Delphi Survey Research Articles

International expert perspectives on access, engagement, and implementation of cognitive remediation for schizophrenia: A Delphi study.

Cognitive remediation (CR) for schizophrenia has been extensively studied and has proven effective in improving both cognition and functioning. Yet, implementation into mental health services is poor, with implementation and engagement barriers and facilitators not understood. The present study aimed to assess expert opinions on CR barriers and facilitators that pertain to staff, mental health services, and consumers. Thirty-seven international CR experts (clinicians/researchers) responded to Likert-scale questions on implementation and engagement facilitators, essential CR components, barriers in mental health facilities, barriers for clinicians, and barriers for consumer access and engagement across three rounds of a Delphi survey. The main barriers to CR implementation were (a) lack of staff training, (b) lack of perceived relevance/lack of knowledge about cognitive deficits in schizophrenia and CR usefulness in both clinicians and consumers, as well as (c) lack of staff employed in cognitive rehabilitation roles. The presence of defeatist beliefs and difficulty in accessing the place of delivery were both barriers to consumer engagement and access. The most important facilitators for CR were a good therapeutic alliance, CR delivered as part of integrated rehabilitation services, psychoeducation provided to families and stakeholders, and CR focusing on generalization of learning to everyday life. This study highlights the barriers to CR implementation from experts. A multitude of factors were identified that need attention. It is also apparent that CR cost-effectiveness studies are needed to facilitate organizational change and national guideline recommendations for improving mental health services policy around serious mental illness/schizophrenia health care provisions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Future Trends in Angler Behavior Based on a Delphi Study in the Nordic Countries

ABSTRACTRecreational fisheries are dynamic social‐ecological systems. Identification of anticipated future trends supports the design of policies and management to deliver outcomes for fisheries resources, users, and communities. To this end, we applied a forecasting method (i.e., Delphi survey) to recreational fisheries in five Nordic countries. The survey consisted of three rounds and included 20 diverse experts from each country. The study focused on expert perceptions of future trends in angler behaviors linked to specific angling activities (e.g., gear used, species targeted), and more general behavior (e.g., social media use, stewardship). Experts unanimously expected increases in fly fishing, stewardship, and use of angling‐related technologies and social media platforms in the upcoming decade. Results can guide future research, management, and collaboration related to recreational fishing in the Nordic countries and beyond.

NCOG-17. THE COMBAT PROJECT - CORE POST OPERATIVE MORBIDITY SET FOR PAEDIATRIC BRAIN TUMOURS

Abstract BACKGROUND Brain tumours are associated with high morbidity both from the tumour and the medical and surgical interventions used to treat them. Post operative morbidity reporting following surgery for paediatric brain tumours is poor due to the lack of a common language when reporting harms. One solution is to develop a core outcome set to stipulate the minimum post operative adverse outcomes that should be reported. The COMBAT (Core Post Operative Morbidity Set for Paediatric Brain Tumours) Project will develop a core outcome set that can be applied to post operative paediatric brain tumour patients to harmonise how adverse outcomes are measured and reported, enabling comparison between different trials, studies and clinical services. We aim to generate interest in The COMBAT Project and invite participation in the project from healthcare professionals and researchers experienced in paediatric neuro-oncology for the consensus process. METHODS AND ANALYSIS We will engage with national and international stakeholders including patients and their carers, healthcare professionals and researchers. A systematic review will identify harms reported in post operative paediatric brain tumour patients and how they are measured. Qualitative interviews with patients and carers will identify any harms of importance to them. A Delphi survey will be created from the harms identified. A consensus meeting will be held to finalise the core outcome set. The final core outcome set will be published and disseminated to encourage uptake. DISCUSSION There is a clear need for a common language to harmonise measurement and reporting of harms following surgery for paediatric brain tumour patients. This project will define post operative adverse outcomes that are of critical importance to key stakeholders. It will be used to standardise surgical morbidity outcome measurement and reporting in trials, studies and clinical practice and will inform future research in this field.

A new trial monitoring plan (TMP) template for clinical trials: output from a Delphi process

BackgroundMonitoring is a crucial part of trial conduct and ensures that participants’ data is fairly represented, and future healthcare information is enhanced. This project aims to improve trial monitoring by creating a trial monitoring plan (TMP) template with input from individuals experienced in monitoring clinical trials.MethodsA review of monitoring plans received from UK Clinical Research Collaboration (UKCRC) registered clinical trials units (CTU)s created the basis for a preliminary TMP template and a Delphi survey. The TMP template was finalised after 2 rounds of a Delphi survey and a two-part consensus meeting including trialists with experience and expertise in monitoring clinical trials.ResultsWe received 31 monitoring plans from UKCRC-registered CTUs and reviewed over 800 monitoring items for inclusion in a TMP template, selecting items based on guidelines such as Good Clinical Practice (GCP) and our monitoring experiences. For certain items, further expert input was required. A total of 66 items were chosen for a Delphi survey involving 47 participants from 25 UK CTUs and industry. After the first round, all 66 items were retained, and six additional items were suggested by Delphi participants. In the second round, 37 items reached consensus for inclusion in the TMP template. The Delphi process was followed by a consensus meeting with 9 participants from 9 UK CTUs and industry. Participants in the consensus meeting voted on the 32 further items that had not reached the definition of consensus within the Delphi, regarding each item’s inclusion in or exclusion from the TMP template. The voting resulted in 18 items being excluded, leaving 14 items to be included in the TMP template. The process overall resulted in a standardised TMP template with input from many individuals with interest, experience, or expertise in monitoring clinical trials.ConclusionA TMP template was developed building on the currently used monitoring plans and with input from those experienced in clinical trial monitoring. Using a centrally developed good quality TMP template should contribute towards maintaining consistency in monitoring standards across all CTUs, resulting in higher research quality and improved quality assurance. Its use should provide reassurance to participants that their participation is carefully monitored to ensure that their data or any samples provided are treated with confidentiality, integrity, and respect and that their rights and well-being are protected.

Development and Validation of the Midwifery Interventions Classification for a Salutogenic Approach to Maternity Care: A Delphi Study

Background/Objectives: This study aims to develop and validate a Midwifery Interventions Classification (MIC), which is an evidence-based, standardized taxonomy and classification of core midwifery interventions based on a salutogenic perspective for maternity care. Methods: This study described the consensus process up to the results regarding the validation of the MIC through a two-round Delphi survey involving three panels of stakeholders: Midwives, Healthcare Researchers, and Maternity Service Users. Results: The resulting MIC comprises 135 core midwifery interventions classified into Direct Midwifery care (n = 101 interventions), Indirect Midwifery Care (n = 52 interventions), and Community Midwifery Care (n = 13 interventions), reaching an overall consensus rate among experts equal to 87%. These interventions were, therefore, adapted specifically for the Italian midwifery care context, with potential for international transferability, implementation, and scalability. Conclusions: The MIC is pivotal to boosting quality improvement, education, and comparable data collection for research, sustaining midwives’ role in promoting optimal health for women, newborns, and families at large.

Defining competencies in curriculum and instruction and developing a new competency model

This research aims to define competencies and propose a new competency model based on expert opinions. Using the Delphi technique, a qualitative research approach was employed. Data were collected through three rounds of Delphi surveys from 29 experts at universities with doctoral programmes in the field of Curriculum and Instruction (CI), who hold doctoral degrees in this area. In the first round, open-ended questions enabled experts to identify key competencies for CI. The subsequent rounds refined these competencies into a 7-point Likert scale questionnaire. Content and descriptive analysis were applied to the first round, while measures of central tendency and dispersion analysed the second and third rounds. The study culminated in a model encompassing 22 competencies: 5 in knowledge, 10 in skills, and 7 in attitudes and values. The knowledge domain includes sub-competencies such as possessing and deepening knowledge. The skills domain covers areas like teamwork and leadership, knowledge dissemination, independent working, problem-solving, and critical thinking, along with innovative and analytical thinking. The attitudes and values domain comprises professional sensitivity, lifelong learning, and commitment to ethical principles and values. This competency model aligns with the European Qualifications Framework (EQF) and the National Qualifications Framework for Higher Education in Türkiye (NQF-HETR), offering a robust framework for CI doctoral programmes. This model not only enhances the quality of CI education but also ensures alignment with international standards.

'Towards a conceptualization of nurses' support of hospitalised patients' self-management-A modified Delphi study'.

To determine patients', nurses' and researchers' opinions on the appropriateness and completeness of the proposed conceptualization of nurses' support of hospitalised patients' self-management. A modified Delphi study. 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). 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. 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. 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. Results are reported in accordance with the guidance on Conducting and Reporting Delphi Studies (CREDES). 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.

Identification of patient-reported outcomes measures (PROMs) and patient-reported experiences measures (PREMs) in Gaucher disease in Spain

BackgroundPatient-reported outcome measures (PROMs) and patient-reported experiences measures (PREMs) are crucial for understanding the impact of GD on quality of life and patient's perceptions on care, but also to guide decision-making processes. Nevertheless, no specific PREMs in GD have been published, neither PROMs for Spanish GD patients have been developed. MethodsTwo project coordinators selected key-points to be included in a PROMs/PREMs questionnaire, and the scientific committee and a group of expert patients contributed to the initial draft. Then, 9 meetings with experts were held to discuss controversial points. After, a questionnaire with 103 items regarding symptomatology, aspects of daily life and care experience was developed. Finally, it was conducted a Delphi survey among a multidisciplinary group of experts in GD. ResultsConsensus was reached on 85 out of the 103 items. Recommendations on PROMs and PREMs regarding symptomatology, aspects of daily life and care experience were obtained. Consensus was reached on the importance of considering fatigue, concentration problems, and communication issues in GD patients using 5-step analog scales. Panelists recommended asking GD patients about the impact on social functioning and work/school performance. Finally, consensus was reached on considering care experiences, such as treatment satisfaction, treatment interruptions or transitions and healthcare professionals involved in patient's management to perceive patient's perceptions. ConclusionThis expert consensus may help developing GD-specific PROMs/PREMs for improving GD management. Properly developed and validated PROMs/PREMs may help decision-making, establishing patient-tailored therapeutic and follow-up goals.

건강장애학생 원격수업에서 고교학점제 적용을 위한 델파이 연구

The purpose of this study is to explore the desirable direction and plan for applying the high school credit system when considering the specificity of remote classes for students with health impairments as special education subjects. To achieve the research objectives, an expert Delphi survey was conducted, and six elements of the application of the high school credit system were investigated and analyzed. As a result, it is agreed that the high school credit system should be applied to the education of students with health impairments. However, they were collected in the direction that it is necessary to relax or apply exceptions by applying the specificity of students with health impairments in terms of attendance rate for each subject, guaranteeing the minimum achievement level, and supplementary guidance for each non-subject, which are the criteria for promotion and graduation. Therefore, reflecting these results a plan to apply the high school credit system in the education of students with health impairments was proposed.

미래 학교 교육과정 체제로서의 다중심성 교육과정 생성·공유 체제

Objectives This study recognizes the need to explore a school curriculum system that responds to the changes brought about by the future hyper-connected networks, artificial intelligence era, and intelligent information society. As an alternative to the traditional Research, Development, and Dissemination (RDD) system of curricu-lum, we investigated the creation and sharing system of a polycentric curriculum. Methods To achieve the research objectives, we conducted two rounds of Delphi surveys with 50 education ex-perts, based on scenario construction for the future school curriculum system. Additionally, we carried out a per-ception survey targeting a total of 3,409 participants, including students, parents, teachers, and educational professionals. This was complemented by a semantic network analysis. Results The results of the first and second rounds of Delphi surveys with experts confirmed seven scenarios re-lated to the development and creation of future curricula. There was a high response rate of agreement on the an-ticipated scenarios related to curriculum development and creation in response to societal changes. Additionally, the semantic network analysis revealed that keywords such as individual student curricula, online networks, con-vergence and fusion curricula, online open markets, and digital and artificial intelligence technologies best repre-sent the characteristics of future curriculum development and creation. Conclusions In a future hyper-connected network society built on the integration of advanced digital information and artificial intelligence technologies, the traditional curriculum research, development, and dissemination sys-tem will transition to a polycentric curriculum creation and sharing system. Consequently, future curricula will be based on connected networks, establishing a unified system that will activate network-based curricula. This net-work curriculum system will form an educational ecosystem centered around educational stakeholders, function-ing through connected networks like a living organism.

Setting national nursing research priorities in Qatar: A Delphi survey.

To establish consensus on the priorities of nursing research in Qatar regarding nursing administration, nursing practice and nursing education for the years 2023-2033. Classic Delphi format over three phases. The first phase involved a qualitative round where participants identified 10 research priorities. In phase two, the collected sentences were analysed and grouped into themes. Participants were then requested to rate these sentences based on their perceived importance. During phase three, participants received their individual responses, the consolidated group response from the second round, and were given the opportunity to agree or disagree with the group ranking. The panel of experts consisted of 32 participants who agreed to participate in all three rounds. They included a mixture of nursing academics, clinical managers and nursing directors from public sectors and nursing schools in Qatar. The experts reached a consensus on the research priorities for Qatar. These prioritized topics focused on improving patient care outcomes, enhancing workforce development, strengthening nursing leadership, integrating technology to improve nursing and nursing education and promoting evidence-based practice. This research emphasizes the importance of progress in nursing to meet healthcare demands. Findings showed the need of future research to focus on improving nursing workforce and well-being, leadership styles and technology, and evidence-based practice and technology in nursing education. The impact of identifying nursing research priorities in Qatar will improve healthcare practices, fostering a culture of evidence-based care. These advancements will motivate nurses to engage more actively in research, thereby enhancing overall healthcare outcomes. Not applicable.

Development of a core predictor set of weaning in critically ill patients: a Delphi-based study protocol.

Prolonged mechanical ventilation in intensive care units (ICUs) leads to increased morbidity, higher mortality rates, and elevated healthcare costs. Predicting successful weaning from mechanical ventilation with accuracy is essential for optimizing resource use and improving patient outcomes. The International Classification of Functioning, Disability and Health (ICF) framework offers a holistic perspective on health conditions and can be adapted to identify key predictors of weaning readiness. This study aims to develop a Delphi-based core predictor set for weaning in critically ill patients, utilizing the ICF model. The core predictor set development comprises three steps: (1) Literature review and expert consultation to gather weaning predictors, (2) Predictor alignment with ICF categories per established rules, and (3) Three-round Delphi survey with a multidisciplinary team. A systematic review across major databases will be conducted to identify predictors related to weaning predictors in critically ill adults from cohort studies, trials, and reviews. Predictors will then be categorized within ICF domains. A multidisciplinary expert panel will evaluate the relevance of each predictor using a 9-point Likert scale to achieve consensus. This study will contribute to the development of a standardized, evidence-based predictor set for weaning readiness in critically ill patients. Using the ICF framework, this study aims to encompass the complex factors that influence weaning, thereby enabling personalized care plans and improving weaning outcomes. The Delphi methodology guarantees a thorough, iterative process for building consensus by integrating diverse clinical perspectives. The proposed Delphi-based study protocol aims to establish a core set of predictors for weaning in the ICU setting, guided by the ICF model. Successful implementation of this predictor set could enhance decision-making around weaning trials, reduce unnecessary ventilation days, and ultimately improve patient outcomes and healthcare efficiency. Future validation and implementation studies will be essential to confirm the utility and generalizability of this predictor set in clinical practice.

Carving out space for co-creation in implementation of evidence-based mental health interventions

Abstract Background Mental health is identified as a pressing public health priority for European countries challenged by societal changes. The ADVANCE project aims to strengthen our understanding of mental health promotion and prevention in seven countries in Europe. In Denmark, the research project sets out to understand how WHO’s stress management intervention Self Help Plus can be embedded within social and integration programmes for adults who have experienced migration. Methods We are using a common methodology across the 7 country projects oriented by co-creation with end users and relevant stakeholders to initially develop implementation scenarios and stigma reduction strategies. We will present findings from this process and reflect on the tension and potential of the co-creation methodology in the implementation of evidence-based mental health interventions. Results In the first project phase of problem analysis and co-creation, the project’s society advisory group discussed 10 tailored intervention scenarios. Then, a Delphi survey and two rounds of scenario-based workshops with additional involvement of 16 end users/actors resulted in a final implementation scenario and stigma reduction strategies. We identified and reflected on questions around ownership of the project, boundaries of the proposed intervention, alignment of expectations, and intervention sustainability within the parameters of the ADVANCE project. Conclusions Even when interventions are pre-selected in response to funding calls, co-creation can facilitate the development of acceptable and sustainable implementation strategies. However, meaningful co-creation requires time, flexibility, and negotiation, which is not always guaranteed. Key messages • Co-creation creates productive tension and potential for the implementation of ADVANCE. • Space for co-creation was negotiated with collaborators to ensure meaningful engagement.

The 1+Million Genomes Maturity Level Model for Genomics in Healthcare

Abstract The 1+Million Genomes Initiative (1+MG) has been fostering reflection in European countries on their national strategies for genomic medicine, and how these can contribute to research development and improved medical practice. For all citizens to truly benefit from genomic medicine, there must be equitable access across Europe. However, European countries are currently at different stages of implementation of genomics in medical practice. To bridge these gaps, health decision-makers need to understand the maturity of genomic medicine practices in their healthcare systems, to make informed decisions about investment, resources, and practices towards optimized adoption of genomics in healthcare systems. This presentation will focus on the 1+MG Maturity Level Model (MLM), developed in the context of the 1+MG Initiative and B1MG project. This MLM was created as a tool for countries to self-assess the maturity of genomic medicine practices in their healthcare systems, and to define a path to optimization. The MLM content was validated through a Delphi survey with international genomics and public health experts, and a pilot in real-life settings was conducted in eight European countries. The 1+MG MLM pilot provided valuable insights regarding common strengths, weaknesses, and asymmetries across Europe, highlighting the need for national and cross-European investments to close existing gaps, and make personalised medicine accessible to all citizens and patients in Europe.

Narratives, expectations, and policy criteria for a democratic and socially engaging energy transition

Energy transition policies can be translated into narratives about how energy systems should change (e.g., towards a centralised or decentralised system). These narratives tend to reflect expectations, priorities, and perceptions on feasibility and the social acceptability of different policy options, as well as long-term goals and trade-offs, all of which influence policy criteria. Taking as its case study Portugal and the implementation of European directives there, this study aims to characterise energy transition narratives (e.g. a swift transformation to renewables) and interrelated policy criteria (e.g., participation of local communities), focusing on expectations for a socially engaging and democratic energy transition. The analysis builds on the results of a Delphi survey with 10 expert stakeholders, a citizens’ survey (n=500), and a workshop with 19 participants. It identifies the most relevant criteria to stakeholders, as well as the importance of different underlying expectations, meanings, and attitudes shaping narratives about energy system futures. The findings indicate that criteria interrelated to narratives which highlight a promise of democratic energy governance may be less important for energy transition policies, and therefore undermine energy democracy goals. The conclusion highlights suggestions for policy and future research more likely to foster sociopolitical acceptance.

Mental health promotion research in co-creation: Lessons from a multisite study in six countries

Abstract Background Mounting public health threats associated with climate change, epidemiological and economic crises, digitalisation, rising migration, and population aging have uncovered at-risk groups’ increased vulnerability to mental ill health. Developing mental health promotion interventions tailored to their specific needs and expectations is essential to protect their wellbeing. However, researchers may find it challenging to identify and implement needed adaptations without engaging with end-users, and other stakeholders, to co-create tailor-made interventions. This study aimed to explore co-creators’ views about opportunities and constraints in participatory mental health promotion research. Methods Between September 2023 and July 2024, a qualitative study drawing on participant observation of bimonthly meetings and semi-structured interviews with six co-creation facilitators was conducted in the scope of Horizon Europe’s project ADVANCE. The multi-methods research approach to co-creation entailed desk reviews and online Delphi surveys co-developed with locally-established Society Advisory Groups, and scenario-based workshops held with stakeholders in the six partner countries: Denmark, Germany, Italy, Lithuania, Netherlands, Switzerland. Thematic analysis of the data was carried out. Results Research teams’ epistemic stances impact research planning, resource allocation, partnership nourishing and the unravelling of co-option risks during participatory research implementation. Research co-creation adds pressure onto research teams’ agenda, skillset and performance, but it also encourages power sharing, mutual learning and greater alignment of research design and implementation with end-users’ priorities and aspirations. Conclusions Research co-creation is a partnership-based and resource-intensive endeavour that can provide a valuable pathway to improve the relevance, acceptability and sustainability of public mental health promotion research. Key messages • Research co-creation demands planning, adequate resource allocation, flexibility and continuous investment to sustain academy-society partnerships. • Engaging stakeholders in knowledge co-creation can increase the relevance, acceptability and sustainability of public mental health promotion research.

International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy

Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts’ experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.

Policy and practice recommendations for services for disabled children during emergencies: Learning from COVID-19.

To seek consensus on recommendations for the delivery of services to disabled children in England during future emergencies. Candidate recommendations were drafted based on our related mapping review and qualitative research related to experiences during the COVID-19 pandemic. Iterative workshops with professionals and parent carers helped to refine the recommendations. A Delphi survey, rating the importance of each recommendation, was conducted with (1) parent carers of disabled children, (2) disabled young people aged 8 to 19 years, and (3) health, education, and social care professionals. A consensus meeting was convened online to discuss the findings and ratify the recommendations. Twenty-eight recommendations were included in the Delphi survey. There were 141 participants in round 1 and 91 in round 2. Seven recommendations reached the agreed consensus criteria for being critical across all stakeholder groups, while 21 recommendations did not reach consensus across all groups. Fourteen participants ratified 23 recommendations, which when aggregated and refined further produced our final 19 recommendations. Reductions in services for disabled children and their families during the COVID-19 pandemic had serious and lasting consequences. This study enabled parent carers, disabled young people, and health, education, and social care professionals to agree recommendations on services for disabled children during future emergencies.

Exploring essential features for developing a human resource management mobile application: Insights from the middle east

This study aims to investigate the key features necessary for the development of a mobile application for human resource management (HRM). It addresses the shortage of empirical studies on digital HRM in the Middle East and emphasizes the increasing importance of HRM mobile applications in the region. The research utilizes qualitative research methods, including the Delphi method, in-depth interviews, literature review, historical analysis, and critical discussion.A qualitative research strategy is employed, analyzing data from 43 HR experts and mobile app development team members from international and local businesses in the UAE and the Kingdom of Bahrain. NVivo software is used for data analysis, encompassing over 120 transcriptions, notes, and academic papers. The study identifies and explores the logical and practical features required for an HRM mobile app. It uncovers challenges related to the Delphi survey experiences, such as managing heterogeneous information and ensuring compatibility with iOS and Android platforms. This research fills a gap in the literature by investigating the digital HRM landscape and HRM mobile applications in the Middle East. It provides valuable insights from HR and technology experts, contributing to the advancement of digital HRM, mobile applications, and the application of the Delphi method methodology. The study highlights implications for industries to enhance HR operations and productivity through the adoption of mobile HR applications. Theoretical contributions include new insights into the digital HRM literature, specifically regarding the identification and discussion of essential features in HRM mobile applications. Practical implications involve the benefits of transitioning from traditional HRM to digitalized HRM in the professional era, as identified through the analyzed features of the HR app. The study offers practical insights for the development and implementation of mobile HR apps. Organizations can leverage these insights to create effective mobile HR apps that enhance HR operations and employee productivity.

Framework for Nursing Quality Assessment in Tracheotomy Dysphagia Following Craniocerebral Trauma Using the Structure-Process-Outcome Model.

This study aimed to establish a comprehensive set of nursing-sensitive quality indicators (NSQIs) for patients with dysphagia following tracheotomy due to acquired brain injury (ABI), based on the 'structure-process-outcome' model. A Delphi survey. The research utilised a mixed-methods approach, including systematic literature reviews, qualitative interviews and two rounds of Delphi expert consultations. A diverse team comprising specialists in dysphagia rehabilitation and nursing management conducted the research, which involved defining and refining NSQIs through extensive evaluations and consensus among recruited experts. The finalised NSQI includes 4 structural indicators, 13 process indicators and 4 outcome indicators, covering key aspects such as resource allocation, patient assessment and clinical outcomes. The expert consensus provides verification. Kendall's harmony coefficients are 0.304 and 0.138 (p < 0.001), respectively, and the mean importance assignments of indicators at all levels are 3.90-5.00. The final care of patients with tracheotomy and dysphagia after brain injury was constructed. The evaluation indicators include a total of 4 first-level indicators, 23 second-level indicators and 52 third-level indicators. The established NSQIs offer a systematic framework to enhance the quality of nursing care for ABI patients with posttracheotomy dysphagia. This model facilitates precise monitoring and proactive management of nursing practices, promising better patient outcomes and streamlined care processes. This study develops targeted NSQIs to improve dysphagia management in ABI patients' posttracheotomy, fostering better patient outcomes and advancing nursing education through essential specialised training. Expert-driven insights from experienced clinicians informed the NSQIs, ensuring their relevance and effectiveness in enhancing patient-centred care.