Journal of evaluation in clinical practice最新文献_第6页

Blood Pressure Variability Between In-Clinic and At-Home Measurements: Implications for Care Quality Assessment 临床和家庭测量之间的血压变异性：对护理质量评估的影响

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-11-02 DOI: 10.1111/jep.70299

L. J. Zimmermann, A. Weaver, M. Gottlieb, K. Pallok, D. Thompson, D. A. Ansell, K. E. Niehaus, G. Walker

Rationale

Nearly half of American adults live with high blood pressure, of whom three-quarters do not have their blood pressure under adequate control. Many challenges exist in assessing blood pressure control, including in-clinic measurement biases and physiologic variability, limiting the ability to appropriately guide therapeutic changes.

Aims and Objectives

This study's objective was to compare blood pressure (BP) variability in-clinic and at-home using a BP monitoring app.

Methods

This retrospective, observational study compared in-clinic BP measurements to at-home BP measurements recorded via a mobile application from April 2024 to May 2025. BP variability was assessed, comparing standard deviations (SD), control status (adequately controlled: systolic BP < 140 mmHg and diastolic BP < 90 mmHg), and both within-day and within-week timeframe fluctuations.

Results

Among 304 patients with sufficient in-clinic data, the mean SD value for in-clinic systolic BP was 12.6 mmHg. Comparing at-home readings 2, 4, and 6 weeks before an in-clinic appointment for 207, 229, and 243 patients with sufficient data, 71.5%, 72.1%, and 72.8% of in-clinic measurements differed by more than 5 mmHg from average at-home systolic BP, and 30.1%, 29.8%, and 29.8% indicated a different hypertension control status, respectively. For patients with at-home readings, the mean systolic BP SD for 288 patients within the same day was 8.8 mmHg. Over 2, 4, and 6 week timeframes, mean SD increased to 10.5, 10.9, and 11.1 mmHg for 322, 329, and 336 patients with sufficient readings, respectively.

Conclusion

Reliance on single in-clinic BP measurements for hypertension management can be inaccurate due to significant variability over time. In addition to impacting treatment decisions, this may impact HEDIS metrics and Medicare Advantage Star ratings, which heavily influence healthcare revenue and quality perception. Findings indicate at-home BP monitoring can result in a meaningfully different BP control rate, emphasizing a role for at-home monitoring to enhance BP measurement reliability.

将近一半的美国成年人患有高血压，其中四分之三的人没有适当控制血压。评估血压控制存在许多挑战，包括临床测量偏差和生理变异，限制了适当指导治疗变化的能力。本研究的目的是比较临床和家庭使用血压监测应用程序的血压（BP）变异性。方法本回顾性观察性研究比较了2024年4月至2025年5月期间通过移动应用程序记录的临床血压测量和家庭血压测量。评估血压变异性，比较标准偏差（SD）、控制状态（充分控制：收缩压和lt 140 mmHg和舒张压和lt 90 mmHg），以及一天和一周内的时间范围波动。结果304例有充分临床资料的患者，临床收缩压SD均值为12.6 mmHg。通过比较207、229和243例数据充足的患者在门诊预约前2、4和6周的家庭读数，71.5%、72.1%和72.8%的临床测量值与家庭平均收缩压相差超过5 mmHg， 30.1%、29.8%和29.8%分别表明高血压控制状况不同。对于在家读数的患者，288例患者同一天内的平均收缩压SD为8.8 mmHg。在2周、4周和6周的时间框架内，322、329和336例具有足够读数的患者的平均SD分别增加到10.5、10.9和11.1 mmHg。结论：由于血压随时间的变化，单次临床血压测量对高血压管理的依赖是不准确的。除了影响治疗决策外，这可能会影响HEDIS指标和医疗保险优势星级评级，这严重影响医疗保健收入和质量感知。研究结果表明，家庭血压监测可以导致有意义的血压控制率不同，强调家庭监测在提高血压测量可靠性方面的作用。

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引用次数: 0

An Umbrella Review of Various Methods for Translating and Culturally Adapting Self-Reported Health Instruments 各种自我报告健康工具翻译和文化适应方法综述

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-11-02 DOI: 10.1111/jep.70287

Marjan Shahbazi, Mehdi Alizadeh Zarei, Afsoon Hassani Mehraban, Samaneh Karamali Esmaili, Fatemeh Shahbazi

Background

With the rise of globalisation, the demand for reliable and valid measurement tools that can be applied across diverse languages and cultures has become increasingly crucial. This situation requires the translation and adaptation of assessment instruments before they can be effectively used in new contexts.

Objective

This umbrella review aimed to synthesise and critically evaluate existing methods for translating and culturally adapting self-report health instruments.

Methods

A comprehensive search was performed in PubMed, CINAHL, and the Cochrane Library for reviews published between January 2000 and April 2025. Two independent reviewers screened the titles, abstracts, and full texts using predefined inclusion and exclusion criteria. Data were extracted and categorised into translation and cultural adaptation processes. The methodological quality of included reviews was appraised using the AMSTAR tool.

Results

Nineteen reviews were included, identifying 46 distinct methods for translation and cultural adaptation. Considerable variation was observed regarding the number of steps, use of forward and back translation, expert committee involvement, and pre-testing with target populations. Only 10 methods fully implemented all essential steps recommended by quality evaluation checklists such as DuBay & Watson.

Conclusion

This umbrella review provides the first quantitative critique of translation and cultural adaptation methods for self-report instruments. Findings highlight the absence of a single ‘gold standard’ but support the adoption of structured, multistep approaches that integrate expert committee review and cognitive testing to ensure linguistic accuracy and cultural appropriateness.

随着全球化的兴起，对可应用于不同语言和文化的可靠和有效的测量工具的需求变得越来越重要。这种情况要求对评估工具进行翻译和调整，然后才能在新的情况下有效地使用它们。目的：本综述旨在综合和批判性地评价现有的自我报告健康工具的翻译和文化适应方法。方法综合检索PubMed、CINAHL和Cochrane图书馆2000年1月至2025年4月间发表的综述。两名独立审稿人使用预定义的纳入和排除标准筛选标题、摘要和全文。数据被提取并归类为翻译和文化适应过程。使用AMSTAR工具对纳入的综述的方法学质量进行评价。结果共纳入19篇综述，确定了46种不同的翻译和文化适应方法。在步骤数、前后翻译的使用、专家委员会的参与以及目标人群的预测试方面，观察到相当大的差异。只有10种方法完全执行了质量评估清单（如DuBay & &； Watson）推荐的所有基本步骤。本综述首次对自我报告工具的翻译和文化适应方法进行了定量批评。研究结果强调了缺乏单一的“黄金标准”，但支持采用结构化的多步骤方法，将专家委员会审查和认知测试结合起来，以确保语言准确性和文化适宜性。

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引用次数: 0

A Review of Physiotherapy and Rehabilitation Students' Metaphorical Perceptions of Exercise 物理治疗与康复专业学生运动隐喻知觉的研究综述

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-11-02 DOI: 10.1111/jep.70306

Ramazan Cihad Yilmaz, Alper Percin, Dilan Demirtas Karaoba, Busra Candiri

Aims and Objectives

This study aimed to investigate the metaphorical perceptions of the students of the Department of Physiotherapy and Rehabilitation regarding exercise.

Methods

The study was designed as a phenomenological case study, following the qualitative research method; it included 180 students from the Department of Physiotherapy and Rehabilitation. The students were asked to complete the sentence, “Exercise is like…; because…” to gain insight into their perception of exercise.

Results

Students produced 180 metaphors, which were grouped into 13 different categories. Students most frequently compared exercise to the notions of water, reading, therapy, air, and medicine. The categories with the highest number of metaphors included “happiness and soothing,” “psychological impact,” “labour, care, and continuity,” and “valuable.” The metaphors suggested by the students of the Department of Physiotherapy and Rehabilitation toward exercise were positive; however, they defined exercise as a challenging activity that requires effort and continuity.

Conclusion

Most students included in the study used positive metaphors about exercise. A few students expressed negative sentiments. Investigating the perceptions of physiotherapy students on exercise beginning from their school years can provide a reference for adopting a better quality and holistic exercise approach, including teaching about and training on exercise, thereby enhancing their future role in developing exercise prescriptions and improving exercise adherence.

目的与目的本研究旨在探讨物理治疗与康复系学生对运动的隐喻认知。方法采用现象学案例研究，采用定性研究方法；其中包括来自物理治疗和康复系的180名学生。学生们被要求完成这个句子，“锻炼就像……；因为……”来深入了解他们对运动的看法。结果学生们能产生180个隐喻，并将其分为13个不同的类别。学生们最常把运动比作水、阅读、治疗、空气和药物。使用隐喻最多的类别包括“快乐和安慰”、“心理影响”、“劳动、关怀和连续性”和“有价值”。物理治疗与康复系学生对运动的隐喻是积极的；然而，他们将锻炼定义为一项具有挑战性的活动，需要努力和持续。研究中大多数学生对运动使用了积极的隐喻。一些学生表达了负面情绪。调查理疗学生在校期间对运动的看法，可以为采取更优质、更全面的运动方法提供参考，包括运动教学和训练，从而增强他们在制定运动处方和提高运动依从性方面的作用。

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引用次数: 0

Evaluation of Artificial Intelligence Conversational Models in Providing Information on Dental Implants: A Comparative Analysis of ChatGPT, Gemini and MedGebra 人工智能会话模型在牙种植体信息提供中的评价：ChatGPT、Gemini和MedGebra的比较分析

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-11-02 DOI: 10.1111/jep.70304

Georgios Kofos, Anastasia Fardi, Theodoros Lillis, Fotopoulos Ioannis, Nickolaos Dabarakis

Aims and Objectives

This cross-sectional study aims to compare the accuracy, precision and clarity of responses to dental implant questions from three artificial intelligence (AI) models: ChatGPT (OpenAI, GPT-4), Gemini (Google) and MedGebra.

Materials and Methods

56 questions from an EAO patient guide were used and responses from each AI system were evaluated independently by two oral surgery specialists using a four-point Likert scale for correctness, precision and clarity.

Results

ChatGPT consistently scored highest especially in clarity with perfect marks from both evaluators. Gemini ranked lower in accuracy and precision but exhibited similar clarity. MedGebra received the lowest ratings on all criteria. Though consistency generally remained excellent, the inter-rater reliability study revealed some variance in agreement levels between two examiners.

Conclusion

ChatGPT and Gemini provided more accurate and informative responses on dental implants questions compared to MedGebra. According to the findings of the present study AI chatbots have potential for enhancing patient education on dental implants but professional oversight is crucial for ensuring accuracy and reliability. The study highlights the promising and potential benefits of large language models (LLMs) in dental patient education.

本横断面研究旨在比较三种人工智能（AI）模型：ChatGPT （OpenAI、GPT-4）、Gemini（谷歌）和MedGebra对种植牙问题的回答的准确性、精密度和清晰度。材料和方法使用EAO患者指南中的56个问题，由两名口腔外科专家使用四分制李克特量表对每个AI系统的回答进行独立评估，以评估其正确性、准确性和清晰度。结果ChatGPT在清晰度方面得分一贯最高，两位评估者均获得满分。双子座在准确性和精确度方面排名较低，但表现出类似的清晰度。MedGebra在所有标准中都获得了最低的评分。虽然一致性总体上仍然很好，但评分者之间的信度研究显示，两个考官之间的协议水平存在一些差异。结论与MedGebra相比，ChatGPT和Gemini对种植体问题的回答更准确、信息更丰富。根据目前的研究结果，人工智能聊天机器人有可能加强患者对牙科种植体的教育，但专业监督对于确保准确性和可靠性至关重要。该研究强调了大语言模型（LLMs）在牙科患者教育中的前景和潜在的好处。

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引用次数: 0

Science for Pandemic Preparedness: A Precautionary Framework 大流行防范的科学：预防框架

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-11-02 DOI: 10.1111/jep.70309

David Kriebel, Rok Ho Kim, Trisha Greenhalgh

In the early weeks of the pandemic year 2020, health agencies were slow to warn of the potential for a global health emergency while scientists waited for ‘sufficient’ evidence of human-to-human transmission of the new coronavirus. There were further delays and confusion in issuing guidance because of uncertainty about the most important routes of exposure. A 2021 international expert panel review of COVID-19 pandemic response concluded: ‘The bias of the current system of pandemic alert is towards inaction—steps may only be taken if the weight of evidence requires them. This bias should be reversed—precautionary action should be taken on a presumptive basis, unless evidence shows it is not necessary’. To implement this recommendation, health agencies should incorporate the concept of precaution into their methods for rapidly and transparently reaching policy decisions. In this article, we summarise the historical development of precautionary policy frameworks, and present 4 key components. First, take action if potential risks are large, even when the science is uncertain. This corresponds to the common sense idea of ‘better safe than sorry’. Second, consider the burden of proof required before choosing among alternative actions. Third, ensure that the full range of potential solutions is considered by broadly defining the problem and consulting all relevant scientific fields. Finally, increase public participation so that all relevant perspectives are included, and the chances of public buy-in are increased. Drawing lessons from past applications and missed opportunities, we propose steps that health agencies could take to incorporate precaution into a pragmatic approach to using science for pandemic preparedness and response. The risk of another pandemic from the highly pathogenic avian influenza A (H5N1) virus underscores the urgency of this new approach.

在2020年大流行的最初几周，卫生机构对可能出现的全球卫生紧急情况发出警告的速度很慢，而科学家们则在等待这种新型冠状病毒人际传播的“充分”证据。由于最重要的接触途径不确定，在发布指导意见方面出现了进一步的延误和混乱。2021年国际专家小组对COVID-19大流行应对措施的审查得出结论：“目前的大流行警报系统倾向于无所作为——只有在证据的重要性需要时才可能采取措施。这种偏见应该被扭转——预防措施应该在假定的基础上采取，除非有证据表明没有必要。”为实施这一建议，卫生机构应将预防概念纳入其方法，以便迅速和透明地作出政策决定。在本文中，我们总结了预防性政策框架的历史发展，并提出了4个关键组成部分。首先，如果潜在风险很大，即使科学不确定，也要采取行动。这符合“安全总比后悔好”的常识。其次，在选择备选行动之前，考虑所需的举证责任。第三，通过广泛定义问题并咨询所有相关科学领域，确保考虑到所有可能的解决方案。最后，增加公众参与，使所有相关观点都纳入其中，从而增加公众支持的机会。从过去的应用和错失的机会中吸取教训，我们提出了卫生机构可以采取的步骤，将预防措施纳入一种实用的方法，利用科学来防备和应对大流行。高致病性甲型（H5N1）禽流感病毒再次大流行的风险凸显了采取这一新方法的紧迫性。

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引用次数: 0

The Role of Traditional Chinese Medicine Health Management Model in Improving the Quality of Clinical Nursing Services 中医健康管理模式在提高临床护理服务质量中的作用

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-11-02 DOI: 10.1111/jep.70301

Desheng Li, Min Zhou, Hongmei Zhang, Lulu Zheng

Objective

To explore the role of the traditional Chinese medicine (TCM) health management model in improving the quality of clinical nursing services.

Methods

The respiratory department of a tertiary hospital began constructing and applying the TCM health management model in 2020. Taking this as the time node, the study was divided into two stages: between February and October 2019 (pre-implementation phase) and between April and December 2020 (post-implementation phase). A total of 300 patients were selected from those admitted during the post-implementation phase as the post-implementation group; another 300 patients were selected from those admitted during the pre-implementation phase as the pre-implementation group. Nursing management quality indicators, nursing service quality scores and patient satisfaction were compared and analysed between the two groups. Sensitivity analyses were conducted to adjust for potential time-related confounders.

Results

Compared with the pre-implementation group, the incidence of adverse events in the post-implementation group was significantly reduced (3.33% vs. 8.67%, p < 0.05), the qualified rate of nursing documents increased to 98.33% (vs. 89.33%, p < 0.05) and the service response time was shortened to 5.2 ± 1.3 min (vs. 9.8 ± 2.1, p < 0.05). Regarding nursing service quality, the scores for guidance service, health education, triage nursing, medication management and risk control increased to 90.55 ± 4.18, 91.48 ± 4.29, 90.82 ± 3.97, 90.17 ± 4.49 and 91.65 ± 4.50 points, respectively (all p < 0.05). For patient satisfaction scores, service situation, treatment environment and treatment experience increased to 90.51 ± 4.71, 90.69 ± 4.78 and 90.29 ± 4.12 points, respectively (all p < 0.05).

Conclusion

Within the context of this single-centre quasi-experimental study, the TCM health management model showed potential in optimising nursing processes and improving selected quality indicators in the respiratory department. However, these findings require validation through multicentre randomised controlled trials before broader implementation can be recommended.

Relevance to Clinical Practice

This study offers preliminary insights into integrating traditional medicine approaches with modern nursing practices, although further research is needed to establish broader applicability, particula

目的探讨中医健康管理模式在提高临床护理服务质量中的作用。方法某三级医院呼吸科于2020年开始构建和应用中医健康管理模式。以此为时间节点，将研究分为两个阶段：2019年2月至10月（实施前阶段）和2020年4月至12月（实施后阶段）。从实施后阶段入院患者中选取300例患者作为实施后组；另外从预实施阶段入院的患者中选择300例作为预实施组。比较分析两组护理管理质量指标、护理服务质量评分及患者满意度。进行敏感性分析以调整潜在的时间相关混杂因素。结果与实施前组相比，实施后组不良事件发生率显著降低（3.33% vs. 8.67%, p < 0.05），护理文件合格率提高至98.33% (89.33%,p < 0.05)，服务响应时间缩短至5.2±1.3 min （p < 0.05）。护理服务质量方面，指导服务、健康教育、分诊护理、用药管理、风险控制得分分别提高至90.55±4.18分、91.48±4.29分、90.82±3.97分、90.17±4.49分、91.65±4.50分（p均为0.05）。在患者满意度得分方面，服务状况、治疗环境和治疗体验分别提高到90.51±4.71分、90.69±4.78分和90.29±4.12分（p均为0.05）。结论在本单中心准实验研究的背景下，中医健康管理模式在优化护理流程和提高呼吸科选定的质量指标方面显示出潜力。然而，在推荐更广泛的实施之前，这些发现需要通过多中心随机对照试验进行验证。这项研究为传统医学方法与现代护理实践的结合提供了初步的见解，尽管需要进一步的研究来建立更广泛的适用性，特别是在国际环境中。

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引用次数: 0

Correction to “Implementation of Clinical Pharmacy Services in Primary Health Care: A Scoping Review” 更正“初级卫生保健中临床药学服务的实施：范围审查”。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-11-02 DOI: 10.1111/jep.70307

Paolinelli, J.P.V., de Alencar, T., Rocha, K.S.S., Pereira, M.L. and dos Santos Júnior, G.A. (2025), Implementation of Clinical Pharmacy Services in Primary Health Care: A Scoping Review. Journal of Evaluation in Clinical Practice, 31: e70285. https://doi.org/10.1111/jep.70285.

The graduate program in the affiliation for Kérilin Stancine Santos Rocha is incorrect:

²Laboratory of Innovation for Healthcare (Linc). Postgraduate Program in Pharmaceutical Assistance (PPGASFAR), Federal University of Espírito Santo, Vitória, ES, Brazil

The correct affiliation should be:

²Laboratory of Innovation for Healthcare (Linc). Graduate Program in Pharmaceutical Services and Policies (PPGASFAR), Federal University of Espírito Santo, Vitória, ES, Brazil

We apologize for this error.

Paolinelli, j.p.v., de Alencar， T., Rocha, k.s.s., Pereira， M.L.和dos Santos Júnior， G.A.(2025)，初级卫生保健中临床药学服务的实施：范围审查。临床临床评价杂志，31(1):70 - 85。https://doi.org/10.1111/jep.70285.The在ksamriin stanine Santos Rocha附属机构的研究生项目是不正确的：2医疗保健创新实验室（Linc）。药物援助研究生课程（PPGASFAR）， Espírito Santo联邦大学，Vitória， ES，巴西正确的隶属关系应该是：2创新医疗实验室（Linc）。医药服务与政策研究生课程（PPGASFAR），联邦大学Espírito Santo， Vitória， ES， brazil我们为这个错误道歉。

引用次数: 0

Evidence-Based Summary on Medication Adherence Management for Adult Tuberculosis Patients With Multi-Dimensional Strategies and Practice Framework 基于证据的成人结核病患者药物依从性管理多维策略与实践框架综述。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-10-27 DOI: 10.1111/jep.70280

Fanghui Xie, Rong Yao, Li Liang, Chuntao Wu, Yinping Hu, Yan Zhou, Min Huang, Jinxia Du, Xia Zhao, Bin Wan, Shengfang Xia

Objective

This study aims to systematically retrieve, evaluate and synthesize the best evidence for medication adherence management in adult tuberculosis (TB) patients, providing an evidence-based foundation for optimizing clinical practice.

Methods

Evidence-based questions were formulated using the PIPOST model. Following the ‘6S’ model, 19 Chinese and international databases (BMJ Best Practice, WHO, Cochrane Library, etc.), guidelines and professional association websites were searched from their inception to March 2025, using keywords such as tuberculosis, TB, medication adherence and drug adherence. Clinical guidelines, systematic reviews and manuals were included. Four researchers independently assessed the quality of the literature using AGREE II, AMSTAR and the Johns Hopkins Nursing Evidence-Based Practice Manual tools. Extracted evidence was classified, summarized and graded using the JBI Evidence-Based Healthcare Center's evidence hierarchy system (2014).

Results

Fourteen publications were included (five systematic reviews, six guidelines, three manuals), yielding 25 pieces of evidence across four dimensions: healthcare services, medication adherence supervision, adverse drug reaction management and patient social support. Key evidence included: Providing patient-centred care (Level 1 evidence); delivering health education and counselling throughout treatment (Level 1); implementing directly observed therapy (DOT) and digital health technologies (Level 1); prioritizing adverse drug reaction management (Level 4); strengthening social support systems (Level 1).

Conclusion

This study integrates a multidimensional intervention framework to systematize adherence management in adult TB patients. However, clinical implementation must consider regional resources, cultural differences and individual patient needs. Future research should focus on three priorities: (1) scaling digital technologies; (2) developing adverse reaction early-warning systems; and (3) exploring cost-effective interventions.

目的：系统检索、评价和综合成人结核病患者药物依从性管理的最佳证据，为优化临床实践提供循证依据。方法：采用PIPOST模型编制循证问题。按照“6S”模式，检索了19个国内外数据库（BMJ Best Practice、WHO、Cochrane Library等）、指南和专业协会网站，从其成立到2025年3月，使用关键词如结核病、TB、药物依从性和药物依从性。包括临床指南、系统评价和手册。四名研究人员使用AGREE II、AMSTAR和约翰霍普金斯护理循证实践手册工具独立评估文献的质量。使用JBI循证医疗保健中心的证据层次系统（2014）对提取的证据进行分类、汇总和分级。结果：纳入14篇出版物（5篇系统综述，6篇指南，3本手册），在卫生保健服务、药物依从性监督、药物不良反应管理和患者社会支持四个方面提供了25条证据。主要证据包括：提供以患者为中心的护理（一级证据）；在整个治疗过程中提供健康教育和咨询（第1级）；实施直接观察治疗（DOT）和数字卫生技术（1级）；优先考虑药物不良反应管理（4级）；加强社会支持系统（第1级）。结论：本研究整合了一个多维干预框架，使成人结核病患者的依从性管理系统化。然而，临床实施必须考虑地区资源、文化差异和患者个体需求。未来的研究重点应集中在三个方面：(1)数字技术的规模化；(2)建立不良反应预警系统；(3)探索具有成本效益的干预措施。

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引用次数: 0

‘Indeed, I Was Afraid. But I See Now I Shouldn't Have’: Voices of Vaccine-Accepting Parents About MMR Vaccination 25 Years After Wakefield's Autism Fallacy “的确，我很害怕。但我现在看到我不应该”：在韦克菲尔德的自闭症谬论25年后，接受疫苗的父母对MMR疫苗接种的声音。

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-10-23 DOI: 10.1111/jep.70302

Isidora Andric, Branko Beronja, Biljana Lukic, Teodora Bubnjevic, Milan Boskovic, Marija Milanovic, Jelena Dotlic, Marija Milic, Natasa Maksimovic, Tatjana Gazibara

Rationale and Aim

Over the past two decades several measles outbreaks occurred in Serbia with 15 fatal outcomes because the measles-mumps-rubella (MMR) vaccine coverage is low. The study purpose was to explore the attitudes of parents of vaccinated children towards the MMR vaccine.

Methods

This qualitative research was conducted on 40 parents of MMR vaccinated children aged 1–8 years throughout Serbia. Purposive sampling with maximum variation was used. Parents were interviewed while attending regular paediatric check-ups at the primary health centres. Participant selection was finalised when thematic saturation was achieved. Qualitative content analysis was applied.

Results

On average, parents were 36 ± 6 years old. The data were classified according to these themes: (1) General attitudes towards vaccination, (2) Sources of information about the MMR vaccine, (3) Interactions with health care workers, (4) Fear of MMR vaccination and (5) Perceived adverse effects associated with the MMR vaccination. The majority of parents expressed positive attitudes about vaccines in general and was accepting of MMR vaccination. Most parents explained that discussion with the paediatrician about the MMR vaccine was crucial in the process of accepting vaccination. Although one-half of parents were not afraid of the MMR vaccine, the other half of parents were still unable to completely let go of fear that something bad can happen to their child, despite the evidence.

Conclusion

The vast majority of parents support MMR vaccination. However, many parents of MMR vaccinated children still expressed lingering fear of adverse effects despite knowing that MMR-autism link was rejected.

理由和目的：在过去二十年中，由于麻疹-腮腺炎-风疹（MMR）疫苗覆盖率低，塞尔维亚发生了几次麻疹暴发，造成15人死亡。本研究的目的是探讨接种过MMR疫苗的儿童家长对MMR疫苗的态度。方法：本定性研究对塞尔维亚全国接种MMR疫苗的40名1-8岁儿童的父母进行了研究。采用最大变异的有目的抽样。在初级保健中心接受定期儿科检查时，对父母进行了访谈。当主题达到饱和时，参与者的选择就完成了。采用定性含量分析。结果：父母平均年龄36±6岁。数据根据以下主题进行分类：(1)对疫苗接种的一般态度，(2)关于MMR疫苗的信息来源，(3)与卫生保健工作者的互动，(4)对MMR疫苗接种的恐惧和(5)与MMR疫苗接种相关的感知不良反应。大多数家长对疫苗总体上持积极态度，并接受MMR疫苗接种。大多数家长解释说，在接受疫苗接种的过程中，与儿科医生讨论MMR疫苗是至关重要的。虽然有一半的父母不害怕MMR疫苗，但另一半的父母仍然无法完全摆脱对孩子可能发生坏事的恐惧，尽管有证据。结论：绝大多数家长支持MMR疫苗接种。然而，许多接种了MMR疫苗的孩子的父母仍然表达了对不良反应的挥之不去的恐惧，尽管他们知道MMR与自闭症的联系被拒绝了。

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引用次数: 0

Health Literacy Levels and Predictors Among Hospitalized Patients With Chronic Diseases 慢性疾病住院患者健康素养水平及预测因素

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice

Pub Date : 2025-10-23 DOI: 10.1111/jep.70305

Elif Okur, Yağmur Akbal Demirci, Nesrin Nural

Objectives

The study investigated the health literacy levels and predictors of hospitalized patients with chronic diseases.

Methods

This descriptive and cross-sectional study was conducted with 128 hospitalized patients with chronic diseases between January 2024 and June 2024 in the internal medicine clinics of a public hospital in a province of Turkey. The data were collected using the “Participant Information Form”, the “Charlson Comorbidity Index” and the “Turkish Health Literacy Scale-32 (THLS-32)”.

Results

The lowest health literacy score was found in chronic renal failure patients (24.82 ± 11.94), and the highest in COPD/asthma patients (32.10 ± 10.75). A significant correlation was observed between the variables of age, duration of chronic disease (years), number of medications used, frequency of visiting a healthcare institution, and frequency of hospitalization for the past year and the health literacy score (Adjusted R² = 0.314, F = 12.350, p < 0.05). Age and frequency of hospitalization were found to be significant predictors of the health literacy score (p < 0.05).

Conclusions

This study revealed that more than half of individuals with chronic diseases have inadequate/problematic/limited health literacy. Approximately one-fourth of individuals with chronic diseases had inadequate health literacy. In addition, the health literacy level was low in older patients, had a high frequency of visits to health care institutions, had a high frequency of hospitalization, had a high frequency of emergency unit visits, had a long duration of chronic disease (years), had a high number of medications, and had a high number of comorbid diseases for the past year. Health education should be provided to patients frequently visiting the hospital to improve their health status.

目的：探讨慢性疾病住院患者健康素养水平及其预测因素。方法：对土耳其某省一家公立医院内科门诊2024年1月至2024年6月住院的128例慢性疾病患者进行描述性和横断面研究。使用“参与者信息表”、“Charlson共病指数”和“土耳其健康素养量表-32 （THLS-32）”收集数据。结果：慢性肾功能衰竭患者健康素养评分最低（24.82±11.94），COPD/哮喘患者健康素养评分最高（32.10±10.75）。年龄、慢性病病程（年）、用药次数、就诊次数、过去一年住院次数等变量与健康素养评分存在显著相关（调整后R2 = 0.314, F = 12.350, p）。结论：超过一半的慢性疾病患者健康素养不足/问题/有限。大约四分之一的慢性病患者缺乏卫生知识。此外，老年患者的卫生素养水平较低，到保健机构就诊的频率高，住院的频率高，急诊就诊的频率高，慢性疾病持续时间长（年），服用药物的数量多，过去一年中患有合并症的疾病的数量多。对经常到医院就诊的病人进行健康教育，改善其健康状况。

{"title":"Health Literacy Levels and Predictors Among Hospitalized Patients With Chronic Diseases","authors":"Elif Okur, Yağmur Akbal Demirci, Nesrin Nural","doi":"10.1111/jep.70305","DOIUrl":"10.1111/jep.70305","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The study investigated the health literacy levels and predictors of hospitalized patients with chronic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive and cross-sectional study was conducted with 128 hospitalized patients with chronic diseases between January 2024 and June 2024 in the internal medicine clinics of a public hospital in a province of Turkey. The data were collected using the “Participant Information Form”, the “Charlson Comorbidity Index” and the “Turkish Health Literacy Scale-32 (THLS-32)”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The lowest health literacy score was found in chronic renal failure patients (24.82 ± 11.94), and the highest in COPD/asthma patients (32.10 ± 10.75). A significant correlation was observed between the variables of age, duration of chronic disease (years), number of medications used, frequency of visiting a healthcare institution, and frequency of hospitalization for the past year and the health literacy score (Adjusted R<sup>2</sup> = 0.314, F = 12.350, <i>p</i> < 0.05). Age and frequency of hospitalization were found to be significant predictors of the health literacy score (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed that more than half of individuals with chronic diseases have inadequate/problematic/limited health literacy. Approximately one-fourth of individuals with chronic diseases had inadequate health literacy. In addition, the health literacy level was low in older patients, had a high frequency of visits to health care institutions, had a high frequency of hospitalization, had a high frequency of emergency unit visits, had a long duration of chronic disease (years), had a high number of medications, and had a high number of comorbid diseases for the past year. Health education should be provided to patients frequently visiting the hospital to improve their health status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354972","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}

引用次数: 0

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