Abstract：
RATIONALE, AIMS, AND OBJECTIVES:The way in which care providers describe incapacitated elderly people is not without implications. The different ways in which they describe their patients-client, patient, or a sick human being-have consequences for their relationships with these patients and the decision-making processes. The aim of this study is to use insights from complexity thinking to understand the dynamic relations between various patient descriptions in decision-making. METHOD:We conducted a retrospective qualitative empirical study. Health care professionals were interviewed on how their decisions with the families of the patients were made during the course of the patients' illness. Transcriptions of interviews with physicians, residential practitioners, nurses, and head nurses were made regarding their contribution to the decision-making process. Methodologies of complexity thinkers can be helpful to not articulate the implications of individual patient descriptions, but also their interrelationships. RESULTS:Instead of reducing their patients with the logic of the market to clients or with the logic of medicine to patients, health care providers learn in an emergent dialogic encounter to care for them as sick persons. CONCLUSIONS:Shared-decision-making favours the involvement of patients and their families in decision-making. However, due to a domination of the logic of the market and the logic of medicine, decision-making is problematic. As professional mediators, health care providers learn, however, to balance client demands, medical perspectives, and embodied dialogic care in decision-making for voiceless patients.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
de Bock BA,Willems DLdoi
10.1111/jep.13357subject
Has Abstractpub_date
2020-04-01 00:00:00pages
419-424issue
2eissn
1356-1294issn
1365-2753journal_volume
26pub_type
杂志文章abstract：RATIONALE, AIMS AND OBJECTIVES:Clinical guidelines are tools that systematize scientific evidence and help to achieve proper care. Several difficulties are reported regarding the effective use, such as the shortcomings in the level of knowledge and attitudes by the professionals, the service structure and the preferenc...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2011.01681.x
更新日期：2011-08-01 00:00:00
abstract：RATIONALE, AIM AND OBJECTIVE:Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is no...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2006.00751.x
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:There are many technologies designed to improve medication safety. Although limited evidence supports their use, there are pressures to implement them. OBJECTIVE:To determine the uptake of technologies designed to improve medication safety, plans for adopting technologies, attitudes towards technology use, ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1365-2753.2007.00780.x
更新日期：2008-02-01 00:00:00
abstract：:Therapist self-disclosure is one of the most controversial topics in the history of psychotherapy. The controversies reflect some basic discussions regarding the nature of psychotherapy practice. In psychotherapy practice, a particular concern is the interaction between the psychotherapist and the patient. The expert-...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13289
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:The main purpose of our study was to subjectively assess the quality of a paediatric intensive care unit (PICU) database according to the Directory of Clinical Databases (DoCDat) criteria. DESIGN AND SETTING:A survey was conducted between April 1 and June 15, 2018, among the Sainte Justine PICU research grou...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13193
更新日期：2020-02-01 00:00:00
abstract：:For over 30 years, "evidence-based" clinical guidelines remained entrenched in an oversimplified, design-based, framework for rating the strength of evidence supporting clinical recommendations. The approach frequently equated the rating of evidence with that of the recommendations themselves. "Grading Recommendations...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13019
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are widely performed to cure obesity and obesity-related diseases. Our aim was to compare these two procedures. MATERIALS AND METHODS:An electronic literature search was performed from inception to December 2018. The cli...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13170
更新日期：2020-02-01 00:00:00
abstract：:Tough but constructive criticisms of evidence-based medicine (EBM) have without doubt informed the evolution and serial reconstitutions of this approach to clinical decision making and behaviour. Yet, concerns about EBM persist and as EBM changes in response to reflection and criticism, so too do the criticisms themse...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2006.00617.x
更新日期：2006-08-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Existing literature suggests that doctors' poor adherence with guidelines is one of the major contributing factors to suboptimal control of hypertension. This study aims to evaluate doctors' adherence with Malaysian clinical practice guideline (CPG 2008) in a tertiary care hospital, and f...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2012.01852.x
更新日期：2013-10-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:We aim to determine the prevalence of reconciliation errors (REs) at admission to surgery departments, report their potential clinical impact and analyse possible risk factors. METHODS:Prospective observational study was conducted for 8 months in a regional public hospital in Spain. The ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12403
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work. OBJECTIVES:To examine the application of EBP in clinical practice by regi...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01316.x
更新日期：2009-12-01 00:00:00
abstract：INTRODUCTION:Although anxiety disorders are highly prevalent, lack of correct diagnosis and related concerns about treatment are serious clinical problems. Several factors affect, positively or negatively, management of anxiety and its improvement. A literature review and thematic analysis was executed to obtain an ove...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,评审
doi：10.1111/j.1365-2753.2007.00845.x
更新日期：2008-04-01 00:00:00
abstract：:Some of the weaknesses of the randomized controlled trial (RCT) are pointed out, among them unavoidable biases, the possibility of coming to erroneous conclusions by the 'luck of the draw' and the fact that most such experiments lack a doctor/patient relationship and are of little assistance in clinical decision makin...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1046/j.1365-2753.1997.00007.x
更新日期：1997-08-01 00:00:00
abstract：BACKGROUND:Recent research indicates that allied health clinicians have difficulty articulating client needs and priorities into specific and measurable goals. As a result, a number of strategies to facilitate improvement in allied health clinicians' goal-setting skills have been recommended in the literature. In order...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,随机对照试验
doi：10.1111/j.1365-2753.2008.01104.x
更新日期：2010-02-01 00:00:00
abstract：:Clinical guidelines are essential in promoting the implementation of evidence-based practice within the NHS. But there are two broad schools of thought about their development and implementation: the first argues that guidelines should be entirely evidence-based and tolerates a degree of complexity which may make the ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.1998.tb00088.x
更新日期：1998-11-01 00:00:00
abstract：:Medical malpractice claims can be analysed to gain insights aimed at improving quality of care. However, using medical malpractice claims in medical research raises epistemological and methodological concerns related to certain features of the litigation process. Medical research should therefore approach medical malp...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13178
更新日期：2019-10-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Guidelines for patients with knee osteoarthritis (OA) are suboptimally implemented in clinical care. To improve guideline adherence, patients' perceived barriers and facilitators in current care were investigated. METHODS:Eleven patients with knee OA were extensively interviewed using a ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12660
更新日期：2017-02-01 00:00:00
abstract：BACKGROUND:Trauma prevention starts with to find out the extent of the problem and who it affects. Insight into morbidity figures is therefore necessary. AIM:To explore sex differences in traumatology and secondary medical care utilization in primary care related to age and socio-economic status (SES). METHODS:Data w...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01172.x
更新日期：2010-08-01 00:00:00
abstract：:Pharmacoeconomic evaluations are often based on computer models which simulate the course of disease with and without medical interventions. The purpose of this study is to propose and illustrate a rigorous approach for validating such disease models. For illustrative purposes, we applied this approach to a computer-b...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1046/j.1365-2753.1999.00174.x
更新日期：1999-08-01 00:00:00
abstract：BACKGROUND:Metaphors are central to the human understanding of complex issues; through the immediate associations they evoke and frame problems and suggest solutions. Our suggestion of Music in the Park as a metaphor for health systems reform brings to the forefront the environmentally diverse but bounded spaces of hea...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2010.01460.x
更新日期：2010-06-01 00:00:00
abstract：RATIONALE AND AIMS:Among the problems to the publicly funded national health services are the waiting lists. Patients who need elective surgery generally have long waiting times before treatment. We aimed to develop a new prioritization tool for primary hip and knee replacement. METHODS:Criteria were developed using a...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2006.00733.x
更新日期：2007-06-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:The onset of acute illness may be accompanied by a profound sense of disorientation for patients. Addressing this vulnerability is a key part of a physician's purview, yet well-intended efforts to do so may be impeded by myriad competing tasks in clinical practice. Resolving this dilemma ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13410
更新日期：2020-05-07 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：RATIONALE, AIMS AND OBJECTIVES:Invasive pneumococcal diseases (IPD) are associated with substantial burden in adults (≥50 years). Moreover, adults with vascular, metabolic or respiratory diseases have been shown to have a 3-6 times higher risk of IPD when compared with their healthy controls. These persons at higher ri...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12131
更新日期：2014-08-01 00:00:00
abstract：:Work on resilience in health and illness has been approached from a number of perspectives. These are the biological and psychosocial with a focus on the individual's responses to cope and adapt to changing circumstances wrought by changing physical health states. This we argue has a place but is far too narrow emphas...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12955
更新日期：2018-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Disparities in haemodialysis outcomes among centres have been well-documented. Besides, attempts to assess haemodialysis results have been based on non-comprehensive methodologies. This study aimed to develop a comprehensive methodology for assessing haemodialysis centres, based on the va...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12483
更新日期：2017-06-01 00:00:00
abstract：RATIONALE AND OBJECTIVES:The effect of the presence of pressure ulcers on burden of caregivers is unknown. We investigated the relationship between the state of pressure ulcers in vulnerable elderly patients and the burden on their informal caregivers. METHODS:This cross-sectional study enrolled 137 patients aged > or...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01171.x
更新日期：2010-06-01 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：RATIONALE, AIMS, AND OBJECTIVES:Heterogeneity is a critical issue in meta-analysis, because it implies the appropriateness of combining the collected studies and impacts the reliability of the synthesized results. The Q test is a traditional method to assess heterogeneity; however, because it does not have an intuitive...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13159
更新日期：2020-02-01 00:00:00
abstract：:Over the past two decades, the majority of medical schools in the USA have embarked upon curricular initiatives to enhance the teaching of ambulatory or office-based primary care. Identifying characteristics of these primary care experiences that make for the most effective learning is a top priority in medical educat...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,评审
doi：10.1046/j.1365-2753.2001.00288.x
更新日期：2001-08-01 00:00:00
