Journal of evaluation in clinical practice最新文献

{"title":"The Use of Electronic Health Records in Physiotherapy Practice: Protocol for a Scoping Review","authors":"Marta Fernandes,&nbsp;Sara Souto-Miranda,&nbsp;Diogo Pires,&nbsp;Cristina Jácome,&nbsp;Fernando Ribeiro,&nbsp;Nuno Cordeiro,&nbsp;Eduardo Cruz","doi":"10.1111/jep.70324","DOIUrl":"10.1111/jep.70324","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Physiotherapy has been proven to be highly cost-effective in managing some health conditions, reducing the demand for surgery, pharmacological treatment, hospitalisations, and long-term care. Several organisations and policymakers have already acknowledged that physiotherapy is essential in any health care system, but services need improvement. However, improving physiotherapy services requires efficient collection of real-world data and more in-depth data management. Electronic Health Records (EHRs) have proven to be reliable in managing data in various health care service settings, yet there continues to be little investment in these platforms, especially in physiotherapy. This scoping review aims to map the evidence on the multiple uses of EHRs in physiotherapy, to better understand their applicability in this field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This protocol will follow the Joanna Briggs Institute methodological guidelines for scoping reviews. Original studies and grey literature from 2010 onwards, written in English, Portuguese, or Spanish, concerning the characteristics, development, implementation process, and outcomes of Physiotherapy registry platforms will be included. Search will be conducted on four electronic databases (PubMed, Scopus, Science Direct, and Web of Science). Two independent reviewers will assess and select the articles. Data extracted will include information regarding EHRs main characteristics (e.g., types of users, type of data collected, functions, context), development and implementation processes, and outcomes of registry platforms, in all fields of physiotherapy. The information will be registered, aggregated by categories, and displayed in tables and charts mapping the distribution of studies alongside a narrative summary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The proposed scoping review will synthesise key knowledge to provide significant literature-based insights into the steps, strategies, and procedures necessary for developing and implementing physiotherapy EHRs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Program to Improve General Palliative Cancer Care Guideline Implementation: Development, Acceptability, and Feasibility of Implementation Strategies","authors":"Dina Melanie Sørensen,&nbsp;Cecilie Lindström Egholm,&nbsp;Susanne Oksbjerg Dalton,&nbsp;Elizabeth Rosted,&nbsp;John Brandt Brodersen,&nbsp;Mia Linda Møller,&nbsp;Mai-Britt Angersbach Petersen,&nbsp;Annika von Heymann,&nbsp;Pernille Bidstrup","doi":"10.1111/jep.70335","DOIUrl":"10.1111/jep.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Implementing palliative care for patients with cancer in the healthcare sector is a complex task. Some patients with cancer do not receive timely and comprehensive palliative care tailored to their needs, potentially reducing their quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>The goal is to develop an Implementation Program to improve the implementation of the national guidelines for general palliative cancer care. Moreover, the study aims to evaluate the acceptability and feasibility of the implementation strategies among healthcare professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We used a participatory action research approach and the Quality Implementation Framework to guide the program. Additionally, we evaluated the acceptability and feasibility of the implementation strategies through a qualitative descriptive design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-one healthcare professionals from oncology, municipalities, and general practice took part in developing the Implementation Program with guidance from a facilitator. We utilized data triangulation, including qualitative interviews (<i>n</i> = 17), observation data from in-person meetings (<i>n</i> = 5), virtual meetings (<i>n</i> = 50), and process data gathered from November 2021 to March 2023. We analyzed the data using Content Analysis methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A program comprising 14 critical steps was developed. The implementation strategies were found acceptable and feasible, particularly for cross-sectoral networking and a facilitator supporting collaboration. However, Plan-Do-Study-Act cycles were considered problematic. The value of learning from experiences was recognized, and healthcare professionals appreciated the advantages of cross-sector collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study involved cross-sectoral healthcare professionals in developing the Implementation Program for general palliative cancer care. Networking is vital in this context and should be considered a stand-alone implementation strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Real-World Implementation and Effectiveness of a Collaborative Care Model for Adults with Depression and Anxiety at an Urban, Academic Hospital","authors":"Peter J. Hahn,&nbsp;Daniel Y. Johnson,&nbsp;Joanne Wang,&nbsp;Carly Lusk,&nbsp;Samantha Allen,&nbsp;Fabiana S. Araújo,&nbsp;Daniel Yohanna,&nbsp;Erin M. Staab,&nbsp;Neda Laiteerapong","doi":"10.1111/jep.70332","DOIUrl":"10.1111/jep.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Over 30% of adults in the United States have symptoms of depressive or anxiety disorders. The majority of these patients are treated only in primary care and have suboptimal outcomes. The Collaborative Care Model (CoCM) is designed to address this problem.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study evaluated the implementation and effectiveness of CoCM at an urban academic medical center primary care clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective chart review and analysis informed by the RE-AIM framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 148 patients, mean PHQ-9 scores decreased by 4.8 (SD, 5.8, <i>p</i> &lt; 0.001) and GAD-7 scores decreased by 5.6 (SD, 5.7, <i>p</i> &lt; 0.001). Overall adoption rate was 36% and differed between attending physicians/APNs (50%) and residents (32%). Implementation showed fidelity to measurement-based care, but only 40% of cases were reviewed with the psychiatrist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A real-world CoCM can improve symptoms of depression and anxiety for adults; however, trainee adoption and adherence to psychiatric case reviews may merit special attention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654485","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":"Child and Caregiver Perspectives on Conversation Club Therapy: A Case Study","authors":"Theresa Pham,&nbsp;Boomerang Health Group","doi":"10.1111/jep.70337","DOIUrl":"10.1111/jep.70337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale, Aims and Objectives</h3>\u0000 \u0000 <p>Conversation Club is a community-based intervention developed to support social and conversation skills in both neurodiverse and neurotypical children who may need additional support in these areas. The purpose of this preliminary evaluation is to examine the efficacy of Conversation Club delivered in the local setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This mixed-methods case study involved a child-caregiver dyad. Pre-post intervention data were collected through interview and battery of tests assessing social skills (e.g., Social Skills Improvement System; Social Responsiveness Scale).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both the child and caregiver shared that they were satisfied with Conversation Club and felt that the child benefitted from the curriculum. Results also indicated that the child made a reliable change on both self- and caregiver-measures of social and conversation skills, but results were mixed for behaviour indices. Interestingly, the child rated their social skills as average before and after intervention, compared to elevated social impairments perceived by the caregiver at both time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An overall strength of this case study was to include the perspective of the child participant, in addition to the caregiver report, to evaluate the social validity and acceptance of the intervention for teaching conversation skills.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness Criteria, Insurance Policies, and the Erosion of Clinical Judgement","authors":"Jacob Duncan","doi":"10.1111/jep.70329","DOIUrl":"https://doi.org/10.1111/jep.70329","url":null,"abstract":"<div>\u0000 \u0000 <p>The American College of Radiology (ACR) Appropriateness Criteria (AC) were designed to guide evidence-based imaging decisions. Increasingly, however, insurers and electronic health record–embedded clinical decision support (CDS) systems use these criteria to determine coverage, shifting their role from clinical guide to gatekeeping tool. This commentary examines the disconnect between policy and practice, driven by low physician awareness, educational gaps, and difficulty navigating the criteria. When applied rigidly, particularly in insurance reimbursement, these shortcomings risk deepening diagnostic inequities. The example of breast cancer screening for patients with dense breast tissue illustrates how restrictive application can limit access to higher-sensitivity imaging and exacerbate disparities. We argue that guidelines should guide, not govern, and that insurer reliance must be paired with physician training, transparent methodology, and adaptability. Policy reform, expanded coverage mandates, and integration of AC education into medical training are needed to align guidelines with both clinical realities and patient needs.</p>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619308","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":"Psychometric Properties of Intolerance of Uncertainty Scale (IUS-5) in a Sample of Nurses: A Methodological Study","authors":"Faryal Khamis,&nbsp;Abdallah Badahdah,&nbsp;Nasser Aloud","doi":"10.1111/jep.70320","DOIUrl":"https://doi.org/10.1111/jep.70320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>The Intolerance of Uncertainty Scale (IUS-12) is widely used in both clinical and community studies. Due to the length and inconsistent factor structure of the IUS-12, an abbreviated version consisting of five items (IUS-5) has been proposed. However, no study has examined its psychometric properties aside from the preliminary work by its developers. The current study investigated the factor structure of the IUS-5 as well as its reliability and validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A sample of 315 nurses completed an online self-report questionnaire during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Confirmatory factor analysis of the IUS-5 suggested a deletion of one item. The final analysis supported a one-factor solution on the remaining four items (IUS-4) with a McDonald's omega of 0.77. The validity of IUS-4 was assessed by testing its positive and negative correlations with existing related and contrary measures, respectively. Further, the validity of the IUS-4 was supported through known-group validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first psychometric assessment of the IUS-5 measure of intolerance of uncertainty in a sample of nurses. Results from the current study supported a shorter measure of four items. However, more work needs to be conducted to examine the IUS-4 and IUS-5 in samples of healthcare providers with different cultural and linguistic backgrounds.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619309","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":"Quality Indicators for Drug Dispensing in Community Pharmacies: A Scoping Review Protocol","authors":"Lara Joana Santos Caxico-Vieira,&nbsp;Elindayane Vieira de Souza,&nbsp;Maria Amélia Joyce da Silva Moura,&nbsp;Rafaella de Oliveira Santos Silva,&nbsp;Alessandra Rezende Mesquita,&nbsp;Tácio de Mendonça Lima,&nbsp;Divaldo Pereira de Lyra Jr.","doi":"10.1111/jep.70333","DOIUrl":"https://doi.org/10.1111/jep.70333","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Assessing health service quality, particularly through indicators, is essential for improvement and accountability. However, the literature lacks a comprehensive analysis of how drug dispensing quality is measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This scoping review protocol aims to identify the validated indicators used to assess the quality of drug dispensing in community pharmacies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review will follow the JBI Reviewer's Manual and PRISMA-ScR guidelines. An electronic search will be conducted in MEDLINE (PubMed), Embase, Scopus, Web of Science and LILACS, using search terms related to “quality indicators, health care”, “dispensing” and “community pharmacies”, along with their synonyms. Study selection and data extraction will be performed independently by two reviewers, disagreements will be resolved by a third. Findings will be synthesized narratively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study will identify and critically analyze quality indicators for drug dispensing in community pharmacies, bridging fragmented practices with evidence-based standards to guide safer, more effective pharmaceutical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interprofessional Patient Safety Education: Assessing Students' Interprofessional Collaboration, Attitudes Towards Safety and Professionalism","authors":"Samaneh Mirzaei,&nbsp;Fatemeh Keshmiri,&nbsp;Mohsen Gholinataj Jelodar,&nbsp;Mandana Shirazi","doi":"10.1111/jep.70319","DOIUrl":"https://doi.org/10.1111/jep.70319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to evaluate the effect of an interprofessional patient safety training programme on students' attitudes and interprofessional collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A quasi-experimental study with a nonequivalent control group was conducted at Shahid Rahnemoon Hospital, affiliated with Shahid Sadoughi University of Medical Sciences. Seventy students participated in the 2023–2024 internship courses, with 35 students in each group. Participants were assigned to two groups using cluster randomization based on their internal medicine rotation schedule. The intervention group received interprofessional education, while the control group received uniprofessional training. The intervention group engaged in case-based learning within mixed medical and nursing teams; the control group completed the same activities in separate uniprofessional groups. Two self-report questionnaires assessed attitudes towards patient safety and professionalism, as well as performance in interprofessional collaboration. Assessments occurred before the intervention, 1 month after, and 3 months after. Data analysis included descriptive and inferential statistics, specifically independent <i>t</i> tests, repeated measures ANOVA, and <i>χ</i>² tests, all conducted at a 95% confidence interval using SPSS version 26.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study revealed a significant difference in both attitude (<i>F</i> = 19.4, <i>p</i> &lt; 0.0001, <i>η</i>² = 0.28) and performance (<i>F</i> = 4.53, <i>p</i> = 0.013, <i>η</i>² = 0.060) across the three assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings demonstrate that interprofessional training improved students' attitudes and produced a moderate effect on performance. Sustained performance improvement may require longitudinal training. Future research should account for cultural factors and the structure of educational and healthcare systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619307","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":"Differences Between Parents and Nurses in Perceived Educational Support for Pediatric Postoperative Pain Management","authors":"Yuanye Hu,&nbsp;Yun Shi","doi":"10.1111/jep.70338","DOIUrl":"https://doi.org/10.1111/jep.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This cross-sectional study aims to investigate the differences between parents and nurses in perceived educational support for pediatric postoperative pain management. It is hypothesized that there is significant difference between the participants that leads to insufficient control of pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Parents of children undergoing major surgery and surgical nurses were invited to respond to the electronic questionnaires. The prioritization of specific information, children's postoperative pain experience, the preferred method for receiving or providing educational support and participants' satisfaction with the educational support was investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 214 participants, including 50 surgical nurses and 164 parents. How to evaluate pain severity in child was rated as the most import information in parents, while it was how to command PCAP in nurses. Significant differences were detected in the importance scores of the following: (1) indication of PCAP [4.5 (2–5) vs. 5 (2–5), <i>p</i> = 0.0241], (2) how to evaluate pain severity in the child [4.5 (1–5) vs. 5 (3–5), <i>p</i> = 0.0482], and (3) target of postoperative pain management [4.5 (2–5) vs. 5 (3–5), <i>p</i> = 0.0130]. There was significantly difference in the preferred method to receive/provide educational support between nurses and parents (<i>p</i> = 0.0100). Parents were significantly less satisfied with the educational support [5 (2–5) vs. 4 (1–5), <i>p</i> = 0.0316]. The pain score at both movement and rest at 24, 48 and 72 h was significantly decreased over time, 6 (5–7), 5 (4–6), 4 (3–4) with <i>p</i> &lt; 0.0001, &lt; 0.0001 and 0.0004 and 3 (3–4), 3 (2–3), 2 (2–3) with <i>p</i> = 0.0010, &lt; 0.0001 and 0.1002, respectively. The median (IQR) press number at 24, 48 and 72 h were 0 (0–1), 1 (0–2) and 1 (1–3), with no significant differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the use of PCAP, children experienced moderate postoperative pain owing to low parental engagement. Differences between parents and surgical nurses in the prioritization of specific information may result in insufficient educational support. Further studies are warranted to evaluate the effectiveness of educational programs that address parents' concerns to improve the postoperative pain management in pediatric population.</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":"145626385","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":"Bearing the Burdens of Medical Uncertainty","authors":"Bjørn Hofmann,&nbsp;Paul K. J. Han","doi":"10.1111/jep.70323","DOIUrl":"https://doi.org/10.1111/jep.70323","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Uncertainty comes in many kinds, is ubiquitous in all parts of clinical work, and is burdensome to physicians, patients, proxies and policy makers. Moreover, it leads to a range of adverse responses such as excessive testing and interventions, overdiagnosis and overtreatment. While the technical aspects of uncertainty are widely accounted for, the burdens of uncertainty need closer scrutiny.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>The aim of this article is to investigate the complex burden of uncertainty for clinicians: as health professionals, carers for patients, and human beings facing the unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A conceptual analysis is applied introducing a case to illustrate the diverse aspects of uncertainty reviewed in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identify six types of burdens of uncertainty: cognitive, emotional, behavioural, social, moral and existential and show how they play out for clinicians in clinical care for their patients, as health professionals, as caregivers and human beings. Moreover, we suggest specific strategies for bearing these various types of burdens of uncertainty in all roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Bearing the burdens of uncertainty is crucial for professional integrity, well-being, and communication with patients, but also for improving the quality, safety, efficiency and sustainability of healthcare.</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":"145619093","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}