Journal of evaluation in clinical practice
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Falls among hospitalized patients are an important patient safety issue. In particular, the incidence of falls and risk of related injuries among the elderly are particularly high. Because the epidemiology of falls is not well scrutinized in Japanese long-term care wards, we evaluated the incidence and risk factors of falls in this setting. ⋯ Many patients on long-term care wards in Japan were elderly and experienced falls during their hospital stay, with consequent injuries. Taking into account the risk factors identified, we need to devise effective strategies to prevent falls and related injuries.
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Studies have challenged the validity and underlying measurement model of the physical and mental component summary scores of the 36-item Short-Form Health Survey in, for example the elderly and people with neurological disorders. However, it is unclear to what extent these observations translate to physical and mental component summary scores derived from the 12-item short form (SF-12) of the 36-item Short-Form Health Survey. This study evaluated the construct validity of the SF-12 in elderly people and people with Parkinson's disease (PD) and stroke. ⋯ These observations challenge the validity and interpretability of SF-12 scores among the elderly, people with PD and stroke survivors. The standard orthogonally weighted SF-12 scoring algorithm is cautioned against. Instead, when the assumed two-dimensional structure is supported in the data, oblique scoring algorithms appear preferable. Failure to consider basic scoring assumptions may yield misleading results.
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Current perspectives concerning clinical decision making favour inclusion of patient preference for therapy. This exploratory study aimed to forge introductory insights into patient preference for outpatient-based rehabilitation after total knee replacement (TKR). ⋯ Patient global satisfaction is similarly high across different modes of outpatient rehabilitation despite differences in perceived benefits. The association between satisfaction and preference potentially indicates that provided the service is deemed high quality, the actual mode of therapy offered is less important to this patient population. Research is required, however, to establish the relationship between preference and outcome, the stability of preference across time, and the effect of multiple rehabilitation exposures on preference. For now, the quality of current uni-modal programmes could be enhanced by incorporation of features typically associated with alternative modes.
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The objectives of this paper were to investigate quality of care for individuals with osteoarthritis (OA) and to determine if those most in need had the outcome of a total joint replacement (TJR). Key quality indicators were involvement in treatment decisions, appropriate information provision and outcomes of care. ⋯ It appears that patients with the most severe symptoms of pain and physical functioning were selected for TJR. However, care for individuals with OA could be improved by providing standard information on OA in general and pain management and exercise. In particular, effective strategies for the implementation of the research evidence and guidelines are required to improve quality of care.
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Diabetes mellitus is a growing health and economic burden. Identification of patients with unrecognized diabetes, or those at high risk for diabetes, provides an opportunity for timely intervention. This study assessed the accuracy of using electronic health care data to identify patients with undiagnosed diabetes. ⋯ Patients with diagnosed and undiagnosed diabetes can be accurately identified using electronic health care data.