JOURNAL OF EVALUATION IN CLINICAL PRACTICE

Toward More Precise Health Care Through Relational Mapping
Buetow S
Precision health seeks to personalize care by accounting for individual variation but is too often reduced to 'personalized biological' interventions. This reductionism overlooks the existential and psychosocial dimensions of health. To address this gap, this paper introduces the relatome as a conceptual framework that systematically and comprehensively records relational patterns, including how patients build trust, prefer to receive information, and approach decision-making. By extending precision health into the relational domain, the relatome makes care more precise in guiding patient experience and treatment effectiveness. As a transferable component of the patient's clinical record, it also helps providers coordinate understanding across systems and settings, preserving psychosocial insights often lost during care transitions. Unlike static genetic data, these relational patterns are updated based on patient feedback and provider observations. Realizing the potential of the relatome requires addressing five sets of implementation challenges: conceptual and epistemic, technical and infrastructural, continuity and system design, equity and participation, and evaluation and investment.
Midwives' Views and Experiences of Practice to Delivered in Water: A Qualitative Study
Kisa BN and Ozdilek R
This study aimed to reveal the experiences of midwives who assisted women giving birth water.
Bearing the Burdens of Medical Uncertainty
Hofmann B and Han PKJ
Uncertainty comes in many kinds, is ubiquitous in all parts of clinical work, and is burdensome to physicians, patients, proxies and policy makers. Moreover, it leads to a range of adverse responses such as excessive testing and interventions, overdiagnosis and overtreatment. While the technical aspects of uncertainty are widely accounted for, the burdens of uncertainty need closer scrutiny.
Differences Between Parents and Nurses in Perceived Educational Support for Pediatric Postoperative Pain Management
Hu Y and Shi Y
This cross-sectional study aims to investigate the differences between parents and nurses in perceived educational support for pediatric postoperative pain management. It is hypothesized that there is significant difference between the participants that leads to insufficient control of pain.
Pregnant Women's Breast Milk and Breastfeeding Myths and Associated Factors: A Case of Refugee and Non-Refugee Women
Nergiz ME and Yalcin SS
Evaluating the Real-World Implementation and Effectiveness of a Collaborative Care Model for Adults with Depression and Anxiety at an Urban, Academic Hospital
Hahn PJ, Johnson DY, Wang J, Lusk C, Allen S, Araújo FS, Yohanna D, Staab EM and Laiteerapong N
Over 30% of adults in the United States have symptoms of depressive or anxiety disorders. The majority of these patients are treated only in primary care and have suboptimal outcomes. The Collaborative Care Model (CoCM) is designed to address this problem.
Healthcare Professionals' Perspectives on Addressing Patients' Medication Adherence in Primary Care Settings
Martinez TR, Schoenthaler AM, Mann DM, Belli H, Bearnot HR, Lustbader I and Blecker S
Medication nonadherence is a common issue among patients with hypertension. Healthcare professionals often overlook medication nonadherence due to limited tools, time constraints, and competing demands. Integrating pharmacy medication fill data into electronic health records (EHRs) presents an opportunity to enhance medication adherence measurement and monitoring in real-time. This study identified facilitators and barriers to addressing adherence to antihypertensive medications by Medical Assistants (MAs), Registered Nurses (RNs), and Primary Care Providers (PCPs) in primary care settings.
Physicians' Attitudes Toward Defensive Medicine and Medical Errors in Palliative Care: A Cross-Sectional Study
Uyğur A, Polat AO and Basat O
Medical errors represent a major issue for healthcare professionals. Although they may not always cause direct harm to patients, timely reporting of such errors is an important step in improving safety and reducing malpractice risk. As the number of these lawsuits rises, physicians often resort to defensive medicine practices.
Psychometric Properties of Intolerance of Uncertainty Scale (IUS-5) in a Sample of Nurses: A Methodological Study
Khamis F, Badahdah A and Aloud N
The Intolerance of Uncertainty Scale (IUS-12) is widely used in both clinical and community studies. Due to the length and inconsistent factor structure of the IUS-12, an abbreviated version consisting of five items (IUS-5) has been proposed. However, no study has examined its psychometric properties aside from the preliminary work by its developers. The current study investigated the factor structure of the IUS-5 as well as its reliability and validity.
Interprofessional Patient Safety Education: Assessing Students' Interprofessional Collaboration, Attitudes Towards Safety and Professionalism
Mirzaei S, Keshmiri F, Gholinataj Jelodar M and Shirazi M
This study aimed to evaluate the effect of an interprofessional patient safety training programme on students' attitudes and interprofessional collaboration.
Quality Indicators for Drug Dispensing in Community Pharmacies: A Scoping Review Protocol
Caxico-Vieira LJS, de Souza EV, Moura MAJDS, Silva ROS, Mesquita AR, Lima TM and de Lyra DP
Assessing health service quality, particularly through indicators, is essential for improvement and accountability. However, the literature lacks a comprehensive analysis of how drug dispensing quality is measured.
Appropriateness Criteria, Insurance Policies, and the Erosion of Clinical Judgement
Duncan J
The American College of Radiology (ACR) Appropriateness Criteria (AC) were designed to guide evidence-based imaging decisions. Increasingly, however, insurers and electronic health record-embedded clinical decision support (CDS) systems use these criteria to determine coverage, shifting their role from clinical guide to gatekeeping tool. This commentary examines the disconnect between policy and practice, driven by low physician awareness, educational gaps, and difficulty navigating the criteria. When applied rigidly, particularly in insurance reimbursement, these shortcomings risk deepening diagnostic inequities. The example of breast cancer screening for patients with dense breast tissue illustrates how restrictive application can limit access to higher-sensitivity imaging and exacerbate disparities. We argue that guidelines should guide, not govern, and that insurer reliance must be paired with physician training, transparent methodology, and adaptability. Policy reform, expanded coverage mandates, and integration of AC education into medical training are needed to align guidelines with both clinical realities and patient needs.
Child and Caregiver Perspectives on Conversation Club Therapy: A Case Study
Pham T and
Conversation Club is a community-based intervention developed to support social and conversation skills in both neurodiverse and neurotypical children who may need additional support in these areas. The purpose of this preliminary evaluation is to examine the efficacy of Conversation Club delivered in the local setting.
Prevalence and Associated Factors of Burnout Among Obstetrics and Gynecology Nurses: A Cross-Sectional Analysis
Chen Y and Cai J
Job burnout significantly impacts the quality and safety of clinical nursing care. Given the unique demands of obstetric and gynecological (OB/GYN) nursing, addressing burnout in this workforce is critical for safeguarding both nurse well-being and patient outcomes. This study aimed to investigate the prevalence of job burnout and identify its contributing factors among OB/GYN nurses, with the goal of providing evidence-based guidance for clinical nurse management and healthcare policy.
Risk of Bias Assessment of Randomized Controlled Trials: From the 1994 Cochrane Collaboration Toolkit to ROBUST-RCT
Pacheco RL and Riera R
Lessons From the COVID-19 Pandemic: The Role of Interventions in Relieving Mental Stress
Tiagi R
The COVID-19 pandemic has significantly impacted healthcare workers' mental health worldwide. Although increased stress, anxiety, and burnout are well documented, there is limited evidence on the effectiveness of workplace interventions such as infection prevention and control (IPC) and personal protective equipment (PPE) training in mitigating these effects.
A Holistic Nursing Programme Based on 24 h Holter Monitoring for Coronary Angiography Patients in the Perioperative Period
Liu T, Xu S and Wang P
This study developed, implemented, and evaluated the effectiveness of a holistic nursing program based on 24 h Holter monitoring for patients undergoing coronary angiography, aiming to improve nursing quality and reduce the incidence of coronary complications during the perioperative period.
Response to Armitage: Reconsidering the Ethical Landscape of AI-Generated Clinical Documentation
Wilton Sun Q, Miller JE and Hull SC
"Both the Training and the Coffee Afterwards Mattered a Lot"-Factors of Importance in a Complex Intervention After Acute Hospitalization: Perspectives of Older Adults With Frailty
Larsen Rasmussen R, Nilsson L, Holst M, Villumsen M and Andreasen J
Older adults with frailty often face functional decline and limitations in doing everyday activities after being discharged from acute hospital admission affecting their health and quality of life. However, engaging them in training interventions can be challenging.
Clinical Outcomes and Guideline Adherence in Distal Radial Fractures with Associated Carpal Dislocations: A Service Evaluation
Duric B, Flowers B, Jagic K, Zuo K and Butt S
Carpal dislocations are rare but serious injuries, sometimes occurring in isolation or in association with distal radial fractures. These complex injuries carry high risks of long-term dysfunction and require timely and standardised management. In 2017, the British Orthopaedic Association (BOA) and British Society for Surgery of the Hand (BSSH) published consensus guidelines to address wide variations in care and outcomes. This audit evaluated adherence to BOA/BSSH guidance at a tertiary trauma centre.
A Program to Improve General Palliative Cancer Care Guideline Implementation: Development, Acceptability, and Feasibility of Implementation Strategies
Sørensen DM, Egholm CL, Dalton SO, Rosted E, Brodersen JB, Møller ML, Petersen MA, Heymann AV and Bidstrup P
Implementing palliative care for patients with cancer in the healthcare sector is a complex task. Some patients with cancer do not receive timely and comprehensive palliative care tailored to their needs, potentially reducing their quality of life.