Conceptual Model Research Articles

A multi-phase approach for developing a conceptual model and preliminary content for patient-reported outcome measurement in TKA patients: from a Chinese perspective.

Patient-reported outcome measures (PROMs) are being used more frequently in total knee arthroplasty (TKA). By utilizing high-quality scales, surgeons can achieve a more comprehensive and accurate evaluation of the effectiveness of TKA surgery. Currently, there is no widely accepted conceptual model for TKA PROMs. The objective of this study is to fill this gap by developing a conceptual model and preliminary content for a PROM that is specifically designed for TKA patients in mainland China. The study design consisted of three stages: (1) a targeted literature review followed by the formation of a conceptual model pool; (2) qualitative data collection involving experts and patients, leading to the development of the preliminary Chinese TKA PROM (CTP); and (3) review of the CTP by experts using the Delphi method, along with cognitive debriefing interviews with patients. 64 patients and 28 experts took part in this study. The conceptual model focused on six key concepts: pain, symptom, function, quality of life, expectation, and satisfaction. To match the model, the authors developed a total of 35 items. A conceptual model and preliminary content for CTP was developed with substantial participation from patients and a multidisciplinary group of experts. The integration of patient and clinical perspectives ensured a comprehensive representation of all relevant disease experiences and the focus of clinical practice. With further refinement through psychometric testing, the CTP is positioned to provide a standardized, comprehensive measure for research specific to Chinese TKA patients.

Enhancing Employee Outcomes Through Common Good Human Resource Management: Exploring the Role of Meaningfulness and Thriving

ABSTRACTIn the evolving landscape of human resource management (HRM), common good HRM (CG‐HRM) practices are increasingly recognized for their potential to align organizational goals with societal sustainability. Despite their importance, how CG‐HRM influences employee outcomes remain underexplored. Drawing on Conversation of Resources (COR) theory, this research explores the impact of CG‐HRM practices, conceptualized as critical organizational‐level resources, on employees' perception of meaningfulness of work. This perception significantly affects employee thriving, which in turn fosters innovative behavior. Employing a multi‐wave, multisource survey design, we collected data from 45 firms in China, involving 82 executives and 206 employees, to test our conceptual model. The findings from a multilevel path model reveal that organizational CG‐HRM practices contribute to employees' perceived meaningfulness of work, which promotes employee thriving and subsequently innovative behavior at the organizational level, while meaningfulness also contributes to thriving and, thus, innovative behavior at the employee level. Our research enriches the COR theory and contributes to the HRM, thriving, and innovation literature, offering insights for future research and practical implications for organizations striving to align their goals with societal and environmental sustainability while nurturing a thriving workforce.

Customer adoption of smartwatches – a privacy calculus perspective

PurposeThis study tries to explain the customer adoption of smartwatches by considering the perceived benefits and perceived costs. Through this study, the authors aim to determine the factors affecting behavioural intentions towards smartwatches.Design/methodology/approachThe authors applied the survey method to collect data to validate the conceptual model related to the research objectives. The authors collected 310 responses using a structured questionnaire; after data cleaning, 270 responses were used for data analysis. Structural equation modelling (SEM) was performed using Smart PLS to test the proposed hypotheses.FindingsThe results established creepiness, privacy concerns, perceived expectancy and performance effort expectancy as factors affecting behavioural intentions related to customer adoption of smartwatches.Originality/valueThis study has incorporated the concept of creepiness into the factors inhibiting factors affecting behavioural intentions in the context of smartwatches.

Beyond surface and deep acting: investigating interaction avoidance in coworkers’ daily relationships and its consequences

ABSTRACT Research on emotional labour toward coworkers focused on surface acting and deep acting, thereby applying the knowledge on emotional labour in service but neglecting specific features of coworkers’ relationships. Addressing this issue, we develop and test a conceptual model in which surface acting and deep acting are complemented by another behavioural strategy toward coworkers: interaction avoidance. We conceptualise emotional labour and interaction avoidance as social exchange responses to negative and positive experiences with coworkers, and exhaustion as a well-being consequence of these responses. We conducted a 10-day diary study (N = 146, n = 986 days) and found that negative experiences with coworkers predicted avoiding interactions with them the next day. Positive experiences predicted next day’s deep acting, and unexpectedly, surface acting toward coworkers. Interaction avoidance was related to evening exhaustion and mediated the relationship between negative experiences and exhaustion the next day. Surface acting was also related to exhaustion in the evening. Our results highlight that employees can use more strategies than surface acting and deep acting, in particular, interaction avoidance when aiming not to show their originally felt emotions to their coworkers. However, avoiding interaction comes with costs, so employees should consider its impact on their well-being.

A Conceptual Model of Learning Adaptability of Higher Vocational Students in China

Abstract Vocational education plays a crucial role in China’s education system, with higher vocational education being a pivotal and dynamic aspect of the country’s educational reform. Despite this, higher vocational students often struggle with lethargy and inadequate adaptation to their studies. This paper constructs a conceptual model of learning adaptability by systematically coding and analyzing textual materials, such as literature, research reports, news, and interviews, pertaining to learning adaptability using grounded theory. The aim is to address the diverse factors influencing learning adaptability. The research revealed that the fundamental categories shaping learning adaptability encompass students’ psychological, academic, and personal growth states. To enhance learning adaptability, proactive intervention is necessary within these core categories outlined in the model, guiding students to anticipate and understand the challenges they may encounter. Notably, there remains a dearth of theoretical research on the learning adaptability of higher vocational students. This study aims to significantly contribute to improving teaching effectiveness in this domain.

Exploring hospital physician relationships in HRD through POS lens: an integrated literature review

Purpose The purpose of the paper is to examine how perceived organizational support (POS) for physicians is situated within different hospital physician relationship (HPR) employment structures and to explore human resource development (HRD) implications within these relationships. Design/methodology/approach This paper focuses on research in the western context using an integrated literature review methodology, which includes employed (“Employed”), affiliated (“Affiliated”) and Locum tenens physicians [“Locum(s)]” who work in hospitals. Findings POS constructs, under the broader purview of organizational support theory (OST), provided evidence for hospital leadership to find intentional ways to support their hospitals physicians within all HPR models. Our review also revealed the strategies adopted by hospitals to align and influence physician practice behaviors, which were researched using economic and/or noneconomic constructs. The findings indicated stronger or isolated alignment with hospitals where the physicians practiced. Research limitations/implications The paper focuses on Employed, Affiliated and Locums HPRs in western healthcare contexts. When available, distinctions are made with respect to the US or Europe. Limitations to our review include (a) limited research within healthcare contexts on organizational support, and (b) limited literature about Affiliated and Locums hospital physician populations in the US and Europe written in English. Practical implications Though hospital physicians are integral to patient care and economic efficiencies in hospitals, not much is known about how hospital physicians perceive organizational support within different HPRs, and what construct contributions are made to hospital system performance. Accordingly, this study contributes to the HRD literature in the healthcare context starting with confirming HPRs from a POS perspective and extending findings to theories of employee alignment that can contribute to organizational performance. The findings of this study serve HRD theory and practice. Theorists may use this to pursue HPR-related inquiries to explore HRD’s influence in creating hospital policies and culture that make physicians feel supported and satisfies the hospital’s financial and patient care-related goals. Practitioners may use the findings of this article to inform quality improvement and organization development efforts. Social implications Hospital physicians are an integral workforce that provides critical patient care across the world. Understanding how organizations can support physicians has a ripple effect from hospitals to communities at large. Originality/value This review contributes toward the development of a conceptual model of organizational support for HRD that can help physicians and their hospital employees within different HPRs to reach mutual goals of support, understanding, integration (clinical, economic and noneconomic) and physician alignment evidenced by improved patient care and organizational performance.

Pengaruh HRM Keadilan Organisasi, Manajemen Konflik, Etika Organisasi Terhadap Hubungan Karyawan dengan Intervening Iklim Kepercayaan

In the modern corporate environment, organizational justice, effective conflict management, and strong ethics are crucial elements in creating harmonious and productive employee relationships. The purpose of this research is to find out how HRM influences organizational justice, conflict management, organizational ethics on employee relations with the intervening climate of trust. This research was conducted at the XYZ company which operates in the shoe manufacturing sector located in Pasar Kemis Tangerang. Descriptive – correlative research design with quantitative methods and using purposive sampling techniques which were distributed via (google form) to 275 respondents aged 18 – 60 years who worked in the production section of the company. Primary data analysis was carried out using the Partial Least Square - Structural Equation Modeling (PLS-SEM) method. The conceptual model was analyzed using Structural Equation Modeling. The findings of this research reveal that organizational justice has a positive influence on employee relationships, management has a positive influence on employee relationships, organizational ethics has a positive influence on employee relationships, organizational justice has a positive influence on the climate of trust, conflict management has a positive influence on the climate of trust. , organizational ethics has a positive influence on the climate of trust, climate of trust has a positive influence on employee relations, climate of trust mediates the relationship between organizational justice and employee relations, climate of trust does not mediate the relationship between conflict management on employee relations and climate of trust does not mediate the relationship between organizational ethics on employee relations.

Unleashing ChatGPT: Redefining Technology Acceptance and Digital Transformation in Higher Education

This article examines the effects of integrating ChatGPT, a generative language model developed by OpenAI, into educational and training contexts in higher education. The research takes as its conceptual framework models of technology acceptance and questions the relevance of these models to the acceptance and adoption of ChatGPT. A qualitative study carried out with teachers from various higher education establishments in France enables us to propose a model adapted to the specific features of generative AI. The ethical dimension and the controllability of the tools by users, made possible by a progressive training program, are two constructions that are essential to a proper understanding of whether or not these new tools are adopted. Additionally, this research contributes to the growing discourse on how generative AI innovations can be leveraged to enhance digital transformation in the academic sector, with a particular focus on business schools’ stakeholders and strategies. Finally, the contributions and prospects for future research are discussed.

Exploring the potential of Technological Innovation in the Hospitality and Tourism Industry to attain Sustainability

Purpose of the study: The hospitality industry is undergoing rapid transformation due to continuous technological innovation in response to intense competition and evolving innovative practices. So, to meet up with the intense competition - technological innovation is inevitable. Methodology: Secondary sources are used to derive fundamental concepts and frameworks of modern technology used in the hospitality and tourism industry to attain sustainability. These sources include articles, books, newspapers, reviews, and company websites. Main Findings: By adopting technological innovation, the industry can reduce its environmental impact, improve operational efficiency, and provide enhanced experiences for guests, thereby moving towards a sustainable future. Implementing technologies in the hospitality industry involves both pros and cons. Applications of the study: Hospitality is the least service-activity sector, and there is a need to explore technological innovation strategies that lead to higher sales turnover, performance, and sustainability. Novelty/Originality of the study: This study's originality lies in its ability to offer updated technology used in the H&T industry to attain sustainable tourism. This concept is depicted with a conceptual model showing skills and innovative trends and their impact on Sustainability.

Impact of Climate Change on Spatiotemporal Patterns of Snow Hydrology: Conceptual Frameworks, Machine learning versus Nested Model

Snow accumulation in mountainous watersheds plays a paramount role in the hydrological cycle and environmental stability. In the current research, three different snow modeling approaches including conceptual models, Random Forest (RF) and their nested (Nested-RF) model have been implemented to project climate change. Also, three distinct calibration scenarios employing Snow Cover Area (SCA) and Snow Water Equivalent (SWE) have been used. These scenarios involve using SCA and SWE data individually or combined to calibrate both conceptual snowpack models and machine learning methods. Considering comparative analysis in the mountainous and complex topographic area of Tashk-Bakhtegan watershed as a case study, the Guo model (calibrated using both SCA and SWE data) achieves the highest prediction accuracy in predicting SCA/SWE using conceptual method. Considering various statistics, RF using the same calibration scenario demonstrates high accuracy in estimating SWE and shows promising results in detecting SCA. Considering the feature importance analysis and statistics of the RF and Nested-RF models indicate that the feeding conceptual outputs as extra information into the Nested-RF had minimal influence and even slightly reduced accuracy. Future projections using RF indicate significant reductions in mean annually SCA/SWE, especially under SSP8.5, with a 28.4% decrease in SCA and a reduction in SWE to 13.62 mm from a historical baseline of 19.4 mm. Lower emission scenarios (SSP2.6 and SSP4.5) show less drastic declines. While minor differences were observed between the best conceptual model and the RF approach in capturing spatiotemporal and annual snow patterns, these discrepancies did not reach statistical significance.

The Role of Sea Ice Insulation Effects on the Probability of AMOC Transitions

Abstract Recent simulations performed with the Community Earth System Model (CESM) have suggested a crucial role of sea ice processes in Atlantic meridional overturning circulation (AMOC) hysteresis behavior under varying surface freshwater forcing. Here, we further investigate this issue using additional CESM simulations and a novel conceptual ocean–sea ice box model. The CESM simulations suggest that the presence of sea ice gives rise to the existence of statistical equilibria with a weak AMOC strength. This is confirmed in the conceptual model, which captures similar AMOC hysteresis behavior as in the CESM simulation and where steady states are computed versus freshwater forcing parameters. In the conceptual model, transition probabilities between the different equilibrium states are determined using rare event techniques. The transition probabilities from a strong AMOC state to a weak AMOC state increase when considering sea ice insulation effects and indicate that sea ice promotes these transitions. On the other hand, sea ice insulation effects strongly reduce the probabilities of the reverse transition from a weak AMOC state to a strong AMOC state and this implies that sea ice also limits AMOC recovery. The results here indicate that sea ice effects play a dominant role in AMOC hysteresis width and influence transition probabilities between the different equilibrium states. Significance Statement We develop a novel conceptual ocean–sea ice box model to explain AMOC hysteresis behavior recently found in a modern complex climate model (the Community Earth System Model) and determine how sea ice insulation effects influence the hysteresis width and the probability of AMOC transitions.

Absorption and diffusion process at the CO[formula omitted]-decane interface considering density fluctuations near the critical CO[formula omitted] point

The injection of CO2 into geological formations for storage and for efficiency enhancement of oil production is considered a promising technology. Fundamental is an understanding of the absorption and diffusion process at the CO2-decane interface and its pressure and temperature dependence when approaching the critical CO2 point (31 °C, 7.38 MPa).Based on a new conceptual model, which considers CO2 density fluctuations in the critical range, we were able to consistently explain the time dependence of the volume increase for the respective thermodynamic state. The experimental results confirm the new conceptual model that volume swelling in the non-critical pressure range (< 6 MPa) is a surface effect with limited penetration depth. In contrast, the volume increase in the critical pressure range (6 - 8 MPa) is caused by mixing of liquid CO2droplets and the oil phase, i.e. to a level increase of the liquid mixed phase. Our experimental contact angles confirm this. The measured minimum miscible pressures (MMP) are 5.6 and 6.5 MPa at 20 °C and 30 °C, respectively.The CO2 absorption process at the CO2-decane interface is studied independently with pressure decay experiments. Our model results show excellent agreement (relative error ≅ 1 %) with the experimental results for both the non-equilibrium and equilibrium model, and the early-time diffusion coefficient is 4.7±1.9×10−7m2/s, confirming a fast CO2 mass transfer process.

Evaluation of Acceptance of Hospital Information Management System Among Nurses Through Technology Acceptance Model

Background: Health Information Management System has widely been used by healthcare professionals, particularly nurses. Purpose: The purpose of the study was to develop a research model showing the factors affecting the use of HIMS. The factors including in this conceptual model were taken from Information Success Model and updated Technology Acceptance Model (TAM). Methods: Total four-hundred and one nurses participated in this cross-sectional study from both public and private hospitals in Turkey. For data analysis, SPSS 25 software package was used. This study employed the following statistical methods: descriptive statistics, correlation and path analysis as well as Structure Equation Model using AMOS. Results: System Quality has a positive and significant effect on both Perceived Ease of Use and Perceived Usefulness. Service Quality has a positive and significant effect only on Perceived Usefulness and Information Quality does not have any effect on both Perceived Usefulness and Perceived Ease of Use. The Perceived Ease of Use has a positive and significant effect on Intention to Use. Similar effect was seen with Perceived Usefulness. Conclusion: This research model identified the factors influencing the acceptance hospital information management system and how those factors can be improved to affect users’ intention in the future.

A Physics-Informed Auto-Learning Framework for Developing Stochastic Conceptual Models for ENSO Diversity

Abstract Understanding El Niño–Southern Oscillation (ENSO) dynamics has tremendously improved over the past few decades. The ENSO diversity in spatial pattern, peak intensity, and temporal evolution is, however, still poorly represented in conceptual ENSO models. In this paper, a physics-informed auto-learning framework is applied to derive ENSO stochastic conceptual models with varying degrees of freedom. The framework is computationally efficient and easy to apply. Once the state vector of the target model is set, causal inference is exploited to build the right-hand side of the equations based on a mathematical function library. Fundamentally different from standard nonlinear regression, the auto-learning framework provides a parsimonious model by retaining only terms that improve the dynamical consistency with observations. It can also identify crucial latent variables and provide physical explanations. This methodology successfully reconstructs the equations of a realistic six-dimensional reference ENSO model based on the recharge oscillator theory from its data. A hierarchy of lower-dimensional models is derived, and their representation of ENSO (including its diversity) is systematically assessed. The minimum model that represents ENSO diversity is four-dimensional, with three interannual variables describing the western Pacific thermocline depth, the eastern and central Pacific sea surface temperatures (SSTs), and one intraseasonal variable for westerly wind events. Without the intraseasonal variable, the resulting three-dimensional model underestimates extreme events and is too regular. A limited number of weak nonlinearities in the model are essential in reproducing the observed extreme El Niño events and the observed nonlinear relationship between eastern and western Pacific SSTs. Significance Statement This study develops a physics-informed auto-learning approach to improve the modeling and understanding of El Niño–Southern Oscillation (ENSO), a major climate phenomenon influencing global weather and climate. The auto-learning framework explores the causality between key processes to systematically produce stochastic conceptual models with different climate factors that simulate the diversity of observed ENSO events. The key finding is that the minimal model for characterizing the ENSO diversity (with the least number of climate factors) is a four-variable model capturing thermocline depth, sea surface temperatures, and wind bursts that can reproduce intensity and spatial pattern variation. This advancement provides an interpretable tool to identify the minimum sufficient processes governing ENSO behavior for improved predictability.

Use of electrical resistivity tomography to reduce landfill siting risks in the south-central kentucky karst

Electrical Resistivity Tomography (ERT) can be a key tool for aiding in characterization of karst geohazard risks at proposed landfill sites. This study is proximal to the south-central Kentucky karst and Mammoth Cave National Park and possesses siliciclastic cap rock upland areas that pose relatively high groundwater-contamination risks due to adjacent ravines floored by carbonates. Complex stratigraphy associated with the Mississippian-Pennsylvanian unconformity and juxtaposition of heterolithic sedimentary rocks in general presents further challenges for demarcating hydrogeological characterization of the base of engineered landfills. A conceptual site model integrates ERT surveying and field geology that both satisfactorily characterize the site and risks to groundwater resources without conducting multiple borings. The proposed landfill site is compared to well-known and mapped caves at a landfill near Bowling Green, Crumps Cave near Smiths Grove, and River Styx Spring at Mammoth Cave. Our work entails review of ERT datasets at known cave sites and compares these to two ERT profiles that traversed the proposed landfill site, which are integrated with study of outcrops, and an excavated pit and trench. ERT data range from several low 10 s to about 400 Ω-meter values for mud rock units whereas sandy units possess ERT values from approximately 500 to several tens of thousands of Ω meters. The greatest values are indicative of basal Pennsylvanian Caseyville Sandstone, and these exceed 32,000Ω meters. In comparison, ERT values at known cave sites range from one to 100,000 Ω meters, with elevated, dry rock or possibly dry (air filled) caves interpreted from the greatest values and low values reflective of conductive underground cave streams and moist caves. An unexpected challenge specific to the Hart County landfill study includes occurrence of well-drained and highly weathered Caseyville at the highest elevations of the site causing increased electrical contact resistance during ERT surveying. The overall ERT contrast however, between quartz-rich and clay poor strata (high-resistivity rocks and regolith) and clay-rich strata (low-resistivity rocks) provides independent data consistent with the observed stratigraphy exposed in site exposures. Nonuniqueness of conductive intervals at the Hart County site contrasts with other conductive areas at depth associated with moist or wet cave passages as documented at Crumps Cave and Mammoth Cave.

Utilizing the HBV-Light semi-distributed conceptual hydrological model to estimate groundwater recharge in the upstream part of the Awash River basin, Ethiopia.

Utilizing the HBV-Light semi-distributed conceptual hydrological model to estimate groundwater recharge in the upstream part of the Awash River basin, Ethiopia.

Design and methodology of a randomized clinical trial of quetiapine to reduce central nervous system polypharmacy in veterans with postconcussive syndrome symptoms

Lack of evidence to guide medication treatments for mild traumatic brain injury (mTBI) in veterans too often results in polypharmacy practices attempting to provide symptomatic relief from multiple postconcussive syndrome symptoms. Therefore, the field needs to find an effective medication that reduces the burden of postconcussive symptoms without complicating the treatment burden of veterans. This clinical trial seeks to determine whether switching veterans to quetiapine monotherapy (intervention) is superior to continuing to receive treatment as usual (TAU, control) polypharmacy for veterans with symptoms of postconcussive syndrome and posttraumatic stress disorder who are receiving rehabilitation treatment for mTBI. This study will test the conceptual mediation model hypothesis that quetiapine monotherapy may enhance recovery from mTBI by (1) increasing engagement in rehabilitation services, and/or (2) reducing the adverse effects of TAU polypharmacy. This study will enroll 146 patients from two Veterans Administration Medical Centers into a 12- week phase III, randomized, pragmatic clinical trial comparing outcomes from treatment with quetiapine monotherapy and TAU. Quetiapine will be cross tapered up to a maximum dose of 200 mg (as tolerated) as other medications are discontinued. The primary outcome measures are postconcussive syndrome symptoms (Neurobehavioral Symptom Inventory), functional disability (World Health Organization Disability Assessment), and quality of life (World Health Organization Quality of Life Assessment). Overall, this study aims to determine whether quetiapine monotherapy is superior to TAU polypharmacy and improves the quality of life for veterans with comorbid postconcussive syndrome and posttraumatic stress disorder symptoms who are receiving rehabilitation treatment for mTBI.

Advertising in the metaverse and its implications for brands and society: A multi-stakeholder perspective

The aim of this paper is to identify the characteristics of advertising in the metaverse and its implications for brands and society. A group of 35 experts representing advertising agencies and brands from Central and Eastern Europe were interviewed. The findings are presented in the form of a conceptual model that provides a cartography for the landscape of metaverse advertising. Our results demonstrate that metaverse advertising uses existing formats (e.g. billboards, product placement), while also developing new ones (e.g. automated avatars, virtual products, and branded spaces). In addition, metaverse advertising is more focused on brand building than on direct, measurable impact. Advertising in the metaverse is not as precisely targeted as it is on the internet. Given their high up-front costs, these activities are currently more suitable for multinationals and well-known global brands. Metaverse advertising is not perceived to be associated with elevated brand risk. However it is burdened with myopia, understood as a lack of long-term perspective. Our findings reveal three stakeholder personas representing different approaches to metaverse advertising; including Cautious Pioneers, Empathic Pragmatists, and Blockchain Enthusiasts. We conclude by documenting the social consequences, capturing shifts towards automated communication, digital ownership, and the metaverse's potential to replace social media.

Woody vegetation cover on cleared areas in the Amazon Basin: temporal mixture mapping suggests a revised conceptual model of deforestation

Woody vegetation cover on cleared areas in the Amazon Basin: temporal mixture mapping suggests a revised conceptual model of deforestation

Development of the First Patient-Reported Experience Measure (PREM) for Hearing Loss in Audiology Care-My Hearing PREM.

Patient-reported experience measures (PREMs) provide important insights into the challenges experienced when living with a chronic condition. Although patient-reported outcome measures (PROMs) exist in audiology, there are no validated PREMs to help clinicians understand patient perspectives and identify areas where patients may need additional support or interventions. The aim of this study was to develop and evaluate content for the new 'My Hearing PREM', which captures lived experiences of hearing loss from patients' perspectives. My Hearing PREM was developed and tested in two key phases. Phase 1 involved generating the PREM prototype in accordance with our conceptual model of the lived experience of hearing loss. In Phase 2, cognitive interviews were conducted with adults with hearing loss to appraise the content of the PREM (relevance, clarity, acceptability and comprehensiveness) and assess its respondent burden. Key stakeholders (e.g., adults with hearing loss, patient and public representatives, clinicians and researchers) were consulted throughout Phases 1 and 2 to review and refine the PREM. Interview data were analysed using thematic analysis. Sixteen participants (aged 16 years and over) with hearing loss took part in cognitive interviews, recruited from UK audiology departments and non-clinical settings (e.g., lip-reading classes, national charity links and social media). Most PREM items were found to be relevant, clear, acceptable and comprehensive. Several problems were identified, including items not working well with the response scale options, irrelevant questions and a lack of clarity about terms (e.g., healthcare professionals) and whether questions should be answered based on the use of hearing aids (or not). The PREM was amended accordingly. Currently, no hearing loss-specific PREMs exist in audiology. Involving multiple stakeholders in the development of the PREM helped to ensure that the items were relevant, clear, acceptable and comprehensive. The PREM is undergoing further evaluation and refinement in preparation for investigating the feasibility of implementing it into clinical practice. Ongoing Patient and Public Involvement and Engagement (PPIE) with key groups (South Asian Women's groups, young people's groups, learning disability networks and student populations) was integral to the study. PPIE members reviewed patient information sheets and consent forms, advised on recruitment, reviewed the interview schedule and checked coding and analysis procedures. PPIE members provided feedback on the PREM's comprehensibility. Members of the public, including adults attending lip-reading classes and hearing aid users from the South Asian community, provided feedback on iterative PREM drafts.