Abstract:
:Sturmberg et al write about multimorbidity as "several diagnosable diseases within the same individual." They posit that this syndrome is the result of multiple interconnected disturbances reflecting scale-free, fractal signs of pathology ranging from biochemical/hormonal alterations at one end of a spectrum to community and societal ills at the other. In this commentary, I will be focusing on 3 perspectives: 1) a preterminal phase of multimorbidity that is indicative of that loss of reparative or even homeokinetic properties, known by some as "advanced serious illness"; 2) the manifestations of advanced serious illness multimorbidity that, using the same networks that connect into the patient, are signs of this syndrome at the levels of the immediate family/friend social network, the broader community, and society at large; and 3) the potential for these same networks that transmit pathological forces to convey the positive effects of therapeutic interventions in a scale-free manner, with a focus on how conversation can lead to what I'm calling "multibeneficence."
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Cohn Jdoi
10.1111/jep.12706subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1279-1281issue
6eissn
1356-1294issn
1365-2753journal_volume
24pub_type
杂志文章abstract:RATIONALE:Nurses' work is inextricably linked to the evaluation of the quality of care provision in health care. Within this evaluation, individualized care is a topical theme in western countries. Currently, there is no suitable instrument to measure the level of individualized care from the nurses' point of view. AI...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2753.2009.01168.x
更新日期:2010-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Loss of situation awareness (SA) by health professionals during handover is a major threat to patient safety in perinatal care. SA refers to knowing what is going on around. Adequate handover communication and process may support situation assessment, a precursor of SA. This study describ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12103
更新日期:2014-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:To develop a reliable and valid questionnaire that can distinguish features of organizational culture for patient safety across subgroups such as hospitals, professions, management/non-management positions and units/wards. METHODS:We developed a Hospital Organizational Culture Questionna...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12123
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Research indicates that multifaceted practice development (PD) interventions are more effective than single strategies. However, models of education in health care need to consider cost-effectiveness. OBJECTIVES:This paper presents a research-based, PD theory called the Individual Practice Development Theor...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01618.x
更新日期:2012-06-01 00:00:00
abstract::Evidence-based health care (EBHC), previously evidence-based medicine (EBM), is considered by many to have modernized health care and brought it from an authority-based past to a more rationalist, scientific grounding. But recent concerns and criticisms pose serious challenges and urge us to look at the fundamentals o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12752
更新日期:2017-10-01 00:00:00
abstract::The objectives of this study were to present a short history of the Critical Care Research Network (CCR-Net), describe its approach to health services research and to summarize completed and current research projects. In doing this, we explored the question is this research network accomplishing its goals? We reviewed...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2000.00214.x
更新日期:2000-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Smoking during pregnancy can cause several maternal and neonatal health risks, yet a considerable number of pregnant women continue to smoke. The objectives of this study were to test the factorial structure, validity and reliability of the Dutch version of the Modified Reasons for Smokin...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12500
更新日期:2016-06-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The patient-centred medical home (PCMH) is an innovative approach to health care reform. Despite a well-established process for recognizing PCMH practices, fidelity to, and/or adaptation of, the PCMH model can limit health care and population health improvements. This study explored the ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13136
更新日期:2019-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:A positive and strong safety culture underpins effective learning from patient safety incidents in health care, including the community pharmacy (CP) setting. To build this culture, perceptions of safety climate must be measured with context-specific and reliable instruments. No pre-exist...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12273
更新日期:2014-12-01 00:00:00
abstract::This article draws attention to an absurd feature of contemporary political life that significantly affects health service policy and calls for an urgent explanation. Policies are formed by a process that privileges rhetoric over reality, producing policies that are conceptualized at a later date. Two influential arti...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2002.00361.x
更新日期:2002-05-01 00:00:00
abstract::The difference between the pth quantiles of 2 survival functions can be used to compare patients' survival between 2 therapies. Setting p = 0.5 yields the median survival time difference. Varying p between 0 and 1 defines the quantile survival time difference curve which can be straightforwardly estimated by the horiz...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12948
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Development of chronic disease risk prediction models has become a growing area of research in recent years. The internal validity of such models is sometimes lower than estimated from the development sample. Overfitting or overoptimism of the developed model and/or differences between the samples are likely...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01834.x
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Few randomized clinical trials focus on patients' symptoms of the first post-operative week following outpatient (OPS) versus inpatient (IPS) laparoscopic cholecystectomy (LC). The objective was to compare these treatment modalities with regard to patients' perceptions of pain and other post-operative sympto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2007.00920.x
更新日期:2008-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The aim of this study was to examine the validity of the Health of the Nation Outcome Scales (HoNOS) in terms of change in relation to sex, clinical characteristics and level of clinical change as assessed using other measures. METHODS:The sample consisted of N = 690 admissions from one ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12296
更新日期:2015-04-01 00:00:00
abstract:AIM:To find out whether a successful multifaceted implementation approach of a local evidence-based guideline on postoperative body temperature measurements (BTM) was persistent over time, and which factors influenced long-term adherence. METHODS:Mixed methods analysis. Patient records were retrospectively examined to...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01687.x
更新日期:2012-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) endeavour to incorporate the best available research evidence together with the clinically informed opinions of leading experts in order to guide clinical practice when dealing with a given condition. There has been increased interest in CPGs that are ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13026
更新日期:2019-08-01 00:00:00
abstract:RATIONALE:This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. AIM AND OBJECTIVES:The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01870.x
更新日期:2013-10-01 00:00:00
abstract:AIMS AND OBJECTIVES:We report findings from a qualitative study to identify patient views of community hospital care. We consider how far these were in accord with the hospital staffs' views. This constituted part of a wider randomized controlled trial (RCT). The methodological challenges in seeking to identify patient...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2006.00653.x
更新日期:2007-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:It has been proposed that delivery should be accomplished within 30 minutes after diagnosis of fetal distress. The objective of this study was to determine the decision-to-delivery interval (DDI) in emergency caesarean delivery for non-reassuring fetal heart rate (FHR). METHODS:A total o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12613
更新日期:2016-12-01 00:00:00
abstract::In this paper we reflect upon and problematize the ways in which 'patient involvement' is interpreted in a substantial proportion of the research literature on involvement and shared decision making. Drawing upon an analysis of this literature we raise concerns about the 'medicalization of involvement' embedded in, an...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01725.x
更新日期:2011-10-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The main purpose of this paper is to measure the efficiency and ranking of medical diagnostic laboratories by applying a network data envelopment analysis (NDEA). METHODS:In this study, each medical diagnostic laboratory is considered as a decision-making unit (DMU), and an NDEA model i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13337
更新日期:2020-10-01 00:00:00
abstract::The foundationalist and anti-foundationalist conceptions of medical knowledge have been at loggerheads for decades. Evidence-based medicine (EBM), the most prominent form of foundationalism, has attained wide appeal and acceptance among authorities. It proposes that evidence is the "base" upon which all clinical decis...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13273
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:Very few studies have addressed the magnitude of the effect of the condition of the patients and the surgical volume on possible cost savings in coronary artery bypass grafting (CABG). The objectives of this study were to analyse and compare the costs of the CABG operating room (OR) between two hospitals, and...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01251.x
更新日期:2010-12-01 00:00:00
abstract:RATIONALE:Self-assessed health (SAH) status is a very simple four-, or five-category self-reported measure of health status that has been shown to be a powerful predictor of mortality, service use and total cost of medical care treatment. It is therefore reasonable to suggest that pre-intervention SAH may influence the...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2005.00563.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:We investigated whether providing participants in an exercise programme with regular feedback on their exercise progress affected their adherence to the programme regimen. METHOD:We conducted a randomized controlled trial. Adult men and women with borderline hypertension and a body mass index ≥ 25.0 were ran...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2009.01342.x
更新日期:2011-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Individual comparisons of the performance of risk-adjustment indices have been widely conducted. Few reviews have been conducted to summarize the performance of different risk-adjustment indices. A 30-day mortality rate is widely used to evaluate the quality of care in hospitals by federa...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jep.12307
更新日期:2015-04-01 00:00:00
abstract:AIM:To measure the impact of French national consensus guidelines on the clinical practices of primary care paediatricians and general practitioners. DESIGN:Non-randomized intervention study, with a first survey 1 year before the consensus development conference and a second survey 1 year after. INTERVENTION:Implemen...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2007.00781.x
更新日期:2007-08-01 00:00:00
abstract:RATIONALES, AIMS AND OBJECTIVES:The increasing dispensing of statins has raised concern about the appropriateness of prescribing to various population groups. We aimed to (1) investigate incident and prevalent statin prescribing according to indication, gender and age and (2) relate prescribing patterns to evidence on ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12462
更新日期:2016-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Predictors of intimate partner violence (IPV) include husband, wife and relational characteristics. However, we know little about the proximal, day-to-day triggering of abusive events. The purpose of the study was to analyse the daily temporal relationships among environmental, relational...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/jep.12259
更新日期:2014-10-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evid...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12760
更新日期:2017-12-01 00:00:00