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Ropaj E, Haddock G, Pratt D. Developing a consensus of recovery from suicidal ideations and behaviours: A Delphi study with experts by experience. PLoS One 2023; 18:e0291377. [PMID: 37729121 PMCID: PMC10511083 DOI: 10.1371/journal.pone.0291377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Understanding recovery in mental health has received significant attention and consequently, recovery has been incorporated into health policy across many countries in the Global North. In comparison, the concept of 'recovery' from suicidal thoughts and behaviours has received little attention. However, the few studies in this area appear to suggest that recovery is a complex and an idiosyncratic process with many contributing factors. This can present a challenge for clinicians and services seeking to become more recovery focused. Thus, it seems of importance to develop a consensus on how recovery from suicidal thoughts and behaviours is conceptualised. AIM The study aimed to use the Delphi design to establish a consensus of how recovery is defined by those with lived experience of suicidal thoughts and behaviours. The Delphi method draws on the expertise of a panel, often involving clinicians, researchers and lived experience experts to develop consensus over a topic by inviting them to rate the importance of, often a series of statements to a given topic area. METHOD Lived experience experts were asked to complete two rounds of questionnaires distributed online to capture their views on recovery. RESULTS A total of 196 individuals gave their views on the first round of the study and 97 gave their views on the second round. A final list of 110 statements was developed that 80% or more of participants defined as essential or important. Statements covered items that were important in defining, facilitation and hindering the process of recovery. CONCLUSION Findings are consistent with the wider literature that suggests that recovery is an idiosyncratic process, but with many commonly shared features. Here we also show that a comprehensive definition of recovery must include factors that hinder the process of recovery. Implications and recommendations for practice, policy development and future research are discussed.
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Affiliation(s)
- Esmira Ropaj
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology & Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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Meinhardt I, Cargo T, Te Maro B, Bowden L, Fortune S, Cuthbert S, James S, Cook R, Papalii T, Kapa-Kingi K, Kapa-Kingi M, Prescott A, Hetrick SE. Development of guidelines for school staff on supporting students who self-harm: a Delphi study. BMC Psychiatry 2022; 22:631. [PMID: 36175876 PMCID: PMC9520113 DOI: 10.1186/s12888-022-04266-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Self-harm is a major public health issue that significantly impacts communities, making early intervention and prevention paramount in addressing this public health issue. This study aimed to develop evidence-based, culturally responsive, safe, and practical guidelines to assist school staff in effectively supporting students who self-harm. METHODS This Delphi study comprised of a five-step process, oversighted by a Rōpū Mātanga Māori (Māori clinical and cultural governance group), and drawing on the expertise and knowledge gained from existing literature, interviews with stakeholders, and two panels of experts (youth and stakeholders). The Rōpū Mātanga Māori ensured accountability to the principles of Te Tiriti o Waitangi (Treaty of Waitangi) and kept Māori processes central to the research aims. The panels completed two rounds of questionnaires, rating their endorsement of each statement. Statements rated as important or essential by 80% or more of both panels and Māori participants were included in the final guidelines. The Rōpū Mātanga Māori reviewed any remaining statements to determine inclusion. RESULTS Following the five-step process, 305 statements were included in the guidelines. These statements provided guiding actions that endorsed communication, collaborative responsibility, and wellbeing and a student-centred approach. CONCLUSION The guidelines provide guidance to all school staff that is culturally responsive and safe, consensus-based, and evidence-based. It is informed by the voices and experiences of young people and those who support them.
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Affiliation(s)
- Inge Meinhardt
- School of Psychology, Faculty of Science, University of Auckland, Science Centre, Building 302, Level 2, 23 Symonds Street, Auckland Central, Auckland, 1010, New Zealand.
| | - Tania Cargo
- grid.9654.e0000 0004 0372 3343School of Psychology, Faculty of Science, University of Auckland, Science Centre, Building 302, Level 2, 23 Symonds Street, Auckland Central, Auckland, 1010 New Zealand ,grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,A Better Start, E Tipu E Rea (Grant Number 15-02688), National Science Challenge, Auckland, New Zealand
| | - Ben Te Maro
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,Clinical Advisory Services Aotearoa, Auckland, New Zealand
| | - Linda Bowden
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,Clinical Advisory Services Aotearoa, Auckland, New Zealand
| | - Sarah Fortune
- grid.9654.e0000 0004 0372 3343Social and Community Health, Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,grid.29980.3a0000 0004 1936 7830Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Sasha Cuthbert
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Susanna James
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,grid.5491.90000 0004 1936 9297School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Riley Cook
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tania Papalii
- grid.507908.30000 0000 8750 5335Northland District Health Board, Whangarei, New Zealand
| | - Korotangi Kapa-Kingi
- grid.507908.30000 0000 8750 5335Northland District Health Board, Whangarei, New Zealand
| | | | - Annabelle Prescott
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sarah Elisabeth Hetrick
- grid.9654.e0000 0004 0372 3343Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ,A Better Start, E Tipu E Rea (Grant Number 15-02688), National Science Challenge, Auckland, New Zealand ,grid.1008.90000 0001 2179 088XCentre of Excellence in Youth Mental Health, The Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Koh WQ, Casey D, Hoel V, Toomey E. Strategies for implementing pet robots in care homes and nursing homes for residents with dementia: protocol for a modified Delphi study. Implement Sci Commun 2022; 3:58. [PMID: 35659111 PMCID: PMC9164492 DOI: 10.1186/s43058-022-00308-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/15/2022] [Indexed: 01/21/2023] Open
Abstract
Background Pet robots are a type of technology-based innovation that have shown positive psychosocial benefits for people with dementia in residential facilities, such as improving mood and social interaction and reducing agitation. Nevertheless, little is known about how pet robots can be implemented in care homes and nursing homes for dementia care in real-world practice. The objectives of this study are to (1) identify contextualised implementation strategies for implementing pet robots into care homes and nursing homes for dementia care and (2) achieve consensus on the most relevant strategies. Method This study is informed by a preceding scoping review and qualitative study, which used the Consolidated Framework of Implementation Research (CFIR) to identify multi-level determinants of implementation (i.e. barriers and facilitators). We will use the CFIR-ERIC matching tool to identify relevant implementation strategies from the Expert Recommendations for Implementing Change (ERIC) taxonomy to address these determinants. Data from the scoping review and qualitative study will be used to contextualise the generic ERIC strategies for our setting. After that, a group of key stakeholders will be consulted to further contextualise and refine these strategies. Next, a two-round modified Delphi process will be conducted. Fifty-four international expert participants including healthcare professionals and organisational leaders from care homes and nursing homes and academic researchers will be recruited through purposive sampling. During the first Delphi round, participants will be invited to rate the relevance of each implementation strategy on a 9-point Likert scale and provide comments or suggestions. Descriptive statistics will be used to identify whether consensus has been obtained. Inductive qualitative content analysis will be used to analyse and summarise textual responses for any new statements suggested by participants. Statements that do not reach consensus and new statements suggested in round 1 will be taken to the next round, which will follow the same rating process. Discussion This study will identify strategies for implementing pet robots in care homes and nursing homes for residents with dementia, which will have practical utility for clinicians, organisations and researchers. It will also demonstrate the practical application (and adaptation) of the CFIR-ERIC tool to identify and contextualise ERIC strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-022-00308-z.
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Affiliation(s)
- Wei Qi Koh
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 E3YV, Galway, Ireland.
| | - Dympna Casey
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 E3YV, Galway, Ireland
| | - Viktoria Hoel
- Institute for Public Health and Nursing Research, University of Bremen, 28359, Bremen, Germany.,Leibniz Science Campus Digital Public Health, 28359, Bremen, Germany
| | - Elaine Toomey
- School of Allied Health, University of Limerick, V94 T9PX, Limerick, Ireland.,Health Research Institute, University of Limerick, V94 T9PX, Limerick, Ireland
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Varndell W, Fry M, Lutze M, Elliott D. Use of the Delphi method to generate guidance in emergency nursing practice: A systematic review. Int Emerg Nurs 2020; 56:100867. [PMID: 32238322 DOI: 10.1016/j.ienj.2020.100867] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 10/24/2022]
Abstract
AIM To examine the application and methodological quality of the Delphi method used in developing guidance for emergency nursing practice. BACKGROUND Emergency nursing scope of practice has rapidly expanded in response to increasing patient acuity, complexity and technological innovation. Determining best practice is crucial for delivering high quality, safe and effective emergency nursing care. The Delphi method has been used to identify, prioritise complex issues and develop evidence-driven guidance in emergency nursing practice. The use and quality of the Delphi method in emergency nursing practice has not been examined. DESIGN Systematic literature review. DATABASES AND DATA TREATMENT A systematic literature search was conducted using the following databases: SCOPUS, EMBASE, Medline and ProQuest from date of inception to August 2019. The database search was limited to scholarly articles or peer-reviewed journals. No language restrictions were applied. The Cochrane Collaboration method and PRISMA checks were utilized to conduct the review. RESULTS Of 246 records identified 22 (8.9%) studies met the inclusion criteria. A modified Delphi method was commonly used (n = 15; 68.2%) and often conducted online (n = 11; 50.0%). Eight practice guidance themes were identified. Overall study quality was high (score 12/14; range 4-13), transparency of reporting varied. CONCLUSION Based on this review, the Delphi method is an appropriate method for exploring emergency nursing practice. The studies reviewed demonstrated that knowledge, skills and clinical expertise has progressively expanded in the specialty of emergency nursing. Variation in the application, conduct and transparency of reporting in Delphi studies developing guidance for emergency nursing practice is discussed.
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Affiliation(s)
- Wayne Varndell
- Prince of Wales Hospital Emergency Department, Randwick 2031, NSW, Australia; Faculty of Health, University of Technology Sydney, Ultimo 2007, NSW, Australia.
| | - Margaret Fry
- Faculty of Health, University of Technology Sydney, Ultimo 2007, NSW, Australia; Director Research and Practice Development Nursing and Midwifery Directorate NSLHD, Level 7 Kolling Building, Royal North Shore Hospital, St Leonards 2065, NSW, Australia.
| | - Matthew Lutze
- Faculty of Health, University of Technology Sydney, Ultimo 2007, NSW, Australia; Nursing Practice and Informatics, NSW Ministry of Health, St Leonards 2065, NSW, Australia; School of Nursing, University of Sydney, Camperdown 2050, NSW, Australia.
| | - Doug Elliott
- Faculty of Health, University of Technology Sydney, Ultimo 2007, NSW, Australia.
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Meyer ER, Cui D. Anatomy Visualizations Using Stereopsis: Assessment and Implication of Stereoscopic Virtual Models in Anatomical Education. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1235:117-130. [PMID: 32488639 DOI: 10.1007/978-3-030-37639-0_7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Anatomical knowledge, such as gross anatomy, neuroanatomy, histology, and embryology, involve three-dimensional (3D) learning and interpretation. Virtual 3D models especially have been used in the anatomical sciences both as a supplement to traditional anatomical education with cadaveric specimens and as a substitute for cadavers at institutions that do not utilize human donors for educational purposes. This paper discusses the methods used to assess the models' validation and accuracy, as well as suggestions for the models' improvement. This paper also aims to describe students' learning of anatomy using stereoscopic 3D models and provides a summary of the results from the literature concerning students' performance outcomes using virtual stereoscopic models as well as both students' and experts' perceptions of their utilization. There have been mixed results in the literature concerning the effectiveness of virtual 3D anatomical models in general, but there is limited research on stereoscopic anatomical models specifically. Stereoscopic anatomical models have shown to improve the learning of students, particularly for the students with low spatial ability, and they have the potential to enhance students' understanding of 3D relationships.
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Affiliation(s)
- Edgar R Meyer
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Dongmei Cui
- Department of Neurobiology and Anatomical Sciences, Division of Clinical Anatomy, University of Mississippi Medical Center, Jackson, MS, USA.
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Blaschke SM, Lambert SD, Livingston PM, Aranda S, Boltong A, Schofield P, Chambers SK, Krishnasamy M, Ugalde A. Identifying priorities for cancer caregiver interventions: protocol for a three-round modified Delphi study. BMJ Open 2019; 9:e024725. [PMID: 30765405 PMCID: PMC6398770 DOI: 10.1136/bmjopen-2018-024725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Cancer is often considered a chronic disease, and most people with cancer have a caregiver, often a family member or friend who provides a significant amount of care during the illness trajectory. Caregivers are frequently in need of support, and a range of interventions have been trialled to improve outcomes. Consensus for optimal ways to support caregivers is not known. The aim of this protocol paper is to describe procedures for a modified Delphi study to explore expert consensus about important factors when developing caregiver interventions. METHODS AND ANALYSIS Online modified Delphi methodology will be used to establish consensus for important caregiver intervention factors incorporating the Patient problem, Intervention, Comparison and Outcome framework. Round 1 will comprise a free-text questionnaire and invite the panel to contribute factors they deem important in the development and evaluation of caregiver interventions. Round 2 is designed to determine preliminary consensus of the importance of factors generated in round 1. The panel will be asked to rate each factor using a 4-point Likert-type scale. The option for panellists to state reasoning for their rating will be provided. Descriptive statistics (median scores and IQR) will be calculated to determine each item's relative importance. Levels of consensus will be assessed based on a predefined consensus rating matrix. In round 3, factors will be recirculated including aggregate group responses (statistics and comment summaries) and panellists' own round 2 scores. Panellists will be invited to reconsider their judgements and resubmit ratings using the same rating system as in round 2. This will result in priority lists based on the panel's total rating scores. ETHICS AND DISSEMINATION Ethics for this study has been gained from the Deakin University Human Ethics Advisory Group. It is anticipated that the results will be published in peer-reviewed journals and presented in a variety of forums.
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Affiliation(s)
- Sarah-May Blaschke
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Patricia M Livingston
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Sanchia Aranda
- Cancer Council Australia, Sydney, New South Wales, Australia
| | - Anna Boltong
- Victorian Comprehensive Cancer Centre, Parkville, Victoria, Australia
| | - Penelope Schofield
- Department of Psychology, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Suzanne K Chambers
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Meinir Krishnasamy
- Victorian Comprehensive Cancer Centre, Parkville, Victoria, Australia
- Centre for Cancer Research, University of Melbourne, Parkville, Victoria, Australia
| | - Anna Ugalde
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Al-Yateem N, Al-Tamimi M, Brenner M, Al Tawil H, Ahmad A, Brownie S, Slewa-Younan S. Nurse-identified patient care and health services research priorities in the United Arab Emirates: a Delphi study. BMC Health Serv Res 2019; 19:77. [PMID: 30696446 PMCID: PMC6350356 DOI: 10.1186/s12913-019-3888-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 01/08/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The need for improved research on ill health has been recognized internationally and locally in the United Arab Emirates (UAE). The UAE Nursing and Midwifery Council recently committed to enhancing the status and contributions of nursing in healthcare research across the UAE by establishing a National Committee for Research Development. This study using a Delphi method to identify research priorities from the perspective of nurses delivering frontline healthcare. METHODS A two-phase Delphi design was implemented with 1032 nurses participating in phase one of the study and 1339 in phase two. RESULTS The most important priority was patient safety and healthcare professionals' awareness of international patient safety goals (including staffing levels and shift length) and potential effects on patient safety. Other important priorities were infection control practices and management of communicable diseases. CONCLUSIONS These priorities may inform nursing research programs to improve patient care and health outcomes in the UAE and similar contexts worldwide.
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Affiliation(s)
- Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, P.O.B 27272, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- School of Nursing, Midwifery and Indigenous Health, Faculty of Science, Charles Sturt University, Orange Campus, Orange, NSW Australia
| | - Muna Al-Tamimi
- Department of Nursing, College of Health Sciences, University of Sharjah, P.O.B 27272, Sharjah, United Arab Emirates
| | | | - Hanan Al Tawil
- Department of Nursing, College of Health Sciences, University of Sharjah, P.O.B 27272, Sharjah, United Arab Emirates
| | - Alaa Ahmad
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Sharon Brownie
- School of Nursing and Midwifery, Aga Khan University, Karachi East Africa, Kenya
- School of Medicine, Griffith University, Griffith, Australia
- Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, UK
| | - Shameran Slewa-Younan
- Mental Health, Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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McCormack MC, Bird H, de Medici A, Haddad F, Simmonds J. The Physical Attributes Most Required in Professional Ballet: A Delphi Study. Sports Med Int Open 2018; 3:E1-E5. [PMID: 30581984 PMCID: PMC6301851 DOI: 10.1055/a-0798-3570] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/30/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022] Open
Abstract
Background It is commonly accepted that dancers are undoubtedly athletes, with ballet perhaps the most demanding dance form. No previous study has sought to define the physical attributes most desired for classical ballet by professional companies and vocational schools. These are likely to include both aesthetic features and attributes that reduce the risk of injury as well as enhance performance. Method An initial survey question using the modified Delphi technique was sent using Opinio Survey Software to a selected international expert panel. This was drawn both from those involved in selection of elite professional ballet dancers, and the international medical professionals involved in the care of dancers. The first questionnaire was open-ended to scope for all the physical attributes most favoured by the professional experts. Results There were 148 responses from the panel of international experts. In total 34 physical attributes were suggested. The 2 most recommended physical criteria for selection into the profession were overall flexibility and overall strength. These results are discussed in the context of the published literature on the mechanics, anatomy and physiology of ballet. Conclusion Flexibility and strength are the 2 features most sought after in elite ballet dancers.
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Affiliation(s)
- Moira Cameron McCormack
- Institute of Sport Exercise and Health, University College London, London, United Kingdom of Great Britain and Northern Ireland.,The Royal Ballet Company, Healthcare, London, United Kingdom of Great Britain and Northern Ireland
| | - Howard Bird
- Institute of Sport Exercise and Health, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Akbar de Medici
- Institute of Sport Exercise and Health, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Fares Haddad
- Institute of Sport Exercise and Health, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Jane Simmonds
- Institute of Sport Exercise and Health, University College London, London, United Kingdom of Great Britain and Northern Ireland
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Swan J, Carr SE, Fisher C. What are the attributes of excellence in an acute practice occupational therapist? Aust Occup Ther J 2018; 66:52-60. [PMID: 30298929 DOI: 10.1111/1440-1630.12519] [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: 07/30/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM There is anecdotal recognition within the profession that novice occupational therapists who perform well at interview do not necessarily make the best practising clinicians. Further anecdotal evidence suggests that it is difficult to tell (at interview) which occupational therapists will follow which path and whether further training can achieve excellence in existing staff. What is it that makes the difference? What attributes do those truly 'excellent' clinicians have that makes them better than others? METHOD A two-round Delphi survey was utilised and 18 expert occupational therapists were purposively recruited from Perth's three adult tertiary hospitals. Panellists rated and ranked sixteen possible attributes that could comprise excellence in an acute practice occupational therapist. RESULTS The final order of importance (from most to least) of the 16 possible attributes of excellence was determined. Communication, Self-management and Critical Thinking were found to be the three most important attributes, whereas Humility was considered the least important attribute. All attribute rankings achieved at least a low level of consensus. CONCLUSION We now have a much clearer picture of what excellence looks like in the acute practice setting, giving managers a new understanding. There is now the possibility of integrating this information into both the recruitment of new staff and the professional development of existing staff. In this way we can move forward to a future that includes the active development of occupational therapy excellence in ways that were not possible before these results were available.
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Affiliation(s)
- Jenny Swan
- Occupational Therapy, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Sandra E Carr
- Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Colleen Fisher
- Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
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Oriol-Peregrina N. Cuestionario de adherencia para las adaptaciones dietéticas en disfagia. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2018. [DOI: 10.5209/rlog.58249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Las adaptaciones de la dieta son estrategias adaptativas de compensación que se utilizan para optimizar la seguridad y la eficacia deglutoria en personas que presentan disfagia. El objetivo del artículo es presentar un Cuestionario de Adherencia para facilitar el encuentro terapéutico entre paciente y familia en cuanto al seguimiento de las orientaciones dietéticas cuando existe disfagia, dado que en la literatura no existe ningún instrumento de estas características. El cuestionario se somete a un procedimiento de consenso, método Delphi, con el objetivo de que un grupo de expertos en la materia llegue a un acuerdo sobre el mismo. Un total de 13 expertos a través de dos rondas llegan a un 100% de acuerdo en un 80% de las cuestiones presentadas sobre el contenido del Cuestionario de Adherencia. El instrumento propuesto inicialmente se modifica y mejora gracias a las opiniones de los expertos. El resultado final es un Cuestionario de Adherencia para utilizar en la práctica clínica con personas que padecen disfagia y necesitan adaptaciones en la dieta, consensuado por un grupo de expertos.
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Clinical classification criteria for nonspecific low back pain: A Delphi-survey of clinical experts. Musculoskelet Sci Pract 2018; 34:66-76. [PMID: 29367122 DOI: 10.1016/j.msksp.2018.01.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/14/2017] [Accepted: 01/05/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Nonspecific low back pain (NSLBP) is a common problem. Attempts have been made to classify NSLBP patients into homogenous subgroups. Classification systems based on identifying the underlying mechanism(s) driving the disorder are clinically useful to guide specific interventions. OBJECTIVE To establish consensus among experts regarding clinical criteria suggestive of a dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns (DPs) in NSLBP patients. STUDY DESIGN A 2-phase sequential design of a focus group and Delphi-study. METHODS A focus group with 10 academic experts was organized to elaborate on the different DPs discernible in LBP patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 DPs resulting from the focus group. RESULTS Fifteen musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating LBP patients completed the Delphi-survey. Respectively, 34 (response rate, 100.0%), 20 (58.8%) and 15 (44.12%) respondents replied to rounds 1, 2 and 3. Twenty-two 'articular', 20 'myofascial', 21 'neural', 18 'central' and 11 'sensorimotor control' criteria reached a predefined ≥80% consensus level. For example, after round 2, 85.0% of the Delphi-experts agreed to identify 'referred pain below the knee' as a subjective examination criterion suggestive for a predominant 'neural DP'. CONCLUSION These indicators suggestive of a clinical dominance of the proposed DPs could help clinicians to assess and diagnose NSLBP patients. Future reliability and validity testing is needed to determine how these criteria may help to improve physical therapy outcome for NSLBP patients.
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Blaschke S, O'Callaghan CC, Schofield P. Identifying opportunities for nature engagement in cancer care practice and design: protocol for four-round modified electronic Delphi. BMJ Open 2017; 7:e013527. [PMID: 28274965 PMCID: PMC5353255 DOI: 10.1136/bmjopen-2016-013527] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/20/2016] [Accepted: 01/05/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Opportunities to engage with nature have shown relevance in experiences of health and recovery of patients with cancer and are attracting interest in cancer care practice and design. Such healthcare innovations can widen the horizon of possible supportive care solutions but require deliberate and rigorous investigation to ensure responsible action is taken and wastage avoided. This protocol outlines a study designed to solicit knowledge from relevant experts drawn from a range of healthcare practitioners, management representatives, designers and researchers to explore levels of opinion consensus for determining opportunities for, and barriers to, providing helpful nature engagement in cancer care settings. METHODS AND ANALYSIS A 4-round modified electronic Delphi methodology will be used to conduct a structured, iterative feedback process for querying and synthesising expert opinion. Round 1 administers an open-ended questionnaire to a panel of selected, relevant experts who will consider the own recommendations of patients with cancer for nature engagement (drawn from a preceding investigation) before contributing salient issues (items) with relevance to the topic. Round 2 circulates anonymised summaries of responses back to the experts who verify and, if they wish, reconsider their own responses. Rounds 3 and 4 determine and rank experts' top 10 items using a 10-point Likert-type scale. Descriptive statistics (median and mean scores) will be calculated to indicate the items' relative importance. Levels of consensus will be explored with consensus defined as 75% agreement. ETHICS AND DISSEMINATION Ethics approval for this study was obtained from the Institution's Human Research Ethics Committee (blinded for review). It is anticipated that the results will be published in peer-reviewed journals and presented in a variety of forums.
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Affiliation(s)
- Sarah Blaschke
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Faculty of Medicine, Sir Peter MacCallum Department of Oncology, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Clare C O'Callaghan
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Palliative Care Service, Cabrini Health, Melbourne, Victoria, Australia
| | - Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Faculty of Medicine, Sir Peter MacCallum Department of Oncology, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Faculty of Health Sciences, Department of Psychology, Swinburne University of Technology, Melbourne, Victoria, Australia
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Al-Yateem N, Docherty C, Brenner M, Alhosany J, Altawil H, Al-Tamimi M. Research Priorities for School Nursing in the United Arab Emirates (UAE). J Sch Nurs 2016; 33:393-401. [PMID: 27698210 DOI: 10.1177/1059840516671783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
School nurses are challenged with more children having complex conditions, who are now surviving into school age. This is paralleled by a shift in focus of health systems toward primary care, and national efforts to develop the health-care services, especially those offered to vulnerable populations. Being at the forefront of this change, school nurses in United Arab Emirates (UAE) are finding themselves under pressure to adapt to and facilitate these changes both by improving their practice and by contributing to its underpinning evidence. A cross-sectional design was used in this study in which 370 school nurses participated, identifying 11 research priorities. The three most important, as ranked by participants, were management of children with complex health-care needs; nutrition, obesity, and lifestyle issues of schoolchildren; and managing illnesses, injuries, and emergencies in schools and provision of medical support. These priorities should direct future research activities in the field.
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Affiliation(s)
- Nabeel Al-Yateem
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,2 Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,3 Faculty of Science, School of Nursing, and Midwifery and Indigenous Health, Charles Sturt University, Orange, Australia
| | - Charles Docherty
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Maria Brenner
- 4 School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | | - Hanan Altawil
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Muna Al-Tamimi
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Hughes AM, Bouças SB, Burridge JH, Alt Murphy M, Buurke J, Feys P, Klamroth-Marganska V, Lamers I, Prange-Lasonder G, Timmermans A, Keller T. Evaluation of upper extremity neurorehabilitation using technology: a European Delphi consensus study within the EU COST Action Network on Robotics for Neurorehabilitation. J Neuroeng Rehabil 2016; 13:86. [PMID: 27663356 PMCID: PMC5035444 DOI: 10.1186/s12984-016-0192-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 09/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need for cost-effective neurorehabilitation is driving investment into technologies for patient assessment and treatment. Translation of these technologies into clinical practice is limited by a paucity of evidence for cost-effectiveness. Methodological issues, including lack of agreement on assessment methods, limit the value of meta-analyses of trials. In this paper we report the consensus reached on assessment protocols and outcome measures for evaluation of the upper extremity in neurorehabilitation using technology. The outcomes of this research will be part of the development of European guidelines. METHODS A rigorous, systematic and comprehensive modified Delphi study incorporated questions and statements generation, design and piloting of consensus questionnaire and five consensus experts groups consisting of clinicians, clinical researchers, non-clinical researchers, and engineers, all with working experience of neurological assessments or technologies. For data analysis, two major groups were created: i) clinicians (e.g., practicing therapists and medical doctors) and ii) researchers (clinical and non-clinical researchers (e.g. movement scientists, technology developers and engineers). RESULTS Fifteen questions or statements were identified during an initial ideas generation round, following which the questionnaire was designed and piloted. Subsequently, questions and statements went through five consensus rounds over 20 months in four European countries. Two hundred eight participants: 60 clinicians (29 %), 35 clinical researchers (17 %), 77 non-clinical researchers (37 %) and 35 engineers (17 %) contributed. At each round questions and statements were added and others removed. Consensus (≥69 %) was obtained for 22 statements on i) the perceived importance of recommendations; ii) the purpose of measurement; iii) use of a minimum set of measures; iv) minimum number, timing and duration of assessments; v) use of technology-generated assessments and the restriction of clinical assessments to validated outcome measures except in certain circumstances for research. CONCLUSIONS Consensus was reached by a large international multidisciplinary expert panel on measures and protocols for assessment of the upper limb in research and clinical practice. Our results will inform the development of best practice for upper extremity assessment using technologies, and the formulation of evidence-based guidelines for the evaluation of upper extremity neurorehabilitation.
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Affiliation(s)
- Ann-Marie Hughes
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Sofia Barbosa Bouças
- Department of Psychology, School of Health & Social Sciences, Buckinghamshire New University, High Wycombe, UK
| | - Jane H. Burridge
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Margit Alt Murphy
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jaap Buurke
- Roessingh Research and Development, Enschede, The Netherlands
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands
| | - Peter Feys
- REVAL- Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Verena Klamroth-Marganska
- Sensory Motor Systems Lab, Department of Health Science and Technologies, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Ilse Lamers
- REVAL- Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Gerdienke Prange-Lasonder
- Roessingh Research and Development, Enschede, The Netherlands
- Department of Mechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Annick Timmermans
- REVAL- Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Thierry Keller
- Neurorehabilitation Department, Health Division, TECNALIA Research & Innovation, Donostia-San Sebastián, Spain
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Uribe Guajardo MG, Slewa-Younan S, Santalucia Y, Jorm AF. Important considerations when providing mental health first aid to Iraqi refugees in Australia: a Delphi study. Int J Ment Health Syst 2016; 10:54. [PMID: 27594898 PMCID: PMC5009547 DOI: 10.1186/s13033-016-0087-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Refugees are one of the most vulnerable groups in Australian society, presenting high levels of exposure to traumatic events and consequently high levels of severe psychological distress. While there is a need for professional help, only a small percentage will receive appropriate care for their mental health concerns. This study aimed to determine cultural considerations required when providing mental health first aid to Iraqi refugees experiencing mental health problems or crises. METHOD Using a Delphi method, 16 experts were presented with statements about possible culturally-appropriate first aid actions via questionnaires and were encouraged to suggest additional actions not covered by the questionnaire content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥90 % of panellists as 'Essential' or 'Important'. RESULTS From a total of 65 statements, 38 were endorsed (17 for cultural awareness, 12 for cross-cultural communication, 7 for stigma associated with mental health problems, and 2 for barriers to seeking professional help). CONCLUSION Experts were able to reach consensus about how to provide culturally-appropriate first aid for mental health problems to Iraqi refugees, demonstrating the suitability of this methodology in developing cultural considerations guidelines. This specific refugee study provided potentially valuable cultural knowledge required to better equip members of the Australian public on how to respond to and assist Iraqi refugees experiencing mental health problems or crises.
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Affiliation(s)
| | - Shameran Slewa-Younan
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia
| | - Yvonne Santalucia
- Health Promotion Service, Multicultural Health, South Western Sydney Local Health District, Sydney, Australia
| | - Anthony Francis Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Dewitte V, Peersman W, Danneels L, Bouche K, Roets A, Cagnie B. Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts. ACTA ACUST UNITED AC 2016; 26:87-96. [PMID: 27507590 DOI: 10.1016/j.math.2016.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/21/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management. OBJECTIVE To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central' and 'sensorimotor control' dysfunction patterns distinguishable in patients with nonspecific neck pain. STUDY DESIGN Delphi study. METHODS A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group. RESULTS A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen 'articular', 16 'myofascial', 20 'neural', 18 'central' and 10 'sensorimotor control' clinical indicators reached a predefined ≥80% consensus level. CONCLUSION These indicators suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients.
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Affiliation(s)
- Vincent Dewitte
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 (3B3), 9000 Ghent, Belgium.
| | - Wim Peersman
- Department of Family Medicine and Primary Health Care, Ghent University, De Pintelaan 185 (6K3), 9000 Ghent, Belgium.
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 (3B3), 9000 Ghent, Belgium.
| | - Katie Bouche
- Centre for Musculoskeletal and Neurological Rehabilitation, Ghent University Hospital, De Pintelaan 185 (K7), 9000 Ghent, Belgium.
| | - Arne Roets
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 (3B3), 9000 Ghent, Belgium.
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Stakeholder involvement in establishing a milk quality sub-index in dairy cow breeding goals: a Delphi approach. Animal 2016; 10:878-91. [DOI: 10.1017/s1751731115002165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Betancourt TS, Zuilkowski SS, Ravichandran A, Einhorn H, Arora N, Bhattacharya Chakravarty A, Brennan RT. Development of the SAFE Checklist Tool for Assessing Site-Level Threats to Child Protection: Use of Delphi Methods and Application to Two Sites in India. PLoS One 2015; 10:e0141222. [PMID: 26540159 PMCID: PMC4634981 DOI: 10.1371/journal.pone.0141222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 10/05/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The child protection community is increasingly focused on developing tools to assess threats to child protection and the basic security needs and rights of children and families living in adverse circumstances. Although tremendous advances have been made to improve measurement of individual child health status or household functioning for use in low-resource settings, little attention has been paid to a more diverse array of settings in which many children in adversity spend time and how context contributes to threats to child protection. The SAFE model posits that insecurity in any of the following fundamental domains threatens security in the others: Safety/freedom from harm; Access to basic physiological needs and healthcare; Family and connection to others; Education and economic security. Site-level tools are needed in order to monitor the conditions that can dramatically undermine or support healthy child growth, development and emotional and behavioral health. From refugee camps and orphanages to schools and housing complexes, site-level threats exist that are not well captured by commonly used measures of child health and well-being or assessments of single households (e.g., SDQ, HOME). METHODS The present study presents a methodology and the development of a scale for assessing site-level child protection threats in various settings of adversity. A modified Delphi panel process was enhanced with two stages of expert review in core content areas as well as review by experts in instrument development, and field pilot testing. RESULTS Field testing in two diverse sites in India-a construction site and a railway station-revealed that the resulting SAFE instrument was sensitive to the differences between the sites from the standpoint of core child protection issues.
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Affiliation(s)
- Theresa S. Betancourt
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, United States of America
| | - Stephanie S. Zuilkowski
- Learning Systems Institute and Department of Educational Leadership and Policy Studies, Florida State University, University Center C4600, Tallahassee, FL, 32306, United States of America
| | - Arathi Ravichandran
- FXB Center for Health and Human Rights, Harvard University, 651 Huntington Avenue, Boston, MA, 02115, United States of America
| | - Honora Einhorn
- FXB Center for Health and Human Rights, Harvard University, 651 Huntington Avenue, Boston, MA, 02115, United States of America
| | - Nikita Arora
- Indian Institute of Public Health–Delhi, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurgaon, 122002, India
| | - Aruna Bhattacharya Chakravarty
- Indian Institute of Public Health–Delhi, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurgaon, 122002, India
| | - Robert T. Brennan
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, United States of America
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Lee FH, Yang YM, Huang JJ, Chang SC, Wang HH, Hsieh HF. Clinical Competencies of Emergency Nurses Toward Violence Against Women: A Delphi Study. J Contin Educ Nurs 2015; 46:272-8. [DOI: 10.3928/00220124-20150518-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 01/07/2015] [Indexed: 11/20/2022]
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McCarthy A, Moore A, Redhead L, McLaughlin P, Iorio A, Chowdary P. Development of haemophilic arthropathy of the ankle: results of a Delphi consensus survey on potential contributory factors. Haemophilia 2014; 21:116-23. [DOI: 10.1111/hae.12500] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2014] [Indexed: 12/26/2022]
Affiliation(s)
- A. McCarthy
- The Katharine Dormandy Haemophilia Centre and Thrombosis Unit; Royal Free London NHS Foundation Trust; London UK
| | - A. Moore
- Centre for Health Research; University of Brighton; Eastbourne UK
| | - L. Redhead
- School of Health Professions; University of Brighton; Eastbourne UK
| | - P. McLaughlin
- The Katharine Dormandy Haemophilia Centre and Thrombosis Unit; Royal Free London NHS Foundation Trust; London UK
| | - A. Iorio
- Clinical Epidemiology and Biostatistics Department, and Hamilton-Niagara Hemophilia Program; McMaster University; Hamilton ON Canada
- Department of Medicine; McMaster University; Hamilton ON Canada
| | - P. Chowdary
- The Katharine Dormandy Haemophilia Centre and Thrombosis Unit; Royal Free London NHS Foundation Trust; London UK
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Snape D, Kirkham J, Britten N, Froggatt K, Gradinger F, Lobban F, Popay J, Wyatt K, Jacoby A. Exploring perceived barriers, drivers, impacts and the need for evaluation of public involvement in health and social care research: a modified Delphi study. BMJ Open 2014; 4:e004943. [PMID: 24939808 PMCID: PMC4067891 DOI: 10.1136/bmjopen-2014-004943] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore areas of consensus and conflict in relation to perceived public involvement (PI) barriers and drivers, perceived impacts of PI and ways of evaluating PI approaches in health and social care research. BACKGROUND Internationally and within the UK the recognition of potential benefits of PI in health and social care research is gathering momentum and PI is increasingly identified by organisations as a prerequisite for funding. However, there is relatively little examination of the impacts of PI and how those impacts might be measured. DESIGN Mixed method, three-phase, modified Delphi technique, conducted as part of a larger MRC multiphase project. SAMPLE Clinical and non-clinical academics, members of the public, research managers, commissioners and funders. FINDINGS This study found high levels of consensus about the most important barriers and drivers to PI. There was acknowledgement that tokenism was common in relation to PI; and strong support for the view that demonstrating the impacts and value of PI was made more difficult by tokenistic practice. PI was seen as having intrinsic value; nonetheless, there was clear support for the importance of evaluating its impact. Research team cohesion and appropriate resources were considered essential to effective PI implementation. Panellists agreed that PI can be challenging, but can be facilitated by clear guidance, together with models of good practice and measurable standards. CONCLUSIONS This study is the first to present empirical evidence of the opinions voiced by key stakeholders on areas of consensus and conflict in relation to perceived PI barriers and drivers, perceived impacts of PI and the need to evaluate PI. As such it further contributes to debate around best practice in PI, the potential for tokenism and how best to evaluate the impacts of PI. These findings have been used in the development of the Public Involvement Impact Assessment Framework (PiiAF), an online resource which offers guidance to researchers and members of the public involved in the PI process.
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Affiliation(s)
- D Snape
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - J Kirkham
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - N Britten
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - K Froggatt
- Division of Health Research, Lancaster University, Lancaster, UK
| | - F Gradinger
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - F Lobban
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Jennie Popay
- Division of Health Research, Lancaster University, Lancaster, UK
| | - K Wyatt
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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Snape D, Kirkham J, Preston J, Popay J, Britten N, Collins M, Froggatt K, Gibson A, Lobban F, Wyatt K, Jacoby A. Exploring areas of consensus and conflict around values underpinning public involvement in health and social care research: a modified Delphi study. BMJ Open 2014; 4:e004217. [PMID: 24413356 PMCID: PMC3902382 DOI: 10.1136/bmjopen-2013-004217] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE There is growing interest in the potential benefits of public involvement (PI) in health and social care research. However, there has been little examination of values underpinning PI or how these values might differ for different groups with an interest in PI in the research process. We aimed to explore areas of consensus and conflict around normative, substantive and process-related values underpinning PI. DESIGN Mixed method, three-phase, modified Delphi study, conducted as part of a larger multiphase project. SETTING The UK health and social care research community. PARTICIPANTS Stakeholders in PI in research, defined as: clinical and non-clinical academics, members of the public, research managers, commissioners and funders; identified via research networks, online searches and a literature review. RESULTS We identified high levels of consensus for many normative, substantive and process-related issues. However, there were also areas of conflict in relation to issues of bias and representativeness, and around whether the purpose of PI in health and social care research is to bring about service change or generate new knowledge. There were large differences by group in the percentages endorsing the ethical justification for PI and the argument that PI equalises power imbalances. With regard to practical implementation of PI, research support infrastructures were reported as lacking. Participants reported shortcomings in the uptake and practice of PI. Embedding PI practice and evaluation in research study designs was seen as fundamental to strengthening the evidence base. CONCLUSIONS Our findings highlight the extent to which PI is already embedded in research. However, they also highlight a need for 'best practice' standards to assist research teams to understand, implement and evaluate PI. These findings have been used in developing a Public Involvement Impact Assessment Framework (PiiAF), which offers guidance to researchers and members of the public involved in the PI process.
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Affiliation(s)
- D Snape
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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Clyne W, White S, McLachlan S. Developing consensus-based policy solutions for medicines adherence for Europe: a Delphi study. BMC Health Serv Res 2012; 12:425. [PMID: 23176439 PMCID: PMC3537728 DOI: 10.1186/1472-6963-12-425] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 10/28/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-adherence to prescribed medication is a pervasive problem that can incur serious effects on patients' health outcomes and well-being, and the availability of resources in healthcare systems. This study aimed to develop practical consensus-based policy solutions to address medicines non-adherence for Europe. METHODS A four-round Delphi study was conducted. The Delphi Expert Panel comprised 50 participants from 14 countries and was representative of: patient/carers organisations; healthcare providers and professionals; commissioners and policy makers; academics; and industry representatives. Participants engaged in the study remotely, anonymously and electronically. Participants were invited to respond to open questions about the causes, consequences and solutions to medicines non-adherence. Subsequent rounds refined responses, and sought ratings of the relative importance, and operational and political feasibility of each potential solution to medicines non-adherence. Feedback of individual and group responses was provided to participants after each round. Members of the Delphi Expert Panel and members of the research group participated in a consensus meeting upon completion of the Delphi study to discuss and further refine the proposed policy solutions. RESULTS 43 separate policy solutions to medication non-adherence were agreed by the Panel. 25 policy solutions were prioritised based on composite scores for importance, and operational and political feasibility. Prioritised policy solutions focused on interventions for patients, training for healthcare professionals, and actions to support partnership between patients and healthcare professionals. Few solutions concerned actions by governments, healthcare commissioners, or interventions at the system level. CONCLUSIONS Consensus about practical actions necessary to address non-adherence to medicines has been developed for Europe. These actions are also applicable to other regions. Prioritised policy solutions for medicines non-adherence offer a benefit to policymakers and healthcare providers seeking to address this multifaceted, complex problem.
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Affiliation(s)
- Wendy Clyne
- School of Pharmacy, Keele University, Staffordshire, ST5 5BG, UK.
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Older adult mistreatment risk screening: contribution to the validation of a screening tool in a domestic setting. Can J Aging 2012; 31:235-52. [PMID: 22647665 DOI: 10.1017/s0714980812000153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
ABSTRACTThe hidden nature of older adult mistreatment renders its detection in the domestic setting particularly challenging. A validated screening instrument that can provide a systematic assessment of risk factors can facilitate this detection. One such instrument, the "expanded Indicators of Abuse" tool, has been previously validated in the Hebrew language in a hospital setting. The present study has contributed to the validation of the "e-IOA" in an English-speaking community setting in Ontario, Canada. It consisted of two phases: (a) a content validity review and adaptation of the instrument by experts throughout Ontario, and (b) an inter-rater reliability assessment by home visiting nurses. The adaptation, the "Mistreatment of Older Adult Risk Factors" tool, offers a comprehensive tool for screening in the home setting. This instrument is significant to professional practice as practitioners working with older adults will be better equipped to assess for risk of mistreatment.
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Chang AM, Gardner GE, Duffield C, Ramis MA. A Delphi study to validate an Advanced Practice Nursing tool. J Adv Nurs 2010; 66:2320-30. [DOI: 10.1111/j.1365-2648.2010.05367.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wilson D, Koziol-McLain J, Garrett N, Sharma P. A hospital-based child protection programme evaluation instrument: a modified Delphi study. Int J Qual Health Care 2010; 22:283-93. [DOI: 10.1093/intqhc/mzq025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
There is a growing emphasis on improving the quality of ending life in China today; however, Chinese professional nursing education in palliative care is limited and inconsistent, and there are no standardized formal training contents. There is a need to construct a related training mode to help Chinese nurses to improve their quality of palliative care. The objective of this study was to construct palliative-care-related training contents for Chinese clinical nurses. A total of 93 training items related to palliative care were developed by literature review. A 36-member expert panel engaged in a 2-round Delphi process to assess the importance of these 93 items and to identify any additional important elements. The expert panelists reached consensus on 69 training items that belonged to 6 modules; these were (1) 8 items for the palliative care overview, (2) 24 items for symptom care, (3) 15 items for psychological care, (4) 13 items for communication and exchange, (5) 5 items for ethics and laws, and (6) 4 items for terminal care. This study formed a 6-module training content through Delphi study, which will provide the basic guideline for Chinese nurses to establish their core competence about palliative care. The 6-module integrated training mode achieved in this study represents the core knowledge and skill that a nurse who provides palliative care in China needs to know; then the nurse can choose any module to get training according to his or her practical needs and availability, totally or separately.
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Lambe P, Bristow D. What are the most important non-academic attributes of good doctors? A Delphi survey of clinicians. MEDICAL TEACHER 2010; 32:e347-e354. [PMID: 20662569 DOI: 10.3109/0142159x.2010.490603] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Although a multiplicity of qualities and behaviours considered essential in a good doctor are identified in the profession's guidance documents, there is no consensus as to their relative importance, or indeed, agreement as to the core qualities that should be, or could be, feasibly assessed in the limited time of the typical medical school interview. AIM The aim of the study was to identify the most important generic attributes of good doctors, which can inform the content of the undergraduate medical student selection processes. METHOD The study used a Delphi survey to systematically gather the opinion of a panel of experts from a range of medical specialties as to the most important core attributes of good doctors. Additionally, a snapshot of opinion was obtained from the attendees of workshops held at a medical school educational conference. RESULTS Common core attributes of a good doctor were identified across a number of medical specialties. CONCLUSIONS Consensus among clinicians from disparate specialties can be reached as to the most important generic attributes of good doctors and can be used to inform the choice of personal qualities and behaviours examined during undergraduate medical student selection process.
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Affiliation(s)
- Paul Lambe
- Peninsula College of Medicine and Dentistry, University of Plymouth, UK.
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Butler MM, Meehan TC, Kemple M, Drennan J, Treacy M, Johnson M. Identifying research priorities for midwifery in Ireland. Midwifery 2009; 25:576-87. [PMID: 18068280 DOI: 10.1016/j.midw.2007.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Revised: 07/06/2007] [Accepted: 08/20/2007] [Indexed: 11/26/2022]
Abstract
OBJECTIVE to identify research priorities for midwifery in Ireland in the short, medium and long term. METHOD a three-round Delphi survey design was used to identify midwifery research topics. Issues identified through content analysis formed Questionnaires 2 and 3. Participants rated the importance of each topic (1=low importance to 7=high importance), and a mean score of 6.0 or more was considered a priority issue. A final discussion group set short-, medium- or long-term timeframes for the research topics. PARTICIPANTS 334 midwives were recruited from a national invitation to all midwives. Response rates were 43% (Round 1; 142/334), 85% (Round 2; 121/142) and 81% (Round 3; 98/121). Nine consumers of maternity services were included in the discussion group workshop. FINDINGS participants identified 11 clinical, eight management, and seven education midwifery research topics with six high-priority issues: promoting woman-centred care (management), promoting the distinctiveness of midwifery (education), satisfaction with care (clinical), care in labour (clinical), preparation for practice (clinical), and promoting research/evidence-based practice (education). KEY CONCLUSIONS this research sought to achieve consensus amongst a representative sample of midwives on the priorities for midwifery research in Ireland. Midwives can now select topics for graduate or other research studies of importance to practice, management and education. Funding agencies can confidently direct the allocation of national and local funding for priority areas of midwifery research within Ireland.
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Affiliation(s)
- Michelle M Butler
- School of Nursing, Midwifery and Health Systems, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.
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Pulford J, Adams P, Sheridan J. Developing a Clinical Assessment Model Suited to use in an Agency Providing Short-Term Substance use Treatment: Findings from a Delphi Survey of Expert Opinion. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2009; 36:322-30. [DOI: 10.1007/s10488-009-0223-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Accepted: 04/15/2009] [Indexed: 11/28/2022]
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Lestage C, Dubuc N, Bravo G. Identifying characteristics of residential care facilities relevant to the placement process of seniors. J Am Med Dir Assoc 2008; 9:95-101. [PMID: 18261701 DOI: 10.1016/j.jamda.2007.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 08/15/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify which characteristics of the physical and organizational environments of residential care facilities (RCFs) need to be known to support the placement process of seniors with cognitive and physical disabilities. DESIGN We used a 2-round postal Delphi survey based on the RAND/UCLA Appropriateness Method with 2 groups of experts. PARTICIPANTS Participants are representatives of concerned stakeholder groups from various sectors (public, private, and community) and geographical regions within the province of Quebec, Canada. RESULTS Of the 58 persons who were interested in participating, 48 (82.8%) returned their questionnaires. The first group identified 171 items essential to consider when a cognitively impaired senior needs to move into an RCF. Of these, 88 were related to the physical environment of the RCF and 83 to its organizational environment. The second group identified 146 items to be relevant to consider when a senior with physical impairments needs to choose an RCF; 75 for the physical and 71 for the organizational environment. 85% of the items selected by both groups (cognitive versus physical group) were identical. CONCLUSION This study provided a list of important items that described residential care facilities in regard to their physical and organizational environments to support the placement process of seniors. It also provides the possibility to develop a self-administered tool that will supply valuable information to seniors and their relatives, to health care professionals, and to administrators and decisions-makers.
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Affiliation(s)
- Catherine Lestage
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada.
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32
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Drennan J, Meehan T, Kemple M, Johnson M, Treacy M(P, Butler M. Nursing Research Priorities for Ireland. J Nurs Scholarsh 2007; 39:298-305. [DOI: 10.1111/j.1547-5069.2007.00184.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Holey EA, Feeley JL, Dixon J, Whittaker VJ. An exploration of the use of simple statistics to measure consensus and stability in Delphi studies. BMC Med Res Methodol 2007; 7:52. [PMID: 18045508 PMCID: PMC2216026 DOI: 10.1186/1471-2288-7-52] [Citation(s) in RCA: 220] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Accepted: 11/29/2007] [Indexed: 12/15/2022] Open
Abstract
Background The criteria for stopping Delphi studies are often subjective. This study aimed to examine whether consensus and stability in the Delphi process can be ascertained by descriptive evaluation of trends in participants' views. Methods A three round email-based Delphi required participants (n = 12) to verify their level of agreement with 8 statements, write comments on each if they considered it necessary and rank the statements for importance. Each statement was analysed quantitatively by the percentage of agreement ratings, importance rankings and the amount of comments made for each statement, and qualitatively using thematic analysis. Importance rankings between rounds were compared by calculating Kappa values to observe trends in how the process impacts on subject's views. Results Evolution of consensus was shown by increase in agreement percentages, convergence of range with standard deviations of importance ratings, and a decrease in the number of comments made. Stability was demonstrated by a trend of increasing Kappa values. Conclusion Following the original use of Delphi in social sciences, Delphi is suggested to be an effective way to gain and measure group consensus in healthcare. However, the proposed analytical process should be followed to ensure maximum validity of results in Delphi methodology for improved evidence of consensual decision-making.
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Affiliation(s)
- Elizabeth A Holey
- School of Health and Social Care, University of Teesside, Middlesbrough, TS1 3BA, UK.
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Wilde VE, Ford JJ, McMeeken JM. Indicators of lumbar zygapophyseal joint pain: survey of an expert panel with the Delphi technique. Phys Ther 2007; 87:1348-61. [PMID: 17684091 DOI: 10.2522/ptj.20060329] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND PURPOSE The lumbar zygapophyseal joints (LZJs) are thought to be a source of low back pain (LBP); however, no valid or reliable indicators exist. The purpose of this study was to obtain a consensus from an expert panel on the indicators of LZJ pain. SUBJECTS A multidisciplinary panel of 20 experts in the field of LBP participated in this study. METHODS A 3-round Delphi survey designed to obtain a consensus on the indicators of LZJ pain was completed by use of accepted protocols. Subjects also were asked to justify their selection of each indicator. RESULTS Following the 3 rounds, consensus was achieved, and 12 indicators were identified. Those that reached the highest levels of consensus were a positive response to facet joint injection, localized unilateral LBP, positive medial branch block, pain upon unilateral palpation of the LZJ or transverse process, lack of radicular features, pain eased by flexion, and pain, if referred, located above the knee. Justifications for the experts' selection of the indicators, predominantly based on pathoanatomical mechanisms, also were described. DISCUSSION AND CONCLUSION This Delphi survey identified 12 indicators of LZJ pain, each with an associated pathoanatomical mechanism justifying selection. This survey provides preliminary validation for these indicators, which will be of value in further research into the classification and treatment of LZJ pain.
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Affiliation(s)
- Viktoria E Wilde
- School of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria 3010, Australia.
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35
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Baker JA, Lovell K, Harris N, Campbell M. Multidisciplinary consensus of best practice for pro re nata (PRN) psychotropic medications within acute mental health settings: a Delphi study. J Psychiatr Ment Health Nurs 2007; 14:478-84. [PMID: 17635256 DOI: 10.1111/j.1365-2850.2007.01112.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
There is a limited evidence base for the use of pro re nata (PRN) 'as required' psychotropic medication within acute mental health settings. This study aimed to explore expert opinion concerning issues and best practice for the prescribing and administration of psychotropic PRN medications within acute inpatient mental health settings. Eighteen experts participated in three Delphi rounds of a modified Delphi panel to establish consensus. A total of 271 items were initially generated from four questions. As a result of the consensus process the number of items retained reduced to 78, then 34 items and finally 13 items. Clinicians' practice could be informed by the 13 recommendations established by the Delphi panel. Further research is required to establish the clinical effectiveness of these recommendations.
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Affiliation(s)
- J A Baker
- School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK.
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36
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O'Brien AP, Boddy JM, Hardy DJ. Culturally specific process measures to improve mental health clinical practice: indigenous focus. Aust N Z J Psychiatry 2007; 41:667-74. [PMID: 17620163 DOI: 10.1080/00048670701449211] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE In New Zealand and Australia, a renewed emphasis on equity and efficiency in the provision of mental health care has seen outcomes-focused, culturally appropriate clinical practice become essential within mental health services. Ascertaining the degree to which quality improvement and monitoring systems are enhancing professional practice and patient outcomes, however, is hindered by the difficulty of measuring the process of quality care delivery. METHOD This paper argues that it is the process of care delivery (i.e. what clinicians do to, and for, patients) that is critical to the effectiveness of treatment and the degree to which treatment either inhibits or promotes an improvement in mental health recovery. Identification of the underlying causes of poor achievement of process factors is likely to positively impact on things such as readmission rates, shared care initiatives, and ultimately patient recovery. Such attention could be the difference between low-quality service provision and a high-quality service provision with positive recovery outcomes for patients. RESULTS Ascertaining the degree to which quality improvement and monitoring systems are enhancing professional practice and patient outcomes for indigenous people, however, is hindered by the difficulty of measuring such concepts. Australia has indeed embraced 'culturally appropriate' practice in recent years, but this appears to be piecemeal when compared with New Zealand. Certainly, there are inconsistent and variable approaches to cultural practices with indigenous people when comparing the two countries. CONCLUSIONS Using evidence from a bicultural mental health nursing study that developed and validated generic and Mâori-specific (indigenous) clinical indicators for mental health nursing standards of practice in New Zealand, it is argued that the process of care delivery is equally as important as outcome measures when ascertaining the effectiveness of nursing care. Second, this paper contends that accurate process measures must be culturally responsive to indigenous and other ethnic groups.
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Affiliation(s)
- Anthony P O'Brien
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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37
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Abstract
The purpose of this Delphi study was to describe the process of innovative teaching in the baccalaureate nursing classroom, based on the consensus of expert nurse educators (n = 28). Round 1 involved a semi-structured survey that required participants to identify essential components of, facilitators of, and barriers to innovative teaching. Content analysis of the responses was used to construct the 62-item Round 2 survey in which participants ranked the importance of each item using a 7-point, Likert-type scale. The Round 3 survey included the same items and provided the median scores of the participants' own and other experts' responses. The highest-ranked essential components were faculty open, seeking new ideas; faculty motivation, commitment, and enthusiasm; and open and effective student-faculty communication. The highest-ranked facilitators were effective communication with students, faculty motivation and enthusiasm for change, and faculty satisfaction with innovative teaching. Faculty attitudes, fears, and lack of knowledge of innovative teaching were the highest-ranked barriers to innovative teaching in the nursing classroom.
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Affiliation(s)
- Kathleen A Schell
- School of Nursing, College of Health Sciences, University of Delaware, Newark, Delaware, USA.
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38
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Maclellan DL, Berenbaum S. Dietitians’ Opinions and Experiences Of Client-Centred Nutrition Counselling. CAN J DIET PRACT RES 2006; 67:119-24. [PMID: 16968559 DOI: 10.3148/67.3.2006.119] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: The concept of “client-centredness” was explored within a nutrition counselling relationship. Methods: A two-round reactive Delphi survey was used. The first survey was sent to 65 Dietitians of Canada members who indicated in the member database that they had advanced counselling skills. Following analysis of the data, the secondround questionnaire was developed and sent to participants with a report of the first-round results. Analysis of the secondround survey indicated that participants’ responses had remained stable, and the Delphi survey was terminated. Results: Participants agreed that most of the issues identified in the Delphi questionnaire should be included in a client-centred approach to practice; however, when participants were asked about their experience in these areas, median responses and/ or the interquartile ranges changed, indicating some difficulty in implementing the client-centred approach. Comments also indicated that the reality of their workplaces did not allow participants to be as client-centred as they thought they should be, and suggested that the concept of “client-centredness” is not universally understood by dietitians. Conclusion: If a client-centred approach to practice is truly important, we need to start a dialogue within the profession to gain a deeper understanding of what this means and how it can be implemented.
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Affiliation(s)
- Debbie L Maclellan
- Department of Family and Nutritional Sciences, University of Prince Edward Island, Charlottestown, PEI
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39
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Efstathiou N, Ameen J, Coll AM. Healthcare providers' priorities for cancer care: A Delphi study in Greece. Eur J Oncol Nurs 2006; 11:141-50. [PMID: 16914376 DOI: 10.1016/j.ejon.2006.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2006] [Revised: 06/22/2006] [Accepted: 06/26/2006] [Indexed: 11/21/2022]
Abstract
Cancer is a major problem globally and effective cancer care services are needed to lessen its burden on the community. In Greece, oncology health services provision is not located efficiently, resulting in few patients receiving high-quality care. Furthermore, shortages of health professionals and underdeveloped services such as primary care, home care and palliative care have aggravated the problem. The absence of a national cancer registry means that the extent of cancer incidence cannot be evaluated effectively. Dissatisfaction with the Greek NHS is well established, despite the reforms proposed by consecutive Greek governments. It remains that limited research exists in the area of cancer services and cancer care. The aim of this study was to identify the key areas of cancer care and services that needed to be developed or improved in Greece and their prioritisation within the Greek healthcare system. A Delphi technique was used to collect data from a sample of 30 healthcare providers, in three rounds. The response rate for each round was over 77%. The priorities for healthcare providers were focused on staff shortages, working conditions, pain management, home care, day units and communication. Based on the priorities provided by the participants and supporting literature, it is suggested that a national cancer registry, the employment of nurses to develop primary care, home care, day care and palliative care services need to be established. Furthermore, education in communication skills and the redistribution of the bio-medical technology are needed in order to provide more effective cancer services in Greece. More research is needed to validate the actual level of cancer services provided in Greece.
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Affiliation(s)
- Nikolaos Efstathiou
- Faculty of Health, Department of Health Professions, UCE Birmingham, England, UK.
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40
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Kemple M. Commentary on Irvine (2005) Exploring district nursing competencies in health promotion: the use of the Delphi technique. Journal of Clinical Nursing14, 1-11. J Clin Nurs 2006; 15:652-3. [PMID: 16629978 DOI: 10.1111/j.1365-2702.2006.01417.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mary Kemple
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
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O'Brien AP, Boddy JM, Hardy DJ, O'Brien AJ. Clinical indicators as measures of mental health nursing standards of practice in New Zealand. Int J Ment Health Nurs 2004; 13:78-88. [PMID: 15318902 DOI: 10.1111/j.1440-0979.2004.00322.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritized in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 District Health Board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. We discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
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Affiliation(s)
- Anthony P O'Brien
- Southern Cross University, School of Nursing and Health Care Practices, Port Macquarie Base Hospital, Wrights Road, Port Macquarie, NSW 2444, Australia.
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