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Al-Yateem N, Mottershead R, Refaat Ahmad F, Arsyad Subu M. A reflection on the use of virtual nominal group technique in health policy and research priority consensus studies. Nurse Res 2024:e1933. [PMID: 38932484 DOI: 10.7748/nr.2024.e1933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Nominal group technique (NGT) is widely used in healthcare research to facilitate decision-making and consensus-building. Traditional NGT requires face-to-face interaction and its limitations include potential biases, logistical challenges and high costs. The COVID-19 pandemic necessitated a shift to virtual methods, which led to the development of virtual nominal group technique (vNGT). Aim To reflect on the use of vNGT, particularly in the context of Ghader et al (2023 ), to understand its effectiveness in overcoming the limitations of traditional NGT and on its applicability in pandemic-affected scenarios. METHOD This paper reviews and discusses literature on the use and effectiveness of NGT compared to other consensus-building methods and examines the emergence of vNGT in overcoming the limitations of traditional NGT. The authors also reflect on their use of vNGT in a study to identify cardiovascular research priorities in the UAE and provide details of its implementation. DISCUSSION vNGT bridges the gap between the localised nature of traditional NGT and the global reach of the Delphi technique. It allows for the inclusion of diverse participants, saves costs and offers time-efficiency. The study demonstrated vNGT's adaptability, with participants engaging in idea generation, discussion and prioritisation using online tools. However, challenges persist with vNGT, including reduced accessibility for certain demographics, timing issues across time zones and technical difficulties. CONCLUSION vNGT successfully integrates the interactive, consensus-building aspects of NGT with the broad reach of Delphi. It can be valuable in research and decision-making, especially in an era of increased remote collaboration. IMPLICATIONS FOR PRACTICE vNGT can significantly impact healthcare research and policy formulation by enabling more inclusive, cost-effective and timely consensus-building processes. However, considerations for accessibility and technical support are crucial for its wider adoption and effectiveness.
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Affiliation(s)
- Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Richard Mottershead
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma Refaat Ahmad
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Muhammad Arsyad Subu
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Lee SH, ten Cate O, Gottlieb M, Horsley T, Shea B, Fournier K, Tran C, Chan T, Wood TJ, Humphrey-Murto S. The use of virtual nominal groups in healthcare research: An extended scoping review. PLoS One 2024; 19:e0302437. [PMID: 38865305 PMCID: PMC11168680 DOI: 10.1371/journal.pone.0302437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 04/03/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION The Nominal Group Technique (NGT) is a consensus group method used to synthesize expert opinions. Given the global shift to virtual meetings, the extent to which researchers leveraged virtual platforms is unclear. This scoping review explores the use of the vNGT in healthcare research during the COVID-19 pandemic. METHODS Following the Arksey and O'Malley's framework, eight cross-disciplinary databases were searched (January 2020-July 2022). Research articles that reported all four vNGT stages (idea generation, round robin sharing, clarification, voting) were included. Media Synchronicity Theory informed analysis. Corresponding authors were surveyed for additional information. RESULTS Of 2,589 citations, 32 references were included. Articles covered healthcare (27/32) and healthcare education (4/32). Platforms used most were Zoom, MS Teams and GoTo but was not reported in 44% of studies. Only 22% commented on the benefits/challenges of moving the NGT virtually. Among authors who responded to our survey (16/32), 80% felt that the vNGT was comparable or superior. CONCLUSIONS The vNGT provides several advantages such as the inclusion of geographically dispersed participants, scheduling flexibility and cost savings. It is a promising alternative to the traditional in-person meeting, but researchers should carefully describe modifications, potential limitations, and impact on results.
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Affiliation(s)
- Seung Ho Lee
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Olle ten Cate
- Utrecht Center for Research and Development of Health Professions Education, Division of Education, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago Illinois, United States of America
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Research, Ottawa Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Beverley Shea
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Karine Fournier
- Health Sciences Library, University of Ottawa, Ottawa Ontario, Canada
| | - Christopher Tran
- Department of Medicine, University of Ottawa, Ottawa Ontario, Canada
| | - Teresa Chan
- Department of Medicine, Division of Emergency Medicine, Division of Education and Innovation, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Timothy J. Wood
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Susan Humphrey-Murto
- Department of Medicine, University of Ottawa, Ottawa Ontario, Canada
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada
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Vellani S, Yous M, Rivas VM, Lucchese S, Kruizinga J, Sussman T, Abelson J, Akhtar‐Danesh N, Bravo G, Brazil K, Ganann R, Kaasalainen S. Patient and public involvement in international research: Perspectives of a team of researchers from six countries on collaborating with people with lived experiences of dementia and end-of-life. Health Expect 2024; 27:e13942. [PMID: 39102702 PMCID: PMC10748824 DOI: 10.1111/hex.13942] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Patient and public involvement (PPI) is a critical priority in research, policy, academia and advocacy organizations. PPI in dementia research is gaining momentum. However, these efforts are missing in international projects aimed at those living with advanced dementia in long-term care (LTC) homes. Additional complexities can arise in enacting PPI within the context of integration of a palliative approach to care and experiences around end-of-life in (EOL) dementia. The mySupport study involved implementing the Family Carer Decision Support (FCDS) intervention for care partners of those living with advanced dementia in LTC in six countries. RESEARCH DESIGN AND OBJECTIVE An interpretive description study was conducted to explore the perspectives of international researchers from six countries on engaging people with lived experiences of dementia and EOL care in research processes. The findings from this study informed the development of a PPI strategy and a subsequent toolkit for the FCDS intervention. FINDINGS Thirty-eight interviews were completed with project researchers: 12 from the United Kingdom, 8 from Canada, 7 from Ireland, 4 each from Italy and The Netherlands and 3 from the Czech Republic. Four broad themes describe international researchers' perspectives on advancing methods of engagement for people with lived experiences of dementia and EOL in international PPI activities: (1) Groundwork to engage in research; (2) planning for research activities is key; (3) focus on meaningful engagement and (4) having foresight for practical issues shaping PPI. DISCUSSION AND IMPLICATIONS International projects that involve PPI can present many sources of challenges. The findings in this study highlight important considerations for foundational work for incorporating PPI in international projects. Learning from world leaders and those with lived experiences in various regions can be insightful and help share tools and resources. PATIENT OR PUBLIC CONTRIBUTION PPI was envisioned as a critical part of conducting the mySupport study. The findings from this study informed the development of a PPI strategy and an international Strategic Guiding Council that included family carers of those living with advanced dementia in LTC homes in six countries. This manuscript focused on the perspectives of researchers on their engagement with people with lived experiences of dementia and EOL. The perspectives of persons with lived experiences on engaging in the mySupport research study will be reported in a forthcoming manuscript.
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Affiliation(s)
- Shirin Vellani
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Marie‐Lee Yous
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | | | - Stephanie Lucchese
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Julia Kruizinga
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Tamara Sussman
- School of Social Work, Faculty of ArtsMcGill UniversityMontrealQuebecCanada
| | - Julia Abelson
- Department of Health Research Methods, Evidence and Impact, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Noori Akhtar‐Danesh
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Gina Bravo
- Department of Community Health Sciences, Faculty of Medicine and Health SciencesSherbrooke UniversitySherbrookeCanada
| | - Kevin Brazil
- School of Nursing and MidwiferyQueens University BelfastNorthern IrelandUK
| | - Rebecca Ganann
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Sharon Kaasalainen
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
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Thompson GN, Hack TF, Chochinov HM, Roger K, St John PD, McClement SE. Developing a question prompt list for family caregivers concerning the progression and palliative care needs of nursing home residents living with dementia. PEC INNOVATION 2023; 2:100160. [PMID: 37384156 PMCID: PMC10294106 DOI: 10.1016/j.pecinn.2023.100160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 06/30/2023]
Abstract
Objective Communication around a palliative approach to dementia care often is problematic or occurs infrequently in nursing homes (NH). Question prompt lists (QPLs), are evidence-based lists designed to improve communication by facilitating discussions within a specific population. This study aimed to develop a QPL concerning the progression and palliative care needs of residents living with dementia. Methods A mixed-methods design in 2 phases. In phase 1, potential questions for inclusion in the QPL were identified using interviews with NH care providers, palliative care clinicians and family caregivers. An international group of experts reviewed the QPL. In phase 2, NH care providers and family caregivers reviewed the QPL assessing the clarity, sensitivity, importance, and relevance of each item. Results From 127 initial questions, 30 questions were included in the first draft of the QPL. After review by experts, including family caregivers, the QPL was finalized with 38 questions covering eight content areas. Conclusion Our study has developed a QPL for persons living with dementia in NHs and their caregivers to initiate conversations to clarify questions they may have regarding the progression of dementia, end of life care, and the NH environment. Further work is needed to evaluate its effectiveness and determine optimal use in clinical practice. Innovation This unique QPL is anticipated to facilitate discussions around dementia care, including self-care for family caregivers.
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Affiliation(s)
- Genevieve N. Thompson
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, Manitoba R3T 2N2, Canada
| | - Thomas F. Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, Manitoba R3T 2N2, Canada
| | - Harvey Max Chochinov
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, PZ433-771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada
- CancerCare Manitoba Research Institute, 4005-675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9, Canada
| | - Kerstin Roger
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, 35-220 Chancellor Circle, Winnipeg, Manitoba R3T 2N2, Canada
| | - Philip D. St John
- Section of Geriatric Medicine, Max Rady College of Medicine, University of Manitoba, GE 547 Health Sciences Centre, 820 Sherbrook St, Winnipeg, MB R2A 1R9, Canada
- Research Affiliate, Centre on Aging, University of Manitoba, 338 Isbister Building, 183 Dafoe Rd, Winnipeg, Manitoba R3T 2N2, Canada
| | - Susan E. McClement
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, Manitoba R3T 2N2, Canada
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Couprie C, van der Steen JT. Talking about Meaning and Loss with Relatives of Persons with Dementia: An Ethnographic Study in a Nursing Home. Geriatrics (Basel) 2023; 8:geriatrics8010023. [PMID: 36826365 PMCID: PMC9956037 DOI: 10.3390/geriatrics8010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/08/2023] Open
Abstract
Advance care planning (ACP) can help prepare for future losses and decisions to be taken. However, relatives of persons with dementia may wait for healthcare professionals to initiate ACP conversations which may not adequately address their individual information needs. To evaluate inducing and enhancing conversations about meaning and loss, we conducted an ethnographic study on nurse-led ACP conversations using a question prompt list (QPL) on six dementia wards of a nursing home in the Netherlands from January to September 2021. Staff received training in using the QPL, with information and sample questions to inspire relatives to ask their questions, in particular on meaning and loss. Thematic analysis was applied to transcribed interviews and memos of observations. Nursing staff in particular was concerned about having to be available to answer questions continuously. Relatives used the study as an opportunity to get in touch with professionals, and they saw the QPL as an acknowledgement of their needs. There was a mismatch in that staff wished to discuss care goals and complete a care plan, but the relatives wanted to (first) address practical matters. A QPL can be helpful to conversations about meaning and loss, but nursing staff need dedicated time and substantial training. Joint agenda setting before the conversation may help resolve a mismatch in the preferred topics and timing of conversations.
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Affiliation(s)
- Caroline Couprie
- Department of Theology and Religion Studies, Spiritual Care, VU Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
- Pieter van Foreest, Kalfjeslaan 2, 2623 AA Delft, The Netherlands
- Correspondence:
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Gebouw 3, 2300 RC Leiden, The Netherlands
- Department of Primary and Community Care and Radboudumc Alzheimer Center, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
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Harding AJE, Doherty J, Bavelaar L, Walshe C, Preston N, Kaasalainen S, Sussman T, van der Steen JT, Cornally N, Hartigan I, Loucka M, Vlckova K, Di Giulio P, Gonella S, Brazil K. A family carer decision support intervention for people with advanced dementia residing in a nursing home: a study protocol for an international advance care planning intervention (mySupport study). BMC Geriatr 2022; 22:822. [PMID: 36289458 PMCID: PMC9607827 DOI: 10.1186/s12877-022-03533-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background Where it has been determined that a resident in a nursing home living with dementia loses decisional capacity, nursing home staff must deliver care that is in the person's best interests. Ideally, decisions should be made involving those close to the person, typically a family carer and health and social care providers. The aim of the Family Carer Decisional Support intervention is to inform family carers on end-of-life care options for a person living with advanced dementia and enable them to contribute to advance care planning. This implementation study proposes to; 1) adopt and apply the intervention internationally; and, 2) train nursing home staff to deliver the family carer decision support intervention. Methods This study will employ a multiple case study design to allow an understanding of the implementation process and to identify the factors which determine how well the intervention will work as intended. We will enrol nursing homes from each country (Canada n = 2 Republic of Ireland = 2, three regions in the UK n = 2 each, The Netherlands n = 2, Italy n = 2 and the Czech Republic n = 2) to reflect the range of characteristics in each national and local context. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. Our mixed methods study design has three phases to (1) establish knowledge about the context of implementation, (2) participant baseline information and measures and (3) follow up evaluation. Discussion The use of a multiple case study design will enable evaluation of the intervention in different national, regional, cultural, clinical, social and organisational contexts, and we anticipate collecting rich and in-depth data. While it is hoped that the intervention resources will impact on policy and practice in the nursing homes that are recruited to the study, the development of implementation guidelines will ensure impact on wider national policy and practice. It is our aim that the resources will be sustainable beyond the duration of the study and this will enable the resources to have a longstanding relevance for future advance care planning practice for staff, family carers and residents with advanced dementia.
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Affiliation(s)
- Andrew J E Harding
- grid.9835.70000 0000 8190 6402Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Julie Doherty
- grid.4777.30000 0004 0374 7521School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Laura Bavelaar
- grid.5132.50000 0001 2312 1970Leiden University Medical Centre, Leiden University, Leiden, The Netherlands
| | - Catherine Walshe
- grid.9835.70000 0000 8190 6402Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Nancy Preston
- grid.9835.70000 0000 8190 6402Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Sharon Kaasalainen
- grid.25073.330000 0004 1936 8227School of Nursing, McMaster University, Hamilton, Canada
| | - Tamara Sussman
- grid.14709.3b0000 0004 1936 8649School of Social Work, McGill University, Hamilton, Canada
| | - Jenny T van der Steen
- grid.5132.50000 0001 2312 1970Leiden University Medical Centre, Leiden University, Leiden, The Netherlands
| | - Nicola Cornally
- grid.7872.a0000000123318773School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | - Irene Hartigan
- grid.7872.a0000000123318773School of Nursing and Midwifery, University College Cork, Cork, Republic of Ireland
| | | | | | - Paola Di Giulio
- grid.7605.40000 0001 2336 6580Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - Silvia Gonella
- grid.7605.40000 0001 2336 6580Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - Kevin Brazil
- grid.4777.30000 0004 0374 7521School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
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