scores at six and 12 weeks in patients with musculoskeletal conditions. A secondary aim was to determine the explanatory power of patient expectations on these outcomes.

Methods

This study followed a prospective cohort design. Participants aged 18–89 years with any musculoskeletal condition, receiving outpatient physical therapy within the Bellin Health System were recruited from January 2024 to July 2024. Data collected included demographics, health information, ETS scores at baseline, and PROMIS PF and PI scores at baseline, six and 12 weeks. Statistical analysis included descriptive statistics, uni- and multivariable quantile regression, and multiple imputations to handle missing data.

Results

The ETS was a significant predictor of both PROMIS PF (p < 0.001) and PROMIS PI (p < 0.001) at 12 weeks, but not at 6 weeks. The multivariable models showed medium explanatory power, with pseudo R² values of 0.28 for PF and 0.15 for PI at 12 weeks.

Conclusion

In this cohort, a patient's baseline expectations score is a positive and significant predictor of long-term (12-week) PF and PI-related outcomes in musculoskeletal conditions. Pseudo R² was higher for physical function than for pain interference, indicating higher explanatory power of the model for 12-week PF. These findings suggest clinicians can use patient expectations to help better predict and potentially improve patient outcomes.

理由：患者期望是共同决策过程的关键组成部分，并且已发现与治疗结果相关。然而，对已发表的关于患者期望的研究存在担忧，包括研究的异质性、可变性、上限效应和测量工具的有效性不足。目的和目的：这项前瞻性、纵向队列研究调查了通过治疗预期量表（ETS）测量的初始患者对物理治疗的期望是否可以预测肌肉骨骼疾病患者在6周和12周时的PROMIS身体功能（PF）和疼痛干扰（PI）评分。第二个目的是确定患者对这些结果的期望的解释力。方法：采用前瞻性队列设计。参与者年龄在18-89岁，患有任何肌肉骨骼疾病，在2024年1月至2024年7月在Bellin卫生系统接受门诊物理治疗。收集的数据包括人口统计数据、健康信息、基线时ETS得分、基线、第6周和第12周时PROMIS PF和PI得分。统计分析包括描述性统计，单变量和多变量分位数回归，以及处理缺失数据的多重输入。结果：ETS是12周时PROMIS PF （p < 0.001）和PROMIS PI （p < 0.001）的显著预测因子，但不是6周时的预测因子。多变量模型具有中等解释力，12周时PF和PI的伪R²值分别为0.28和0.15。结论：在该队列中，患者的基线期望评分是肌肉骨骼疾病长期（12周）PF和pi相关结果的积极且显著的预测因子。与疼痛干扰相比，身体功能的伪R2更高，表明模型对12周PF的解释力更高。这些发现表明临床医生可以使用患者期望来帮助更好地预测和潜在地改善患者的预后。

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引用次数: 0

Retrospective Analysis of Intervention Effectiveness in Preventing Glaucoma Blindness in a Tertiary Care Setting 三级医疗机构预防青光眼失明干预效果的回顾性分析。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-29 DOI: 10.1111/jep.70341

Thetthar Kanthar, Pasitpon Vatcharavongvan, Vanida Prasert

Rationale

The global prevalence rate of glaucoma blindness is extremely high and is a leading cause of irreversible blindness. Despite many advancements in treatment, evaluating glaucoma blindness remains challenging due to the long time required for its development and the combined use of treatment modalities.

Aims and Objectives

To evaluate the effectiveness of various treatment modalities in preventing glaucoma-related blindness using a 5-year retrospective study from a tertiary care hospital in Thailand.

Methods

A retrospective, cross-sectional study was conducted on 1031 glaucoma patients diagnosed between October 2017 and September 2022. Patients with advanced pterygium, corneal opacity, or macular degeneration were excluded. Data on demographics, clinical characteristics, and treatment modalities (medications, phacoemulsification with intraocular lens implantation [PE with IOL], laser iridotomy [LI], and trabeculectomy) were analyzed. Blindness was defined according to WHO criteria. Multivariate logistic regression assessed associations between blindness and risk factors.

Results

Of the 1031 patients, 21.0% experienced blindness. Secondary glaucoma (SG) had the highest blindness rate (33.5%) compared to primary open-angle glaucoma (POAG, 19.0%) and primary angle-closure glaucoma (PACG, 19.9%). Multimodal interventions significantly reduced blindness in POAG (adjusted OR: 0.57; 95% CI: 0.38–0.87; p = 0.027), but no significant benefit was observed in PACG or SG. PE with IOL showed the lowest blindness rate (14.9%), while trabeculectomy had the highest (47.2%). Treatment initiation within 5 years of diagnosis did not significantly affect blindness rates.

Conclusion

Multimodal interventions effectively reduce blindness in POAG but not in PACG or SG. Future studies should explore the impact of adherence, IOP fluctuation, and secondary glaucoma etiology on outcomes to optimize treatment strategies.

理由：青光眼失明的全球患病率非常高，是不可逆失明的主要原因。尽管治疗取得了许多进步，但由于青光眼的发展和综合使用治疗方式需要很长时间，因此评估青光眼失明仍然具有挑战性。目的和目的：通过泰国一家三级医院的5年回顾性研究，评估各种治疗方式在预防青光眼相关性失明方面的有效性。方法：对2017年10月至2022年9月诊断的1031例青光眼患者进行回顾性横断面研究。排除了晚期翼状胬肉、角膜混浊或黄斑变性患者。统计数据、临床特征和治疗方式（药物、超声乳化人工晶状体植入术[PE with IOL]、激光虹膜切开术[LI]和小梁切除术）进行分析。根据世卫组织的标准定义失明。多因素logistic回归评估失明与危险因素之间的关系。结果：1031例患者中，21.0%出现失明。继发性青光眼致盲率（33.5%）高于原发性开角型青光眼（POAG, 19.0%）和原发性闭角型青光眼（PACG, 19.9%）。多模式干预显著降低了POAG的失明（校正OR: 0.57; 95% CI: 0.38-0.87; p = 0.027），但在PACG或SG中未观察到显著的益处。人工晶状体置换术致盲率最低（14.9%），而小梁切除术致盲率最高（47.2%）。诊断后5年内开始治疗对失明率没有显著影响。结论：多模式干预能有效降低POAG患者的失明，而对PACG和SG患者的失明无显著影响。未来的研究应探讨依从性、IOP波动和继发性青光眼病因对结果的影响，以优化治疗策略。

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引用次数: 0

Shared Decision Making and Social Prescribing in General Practitioner Consultations: An Observational Study 共同决策和社会处方在全科医生咨询：一项观察性研究。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-29 DOI: 10.1111/jep.70334

Michael Kugel, Tim M. Jackson, Abi Antonito, Manas Mohandass, Kathleen Yin, Jim Smith, Annie Y. S. Lau

Background

Shared decision making (SDM) is a co-operative process where general practitioners (GPs) and patients share the best available evidence when facing a healthcare decision. Social prescribing (SP) is a method of encouraging patients to improve their own well-being through community-based treatments and support. With the rise of virtual care, it is important to examine how GP consultations involving SP and SDM can be facilitated in the virtual care setting. A few studies have compared these concepts or how they can be supported using virtual care.

Aim

This paper assesses the extent of SDM observed between GPs and patients during consultations regarding SP. In addition, it investigates the potential for this process to be supported with virtual care.

Method

Retrospective observational study of recorded GP consultations in southwest England. Consultation transcripts were analysed using the OPTION¹² scale (Observing Patient Involvement in Decision Making).

Results

The study included 65 consultations involving social prescription by 10 GPs. The mean total OPTION¹² score for all consultations was 47.90 (on a 100-point scale, where 0 stands for the lowest level of SDM and 100 for the highest). GPs scored highest in item 1 (identifying a relevant problem) and lowest in item 4 (explaining pros and cons). For physical health consultations (n = 38), the mean OPTION¹² score was 45.83. For mental health consultations (n = 27), the mean OPTION¹² score was slightly higher at 50.10.

Conclusion

SDM, as measured by the OPTION score, was observed to have no difference between physical and mental health GP consultations that included SP. Further research is required to explore the role of virtual care in facilitating SDM between GPs and patients in the SP context.

背景：共享决策（SDM）是一个合作的过程，全科医生（全科医生）和患者分享最好的可用证据时，面临的医疗保健决策。社会处方（SP）是一种鼓励患者通过社区治疗和支持来改善自身健康的方法。随着虚拟护理的兴起，重要的是要研究如何全科医生咨询涉及SP和SDM可以促进在虚拟护理设置。一些研究比较了这些概念，或者如何使用虚拟护理来支持它们。目的：本文评估了全科医生和患者在SP咨询期间观察到的SDM的程度。此外，它还调查了虚拟护理支持这一过程的潜力。方法：回顾性观察研究记录全科医生咨询在英格兰西南部。使用OPTION12量表（观察患者参与决策）分析会诊记录。结果：本研究包括10名全科医生的65次社会处方咨询。所有咨询的OPTION12平均总分为47.90分（100分制，其中0代表SDM的最低水平，100代表最高水平）。全科医生在第1项（识别相关问题）得分最高，在第4项（解释利弊）得分最低。对于身体健康咨询（n = 38），平均OPTION12评分为45.83。对于心理健康咨询（n = 27）， OPTION12平均得分略高，为50.10。结论：通过OPTION评分衡量的SDM在包括SP的身心健康全科医生咨询中没有差异。在SP背景下，虚拟护理在促进全科医生与患者之间SDM方面的作用有待进一步研究。

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引用次数: 0

Evaluation of Nurse-Patient Language Barrier Issues: A Qualitative Study on the Views of Psychiatric Clinic Nurses 护患语言障碍问题评价：精神科门诊护士观点的质性研究。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-15 DOI: 10.1111/jep.70340

Sercan Mansuroğlu, Yunis Şahinkayası

Rationale

Effective communication, which is critical for quality care and therapeutic relationships in psychiatric nursing, becomes difficult when hindered by language barriers. This makes it challenging for nurses to fulfil their caregiving roles, establish trust with patients, and support the treatment process. Therefore, it is essential to evaluate nurses' experiences with language barriers when providing care to their patients.

Aim

This study aims to identify the language barriers experienced by nurses working in an acute psychiatric clinic who are unable to communicate in the same language as their patients, and to determine possible strategies to overcome these challenges.

Method

The study was designed as a qualitative case study. The participants were eight nurses working in a state hospital's acute psychiatric clinic in Türkiye. The data was collected with a semi-structured interview guide. Then it was transcribed and coded through content analysis.

Findings

Three main themes emerged: (1) professional implications of communication in psychiatric care, (2) challenges related to language barriers, and (3) proposed solutions.

Conclusion

The findings suggest that integrating psychiatric nurses' insights on language barriers is crucial for delivering high-quality healthcare in psychiatric care. It has been determined that language differences between patients and nurses affect the quality of care and pose a threat to establishing and maintaining a therapeutic relationship based on trust between nurses and patients. These problems disrupt the psychiatric treatment and care process. Psychiatric nurses have proposed individual and institutional solutions to these problems, as well as practical solutions aimed at establishing trust.

理由：在精神科护理中，有效的沟通对于高质量的护理和治疗关系至关重要，当语言障碍阻碍时，沟通变得困难。这使得护士履行其护理角色，与患者建立信任并支持治疗过程具有挑战性。因此，评估护士在为患者提供护理时的语言障碍经验是至关重要的。目的：本研究旨在找出在急性精神科诊所工作的护士所经历的语言障碍，这些护士无法与他们的病人用同一种语言交流，并确定可能的策略来克服这些挑战。方法：采用定性个案研究方法。参与者是在基耶省一家州立医院急性精神病诊所工作的八名护士。数据是通过半结构化访谈指南收集的。然后通过内容分析对其进行转录编码。研究结果：出现了三个主要主题：(1)精神科护理中沟通的专业含义；(2)与语言障碍相关的挑战；(3)提出的解决方案。结论：研究结果表明，整合精神科护士对语言障碍的见解对于提供高质量的精神科护理至关重要。已经确定，患者和护士之间的语言差异会影响护理质量，并对建立和维持基于护士和患者之间信任的治疗关系构成威胁。这些问题扰乱了精神病治疗和护理过程。精神科护士针对这些问题提出了个人和机构的解决方案，以及旨在建立信任的实际解决方案。

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引用次数: 0

The Impact of Polypharmacy and Potentially Inappropriate Medications on Intrinsic Capacity Decline in Community-Dwelling Older Adults 多种药物和潜在不适当药物对社区居住老年人内在能力下降的影响。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-15 DOI: 10.1111/jep.70330

Shao-En Weng, Tai-Yin Wu, Jiunn-Bey Pao, Fei-Yuan Hsiao, Ching-Yao Tsai, Sheng-Huang Hsiao

Background

Intrinsic capacity (IC) is a clinically meaningful and potentially modifiable outcome that predicts dependence, hospital admission, and mortality in older adults. Research on the relationships among polypharmacy, potentially inappropriate medications (PIMs), and IC in older adults remains scarce. We therefore examined the associations of polypharmacy and PIM use with IC decline in community-dwelling older adults.

Methods

In this cross-sectional study, we analyzed data from the World Health Organization (WHO) Integrated Care for Older People (ICOPE) screening and corresponding medical records collected during annual senior health examinations in Taiwan. Participants were adults aged ≥ 65 years who completed the WHO ICOPE screening. IC was scored across six domains—locomotion; sensory function (vision and hearing); vitality; psychological well-being; and cognition—yielding a total score from 0 to 6. An IC score ≤ 4 denoted decline. Polypharmacy was defined as the concurrent use of ≥ 5 medications, and PIMs were identified according to the 2019 Beers Criteria.

Results

Among 394 participants (mean age 72.0 ± 6.7 years; 51.8% female), the average daily medication count was 6.4 ± 7.1. More than 50% of participants received ≥ 1 PIM, and 36.8% met criteria for polypharmacy. The mean IC score was 4.5 ± 1.1, and 43.9% of participants exhibited IC decline. After adjustment for age, gender, and number of comorbidities, PIM use was associated with a 2.06-fold increase and polypharmacy with a 2.46-fold increase in the risk of IC decline, respectively.

Conclusion

Polypharmacy and PIM use are highly prevalent among community-dwelling older adults and are significantly associated with an increased risk of IC decline. These findings underscore the need for medication review and deprescribing strategies to preserve intrinsic capacity in this population.

背景：内在能力（IC）是一项有临床意义且可能改变的预后指标，可预测老年人的依赖性、住院率和死亡率。关于多种药物、潜在不适当药物（PIMs）和老年人IC之间关系的研究仍然很少。因此，我们研究了社区居住老年人使用多种药物和PIM与IC下降的关系。参与者为完成who ICOPE筛查的年龄≥65岁的成年人。IC分为六个方面：运动；感觉功能（视觉和听觉）；活力;心理健康;认知能力得分从0到6。IC评分≤4为下降。多重用药定义为同时使用≥5种药物，并根据2019年Beers标准确定pim。结果：394例患者（平均年龄72.0±6.7岁，女性占51.8%），平均每日用药次数为6.4±7.1次。超过50%的患者接受了≥1次PIM治疗，36.8%的患者符合多药治疗标准。平均智力得分为4.5±1.1分，43.9%的参与者表现出智力下降。在调整了年龄、性别和合并症的数量后，PIM的使用与IC下降的风险分别增加2.06倍和2.46倍相关。结论：在社区居住的老年人中，多种药物和PIM的使用非常普遍，并且与IC下降的风险增加显著相关。这些发现强调了药物审查和处方策略的必要性，以保持这一人群的内在能力。

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引用次数: 0

Mapping the Quality and Standardization of Methodological Reports in POCUS Research: A Scoping Review Protocol 绘制POCUS研究方法报告的质量和标准化：范围审查方案。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-15 DOI: 10.1111/jep.70342

Rosana Aparecida Pereira, Larissa Gleyciani Verdeli, Joao Henrique Ribeiro Machado Silva, Laís Facioli Rosa Moreno da Costa, Fernanda Raphael Escobar Gimenes

Background

Point-of-Care Ultrasound (POCUS) has become an essential tool for diagnosis and monitoring across diverse clinical settings, enabling rapid and safe decision-making. Despite its widespread use, considerable heterogeneity persists in how studies report methodological aspects such as protocol descriptions, operator qualifications, and equipment characteristics. This lack of standardization limits comparability between studies, compromises reproducibility, and hinders the integration of POCUS into clinical guidelines and training curricula.

Objective

To map and critically analyze the methodological aspects of studies using POCUS, with a focus on standardization, quality, and reproducibility of reported procedures.

Methods

This scoping review will follow the JBI guidelines and be reported according to the PRISMA-ScR checklist. Searches will be conducted in PubMed, Web of Science, Embase, CINAHL, Scopus, LILACS, and the Cochrane Database of Systematic Reviews, without restrictions on language or publication period. We will include original studies applying POCUS in humans, regardless of clinical context. Two reviewers will independently screen titles, abstracts, and full texts, with a third reviewer resolving disagreements. Data will be extracted using a standardized form adapted from JBI, capturing information on study design, population characteristics, ultrasound protocols, operator qualifications, and reported outcomes. Results will be synthesized descriptively and organized according to the I-AIM framework (Indication, Acquisition, Interpretation, and Medical Decision-Making), supplemented with tables, conceptual diagrams, and visual representations.

Discussion

Given the variability in POCUS literature, this scoping review will identify patterns, inconsistencies, and gaps in methodological reporting. Although international frameworks, such as I-AIM provide guidance, adherence remains inconsistent, underscoring the need for more uniform standards. Findings from this review are expected to inform reporting practices, enhance methodological quality, and support the safe and effective incorporation of POCUS into clinical practice.

背景：即时超声（POCUS）已成为各种临床环境中诊断和监测的重要工具，可实现快速和安全的决策。尽管它被广泛使用，但在研究报告方法方面，如协议描述、操作员资格和设备特性方面，仍然存在相当大的异质性。这种标准化的缺乏限制了研究之间的可比性，损害了可重复性，并阻碍了POCUS纳入临床指南和培训课程。目的：绘制和批判性地分析使用POCUS研究的方法学方面，重点关注报告过程的标准化、质量和可重复性。方法：本次范围审查将遵循JBI指南，并根据PRISMA-ScR检查表进行报告。检索将在PubMed， Web of Science, Embase， CINAHL, Scopus， LILACS和Cochrane系统综述数据库中进行，不受语言或出版期的限制。我们将包括在人类中应用POCUS的原始研究，无论临床背景如何。两名审稿人将独立筛选标题、摘要和全文，第三名审稿人解决分歧。数据将使用JBI的标准化表格提取，获取有关研究设计、人群特征、超声方案、操作员资格和报告结果的信息。结果将根据I-AIM框架（指征、获取、解释和医疗决策）进行描述性综合和组织，并辅以表格、概念图和视觉表示。讨论：考虑到POCUS文献的可变性，本次范围审查将确定方法学报告中的模式、不一致和差距。虽然国际框架，如国际艾滋病监测目标提供了指导，但遵守情况仍然不一致，强调需要更统一的标准。本综述的发现有望为报告实践提供信息，提高方法质量，并支持POCUS安全有效地纳入临床实践。

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引用次数: 0

The Impact of Mobile Health Interventions on Mental Health Literacy: Protocol for a Systematic Review and Meta-Analysis of Randomized Controlled Trials 流动卫生干预对心理健康素养的影响：随机对照试验的系统评价和荟萃分析方案。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-15 DOI: 10.1111/jep.70325

Jamin Patel, Madeline Li, Nadine Elsahli, Tarun Reddy Katapally

<div> <section> <h3> Background</h3> <p>The increasing prevalence of mental health disorders is a global public health challenge. Mental health literacy is essential for preventing, recognizing, and managing mental disorders. Mobile health (mHealth) platforms, with their accessibility and portability, offer an opportunity to enhance mental health literacy.</p> </section> <section> <h3> Objective</h3> <p>This protocol outlines the methodology for conducting a systematic review and meta-analysis of randomized controlled trials to quantitatively assess the effectiveness of mHealth platforms in improving mental health literacy.</p> </section> <section> <h3> Methods</h3> <p>A comprehensive search will be conducted across databases, including Medline, Embase, PsycINFO, Web of Science, and CINAHL, using predefined keywords related to “mental health literacy,” “mHealth,” “mobile health,” and “randomized controlled trials.” The search will be supplemented by manual searches of reference lists of relevant studies and reviews to identify additional eligible studies. The key inclusion criterion is the restriction of studies to randomized controlled trials assessing mHealth interventions aimed at enhancing mental health literacy. Only studies published in English will be included. The primary outcome will be changes in mental health literacy scores, measured using validated questionnaires. The primary summary measure will be the standardized mean difference in mental health literacy scores between intervention and control groups, with 95% confidence intervals calculated for each effect size. A mixed-effects model will be used to account for variability across studies. Subgroup analyses will examine variations based on participant age, type of mHealth platform, and intervention duration. The Cochrane Risk of Bias tool will be employed to assess study quality. Sensitivity analyses will be conducted to assess the robustness of the findings, and publication bias will be evaluated using funnel plots and Egger's test.</p> </section> <section> <h3> Conclusions</h3> <p>To our knowledge, this is the first systematic review and meta-analysis of randomized controlled trials to evaluate the effectiveness of mHealth platforms in increasing mental health literacy. The findings will inform policy and practice by empirically assessing the role of digital health technology in promoting mental health education, potentially guiding the integration of mHealth interventions into mental health services and shaping future strategies for public health initiatives.</p> <

背景：精神健康障碍的日益流行是一项全球公共卫生挑战。精神卫生素养对于预防、识别和管理精神障碍至关重要。移动医疗（mHealth）平台具有可访问性和便携性，为提高心理健康素养提供了机会。目的：本协议概述了对随机对照试验进行系统评价和荟萃分析的方法，以定量评估移动健康平台在提高心理健康素养方面的有效性。方法：将在包括Medline、Embase、PsycINFO、Web of Science和CINAHL在内的数据库中进行全面搜索，使用与“心理健康素养”、“移动健康”、“移动健康”和“随机对照试验”相关的预定义关键词。检索将通过人工检索相关研究和综述的参考文献列表来补充，以确定其他符合条件的研究。关键的纳入标准是研究仅限于评估旨在提高心理健康素养的移动健康干预措施的随机对照试验。只包括以英文发表的研究。主要结果将是使用有效问卷测量的心理健康素养分数的变化。主要的综合测量将是干预组和对照组之间心理健康素养得分的标准化平均差异，并为每个效应值计算95%的置信区间。混合效应模型将用于解释研究之间的可变性。亚组分析将检查基于参与者年龄、移动健康平台类型和干预持续时间的差异。采用Cochrane偏倚风险工具评估研究质量。将进行敏感性分析以评估研究结果的稳健性，并使用漏斗图和Egger检验评估发表偏倚。结论：据我们所知，这是首次对随机对照试验进行系统回顾和荟萃分析，以评估移动健康平台在提高心理健康素养方面的有效性。通过经验评估数字健康技术在促进心理健康教育方面的作用，这些发现将为政策和实践提供信息，可能指导将移动健康干预措施整合到心理健康服务中，并制定未来的公共卫生举措战略。

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引用次数: 0

The Demand and Influencing Factors of Health Management for Elderly Patients With Chronic Diseases in China 中国老年慢性病患者健康管理需求及影响因素

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-15 DOI: 10.1111/jep.70331

Jing-Ying Liu, Zhuo-Lin Liang, Rong-Sai Wei, Xu-Miao Li, Hong-Wen Ma

Rationale

Effective health management is of vital importance in slowing down the progression of chronic diseases and improving the quality of life for the elderly. Identifying the factors that influence health management needs is the first step in formulating targeted intervention measures.

Aims and Objectives

This study aims to explore the influencing factors of social support and self-transcendence on the health management needs of elderly patients with chronic diseases in China.

Methods

From January to June 2024, a cross-sectional study was conducted. 495 elderly patients with chronic diseases from a tertiary hospital in Tianjin, China, were recruited as the research subjects. Data on social demographic characteristics, health management needs, self-transcendence, and social support were collected through questionnaires. Data analysis was performed using bivariate analysis and stratified regression. This study followed the STROBE guidelines to ensure the standardization of the report.

Results

This study found that the health management needs of elderly patients with chronic diseases in China are at a moderate level. The relevant analysis results showed that there was a negative correlation between health management needs and self-transcendence (correlation coefficient of −0.153, p < 0.01) as well as social support (correlation coefficient of −0.254, p < 0.01). The hierarchical regression analysis indicated that social support, old-age insurance, long-term residence location, and the perception of the importance of chronic disease management were the influencing factors of health management needs. The explanatory power of this model was 30.8% (F = 9.944, p < 0.001).

Conclusions

The health management needs of elderly patients with chronic diseases in China are at a moderate level, and are influenced by socio-demographic factors and social support. These findings emphasize the necessity of strengthening social support in health management intervention measures. The role of self-transcendence merits further research through culturally adapted methods.

理由：有效的健康管理对减缓慢性疾病的发展和提高老年人的生活质量至关重要。确定影响健康管理需求的因素是制定有针对性干预措施的第一步。目的与目的：本研究旨在探讨社会支持和自我超越对中国老年慢性病患者健康管理需求的影响因素。方法：于2024年1 - 6月进行横断面研究。选取天津市某三级医院老年慢性病患者495例作为研究对象。通过问卷调查收集社会人口学特征、健康管理需求、自我超越、社会支持等方面的数据。数据分析采用双变量分析和分层回归。本研究遵循STROBE指南，以确保报告的标准化。结果：本研究发现，中国老年慢性病患者的健康管理需求处于中等水平。相关分析结果显示，健康管理需求与自我超越呈负相关（相关系数为-0.153,p）。结论：中国老年慢性病患者的健康管理需求处于中等水平，受社会人口因素和社会支持的影响。这些发现强调了在健康管理干预措施中加强社会支持的必要性。自我超越的作用值得通过与文化相适应的方法进一步研究。

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引用次数: 0

Psychological Support and Single-Session Interventions for Parents of Children With Long-Term Health Conditions: A Qualitative Service Evaluation 长期健康问题儿童父母的心理支持和单次干预：一项定性服务评价。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-12-15 DOI: 10.1111/jep.70336

Yik Ching Lee, Alyssa, Anna Roach, XinLu Li, Camilla A. Hinde, Thomas King, Isobel Heyman, Roz Shafran, Sara O'Curry

Rationale

Parents of children with long-term physical health conditions (LTC) experience elevated rates of stress and mental health problems. Existing psychological interventions targeting this population may be effective in improving their mental health, but accessibility is a concern.

Aims and Objectives

Given the increasing effectiveness and accessibility of single-session interventions (SSIs) across diverse populations, this qualitative study aimed to understand parents' need for psychological interventions and their opinions on SSIs.

Methods

Qualitative data were collected from 12 semi-structured interviews with 13 parents or primary carers of children with LTCs.

Results

Data were analysed using thematic analysis and four key themes, including (i) Mental health impact and coping mechanisms; (ii) Experience of psychological support; (iii) Format of psychological support and (iv) Opinions on single-session interventions, were identified. Participants described the impact their child's health condition had on their own mental health and outlined coping mechanisms. They talked about their previous and current experiences of psychological support to date, their expectations of psychological support and the elements they considered crucial in psychological interventions. Participants also shared their initial opinions about SSIs as a feasible treatment option.

Conclusion

Overall, tailored interventions, the development of a professional therapeutic relationship, having choice and control were deemed important by parents. Future development of psychological interventions for this population should consider these aspects. Positive opinions on SSIs also revealed their potential applicability, and future studies should be conducted to assess their feasibility and effectiveness.

理由：患有长期身体健康状况（LTC）的儿童的父母面临压力和心理健康问题的比率较高。针对这一人群的现有心理干预措施可能有效地改善了他们的心理健康，但可及性是一个问题。目的和目的：鉴于在不同人群中，单期干预（ssi）的有效性和可及性越来越高，本定性研究旨在了解家长对心理干预的需求以及他们对ssi的看法。方法：对13名LTCs患儿的父母或主要照顾者进行12次半结构化访谈，收集定性数据。结果：采用专题分析和四个关键主题对数据进行了分析，包括：(i)心理健康影响和应对机制；获得心理支助的经验；确定了心理支助的形式和关于单次会议干预的意见。参与者描述了他们孩子的健康状况对他们自己心理健康的影响，并概述了应对机制。他们谈论了到目前为止他们过去和现在的心理支持经历，他们对心理支持的期望以及他们认为在心理干预中至关重要的因素。参与者还分享了他们对ssi作为一种可行治疗方案的初步看法。结论：总体而言，家长认为有针对性的干预、专业治疗关系的发展、选择和控制是重要的。未来针对这一人群的心理干预应考虑这些方面。对ssi的积极评价也揭示了其潜在的适用性，需要进一步的研究来评估其可行性和有效性。

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引用次数: 0