Older adults with frailty often face functional decline and limitations in doing everyday activities after being discharged from acute hospital admission affecting their health and quality of life. However, engaging them in training interventions can be challenging.
Aims and Objectives
The aim of this study was to evaluate a combined training, nutrition, and social intervention from the perspective of newly discharged older adults with frailty participating in the intervention.
Methods
Semi-structured interviews were conducted with 14 participants of whom 10 were interviewed twice. Data were analyzed using a theory-based evaluation approach using a CIMO (Context–Intervention–Mechanism–Outcome) framework, followed by subsequent analysis of key elements.
Results
The study found that a skilled and person-centered physiotherapist was crucial to making strength training feasible for participants, resulting in adherence and effort in training, although continuation after the intervention was challenged by different aspects such as geography and social factors. Including goal setting and test results could potentially be relevant motivational tools, but goal setting was not implemented well, according to the experiences of the participants. The social part of the intervention was important for encouraging participation and the well-being of participants, as groups were cohesive, and participants were accepting of each other. Participants did not recall the nutritional intervention very well, and it seemingly only had a small impact.
Conclusion
The physiotherapist's approach was essential for ensuring compliance and motivation for strength training for the older adults with frailty. Furthermore, fostering social cohesion within training groups could be important for promoting compliance and participant well-being. Factors influencing the continuation of training should be considered to ensure its long-term sustainability. Further research is warranted on incorporating nutritional guidance to enhance the impact of interventions for newly discharged older adults with frailty.
{"title":"“Both the Training and the Coffee Afterwards Mattered a Lot”—Factors of Importance in a Complex Intervention After Acute Hospitalization: Perspectives of Older Adults With Frailty","authors":"Rikke Larsen Rasmussen, Laurine Nilsson, Mette Holst, Morten Villumsen, Jane Andreasen","doi":"10.1111/jep.70321","DOIUrl":"https://doi.org/10.1111/jep.70321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Older adults with frailty often face functional decline and limitations in doing everyday activities after being discharged from acute hospital admission affecting their health and quality of life. However, engaging them in training interventions can be challenging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>The aim of this study was to evaluate a combined training, nutrition, and social intervention from the perspective of newly discharged older adults with frailty participating in the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with 14 participants of whom 10 were interviewed twice. Data were analyzed using a theory-based evaluation approach using a CIMO (Context–Intervention–Mechanism–Outcome) framework, followed by subsequent analysis of key elements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that a skilled and person-centered physiotherapist was crucial to making strength training feasible for participants, resulting in adherence and effort in training, although continuation after the intervention was challenged by different aspects such as geography and social factors. Including goal setting and test results could potentially be relevant motivational tools, but goal setting was not implemented well, according to the experiences of the participants. The social part of the intervention was important for encouraging participation and the well-being of participants, as groups were cohesive, and participants were accepting of each other. Participants did not recall the nutritional intervention very well, and it seemingly only had a small impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The physiotherapist's approach was essential for ensuring compliance and motivation for strength training for the older adults with frailty. Furthermore, fostering social cohesion within training groups could be important for promoting compliance and participant well-being. Factors influencing the continuation of training should be considered to ensure its long-term sustainability. Further research is warranted on incorporating nutritional guidance to enhance the impact of interventions for newly discharged older adults with frailty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626386","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}
<p>In March 1994, the Cochrane Collaboration issued its inaugural formal guidance on the methodology for conducting and updating systematic reviews, presented as a section within the Cochrane Collaboration toolkit. This section, titled ‘Section VI: Preparing and Maintaining Systematic Reviews’, offered directives for assessing the methodological quality of randomized controlled trials incorporated into the reviews. It drew upon a prior study by Moher et al. [<span>1</span>], which systematically appraised scales and checklists devised to evaluate trial quality, including the Jadad scale [<span>2</span>]. The authors concluded that none of the existing scales at that time could be recommended without concerns.</p><p>The newly proposed framework for assessing methodological quality rested on four bias domains, termed ‘categories’ within the document: selection, performance, exclusion, and detection. The selective reporting of significant results was also noted as a criterion that might prove pertinent in certain contexts, though it was not considered as a fundamental domain.</p><p>The evaluation system delineated three possible ratings for the overall risk of bias: low, moderate, or high. Review authors were tasked with determining whether the trials fulfilled valid criteria across all domains (signifying a trial with a low risk of bias), whether some criteria were only partially satisfied (indicating a moderate risk), or whether one or more criteria remained unmet (denoting a high risk of bias).</p><p>This underscores that the necessity of striking a balance between complexity and methodological rigour was already a matter of concern.</p><p>In October 1996, Section VI was revised and reissued as a standalone publication, henceforth titled the Cochrane Collaboration Handbook. This third edition emphasizes the importance of critically appraising studies, shifting away from the earlier terminology of methodological quality assessment.</p><p>The principal recommendation retained the same four bias domains: selection, performance, attrition, and detection. The domain formerly designated as exclusion bias was renamed as attrition bias. The evaluation framework preserved its established logic for classifying the overall risk of bias as low, moderate, or high.</p><p>In 1999, the Cochrane Handbook was refined into its fourth version, preserving the recommendations for trial assessment with no substantial alterations. The fourth version of the handbook had some minor updates, including changes to its name in different versions. For example, version 4.2.1 [<span>3</span>] was named ‘Cochrane Reviwers' Handbook’ while version 4.2.6 [<span>4</span>] was named ‘Cochrane Handbook for Systematic Reviews of Interventions’, a designation that endures in the present version.</p><p>In the 11th volume of the Cochrane Collaboration Methods Groups Newsletter, released in June 2007, Julian Higgins and Douglas Altman foreshadowed the principal attributes of an innovative
{"title":"Risk of Bias Assessment of Randomized Controlled Trials: From the 1994 Cochrane Collaboration Toolkit to ROBUST-RCT","authors":"Rafael Leite Pacheco, Rachel Riera","doi":"10.1111/jep.70328","DOIUrl":"https://doi.org/10.1111/jep.70328","url":null,"abstract":"<p>In March 1994, the Cochrane Collaboration issued its inaugural formal guidance on the methodology for conducting and updating systematic reviews, presented as a section within the Cochrane Collaboration toolkit. This section, titled ‘Section VI: Preparing and Maintaining Systematic Reviews’, offered directives for assessing the methodological quality of randomized controlled trials incorporated into the reviews. It drew upon a prior study by Moher et al. [<span>1</span>], which systematically appraised scales and checklists devised to evaluate trial quality, including the Jadad scale [<span>2</span>]. The authors concluded that none of the existing scales at that time could be recommended without concerns.</p><p>The newly proposed framework for assessing methodological quality rested on four bias domains, termed ‘categories’ within the document: selection, performance, exclusion, and detection. The selective reporting of significant results was also noted as a criterion that might prove pertinent in certain contexts, though it was not considered as a fundamental domain.</p><p>The evaluation system delineated three possible ratings for the overall risk of bias: low, moderate, or high. Review authors were tasked with determining whether the trials fulfilled valid criteria across all domains (signifying a trial with a low risk of bias), whether some criteria were only partially satisfied (indicating a moderate risk), or whether one or more criteria remained unmet (denoting a high risk of bias).</p><p>This underscores that the necessity of striking a balance between complexity and methodological rigour was already a matter of concern.</p><p>In October 1996, Section VI was revised and reissued as a standalone publication, henceforth titled the Cochrane Collaboration Handbook. This third edition emphasizes the importance of critically appraising studies, shifting away from the earlier terminology of methodological quality assessment.</p><p>The principal recommendation retained the same four bias domains: selection, performance, attrition, and detection. The domain formerly designated as exclusion bias was renamed as attrition bias. The evaluation framework preserved its established logic for classifying the overall risk of bias as low, moderate, or high.</p><p>In 1999, the Cochrane Handbook was refined into its fourth version, preserving the recommendations for trial assessment with no substantial alterations. The fourth version of the handbook had some minor updates, including changes to its name in different versions. For example, version 4.2.1 [<span>3</span>] was named ‘Cochrane Reviwers' Handbook’ while version 4.2.6 [<span>4</span>] was named ‘Cochrane Handbook for Systematic Reviews of Interventions’, a designation that endures in the present version.</p><p>In the 11th volume of the Cochrane Collaboration Methods Groups Newsletter, released in June 2007, Julian Higgins and Douglas Altman foreshadowed the principal attributes of an innovative ","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619042","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}
Job burnout significantly impacts the quality and safety of clinical nursing care. Given the unique demands of obstetric and gynecological (OB/GYN) nursing, addressing burnout in this workforce is critical for safeguarding both nurse well-being and patient outcomes. This study aimed to investigate the prevalence of job burnout and identify its contributing factors among OB/GYN nurses, with the goal of providing evidence-based guidance for clinical nurse management and healthcare policy.
Methods
A cross-sectional survey was conducted with nurses in the OB/GYN department of our hospital between July 1 and August 31, 2024. The Nursing Burnout Scale (validated previously for nursing populations) was used to assess burnout levels, and multiple linear regression analysis was applied to identify potential influencing factors.
Results
A total of 116 OB/GYN nurses participated. The mean job burnout score was 158.64 ± 16.07, which corresponds to a moderate level of burnout based on the scale's established criteria. Correlation analysis showed significant associations between burnout scores and educational level (r = 0.558), number of children (r = 0.527), professional title (r = 0.604), years of nursing experience (r = 0.622), and average monthly income (r = 0.606) (all p < 0.05). Multiple linear regression further confirmed these variables as significant predictors of job burnout (all p < 0.05).
Conclusion
OB/GYN nurses in this study experience moderate levels of job burnout, influenced by multiple personal and professional factors. These findings support the need for targeted interventions—such as tailored support programs for nurses with varying experience or family structures—and highlight the value of using such data to inform hospital management strategies and healthcare policies aimed at reducing burnout and enhancing nursing care quality and safety.
{"title":"Prevalence and Associated Factors of Burnout Among Obstetrics and Gynecology Nurses: A Cross-Sectional Analysis","authors":"Yali Chen, Jingjing Cai","doi":"10.1111/jep.70315","DOIUrl":"10.1111/jep.70315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Job burnout significantly impacts the quality and safety of clinical nursing care. Given the unique demands of obstetric and gynecological (OB/GYN) nursing, addressing burnout in this workforce is critical for safeguarding both nurse well-being and patient outcomes. This study aimed to investigate the prevalence of job burnout and identify its contributing factors among OB/GYN nurses, with the goal of providing evidence-based guidance for clinical nurse management and healthcare policy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was conducted with nurses in the OB/GYN department of our hospital between July 1 and August 31, 2024. The Nursing Burnout Scale (validated previously for nursing populations) was used to assess burnout levels, and multiple linear regression analysis was applied to identify potential influencing factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 116 OB/GYN nurses participated. The mean job burnout score was 158.64 ± 16.07, which corresponds to a moderate level of burnout based on the scale's established criteria. Correlation analysis showed significant associations between burnout scores and educational level (r = 0.558), number of children (r = 0.527), professional title (r = 0.604), years of nursing experience (r = 0.622), and average monthly income (r = 0.606) (all <i>p</i> < 0.05). Multiple linear regression further confirmed these variables as significant predictors of job burnout (all <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>OB/GYN nurses in this study experience moderate levels of job burnout, influenced by multiple personal and professional factors. These findings support the need for targeted interventions—such as tailored support programs for nurses with varying experience or family structures—and highlight the value of using such data to inform hospital management strategies and healthcare policies aimed at reducing burnout and enhancing nursing care quality and safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549564","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}
Precision health seeks to personalize care by accounting for individual variation but is too often reduced to ‘personalized biological’ interventions. This reductionism overlooks the existential and psychosocial dimensions of health. To address this gap, this paper introduces the relatome as a conceptual framework that systematically and comprehensively records relational patterns, including how patients build trust, prefer to receive information, and approach decision-making. By extending precision health into the relational domain, the relatome makes care more precise in guiding patient experience and treatment effectiveness. As a transferable component of the patient's clinical record, it also helps providers coordinate understanding across systems and settings, preserving psychosocial insights often lost during care transitions. Unlike static genetic data, these relational patterns are updated based on patient feedback and provider observations. Realizing the potential of the relatome requires addressing five sets of implementation challenges: conceptual and epistemic, technical and infrastructural, continuity and system design, equity and participation, and evaluation and investment.
{"title":"Toward More Precise Health Care Through Relational Mapping","authors":"Stephen Buetow","doi":"10.1111/jep.70308","DOIUrl":"10.1111/jep.70308","url":null,"abstract":"<div>\u0000 \u0000 <p>Precision health seeks to personalize care by accounting for individual variation but is too often reduced to ‘personalized biological’ interventions. This reductionism overlooks the existential and psychosocial dimensions of health. To address this gap, this paper introduces the <i>relatome</i> as a conceptual framework that systematically and comprehensively records relational patterns, including how patients build trust, prefer to receive information, and approach decision-making. By extending precision health into the relational domain, the relatome makes care more precise in guiding patient experience and treatment effectiveness. As a transferable component of the patient's clinical record, it also helps providers coordinate understanding across systems and settings, preserving psychosocial insights often lost during care transitions. Unlike static genetic data, these relational patterns are updated based on patient feedback and provider observations. Realizing the potential of the relatome requires addressing five sets of implementation challenges: conceptual and epistemic, technical and infrastructural, continuity and system design, equity and participation, and evaluation and investment.</p>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549557","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}
This study aimed to reveal the experiences of midwives who assisted women giving birth water.
Method
A phenomenological design, which is one of the qualitative research methods, was used in the study that was conducted with freelance midwives between June and August 2023. The sample of the study consisted of 14 midwives who met the inclusion criteria and agreed to participate in the research. Data were collected face to face using a ‘Descriptive Information Form’ and a ‘Semi-Structured Interview Form’ and were analysed using the thematic analysis method and the MAXQDA Analytics Pro2020 software.
Discussion
Midwives' narratives about water birth were grouped under three themes: water birth process, water birth team, and evaluation of water birth. The eight categories that made up these themes were conveniences, difficulties, characteristics of the team, equipment used during birth, difficulties in using the equipment, prenatal preparation, midwives' self-evaluations, and views about pregnant women's experiences.
Conclusion
According to this study, midwives talked more about the category of convenience than difficulties regarding the water birth process. It was determined that all midwives repeated the code of comforting the pregnant woman, which is in the convenience category under the theme of the water birth process. The most frequently stated difficulty was ensuring that the water was kept as clean as possible. Midwives reported that they most frequently observed that pregnant women gave birth more easily in water.
{"title":"Midwives' Views and Experiences of Practice to Delivered in Water: A Qualitative Study","authors":"Buse Nur Kisa, Resmiye Ozdilek","doi":"10.1111/jep.70318","DOIUrl":"10.1111/jep.70318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to reveal the experiences of midwives who assisted women giving birth water.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A phenomenological design, which is one of the qualitative research methods, was used in the study that was conducted with freelance midwives between June and August 2023. The sample of the study consisted of 14 midwives who met the inclusion criteria and agreed to participate in the research. Data were collected face to face using a ‘Descriptive Information Form’ and a ‘Semi-Structured Interview Form’ and were analysed using the thematic analysis method and the MAXQDA Analytics Pro2020 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Midwives' narratives about water birth were grouped under three themes: water birth process, water birth team, and evaluation of water birth. The eight categories that made up these themes were conveniences, difficulties, characteristics of the team, equipment used during birth, difficulties in using the equipment, prenatal preparation, midwives' self-evaluations, and views about pregnant women's experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>According to this study, midwives talked more about the category of convenience than difficulties regarding the water birth process. It was determined that all midwives repeated the code of comforting the pregnant woman, which is in the convenience category under the theme of the water birth process. The most frequently stated difficulty was ensuring that the water was kept as clean as possible. Midwives reported that they most frequently observed that pregnant women gave birth more easily in water.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549348","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}
The COVID-19 pandemic has significantly impacted healthcare workers’ mental health worldwide. Although increased stress, anxiety, and burnout are well documented, there is limited evidence on the effectiveness of workplace interventions such as infection prevention and control (IPC) and personal protective equipment (PPE) training in mitigating these effects.
Aim
To examine the association between IPC training, PPE training, and consistent adherence to safety protocols with self-reported mental health outcomes among healthcare workers in Canada during the COVID-19 pandemic.
Methods
This study analyzed data from 12,727 healthcare workers who responded to a 2021 Statistics Canada crowdsource survey. Logistic regression models assessed the relationship between mental health status (same/better vs worse compared to pre-pandemic) and three predictors: sufficient IPC training, sufficient PPE training, and consistent protocol adherence, controlling for demographic and occupational factors.
Results
Adequate IPC and PPE training, along with consistent adherence to protocols, were significantly associated with better self-reported mental health outcomes across healthcare worker groups. Regional differences and survey design limitations affecting generalizability are acknowledged.
Conclusions
Basic workplace interventions such as IPC and PPE training and adherence to safety protocols may help protect healthcare workers’ mental health during public health crises. Policymakers should prioritize these feasible, low-cost measures to mitigate pandemic-related psychological distress.
{"title":"Lessons From the COVID-19 Pandemic: The Role of Interventions in Relieving Mental Stress","authors":"Raaj Tiagi","doi":"10.1111/jep.70317","DOIUrl":"10.1111/jep.70317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic has significantly impacted healthcare workers’ mental health worldwide. Although increased stress, anxiety, and burnout are well documented, there is limited evidence on the effectiveness of workplace interventions such as infection prevention and control (IPC) and personal protective equipment (PPE) training in mitigating these effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the association between IPC training, PPE training, and consistent adherence to safety protocols with self-reported mental health outcomes among healthcare workers in Canada during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analyzed data from 12,727 healthcare workers who responded to a 2021 Statistics Canada crowdsource survey. Logistic regression models assessed the relationship between mental health status (same/better vs worse compared to pre-pandemic) and three predictors: sufficient IPC training, sufficient PPE training, and consistent protocol adherence, controlling for demographic and occupational factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adequate IPC and PPE training, along with consistent adherence to protocols, were significantly associated with better self-reported mental health outcomes across healthcare worker groups. Regional differences and survey design limitations affecting generalizability are acknowledged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Basic workplace interventions such as IPC and PPE training and adherence to safety protocols may help protect healthcare workers’ mental health during public health crises. Policymakers should prioritize these feasible, low-cost measures to mitigate pandemic-related psychological distress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to Armitage: Reconsidering the Ethical Landscape of AI-Generated Clinical Documentation","authors":"Q. Wilton Sun, Jennifer E. Miller, Sarah C. Hull","doi":"10.1111/jep.70313","DOIUrl":"10.1111/jep.70313","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504661","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}
Bea Duric, Benjamin Flowers, Karlo Jagic, Katie Zuo, Sundas Butt
Background
Carpal dislocations are rare but serious injuries, sometimes occurring in isolation or in association with distal radial fractures. These complex injuries carry high risks of long-term dysfunction and require timely and standardised management. In 2017, the British Orthopaedic Association (BOA) and British Society for Surgery of the Hand (BSSH) published consensus guidelines to address wide variations in care and outcomes. This audit evaluated adherence to BOA/BSSH guidance at a tertiary trauma centre.
Methods
80 patients with extra-articular distal radial fractures and carpal dislocations were retrospectively identified (October 2022–March 2023). A structured checklist based on BOA/BSSH recommendations was applied, focusing on documentation, anaesthesia, timing of surgery, immobilisation, and Postoperative care.
Results
Mean age was 38.2 (±13.7) years, and 76/80 (95.0%) patients underwent surgical management. Only 4/37 (10.8%) patients with available anaesthesia data received intravenous regional anaesthesia as recommended. Mean immobilisation time was 8.2 (±2.6) weeks, exceeding the 4-week standard. Surgery within 1 week occurred in 34/76 (44.7%). No cases documented a neurovascular assessment. At 6 months, 22/80 (27.5%) reported ongoing stiffness and 40/80 (50.0%) required hand therapy.
Conclusion
Adherence to BOA/BSSH guidelines was poor, particularly for anaesthesia choice, immobilisation duration, and surgical timing. This may have contributed to mediocre outcomes. As current standards are primarily designed for DRFs rather than CDs, their direct application to these complex cases should be interpreted cautiously. Nonetheless, improved documentation, anaesthesia practice, and adherence to early mobilisation protocols represent clear opportunities for service improvement.
{"title":"Clinical Outcomes and Guideline Adherence in Distal Radial Fractures with Associated Carpal Dislocations: A Service Evaluation","authors":"Bea Duric, Benjamin Flowers, Karlo Jagic, Katie Zuo, Sundas Butt","doi":"10.1111/jep.70312","DOIUrl":"10.1111/jep.70312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Carpal dislocations are rare but serious injuries, sometimes occurring in isolation or in association with distal radial fractures. These complex injuries carry high risks of long-term dysfunction and require timely and standardised management. In 2017, the British Orthopaedic Association (BOA) and British Society for Surgery of the Hand (BSSH) published consensus guidelines to address wide variations in care and outcomes. This audit evaluated adherence to BOA/BSSH guidance at a tertiary trauma centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>80 patients with extra-articular distal radial fractures and carpal dislocations were retrospectively identified (October 2022–March 2023). A structured checklist based on BOA/BSSH recommendations was applied, focusing on documentation, anaesthesia, timing of surgery, immobilisation, and Postoperative care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age was 38.2 (±13.7) years, and 76/80 (95.0%) patients underwent surgical management. Only 4/37 (10.8%) patients with available anaesthesia data received intravenous regional anaesthesia as recommended. Mean immobilisation time was 8.2 (±2.6) weeks, exceeding the 4-week standard. Surgery within 1 week occurred in 34/76 (44.7%). No cases documented a neurovascular assessment. At 6 months, 22/80 (27.5%) reported ongoing stiffness and 40/80 (50.0%) required hand therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adherence to BOA/BSSH guidelines was poor, particularly for anaesthesia choice, immobilisation duration, and surgical timing. This may have contributed to mediocre outcomes. As current standards are primarily designed for DRFs rather than CDs, their direct application to these complex cases should be interpreted cautiously. Nonetheless, improved documentation, anaesthesia practice, and adherence to early mobilisation protocols represent clear opportunities for service improvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pregnant Women's Breast Milk and Breastfeeding Myths and Associated Factors: A Case of Refugee and Non-Refugee Women","authors":"Meryem Erat Nergiz, Siddika Songul Yalcin","doi":"10.1111/jep.70314","DOIUrl":"10.1111/jep.70314","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504672","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}
Medical errors represent a major issue for healthcare professionals. Although they may not always cause direct harm to patients, timely reporting of such errors is an important step in improving safety and reducing malpractice risk. As the number of these lawsuits rises, physicians often resort to defensive medicine practices.
Aims and Objectives
The aim of this study is to evaluate the attitudes, behaviours and knowledge levels of physicians working in palliative care services with resprect to defensive medicine.
Method
This multicenter, cross-sectional and analytical study, 110 physicians working in the Palliative Care Service participated in the study between 01.10.2023 and 31.10.2023. Demographic information, defensive medicine attitude scale and medical error attitude scale were applied to the participants.
Results
Sixty-two of the participants were female and 48 were male. Based on the data, 5.5% of the participants had a moderate, 64.5% had a high, and 30.0% had a very high level of defensive medicine attitudes. Resident physicians rated their defensive medicine attitude with higher scores than specialist physicians. In addition, physicians with less than 5 years of experience have higher positive defensive medicine scores. There is a significant relationship between age and the medical error attitude scale score. Most of the participants received palliative care training, but they stated that they did not have sufficient knowledge about defensive medicine.
Conclusion
Although the defensive medicine scores of the participants are high, additional training is necessary to close the gaps in knowledge. There is also a promising situation in terms of medical error awareness.
{"title":"Physicians' Attitudes Toward Defensive Medicine and Medical Errors in Palliative Care: A Cross-Sectional Study","authors":"Ardacan Uyğur, Abdullah Ozan Polat, Okcan Basat","doi":"10.1111/jep.70316","DOIUrl":"10.1111/jep.70316","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Medical errors represent a major issue for healthcare professionals. Although they may not always cause direct harm to patients, timely reporting of such errors is an important step in improving safety and reducing malpractice risk. As the number of these lawsuits rises, physicians often resort to defensive medicine practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>The aim of this study is to evaluate the attitudes, behaviours and knowledge levels of physicians working in palliative care services with resprect to defensive medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This multicenter, cross-sectional and analytical study, 110 physicians working in the Palliative Care Service participated in the study between 01.10.2023 and 31.10.2023. Demographic information, defensive medicine attitude scale and medical error attitude scale were applied to the participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-two of the participants were female and 48 were male. Based on the data, 5.5% of the participants had a moderate, 64.5% had a high, and 30.0% had a very high level of defensive medicine attitudes. Resident physicians rated their defensive medicine attitude with higher scores than specialist physicians. In addition, physicians with less than 5 years of experience have higher positive defensive medicine scores. There is a significant relationship between age and the medical error attitude scale score. Most of the participants received palliative care training, but they stated that they did not have sufficient knowledge about defensive medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the defensive medicine scores of the participants are high, additional training is necessary to close the gaps in knowledge. There is also a promising situation in terms of medical error awareness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504979","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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