Journal of evaluation in clinical practice
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Problems exist with Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders: they are often misinterpreted by clinicians to mean that other treatments should be withheld; resuscitation decision discussions are difficult; patients remain inappropriately for resuscitation. We developed an alternative approach. ⋯ The Universal Form of Treatment Options was developed iteratively with patients, doctors and nurses as an alternative approach to resuscitation decisions. This paper illustrates a cross-disciplinary approach to developing practical alternatives in health care.
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To analyse anthropometric parameters, clinical pain and experimental pain in women with chronic pelvic pain (CPP). ⋯ Evaluation of anthropometric parameters and pain measurements can be applied in clinical practice, making a contribution to the diagnosis and influencing the choice of a more effective treatment for women with CPP.
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Diagnostic systems exist in many disciplines. Strengths and weaknesses of such diagnostic systems vary considerably within and among disciplinary domains of the health sciences. The logical framework behind each diagnostic process involves identifying a condition, seeking causes, establishing a prognosis and a treatment. Notably, a clinical diagnosis is a judgment focused on the present, aiming to cluster events associated with a disease. Diagnostic judgment focuses on the past when it attempts to isolate possible causes, and towards the future when it indicates prognoses and treatments. ⋯ The proposed logical framework has been applied to a nursing taxonomy-based diagnostic system in order to evaluate its strengths and weaknesses consistently with the epistemology of a diagnostic judgment.
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We aim to investigate a range of risk factors associated with medication adherence among Chinese hypertensive patients. We also aim to investigate the association between medication adherence and blood pressure control. ⋯ The rate of suboptimal medication adherence among Chinese hypertensive patients is quite high. Interventions could focus upon the risk factors to improve antihypertensive medication adherence in clinical practice.
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Increasing numbers of clinical nurse specialists (CNSs) are working in outpatient settings. The objective of this paper is to describe a systematic review of randomized controlled trials (RCTs) evaluating the cost-effectiveness of CNSs delivering outpatient care in alternative or complementary provider roles. ⋯ Low-to-moderate quality evidence supports the effectiveness and two fair-to-high quality economic analyses support the cost-effectiveness of outpatient alternative provider CNSs. Low-to-moderate quality evidence supports the effectiveness of outpatient complementary provider CNSs; however, robust economic evaluations are needed to address cost-effectiveness.