Journal of evaluation in clinical practice
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Representation of benefits and harms associated with specific interventions in an understandable and comparable way is crucial for informed decision making that clinical practice guidelines (CPGs) aim to enhance. Therefore, we investigated how statements concerning the effects of interventions considered and described benefits and harms, magnitude of effect and its uncertainty, numeric and non-numeric information, and outcomes in Finnish CPGs. ⋯ In the Finnish CPGs, the statements were rarely framed with both absolute and relative numeric measures of an intervention's effect. Harms were rarely reported with a grade indicating the level of evidence. The users of CPGs would benefit from more consistent and understandable framing of statements considering both benefits and harms of interventions.
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There are various models attempting to predict 30-day readmissions of acutely admitted internal medicine patients. However, it is uncertain how to create a parsimonious index that has equivalent predictive ability and can be extrapolated to other settings. ⋯ An index derived from the number of previous hospital admissions, days since last admission, age, and length of stay in days differentiated between the risks of readmission within 30 days without the need for discharge diagnosis and laboratory variables.
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Empathic attitudes and behaviours of midwives directly affect obstetric outcomes. The study aims to examine the effect of empathy training on the empathic communication skills of midwives and the childbirth satisfaction of primiparous mothers. ⋯ The empathy training improved both the empathy skills of midwives, and translated to improved maternal satisfaction with birth among their mothers. It is recommended to increase the number of follow-ups to evaluate the long-term effect of empathy training.
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The efficacy, cost-effectiveness, and safety of a number of endoscopic procedures are largely dependent on optimal preparation. Despite this however, inadequate or suboptimal preparation is relatively common. Most studies have revealed inadequate preparation for between 20% and 30% of patients. This audit sought to examine the impact of English language proficiency, and ethnicity, on endoscopic preparation and procedure success or failure. ⋯ Amongst these patients, we found that a little more than 20% of participants were inadequately prepared for their endoscopic procedure. We found no relationship between language proficiency on preparation. Given the mixed literature on interventions to improve preparation before endoscopic procedures, further directions are identified to work toward the development and testing of a novel intervention amongst this population. In identifying those who may be at risk for inadequate preparation for endoscopic procedures, practice needs to take into account a range of factors beyond language and ethnicity. Furthermore, the persistent reliance on family members to interpret information sheets and preparation advice suggests that revision and/or development of culture and language-specific materials is necessary.