OBJECTIVES

This study aimed to develop and to pilot-test a tailored introductory Evidence-Based Practice (EBP) training program for registered nurses. Despite the recognized importance of EBP in nursing, many practicing nurses lacked formal training and confidence in its application. This study addressed the gap in accessible and entry-level EBP education designed specifically for EBP competency among nurses.

A quasi-experimental one-group pretest-post test design was employed in this study. A convenient sample of 23 registered nurses from a tertiary educational institution in Angeles City, Pampanga, Philippines had participated in the pilot testing. The introductory EBP Training Program was developed based on core EBP competencies and structured into a modular format. The program was delivered in a computer laboratory setting and conducted for eight to ten hours. The training included lectures, guided case-based discussions, and hands-on exercises covering each step of the EBP process.

Data were collected using the Academic Center for Evidence-Based Practice Readiness Inventory (ACE-ERI) before and after the intervention. Statistical analysis was performed using paired sample t-tests to assess differences in pre- and post-intervention scores. All analyses were conducted using SPSS version 26. Ethical approval was obtained from the Holy Angel University Institutional Review Board (HAU-IRB).

The EBP training program resulted in a statistically significant improvement in both knowledge and confidence in using evidence-based practice. Participants' knowledge scores increased from a pre-test mean of 7.04 (SD = 1.72) to a post-test mean of 8.30 (SD = 1.87), while confidence scores rose from 64.61 (SD = 17.32) to 88.43 (SD = 16.80). Wilcoxon signed-rank tests confirmed the significance of these improvements in both EBP knowledge (Z = -4.16, p < .001) and confidence (Z = -3.56, p < .001).

The study demonstrated that the evidence-based practice (EBP) training program led to a significant improvement in nurses' knowledge and skills, as evidenced by the marked difference in pre- and post-test scores. EBP training programs can effectively enhance healthcare professionals' capacity to integrate evidence into clinical practice. Based on these findings, healthcare organizations should consider incorporating EBP training into regular professional development programs for nurses. EBP training programs should focus on fostering practical application skills and include more case-based learning to further reinforce the integration of EBP in clinical decision-making. Lastly, future researches may explore focusing on long-term outcomes of EBP training, including its impact on patient care and organizational practices, to assess the sustainability of the knowledge gained through such interventions. Overall, by enhancing EBP training and supporting its widespread adoption, healthcare systems can further improve the quality of patient care and promote a culture of continuous learning and evidence-based decision-making.

Databases, Bibliographic ; Evidence-based Practice ; Health Services Needs And Demand

As a diagnostic method to guide the treatment of sinew/fascia diseases, jingjin (muscle regions of meridians) differentiation is an important component of syndrome differentiation system of acupuncture and moxibustion. In clinical practice, because of the limitations of the ideological guidance of the holistic view, the systemic and dialectical thinking and the syndrome element collection, the system of diagnosis and treatment of sinew/fascia diseases is not comprehensive. Through combing the origin of the holistic view of jingjin, the paper expounds the differentiation framework of sinew/fascia diseases from 4 aspects of differentiation, i.e. the location of disease, etiology, nature of disease and condition of disease. It suggests to construct jingjin differentiation system by taking the holistic ideas as the core, the syndrome element research as the common method and the evidence-based medicine as the theoretical basis so that the thinking of syndrome differentiation and the diagnostic approaches based on jingjin theory can be enriched.
Humans ; Acupuncture Therapy ; Evidence-Based Medicine ; Language ; Meridians ; Moxibustion ; Syndrome

Evidence-based medicine plays an important role in promoting the scientific nature of clinical decision-making. Howe-ver, there is a problem where evidence derived from clinical research may not necessarily be applicable to individual patients. Evidence-based medicine has been introduced into the field of traditional Chinese medicine(TCM) for over 20 years, and although certain achievements have been made, the overall level of clinical research evidence based on the principles of evidence-based medicine in TCM is not high. The acceptance of TCM diagnosis and treatment guidelines developed based on evidence-based medicine methods is generally low. As revealed by the analysis of the problems in the application of evidence-based medicine in the field of TCM, it is found that there is a structural contradiction between clinical randomized controlled trial(RCT) of TCM and the characteristics of TCM clinical practice. They cannot comprehensively, objectively, and truthfully reflect the clinical efficacy and safety of TCM. Conducting clinical RCTs of TCM in pursuit of "evidence" actually means giving up the advantages of TCM in clinical treatment based on syndrome differentiation, prescription changes along with syndromes, and treatment in accordance with three categories of disease cause, which leads to sacrificing some clinical effectiveness of TCM. Based on the concept of evidence-based medicine, this article proposed the construction of "clinical syndrome-based medicine" based on the optimal clinical experience, which was suitable for the characteristics of TCM clinical practice. The key to clinical syndrome-based medicine is the optimal clinical experience, and the core elements of the optimal clinical experience are regularity and reproducibility. Real-world research methods are recommended as a reference for obtaining the optimal clinical experience. Clinical syndrome-based medicine, combining the characteristics of TCM clinical practice and incorporating the concept of evidence-based medicine, is the product of integrating TCM into evidence-based medicine. It is dedicated to improving the clinical efficacy of TCM along with evidence-based medicine.
Humans ; Reproducibility of Results ; Medicine, Chinese Traditional ; Treatment Outcome ; Evidence-Based Medicine ; Syndrome ; Drugs, Chinese Herbal/therapeutic use*

The Guidelines for prevention and treatment of colorectal adenoma with integrated Chinese and western medicine are put forward by Nanjing University of Chinese Medicine and approved by China Association of Chinese Medicine. According to the formulation processes and methods of relevant clinical practice guidelines, the experts in clinical medicine and methodology were organized to discuss the key problems to be addressed in the clinical prevention and treatment of colorectal adenoma(CRA) and provided answers following the evidence-based medicine method, so as to provide guidance for clinical decision-making. CRA is the major precancerous disease of colorectal cancer. Although the prevention and treatment with integrated Chinese and western medicine have been applied to the clinical practice of CRA, there is still a lack of high-quality guidelines. Four basic questions, 15 clinical questions, and 10 outcome indicators were determined by literature research and Delphi questionnaire. The relevant randomized controlled trial(RCT) was retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, Web of Science, and 2 clinical trial registries, and finally several RCTs meeting the inclusion criteria were included. The data extracted from the RCT was imported into RevMan 5.3 for evidence synthesis, and the evidence was evaluated based on the Grading of Recommendations, Assessment, Development, and Evaluations(GRADE). The final recommendations were formed by the nominal group method based on the evidence summary table. The guidelines involve the diagnosis, screening, treatment with integrated Chinese and western medicine, prevention, and follow-up of colorectal adenoma, providing options for the clinical prevention and treatment of CRA.
Humans ; Adenoma/prevention & control* ; Colorectal Neoplasms/prevention & control* ; Drugs, Chinese Herbal/therapeutic use* ; Evidence-Based Medicine ; Medicine, Chinese Traditional

PURPOSE: The disparity between conducting research and putting it into practice has remains a global healthcare issue, with less than 50% of nurses utilizing research. This study aims to determine the level and relationship between Evidence-based practice (EBP) competency, current EBP beliefs and research utilization among nurses. DESIGN AND METHOD: This quantitative study utilized a descriptive-correlational design and mediation analysis. A purposive sampling was used to select six Christian Health Association of Ghana (CHAG) hospitals. Simple random sampling was used to recruit 544 nurses from the six CHAG hospitals. The study utilized mean and standard deviation, Pearson Correlation, ANOVA, and GLS mediation analysis. The researcher obtained ethical approval from the Saint Louis University Research Ethics committee and, the institutional review board of the CHAG. FINDINGS: The results showed that nurses had a low level of EBP competency (M=2.27, SD= 0.255), strong positive EBP beliefs (M=2.58, SD=0.322) and low research utilization (M=2.57, SD=0.300). There was a moderately significant positive relationship between EBP competency and research utilization (r= .431, p= .000), EBP competency and EBP beliefs (r= .327, p= .000) and EBP beliefs and research utilization (r= .306, p= .000). There is no significant difference in terms of EBP competency and research utilization when EBP training attendance was considered. Nurses with 1-2 years of experience had a higher level of EBP competency. Theatre nurses had a higher level of EBP competency, however, emergency nurses had a lower level of research utilization than nurses in the surgical unit. EBP beliefs mediated the relationship (B= 0.0604, z= 3.99, p < .001) between EBP competency and research utilization. CONCLUSIONS Nurses in CHAG hospitals have a limited ability to implement the EBP process. The respondent perceived the value of EBP in nursing practice to be significant and has the confidence to implement the EBP process. The nurses' respondents use of research in nursing practice is limited due to the organizational barriers in CHAG institutions in Ghana. Based on the findings, it is recommended for nurse administrators and policy makers to prioritize the provision of adequate resources, support, EBP policies and targeted training programs to facilitate a culture of evidence-based practice and research utilization in CHAG institutions. By improving EBP competency and promoting research utilization, nurses can enhance the quality and safety of patient care.
Evidence-based practice ; Competencies

The incidence of parastomal hernia is substantially high, significantly affecting the quality of life of patients with stoma. How to effectively solve the problem of parastomal hernia is a long-term focus of hernia and abdominal wall surgery and colorectal surgery. The European Hernia Society guidelines on prevention and treatment of parastomal hernia published in 2018 has recommended the use of a prophylactic mesh to prevent parastomal hernia for the first time. In the following 5 years, more randomized controlled trials of multi-center, large-sample, double-blind, long-term follow-up have been published, and no significant effect of mesh prophylaxis has been observed on the incidence of parastomal hernia. However, whether mesh could decrease surgical intervention by limiting the symptoms of parastomal hernias would become a potential value of prophylaxis, which requires further research to elucidate.
Humans ; Hernia, Ventral/surgery* ; Surgical Mesh/adverse effects* ; Quality of Life ; Incisional Hernia/prevention & control* ; Surgical Stomas/adverse effects* ; Evidence-Based Medicine ; Colostomy/adverse effects* ; Randomized Controlled Trials as Topic

The systematic reviews (SRs) of acupuncture published before December 31 of 2020 in PubMed, Cochrane and EMbase databases were searched, and the publication overview of international acupuncture SRs were analyzed. As a result, a total of 717 SRs were included, and the overall number of published SRs showed a fluctuating upward trend. A total of 15 categories of diseases were involved, of which 113 SRs suggested that acupuncture was effective, and 12 SRs did not support acupuncture, and the remaining SRs showed uncertain conclusions. It is suggested that the standard of evidence-based medicine should be adopted to standardize the design of acupuncture trial and improve the level of clinical research; SRs should include high-quality literature that met the standards according to the principles and methods of PRISMA, so as to provide reliable clinical evidence for acupuncture.
Acupuncture ; Acupuncture Therapy ; Evidence-Based Medicine ; Periodicals as Topic ; PubMed

Rich experience of clinical diagnosis and treatment has been accumulated in the developmental history of Chinese medicine, and the efficacy has been increasingly accepted by the public. However, the evaluation of clinical efficacy is currently based more on scientific evidence instead of merely the changes of patient symptoms. In Chinese medicine, the changes of major disease indicators, patient symptoms, and pathogenesis are the major criteria for the evaluation of clinical efficacy. The lack of well-accepted and uniform criteria and the uncertainty of subjective evaluation limit the development of clinical Chinese medicine. Evidence-based medicine combines clinical skills with the current best evidence. Narrative medicine, utilizing people's narratives in clinical practice, emphasizes patient feelings, willingness, and value orientation. The introduction of both evidence-based medicine and narrative medicine into the evaluation of clinical efficacy refers to the construction of the clinical efficacy evaluation system in a paradigm of participatory diagnosis and treatment. It can fully reflect the characteristics of Chinese medicine, respect the values of patients, and achieve universal clinical evidence. Therefore, it helps to improve the diagnosis and treatment, the relationship between doctors and patients, patients' life quality and decision-making awareness, and finally the new evaluation model of clinical efficacy of Chinese medicine.
Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Narrative Medicine ; Physicians ; Treatment Outcome

While the definition of EBM can be straightforward in other medical field, family and community medicine practitioners take on very different roles in different health systems. Despite the challenges presented, EBM is still necessary in family and community practice. Family and community medicine practitioners must be able to obtain, assess, apply and integrate new knowledge based on available evidence throughout their professional life. From the definition of EBM and the nature of family practice described previously, we propose to define “Evidence-based Family Practice as the conscientious and judicious use of the current, relevant, applicable and best available evidence in making shared clinical decisions for patient care. Such decisions must account for the capacity and setting of the family practitioner and patient preference”. The proposed steps are: 1) Framing the Clinical Problem, 2) Searching for the Evidence, 3) Critical Appraisal, 4) Informing the Patient About the Evidence, 5) Shared Decision Making, and 6) Evaluation of the Decision.
Evidence-Based Medicine ; Evidence-Based Practice