Journal of evaluation in clinical practice最新文献

{"title":"Correction to “Implementation of Clinical Pharmacy Services in Primary Health Care: A Scoping Review”","authors":"","doi":"10.1111/jep.70307","DOIUrl":"10.1111/jep.70307","url":null,"abstract":"<p>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.</p><p>The graduate program in the affiliation for <b>Kérilin Stancine Santos Rocha</b> is incorrect:</p><p>²Laboratory of Innovation for Healthcare (Linc). Postgraduate Program in Pharmaceutical Assistance (PPGASFAR), Federal University of Espírito Santo, Vitória, ES, Brazil</p><p>The correct affiliation should be:</p><p>²Laboratory of Innovation for Healthcare (Linc). <b>Graduate Program in Pharmaceutical Services and Policies</b> (PPGASFAR), Federal University of Espírito Santo, Vitória, ES, Brazil</p><p>We apologize for this error.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431508","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":"Evidence-Based Summary on Medication Adherence Management for Adult Tuberculosis Patients With Multi-Dimensional Strategies and Practice Framework","authors":"Fanghui Xie,&nbsp;Rong Yao,&nbsp;Li Liang,&nbsp;Chuntao Wu,&nbsp;Yinping Hu,&nbsp;Yan Zhou,&nbsp;Min Huang,&nbsp;Jinxia Du,&nbsp;Xia Zhao,&nbsp;Bin Wan,&nbsp;Shengfang Xia","doi":"10.1111/jep.70280","DOIUrl":"10.1111/jep.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372753","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":"‘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","authors":"Isidora Andric,&nbsp;Branko Beronja,&nbsp;Biljana Lukic,&nbsp;Teodora Bubnjevic,&nbsp;Milan Boskovic,&nbsp;Marija Milanovic,&nbsp;Jelena Dotlic,&nbsp;Marija Milic,&nbsp;Natasa Maksimovic,&nbsp;Tatjana Gazibara","doi":"10.1111/jep.70302","DOIUrl":"10.1111/jep.70302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale and Aim</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</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":"145355015","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":"Health Literacy Levels and Predictors Among Hospitalized Patients With Chronic Diseases","authors":"Elif Okur,&nbsp;Yağmur Akbal Demirci,&nbsp;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 R² = 0.314, F = 12.350, <i>p</i> &lt; 0.05). Age and frequency of hospitalization were found to be significant predictors of the health literacy score (<i>p</i> &lt; 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}

{"title":"Understanding and Managing Confounders, Mediators and Colliders in Research","authors":"Ahtisham Younas,&nbsp;Shahzad Inayat","doi":"10.1111/jep.70298","DOIUrl":"10.1111/jep.70298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Researchers often make causal inferences about relationships among variables and constructs. However, third-variable effects may obscure the relationship among studied variables. Third-variable effects generally include confounders and mediators, but recently there has been an emerging discussion on colliders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To provide a concise introduction of confounders, colliders, and mediators for health researchers and outline strategies for minimising the impact of confounders, colliders and mediators in quantitative research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Methodological literature from biostatistics textbooks, methodology papers, and methodological reviews published in nursing, health, psychological and behavioural sciences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Understanding third-variable effects is crucial to conducting rigorous research and drawing valid causal inferences from research data. Health researchers should embrace both theory and model-based thinking as a foundational element of their methodology. This involves explicitly theorising the underlying causal structures before data collection and analysis using Directed Acyclic Graphs which are useful for visually representing hypothesised causal pathways and their relationships with potential third variables.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337245","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":"There Is No Dilemma: The Issue of Female Genital Reinfibulation in High-Income Countries Need Not be Revisited","authors":"Richard C. Armitage","doi":"10.1111/jep.70303","DOIUrl":"https://doi.org/10.1111/jep.70303","url":null,"abstract":"&lt;p&gt;According to the World Health Organisation, female genital mutilation (FGM) comprises all procedures that involve the partial or total removal of external female genitalia or other injury to the female genital organs for nonmedical reasons [&lt;span&gt;1&lt;/span&gt;]. The same classification describes Type III FGM—often referred to as infibulation—as the narrowing of the vaginal orifice through the creation of a covering seal formed by cutting and apposition of the labia minora and/or the labia majora, with or without excision of the clitoris [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Defibulation is the anterior midline vulval incision of the infibulation scar performed prenatally or at the time of delivery. While it restores sufficient access to the female reproductive tract, defibulation does not reinstate physical or emotional normality [&lt;span&gt;2&lt;/span&gt;]. Reinfibulation is the subsequent resuturing of the incised infibulation scar tissue after delivery [&lt;span&gt;2&lt;/span&gt;]. Approximately 13 million women have undergone infibulation globally, and an estimated 6.5–10.4 million women are likely to have been reinfibulated worldwide [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The prevalence of FGM is highly concentrated in a band of countries from the Atlantic coast to the Horn of Africa [&lt;span&gt;3&lt;/span&gt;], and reinfibulation is most prevalent in countries where Type III FGM is the most practiced type, including Somalia (98%–100%), Sudan (82%), Djibouti (50%), and Eritrea (34%) [&lt;span&gt;1&lt;/span&gt;]. While offering no medical benefits, reinfibulation returns women who have been defibulated to an infibulated state and subjects them once again to its accompanying harms. The process is associated with, among other risks, localised infection or abscess formation, sepsis, haemorrhage, shock, acute urinary retention, and contraction of hepatitis and/or HIV [&lt;span&gt;4&lt;/span&gt;], while the infibulated state is associated with a plethora of gynaecological and obstetric complications [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In their recent Correspondence in &lt;i&gt;The Lancet&lt;/i&gt;, Bonavina and colleagues lament the unlawful status of reinfibulation in high-income countries as ‘potentially depriving [women] of their choice’, and claim there exists an ethical dilemma between preserving the ability of women to choose reinfibulation and protecting them against its harmful consequences [&lt;span&gt;6&lt;/span&gt;]. The article contains multiple ethical problems, which I addressed in a reply submitted to the &lt;i&gt;The Lancet&lt;/i&gt;. The reply was rejected by the editorial board, and my subsequent request for the board′s reasoning behind its decision was not granted. I shall, therefore, rebut the article here instead.&lt;/p&gt;&lt;p&gt;In their article, Bonavina and colleagues presume that the women who ‘choose’ reinfibulation simply exercise their autonomy in doing so. This reflects a superficial understanding of autonomy that conflates mere expression of preference with genuine autonomous choice. Autonomy, properly conceived, requires not only the capacity to express pref","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317756","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":"AI Anxiety: A Web of Science-Based Bibliometric Analysis","authors":"Betul Akalin,&nbsp;Furkan Alp,&nbsp;Birkan Tapan,&nbsp;Mehmet Besir Demirbas","doi":"10.1111/jep.70296","DOIUrl":"10.1111/jep.70296","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Artificial Intelligence Anxiety (AI Anxiety) refers to the apprehension and distrust individuals may feel in response to the rapid development and integration of artificial intelligence into various aspects of life. These emotions are often driven by concerns about AI's potential implications in domains such as employment, security, privacy, and human interaction. This study aims to conduct a comprehensive bibliometric analysis of the scientific literature on ‘AI Anxiety’ published between 2011 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 80 articles indexed in the Web of Science (WoS) Core Collection database were analysed. The study evaluated parameters including the most cited publications, annual distribution of research, contributing countries, leading publishers, main research domains, and keyword trends. Network analyses involving coauthorship, author citations, institutional citations, and country-level citations were conducted using VOSviewer software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings indicate a notable increase in AI Anxiety-related studies, particularly between 2021 and 2024. Highly cited articles include works by Youn (2021) and Wang (2022). The United States emerged as the leading contributor, followed by China and Türkiye. Prominent publishers were Elsevier, Springer Nature, and Taylor &amp; Francis. In the coauthorship network, authors such as Merlo and Johnson occupied central positions. Frequently used keywords included ‘Artificial Intelligence’, ‘AI Anxiety’, ‘Technology Acceptance Model’, and ‘Trust’. Country citation analysis revealed that the United States and China occupied central roles with strong citation linkages to other countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study highlights the growing scholarly interest in the psychological and societal implications of artificial intelligence. It also provides a roadmap for future research directions by identifying key contributors, collaborative patterns, and thematic trends within the field of AI Anxiety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301400","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":"Factors Influencing Readiness for Hospital Discharge Among Patients With Schizophrenia: A Cross-Sectional Study","authors":"Aliane Uwera,&nbsp;Qingqing Yang,&nbsp;Shumin Zhang,&nbsp;Jie Shi,&nbsp;Min Gao,&nbsp;Meizhi Li,&nbsp;Jianjian Wang,&nbsp;Zhanchou Zhang,&nbsp;Li He,&nbsp;Lulu Lu,&nbsp;Qiongni Chen","doi":"10.1111/jep.70277","DOIUrl":"10.1111/jep.70277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Schizophrenia is a severe disabling disease associated with disease relapse and a high readmission rate after hospital discharge. Readiness for hospital discharge plays a crucial role in patients transitioning from the hospital to the community, as well as in improving post-discharge outcomes. However, previous studies have predominantly focused on personal characteristics, social support, and nurses' guidance during discharge, while disease-related factors and ward environment factors have been overlooked.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the current status and factors influencing readiness for hospital discharge among patients with schizophrenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>390 patients and 14 head nurses of psychiatric wards from six tertiary hospitals in China completed the questionnaire from July 2023 to January 2024. Data was analysed using descriptive statistics, <i>t</i>-tests, ANOVA, Pearson correlation, and multiple linear regression. This study was reported using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean score of readiness for hospital discharge among patients with schizophrenia was high (102.63 ± 15.69). The quality of discharge teaching, schizophrenia self-management, perceived social support, and other factors affecting the ability to control symptoms such as stigma and family conflicts significantly influenced readiness for hospital discharge, explained by 47.50% of the total variation in the model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study has revealed a high level of readiness for hospital discharge, schizophrenia self-management, perceived social support, and quality of discharge teaching among patients with schizophrenia. In addition, the quality of discharge teaching, self-management, social support, and other reasons affecting the ability to control symptoms were the key factors influencing readiness for hospital discharge among patients with schizophrenia. Therefore, personalised hospital discharge preparation for patients with schizophrenia throughout their hospitalisation period is needed for effective community reintegration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286413","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":"Reframing EHR Policy in China: Towards Balanced Implementation and Ethical Foundations","authors":"Shuyuan Chen,&nbsp;Wenhao Huang,&nbsp;Yan Xu,&nbsp;Jie Yang","doi":"10.1111/jep.70273","DOIUrl":"10.1111/jep.70273","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Electronic Health Record (EHR) systems are a core component of healthcare informatization, playing a crucial role in the development of digital and smart healthcare. This study utilizes policy tool theory to analyse policies related to China's EHR system. By gaining a deep understanding of the mechanisms of policy impact, we believe we can better guide the development direction of EHR systems, optimize resource allocation, and improve system effectiveness and efficiency. Ultimately, this will make a substantial contribution to the construction of healthcare informatization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The research employs Christopher Hood's ʻNATOʼ model of policy tools to construct a three-dimensional analytical framework. A total of 427 relevant policy documents were retrieved and screened from the PKULAW.COM and WWW.GOV.COM databases. NVivo 14 software was used for text mining and quantitative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study reveals that authority tools (36.88%) dominate across most policy objectives, particularly in improving healthcare quality and promoting technological innovation. Nodality tools (27.90%) also demonstrate significant influence in enhancing healthcare quality and fostering technological innovation. Organization tools (21.75%) reflect governmental efforts in institutional development and organizational coordination. While economic tools (13.48%) show a lower overall frequency of use, they are applied relatively more in objectives related to rational resource allocation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Recommendations include optimizing the government's role and balancing the use of authority tools; refining the policy objective system with increased attention to ethical issues; and strengthening the synergistic application of policy tools to enhance policy implementation effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286381","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":"Ethical Dilemmas Surrounding ECMO Withdrawal: A Qualitative Empirical Study","authors":"Abdelrahman M. Makram,&nbsp;Randa Elsheikh,&nbsp;Truong Thanh Phuong Ha,&nbsp;Mahmoud Sayed Saad Mohammed,&nbsp;Nguyen Tien Huy","doi":"10.1111/jep.70294","DOIUrl":"10.1111/jep.70294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Extracorporeal membrane oxygenation (ECMO) is a critical, life-sustaining intervention often described as ‘a bridge to nowhere’ due to its transient nature and the ethical complexities it entails. This qualitative empirical study examines the moral dilemmas surrounding ECMO utilization in clinical practice, with a particular focus on the unilateral withdrawal of support for capacitated patients with a poor prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a qualitative, thematic analysis of existing literature, we performed a literature search in PubMed with ECMO and ethical principles as search concepts. We reviewed 139 articles for possible inclusion, where articles were included if they discussed the ethical dilemmas or implications of unilateral ECMO withdrawal. The patient's condition did not also play a role in the selection of eligible arguments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that in the context of pandemics, the shortage of ECMO machines for a growing number of critically ill patients placed significant pressure on ethical evaluations, with concerns involving distributive justice, quality of life, patients' rights, and professional integrity. The paper systematically analyzed the ethics of resource allocation, the impact on patient autonomy, and the role of palliative care, highlighting the intricacies of the Equivalence Thesis in decision-making. Furthermore, it critically explored the foundational principles, such as beneficence and non-maleficence, and proportionality, alongside other ethical concepts discussed in the literature, like professional and legal considerations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By analyzing these ethical dimensions, this paper seeks to inform and shape evidence-based, patient-centered policies and practices in ECMO management, fostering decisions that respect both the rights of patients and the ethical duties of clinicians.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286243","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}