Journal of evaluation in clinical practice
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Cancer patients experience substantial psychological distress which causes the reduction of the quality of life. However, the risk of psychological distress has not been well predicted especially in young- and middle-aged gynaecological cancer patients. This study aimed to develop a prediction model for psychological distress in young- and middle-aged gynaecological cancer patients using the artificial neural network (ANN). ⋯ Compared with the LR model, the ANN model shows obvious superiority across all assessment index outcomes, and it may be used as a decision-support tool for early identification of young- and middle-aged gynaecological cancer patients suffering from psychological distress.
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This paper examines the concept of centredness in health care, with a particular focus on person-centred care. While the principle of centring care is widely accepted, the concept of a 'centre' remains ambiguous, complicating its implementation. The paper defines centredness, questions the necessity of a central focus and explores alternative models. ⋯ Distributed care offers flexibility and inclusivity, but it raises challenges about coordination and the potential emergence of a new implicit centre: distribution itself. Hybrid models combining elements of centred and distributed care offer a path forward. Empirical research is needed to compare these approaches, with the aim of developing more responsive and adaptable systems to address diverse and complex needs for health care.
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Randomized Controlled Trial
Impact of text message reminders on immunosuppressive medication adherence among kidney transplant recipients: A randomized controlled study.
One of the most common problems encountered in transplant patients is nonadherence with immunosuppressive drugs, one of the most important reasons for graft rejection. ⋯ Sending text message reminders to kidney transplant recipients is a statistically and clinically effective intervention to improve immunosuppressive medication adherence.
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Appropriate patient reassurance is an essential feature of clinical practice. My recent experience as a patient, interpreted via my expertise as a health services researcher, led me to insights on ideal and suboptimal reassurance styles in the context of worrisome symptoms. Reassurance is complex: often poorly defined in the scientific literature, rarely rigorously studied, imperfectly understood, and requiring some adaptation to each patient situation. ⋯ Explicit medically appropriate reassurance notably reduced my concerns and anxiety. Interactions devoid of key reassurance components (acknowledging concerns, contextualising the problem, providing information on risk and next steps and incorporating discussion) exacted an unnecessary psychic toll. The striking differences among my clinicians' approaches illustrate how more thoughtful and salubrious interactions can occur using straightforward existing guidance on best reassurance practices, even without burdensome training, time, or resources.
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Patient participation should encapsulate the individual's resources and needs, though such standards remain rationed for people living with a long-term health concern like kidney failure. ⋯ Both patients and staff stress the importance of patient participation, although they focus on different elements. Further person-centred conduct warrants a shared conceptualisation and strategies addressing and scaffolding patients' preferences and means.