Coordination Coefficient Research Articles

Exploration of Establishing Evaluation Indicators for Hand Trauma Rehabilitation Nursing Based on Delphi Method.

This study aimed to develop an evaluation index system for hand surgery rehabilitation nursing using the Delphi method. A survey questionnaire on evaluation indicators for hand surgery rehabilitation nursing was developed, and 18 professionals including orthopedic surgeons, orthopedic nursing, and rehabilitation departments were selected. The survey was conducted using the letter method, and a database was established to screen the items, forming a hand surgery rehabilitation nursing evaluation scale. The expert's positive coefficient, authority coefficient, and coordination coefficient were analyzed, and the mean, standard deviation, coefficient of variation, and weight coefficient were calculated. Based on the correlation assignment results, the Item-level Content Validity Index (I-CVI), Scale-level Content Validity Index (S-CVI), average S-CVI, Probability of random consistency (Pc), and corrected I-CVI Kendall's coefficient of concordance (K*) were determined. In the first round of expert inquiry, a total of 18 questionnaires were distributed, and 15 valid questionnaires were collected, with an effective response rate of 83.33%. In the second round, 15 questionnaires were distributed and 15 valid questionnaires were collected, with an effective response rate of 100%. The two rounds of expert evaluations yielded judgment scores of 0.91 and 0.95, with proficiency levels of 0.83 and 0.87 and authority coefficients of 0.87 and 0.91, respectively. The Kendall's W values for the two rounds were 0.313 and 0.224, respectively, with a statistically significant difference (p < 0.01). After screening, 23 indicators were retained, with a coefficient of variation ranging from 0.072 to 0.166. Among the third-level indicators, 12 had an I-CVI of 1.00, 4 had an I-CVI of 0.93, and 7 had an I-CVI of 0.87. The overall S-CVI was 0.80, with an average S-CVI of 0.95. The K* values for the 23 indicators ranged from 0.8662 to 1.0000. The evaluation index system for hand injury rehabilitation nursing based on the Delphi method is highly scientific, and is expected to be used to guide the clinical evaluation of hand injury rehabilitation nursing.

Constructing a Competency Training Index System in Public Health Emergencies for Community Nurses.

A competency training index system was designed in public health emergencies for community nurses. The purpose of this approach is to provide community nurses with guidelines for standardized training programs on how to respond to public health emergencies. Through semi-structured interviews, a literature review, and team discussion, the first draft of competency training index system in public health emergencies for community nurses was formed. The Delphi method was used for two rounds of expert consultation to screen, modify and determine indicators. Finally, the analytic hierarchy process was utilized to calculate the weights of indicators at all levels. A total of 15 expert consultants were included. The effective recovery rate of the two rounds of expert consultation questionnaire was 100%, the expert authority coefficient was 0.880, 0.887, and the Kendall coordination coefficient was 0.172 and 0.171 (p < 0.001). Expert opinions have determined that the final revised competency index system in public health emergencies for community nurses training consists of 2 primary indicators, 10 secondary indicators, and 46 tertiary indicators. The study has developed a competency training index system in public health emergencies for community nurses. This system can serve as a foundation for standardized training in community health service institutions. It is characterized by its high demand, scientific approach, reliability, and rationality.

Analyzing and predicting the urbanization and ecological resilience coupling and coordination of Guangdong Province

Taking 21 cities in Guangdong Province as the research object, this study quantitatively analyzes the spatiotemporal evolution of urbanization and ecological environment coupling from 2000 to 2020 using a coupling coordination model, and predicts the coordinated development of urbanization and ecological resilience coupling from 2000 to 2020 using an LSTM deep learning model. Analysis of the geographical data conveys the following observations: (1) Remotely sensed night-time luminosity data indicate a precipitous escalation in the urbanization quotient within Guangdong, with the Pearl River Delta, featuring Guangzhou and Shenzhen as hubs, exhibiting high levels of nocturnal radiance, in stark contrast to the lower and more dispersed illumination in the province’s northern latitudes. (2) Indices of ecological resilience suggest a progressive enhancement across Guangdong, with Maoming exhibiting the utmost resilience, succeeded by Jiangmen, Dongguan, Shenzhen, and Zhongshan in terms of ecological robustness. (3) The synergistic relationship between urbanization dynamics and ecological resilience metrics in Guangdong has been incrementally enhanced, with Qingyuan and Shaoguan exemplifying optimal coupling and coordination, while Zhongshan has experienced the most pronounced increment in these interdependencies. (4) The proportional advancement of urbanization and ecological resilience in the province is approaching a theoretical equilibrium state. (5) Projections based on spatiotemporal models forecast a gradual upgrade in the urban-ecological systems’ coupling and coordination coefficients from 2021 to 2025, with a general trend of incremental progression among the majority of the province’s urban centers towards a moderate level of integrated development.

Optimization Study on Stakeholder Capability Configuration in Green Construction

Green construction is considered to be a construction model that pursues high resource efficiency and the utilization of reduced environmental impacts through technological innovation and management optimization under the realization of the project’s iron triangle. The realization of its performance relies on the level of stakeholder capability configuration. To reveal the optimal capability configuration and interaction between regulators and executors, this study constructed a utility model based on a post-positivist methodology. By analyzing the optimal capability configuration and coordination levels of regulators and executors according to the practices and constraints of green construction, this study conducted a static analysis to compare the effects of marginal value on regulators’ capability input and coordination coefficients. Finally, a sensitivity analysis uncovers the changes in capability configuration interaction and coordination coefficients at different stages of green construction. The results indicate that high levels of coordination in green construction cannot be maintained in the long term; continuous capability input from regulators is required for sustained support. Only by eliminating external uncertainties, reducing the variable costs for executors in advancing green construction, and controlling their risk aversion can executors be truly motivated to promote green construction. The capability configuration of both regulators and executors adjusts with corresponding marginal values. The capability configuration of executors shows a trend of initially increasing and then decreasing as the progressive coefficient rises. The model proposed in this study ensures that the final coordination level stabilizes at a relatively high level, which is between 0.6 and 0.7. In summary, the breakthrough findings provide critical insights into green construction management, contributing to the achievement of the anticipated green construction objectives.

Construction of Preoperative Assessment Program for Day Surgery in Geriatric Cataract Patients: An Evidence-Based Delphi Study

PurposeTo construct a scientific cataract day surgery preoperative assessment program to provide a scientific assessment tool for health care providers. DesignLiterature review, two-round e-Delphi study, and quantitative studies. MethodsWith the recommended opinions of clinical practice guidelines for cataract surgery as the guiding framework, an item pool was formed on the basis of literature review and guideline content analysis, and the dimensions and items of evaluation program were determined by two rounds of correspondence consultation using Delphi expert method. Then, 315 patients from an ophthalmic hospital were selected for investigation to analyze its reliability and validity. FindingsThe positive coefficients for the 2 rounds of correspondence with experts were 100.00% and 95.83%, and the authority coefficients were 0.90 and 0.89. Kendall's coordination coefficient W values of 0.29 and 0.24 for the first and second rounds and the differences were statistically different (P < .05). The coefficient of variation was 0.14 and 0.10, respectively. The formal assessment items included 3 first-level indicators, 12 secondary-level indicators, and 48 tertiary indicators, with an overall Cronbach's coefficient of 0.66 and cumulative variance contributions of 69.19%, 65.84%, and 57.15% for the 3 first-level indicators. ConclusionThe high reliability of the preoperative cataract day surgery program compiled by applying evidence-based analysis and the Delphi method can provide scientific guidance to clinical nurses for preoperative assessment, which in turn ensures patient safety and improves the quality of patient access services.

The construction of the index system for nurses' innovation competence evaluation in China: A Delphi study

BackgroundScientific and technological innovation has become the "key variable" of national social and economic development. Nurses' innovation ability can improve the quality of patient care, thus shorten the hospital stay, reduce the medical costs, and promote the rapid development of the nursing industry. Nowadays nurses have gradually involved in various innovation, but less concerns are focus on the evaluation of nurse’s innovation competence. ObjectiveTo develop evaluation index system for nurse's innovation competence. ParticipantsEleven experts with innovation experience from different regions in China. MethodsLiterature review and qualitative interview were used to establish first version of index system. Then, a two-round Delphi expert consultation was conducted to collect opinions from 11 experts. Then the final version of nurses' innovation competence evaluation index was used in one tertiary hospital for preliminary application. ResultsThe response rate of the two rounds was more than 90%, the expert familiarity coefficient was 0.818, the judgment coefficient was 0.918, and the authority coefficient was 0.868. The two rounds of expert coordination coefficient test showed P < 0.05. The evaluation index system of nurses' innovation competence includes 4 first-level indicators, 9 second-level indicators and 36 third-level indicators. The scores of innovation production and innovation subject were the lowest among all the first-level indicators when use this index for preliminary application. ConclusionThe constructed evaluation index system of nurses' innovation competence are scientific, reliable and practical, and can be used to promote nurse's innovation competence and innovation conversion competence in clinical practice. Hospital managers should pay more attention on cultivate nurse’s innovation competence and provide resources and multi-form platforms to support the nurses with innovative ideas and willingness.

A coordination control between energy storage based DVR and wind turbine for continuous fault ride‐through

AbstractContinuous fault ride‐through (CFRT) issues often arise in wind power systems. CFRT results in continuous voltage fluctuations which is characterized by “initially decreasing and then increasing” and can significantly disrupt the normal operation of wind power systems. To mitigate CFRT related problems, one approach is the utilization of energy storage (ES) based dynamic voltage restorers (DVRs). Nevertheless, the prohibitive costs and substantial ES requirements hamper practical implementation. In this article, a control scheme incorporating adaptive mode switching and coordinated control is proposed. First, the adaptive mode switching control leverages the advantages of two DVR compensation methods to reduce the injected voltage amplitude. The mode switching is activated by the DC link voltage and utilizes the PQR transformation to unlock the phase‐locked loop (PLL). Subsequently, an adaptive coordination coefficient is introduced, which considers the margin of ES regulation power and rotor inertia, to maintain power balance during CFRT. This proposed control strategy not only enables wind turbines to seamlessly ride through continuous faults without disconnecting from the grid but also leads to a reduction in the ES compensation requirement. To validate the effectiveness of the proposed approach, simulations based on Simulink and hardware‐in‐loop (HIL) experiments are conducted.

Construction of indicators for evaluating the quality of extended care for children with asthma

Background and aims To construct a set of scientific and effective quality evaluation indicators of continuing care for children with asthma, and to promote the development of continuing care for children with asthma toward a more specialized and standardized direction. Methods Through literature research and semi-structured interview, the item pool of evaluation index was drawn up, and the first draft of expert inquiry questionnaire was formed based on the three-dimensional quality theoretical model of structure-process-result, and the construction of quality evaluation index was completed through two rounds of expert inquiry and analytic hierarchy process. Results The effective recovery rate was 94.44% in the first round and 100.00% in the second round, the expert authority coefficient was 0.852 and 0.863, and the Kendal coordination coefficient was 0.129 and 0.126, respectively (p < 0.01). Finally, the evaluation index of continuing care quality for children with asthma was formed, including 3 first-level indicators, 9 s-level indicators and 36 third-level indicators, and then the weight and combination weight of each index were obtained by AHP. Conclusions The evaluation index of continuing care quality for children with asthma is scientific and specific, which is of great significance to the improvement of continuing care quality for children with asthma.

Construction of sensitive quality indicators for rapid rehabilitation care of patients after combined pancreaticoduodenectomy

AimTo construct evidence-based sensitive quality indicators for patients’ rapid rehabilitation care after combined pancreaticoduodenectomy (PD) and to provide a reference for clinical nursing professionals to scientifically evaluate the quality of patients’ rehabilitation post-PD.BackgroundSince PD is associated with higher surgical risk and anastomotic complications, it leads to higher complication rates and longer postoperative recovery cycles. This reiterates the need for rapid recovery of patients after PD; however, the evaluation of sensitive nursing care indicators regarding rapid recovery post-PD has not yet been established to date.MethodsBased on the Donabedian structure-process-result theory model, we used available literature, semi-structured interviews, the Delphi method, and hierarchical analysis to establish a sensitive indicator system for patients’ rapid rehabilitation after PD and evaluate the importance of such indicators.ResultsThere were two rounds of expert correspondence, and the effective recovery rate of the questionnaires of these rounds was 100%. The expert authority coefficients, as well as the Kendall coordination coefficients of the expert opinions, were 0.859 and 0.872 as well as 0.423 and 0.431, with statistically significant differences (p < 0.05), respectively. Consequently, we developed a sensitive quality index system for patients’ rapid rehabilitation care after combined PD, including 3 first-level, 12 s-level, and 23 third-level indexes, respectively.ConclusionThe constructed sensitive quality index system developed for patients’ rapid rehabilitation nursing care after combined PD is standardized, practical, and aligned with the specialty characteristics. Furthermore, this might help greatly in improving the quality and safety of patients’ rapid rehabilitation nursing care after combined PD, standardizing nursing management skills, and enhancing nursing quality.

The sensitivity outcome index system for home care of elderly liver transplant patients was developed based on the Omaha problem classification system

ObjectiveBased on the Omaha problem classification system, a sensitivity outcome index system for home nursing of elderly liver transplant patients was established.MethodsThrough a comprehensive literature review and rigorous application of the Delphi method, a panel of 20 experts completed two rounds of effective letter consultation to obtain expert consensus opinions. The contents of indicators were determined based on this process, and the analytic hierarchy process was employed to confirm the weightage assigned to each indicator. Consequently, we established a sensitivity outcome index system for home care in elderly liver transplant patients.ResultsThe effective recovery rate of the questionnaire in two rounds of expert consultation was 100%, and the proportion of experts who gave opinions was 55% and 15%, respectively, indicating that the experts were highly active. The expert authority coefficients were calculated as 0.904 and 0.905, respectively, indicating a high degree of expert authority. In the second round, Kendall’s coordination coefficients for primary, secondary, and tertiary indicators were determined to be 0.419, 0.418, and 0.394 (P < 0.001), indicating that expert opinions tended to be consistent. Finally, we established a comprehensive sensitivity outcome index system comprising 4 first-level indexes, 20 s-level indexes, and 72 third-level indexes specifically designed for elderly liver transplantation patients.ConclusionThe sensitivity outcome index system of home nursing for elderly liver transplant patients can provide theoretical basis for nursing staff to build accurate individualized continuous nursing model.

Development of a Preoperative Screening Tool to Reduce Morbidity and Mortality of COVID-19-positive Hepatobiliary Patients

PurposeThis study aimed to create a preoperative risk assessment form for COVID-19-positive hepatobiliary patients to guide further prevention of complications after surgery and reduce morbidity and mortality. DesignBased on the literature, focus groups, and case studies, a multidisciplinary panel of 15 experts conducted three rounds of a Delphi study that resulted in the development of a preoperative risk assessment form to be used by healthcare professionals in the treatment of COVID-19-positive hepatobiliary patients. MethodsA preoperative risk assessment form for health professionals to use among COVID-19-positive hepatobiliary patients was developed based on literature, focus groups, and case studies. A 3-round Delphi study was conducted to validate and revise the risk assessment form using a multidisciplinary panel of 15 experts involved in hepatobiliary surgery. FindingsThe experts demonstrated high cooperation and familiarity with the research topic, with positive coefficients ranging from 93.33% to 100% and authority coefficients ranging from 0.83 to 0.86. The coordination coefficients were 0.33, 0.26, and 0.22, respectively, indicating good coordination among expert opinions. The final risk assessment form included 9 primary (first-level) indicators, 38 secondary (second-level) indicators, and 122 tertiary (third-level) indicators. ConclusionsThe preoperative risk assessment form for hepatobiliary surgery patients infected with COVID-19 is scientifically rigorous, reliable, and valid. This screening tool may be used by health providers to identify high-risk patients, prevent postoperative complications, and reduce morbidity and mortality.

Development of a marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer and undergoing chemotherapy: a modified Delphi method.

This study aimed to develop a marital self-disclosure programme to alleviate the fear of cancer recurrence in patients with gastric cancer who are undergoing chemotherapy. Delphi method. Data from available literature and stakeholder interviews were utilised to formulate the initial draft of a marital self-disclosure programme aimed to alleviate the fear of cancer recurring in patients with gastric cancer and undergoing chemotherapy. A panel of experts subsequently conducted a two-round modified Delphi method to finalise the programme. A total of 13 experts participated in the first round of consultation, while 11 experts were involved in the second round, as two experts withdrew due to unavailability. The response rates of both rounds of expert consultation were 100 and 84.62%, respectively, and the expert authority coefficients (Cr) of the programme were 0.83 and 0.84, respectively. The coordination coefficients of the expert opinions were 0.124 (χ2 = 61.214, p = 0.010) and 0.167 (χ2 = 69.668, p = 0.001) for each Delphi round. The average score of the second round was (4.545 ± 0.688) to (5.000 ± 0), with a full score ratio of 0.55-1.00. The coefficient of variation (CV) ranged from 0 to 0.031. Outcomes from both rounds of consultations were considered acceptable and credible. The finalised marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer undergoing chemotherapy consists of two parts; disclosure guidance for patients and their spouse with nine items, and the structure and themes of marital self-disclosure with 31 items. After two rounds of expert consultations, the marital self-disclosure programme for patients with gastric cancer undergoing chemotherapy is suggested to be scientifically valid and reliable. This programme is anticipated to potentially support patients and their spouses effectively by providing a reliable intervention plan focused on alleviating the fear of cancer recurrence.

Establishment and analysis of quality index system for pediatric tumor nursing.

Nursing management considers nursing quality management at its core. Evaluation indexes of nursing quality not only control nursing quality, measure work enthusiasm, and judge the difference in nursing levels but also help nurses accurately understand the satisfaction degree of patients. To analyze pediatric tumor nursing quality evaluation indexes and establish a scientific and rigorous index system of children's nursing quality. Based on the "structure-process-result" in this study, the Delphi method was used to carry out questionnaire investigations and opinion collection for domestic experts in pediatrics, pediatric oncology internal medicine, and pediatric oncology surgical care and clinical aspects two times. In addition, the Kendall coordination coefficient and analytic hierarchy process were used to determine the content of indicators at all levels, set the weight, and finally establish the quality index system of pediatric tumor nursing. The response rate of 27 experts in the first round of the questionnaire was 100%, Ca0.77, Cs,0.73, Cr0.75, and the W value of the expert coordination coefficient was 0.315. In the second round of 27 expert consultations, the reply rate was 96%, Ca0.81, Cs0.80, Cr0.805, and the specialist coordination coefficient W value was 0.369. After two rounds of consultation, the importance evaluation scores of each indicator ranged from 3.31 to 4.88 and 3.29 to 5.00, respectively, and more than 94.7% of the indicators' importance evaluation scores were higher than 3.50. Finally, 3 Level-1 indicators, 12 Level-2 indicators, and 54 Level-3 indicators are established. This study has established a simple, comprehensive, and scientific quality index system for pediatric tumor nursing, highlighted the characteristics of pediatric tumor nursing, and provided an evaluation system for specialized nursing of pediatric tumors to more standardized pediatric tumor nursing and contribute to the sustainable and scientific development of pediatric tumor nursing.

Developing integrated person-centered care quality indicators for home health agencies in Shanghai, China: A modified Delphi-analytic hierarchy process study

ObjectivesTo develop person-centered integrated care quality indicators for home health agencies in Shanghai, China. DesignThe study combined the Delphi method and the analytic hierarchy process (AHP). Material and methodsThe Delphi consultation questionnaire was distributed to experts in home healthcare in Shanghai, China. A panel of experts with experience in home healthcare in Shanghai, China, was selected. Purposive sampling was used to choose experts. In this study, ten experts were selected from within sub-fields of home healthcare, including nursing, health policy, quality improvement, person-centered care (PCC), and integrated care. ResultsThe authority coefficient (Cr) in this study was 0.835. The coordination degree of experts’ opinions, which is expressed by Kendall coordination coefficient W (a higher value, better coordination of the item), ranged from 0.352 to 0.386 (p < 0.001). The consistency ratio (CR) values for each level were less than 0.1. The quality indicator system included three first-level indicators, 15 second-level indicators, and 56 third-level indicators. ConclusionsA person-centered integrated care quality indicator system was developed for home health agencies. The findings from this study enable nurses, managers, and policymakers in home and community-based settings to evaluate person-centered integrated care quality using a robust framework. In addition, these indicators can also be used as a standardized tool to guide the development of long-term care services and supports (LTSS) for home-bound elderly.

Constructing and implementing a performance evaluation indicator set for artificial intelligence decision support systems in pediatric outpatient clinics: an observational study

Artificial intelligence (AI) decision support systems in pediatric healthcare have a complex application background. As an AI decision support system (AI-DSS) can be costly, once applied, it is crucial to focus on its performance, interpret its success, and then monitor and update it to ensure ongoing success consistently. Therefore, a set of evaluation indicators was explicitly developed for AI-DSS in pediatric healthcare, enabling continuous and systematic performance monitoring. The study unfolded in two stages. The first stage encompassed establishing the evaluation indicator set through a literature review, a focus group interview, and expert consultation using the Delphi method. In the second stage, weight analysis was conducted. Subjective weights were calculated based on expert opinions through analytic hierarchy process, while objective weights were determined using the entropy weight method. Subsequently, subject and object weights were synthesized to form the combined weight. In the two rounds of expert consultation, the authority coefficients were 0.834 and 0.846, Kendall's coordination coefficient was 0.135 in Round 1 and 0.312 in Round 2. The final evaluation indicator set has three first-class indicators, fifteen second-class indicators, and forty-seven third-class indicators. Indicator I-1(Organizational performance) carries the highest weight, followed by Indicator I-2(Societal performance) and Indicator I-3(User experience performance) in the objective and combined weights. Conversely, 'Societal performance' holds the most weight among the subjective weights, followed by 'Organizational performance' and 'User experience performance'. In this study, a comprehensive and specialized set of evaluation indicators for the AI-DSS in the pediatric outpatient clinic was established, and then implemented. Continuous evaluation still requires long-term data collection to optimize the weight proportions of the established indicators.

Screening indicators to evaluate the clinical significance of drug-drug interactions in polypharmacy among older adults with psychiatric disorders: a delphi study

BackgroundPolypharmacy is common in older adults with psychiatric disorders, but no consensus has reached about the reliable indicators evaluating the benefits and risks of drug-drug interactions (DDIs) in polypharmacy. We aimed to identify indicators suitable for evaluating the clinical significance of DDIs in polypharmacy in older adults with psychiatric disorders.MethodsThe online tools were used to distribute and collect the questionnaires. The Delphi method was applied to analyze experts’ opinions. The degree of authority and coordination of experts were analyzed using the coefficient of variation, coefficient of coordination, expert’s judgment factor, familiarity with the study content factor, and Kendall coordination coefficient. Statistical analysis was conducted using the IBM SPSS® Statistics Package version 26.0.ResultsAfter three rounds of expert consultation, five primary and eleven secondary indicators were identified. The primary “pharmacodynamic indicator” included “severity of adverse drug reactions”, “duration of adverse drug reaction”, “symptom relief”, “time to onset of symptomatic relief”, “number of days in hospital”, and “duration of medication”. The secondary “pharmacokinetic indicator” contained “dosage administered” and “dosing intervals”. The primary “patient tolerance indicator” contained one secondary indicator of “patient tolerability”. The primary indicator “patient adherence” contained one secondary indicator of “patient adherence to medication”. The primary indicator “cost of drug combination” contained one secondary indicator of “readmission”. These indicators were used to determine the clinical significance of DDIs during polypharmacy.ConclusionsThe clinical significance of drug combinations should be taken into account when polypharmacy is used in the elderly. The five primary indicators and eleven secondary indicators might be preferred to evaluate their risks and benefits. Medication management in this population requires a multidisciplinary team, in which nurses play a key role. Future research should focus on how to establish efficient multidisciplinary team workflows and use functional factors to assess DDIs in polypharmacy for psychiatric disorders.

Establishing a course to train ICU nurses on prone position mechanical ventilation: A Delphi study.

To develop a comprehensive training course for training ICU nurses in prone positioning. A mixed study combining semi-structured interviews and two rounds of Delphi surveys. We constructed a questionnaire after collecting data through a literature review and semi-structured interviews. We used the Delphi expert correspondence method to conduct two rounds of research among 17 experts in the field of critical illness. Data collection took place between May and August 2022. The effective questionnaire recovery rate was 88.2%. The expert authority coefficient was 0.876; the Kendall coordination coefficient was 0.402; the average importance score for each index ranged from 4.00 to 4.93; and the coefficient of variation for each index ranged from 0.05 to 0.19. We established 13 second-level indicators and 41 third-level indicators on prone position ventilation training according to three aspects: training contents, training methods and training assessment. The training system of prone mechanical ventilation for ICU nurses established in this study will provide an effective framework for training and evaluating the practical ability of prone mechanical ventilation for ICU nurses.

Hot deformation behavior analysis of CNT/2009Al composite with bimodal heterostructure via constructing a new processing map

Bimodal heterostructure consisted of reinforcement-rich and reinforcement-free micro-regions could significantly enhance the strength-ductility of metal matrix composites. However, it could also induce difficult controlling of the heterostructure during hot deformation processing. In this work, an innovative coordination coefficient map based on processing map was proposed to qualitatively evaluate the deformation coordination of two micro-regions within bimodal heterostructure CNT/2009Al composite under different hot compression parameters and analyze its influencing factors. The results showed that the deformation coordination of the two micro-regions was influenced by microstructure evolution as well as the stress-strain distribution between the CNT-rich and CNT-free micro-regions. At medium temperature with medium strain rate (400 °C-0.1 s−1) rather than other parameters, the deformation coordination between the CNT-rich and CNT-free micro-regions was well, and the power dissipation distribution within heterostructure conformed to the rule of mixtures. While the additional microstructure evolution at high temperature would lead to the opposite deviation trend of the calculated coordination coefficient. The abnormal grain growth at low strain rate (450 °C-0.001 s−1) and the distortion energy between the different micro-regions interfaces at high strain rate (500 °C-1 s−1) were the reasons for this phenomenon. The establishment of the new coordination coefficient map provided guidance for the analysis of the hot deformation behavior of the bimodal heterostructure CNT/2009Al composite.

Application of Delphi method and analytic hierarchy process to construct the evaluation index system of healthy enterprises

Objective: Explore the application of Delphi method and analytic hierarchy process to explore the construction of scientific, objective and comprehensive evaluation index system for healthy enterprise construction and promote the construction of healthy enterprises. Methods: In October 2022, through Delphi expert consultation and analytic hierarchy process, the indexes were screened and the weights of the indexes were determined, and the evaluation index system of healthy enterprises was established. Results: The positive coefficients of experts in the two rounds were all 100.00%, the authority coefficient of experts was 0.82, the coefficients of variation of the indexes in the two rounds were all less than 0.30. The coordination coefficients of experts in the first and second rounds were 0.64 and 0.77, respectively (P<0.001) . After two rounds of Delphi method expert consultation, a healthy enterprise evaluation index system including 4 first-level indexes, 14 second-level indexes, and 63 third-level indexes was constructed. Conclusion: The constructed health enterprise evaluation index system is highly scientific and reliable, covering the main factors of healthy enterprise construction, and providing a reliable and quantifiable basis and self-assessment basis for the establishment of healthy enterprises.

Developing a psychological care competences framework for nurses in China: a mixed methods study

BackgroundWith social transformation, rapid economic development and deepening awareness of psychological health in China, people’s demand for psychological health services is becoming increasingly urgent. A key challenge for Chinese medical organizations is to train enough qualified psychological care nurses. A greater understanding of psychological care competences (PCC) can help in clinical nurse selection, training, and assessment.ObjectiveTo develop a PCC framework for Chinese nurses and obtain a consensus on the framework among experts.MethodsA descriptive mixed methods study was designed consisting of a literature review and semi-structured interviews followed by three Delphi rounds. The experts (n = 16) involved were nurses, nursing managers and educators from nine Chinese provinces with a specific interest in psychological care. Descriptive statistics assisted in data analysis.ResultsUsing the Iceberg Model as a theoretical foundation, five main dimensions and associated subdomains were integrated from 39 chosen articles. The semi-structured interviews with 24 nursing managers and nurses confirmed all of the themes from the literature review while generating new themes, both of which were incorporated into the initial PCC framework. After three Delphi rounds, the experts reached consensus on the PCC framework, including five domains (knowledge, skills, professional ethics, personal traits, internal motivations) and 22 subdomains with connotations. The response rate (RR) values for the three rounds of consultation were 80.00%, 87.50% and 92.86%, the composite reliability (Cr) values were 0.89–0.90, and the Kendall coordination coefficients were 0.155-0.200 (P < 0.05).ConclusionsOn the basis of the Iceberg Model, literature review and qualitative research methods along with Delphi technique were used to develop a scientific and systematic PCC framework. The research methods were feasible and the results were reliable, thereby providing a basis for adopting this framework into nursing education. A formal assessment tool should be developed to test the PCC of nurses in clinical practice.