Generally, the effectiveness of scale-up programmes involving CHWs has been difficult to determine given the variation in the scale-up approach and the difficulties measuring outcomes [ 5- 8, 17].
The main difficulties in outcome evaluation of multidisciplinary treatment concepts are: (a) measurement of overall outcome (for example headache days and quality of live) does not allow conclusions about the efficacy of the implement different parts of such a modular treatment concept.
While projects were initially designed to be of similar scope and difficulty, the outcomes were dramatically different from a project management and implementation standpoint, and learning outcomes for students were also different.
"The relative scarcity of scientifically derived data on efficacy and safety stems from a number of factors, ranging from a lack of financial incentives for practitioners and suppliers (Why study something that is already profitable and accepted by patients?) to difficulty measuring outcomes," he wrote.
A pilot study can identify difficulties in outcome measurement before starting the main trial.
Before, during, and after data-collection, difficulties regarding outcome assessment, analysis of the results, the withdrawal of patients, and the follow-up had to be dealt with.
Both ICU LOS and time of mechanical ventilation tended to be longer in non-survivors of the hypothermia group compared with non-survivors of the control group, which may reflect the difficulty of outcome prediction in patients routinely requiring sedation and muscle relaxation in the first days of intensive care.
As a consequence, surgeons have difficulties predicting surgical outcome [ 4, 5].
Considering the wide variation between individuals in the manifestation of illness, including biphasic and recurring courses, difficulties in defining outcomes should be expected.
In the current study, we examined the mediating role of emotion dysregulation in the relationship between refugee experiences (trauma and living difficulties) and psychological outcomes.
