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Otter CEM, de Man-van Ginkel JM, Keers JC, Smit J, Schoonhoven L. 'Towards a conceptualization of nurses' support of hospitalised patients' self-management-A modified Delphi study'. J Clin Nurs 2024. [PMID: 38433362 DOI: 10.1111/jocn.17066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/29/2023] [Accepted: 01/10/2024] [Indexed: 03/05/2024]
Abstract
AIM To determine patients', nurses' and researchers' opinions on the appropriateness and completeness of the proposed conceptualization of nurses' support of hospitalised patients' self-management. DESIGN A modified Delphi study. METHODS We conducted a two-round Delphi survey. The panel group consisted of patients, nurses and researchers. The conceptualization of nurses' support of hospitalised patients' self-management presented in the first Delphi round was based on previous research, including a scoping review of the literature. Data was analysed between both rounds and after the second round. Results are reported in accordance with the guidance on Conducting and Reporting Delphi Studies (CREDES). RESULTS In the first round all activities of the proposed conceptualization were considered appropriate to support the patients' self-management. Panel members' comments led to the textual adjustment of 19 activities, the development of 15 new activities, and three general questions related to self-management support during hospitalisation. In the second round the modified and the newly added activities were also deemed appropriate. The clarification statements raised in the first Delphi round were accepted, although questions remained about the wording of the activities and about what is and what is not self-management support. CONCLUSION After textual adjustments and the addition of some activities, the proposed conceptualization of nurses' support in patients' self-management while hospitalised have been considered appropriate and complete. Nevertheless, questions about the scope of this concept still remains. The results provide a starting point for further discussion and the development of self-management programs aimed at the hospitalised patient. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE The results can be considered as a starting point for practice to discuss the concept of nurses' support for hospitalised patients' self-management and develop, implement and research self-management programs specific for their patient population. REPORTING METHOD Results are reported in accordance with the guidance on Conducting and Reporting Delphi Studies (CREDES). PATIENT OR PUBLIC CONTRIBUTION Patients were involved as expert panellist in this Delphi study. Impact statement What problem did the study address? Self-management support during hospitalisation is understudied, which undermines the development of evidence-based interventions. What were the main findings? A panel, consisting of patients, nurses and researchers, agreed on the appropriateness of a conceptualization of nurses' support of inpatients' self-management, and identified some points for discussion, mainly related to the boundaries of the concept self-management. Where and on whom will the research have an impact? This study is crucial for generating conceptual understanding of how nurses support patients' self-management during hospitalisation. This is necessary for policy, clinical practice, education, and research on this topic.
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Affiliation(s)
| | - Janneke M de Man-van Ginkel
- Julius Centre for Health Sciences and Primary Care, Nursing Science, University Medical Centre Utrecht, University Utrecht, Utrecht, The Netherlands
- Academic Nursing, Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Joost C Keers
- Regional Public Health Services, Utrecht, The Netherlands
| | - Jakobus Smit
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Lisette Schoonhoven
- Julius Centre for Health Sciences and Primary Care, Nursing Science, University Medical Centre Utrecht, University Utrecht, Utrecht, The Netherlands
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
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Moreels T, Cruyt E, De Baets S, Andries L, Arts-Tielemans M, Rodriguez-Bailon M, Bergström A, Boete K, Bormans I, Costa U, Declercq H, Dekelver S, Dekyvere V, Delooz E, Engels C, Helderweirt S, Jarrey M, Lenaerts A, Leyman A, Lim KH, Meynen L, Satink T, Schoenmakers F, Senn D, Slembrouck L, Van Meensel E, Vangenechten D, Van Paepeghem B, De Vriendt P, Van de Velde D. Self-Management Analysis in Chronic Conditions (SMACC) checklist: an international consensus-based tool to develop, compare and evaluate self-management support programmes. BMJ Open 2023; 13:e075676. [PMID: 38128945 DOI: 10.1136/bmjopen-2023-075676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES The Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version. DESIGN A two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers' networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement. RESULTS Fifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback. CONCLUSIONS The SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable.
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Affiliation(s)
- Timothy Moreels
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Ellen Cruyt
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Stijn De Baets
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
- Department of Gerontology and Frailty in Ageing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lore Andries
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Magelien Arts-Tielemans
- Department of Occupational Therapy, HAN University of Applied Science, Nijmegen, The Netherlands
| | | | - Aileen Bergström
- Karolinska Institutet Department of Neurobiology Care Sciences and Society, Stockholm, Sweden
| | - Kyara Boete
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Iris Bormans
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Ursula Costa
- Occupational Science, Health University of Applied Science Tyrol, Tyrol, Austria
| | - Hanne Declercq
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Sari Dekelver
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Virginie Dekyvere
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Eva Delooz
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Cynthia Engels
- Clinical Epidemiology and Ageing Unit, Université Paris Est Créteil (UPEC), Créteil, France
| | - Sam Helderweirt
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Mike Jarrey
- Occupational Therapy, Artevelde University College, Ghent, Belgium
| | - Anneleen Lenaerts
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Anneleen Leyman
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Kee Hean Lim
- Department of Health Sciences, St Mary's Hospital Medical School, London, UK
| | - Louise Meynen
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Ton Satink
- Department of Occupational Therapy, HAN University of Applied Science, Nijmegen, The Netherlands
| | | | - Daniela Senn
- Occupational Therapy, ZHAW School of Health Professions, Winterthur, Switzerland
| | - Lise Slembrouck
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Emma Van Meensel
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Dani Vangenechten
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | | | - Patricia De Vriendt
- Department of Gerontology and Frailty in Ageing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Occupational Therapy, Artevelde University College, Ghent, Belgium
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