Journal of evaluation in clinical practice
-
The benefits of clinical practice guideline (CPG) adoption for the management of patients with back pain are well documented. However, the gap between knowledge creation and implementation remains wide with few studies documenting the iterative process of comprehensive implementation in clinical settings. The objective of this study was to improve adherent physical therapy care according to CPG's for low back pain and describe the knowledge to action (K2A) process used in a rural healthcare organization. ⋯ This study extends the literature of guideline implementation by describing the unique cycles required for promoting provider behaviour change within a rural healthcare system. Adherence and confidence results suggest increased provider CPG use which was supported by the process evaluation. This study demonstrates the importance of multiple site comparisons, long-term reporting and standardized frameworks for assessment of real-world CPG implementation.
-
The primary purpose of this study was to test both classic and novel FM pain and non-pain symptoms to determine their practical efficacy in aiding clinicians to distinguish FM pain from other chronic pain disorders. ⋯ Our results herein suggest that clinicians may be well-served to consider symptoms in addition to those contained in current diagnostic criteria when recognizing FM in their chronic pain patients.
-
COVID-19 has seen politicians use a selective 'science' to justify restrictions on mobility and association, to mandate the wearing of face masks, and to close public infrastructure. There seems to be no role for health humanities scholars as yet, but perhaps there should be. ⋯ This article, which did not operate from within the biomedical episteme but which was in conversation with the episteme, was misappropriated on both sides of the political spectrum to justify personal beliefs around mask use in the pandemic. This mistaken misappropriation is not only evidence of the utility of the common ground shared between biomedicine and the health humanities, it is also evidence of the possibilities inherent in a future interdisciplinary involving biomedicine and the health humanities.
-
Perform sound decisions making while operating is crucial to the success of surgical procedures. The bewildering to choose the preferred mode of decision-making during a surgical procedure is regularly observed. This study was aimed to assess the mode of decision-making approach in surgical procedures among women who have undergone obstetrics and gynaecologic surgeries, Jimma, Ethiopia 2020. ⋯ In the study, the shared decision-making was inadequate and not in line with recent recommendation guidelines. The paternalism mode of decision-making was still practice. Build patient-health care providers' relationship is vital for promoting and advance the patients' autonomy on the decision-making approach. The healthcare providers should be motive for collaborative decision-making with the patient.
-
This paper addresses an ontological question about the nature of health and challenges some underpinning assumptions in western healthcare. In its analysis, health in its various statuses, is framed as a naturally occurring complex adaptive system made up of dynamically interacting subsystems that include the physiological, psychological, and social realms. Furthermore, openness in complex systems such as health, is necessary for the exchange of energy, information, and resources. ⋯ This paper draws on the complexity sciences and Levinasian philosophy to explicate the essential role of system openness in individual, population, and systemic viability. It highlights holism to be "not whole-ism", and system openness to be, not just a reality, but a critical feature of viability. Hence requisite openness is advocated as essential to efficacious and ethical healthcare practice and strategy, and vital for health.