Expert Authority Coefficient Research Articles

The development of a Cancer Pain Belief Modification Program for patients with oral cancer in China: a feasibility study

BackgroundAcceptance-based pain management interventions have been receiving growing attention in cancer pain care. This study aimed to develop a cancer pain management program based on belief modification to improve the cancer pain experience of Chinese oral cancer survivors and to explore the acceptability and preliminary outcomes of the Cancer Pain Belief Modification Program (CPBMP).MethodsA mixed-methods approach was applied to develop and revise the program. The CPBMP was developed and revised using the Delphi technique, and its further improvement was explored with a one-group pre- and post-trial designed with a sample of 16 Chinese oral cancer survivors, and semi-structured interviews. Research instruments included Numeric Rating Scale (NRS), Chinese version of Illness Perception Questionnaire-Revised for Cancer Pain (IPQ-CaCP), and the University of Washington Quality of Life assessment scale (UW-QOL). Descriptive statistics, t-test, and Mann–Whitney U test were used to analyse the data. The semi-structured questions were analysed using content analysis.ResultsThe six-module CPBMP was endorsed by most experts and patients. The expert authority coefficient value was 0.75 in the first round of the Delphi survey and 0.78 in the second round. The “pain intense”, “negative pain beliefs” scores of pre- and post-testing decreased from 5.63 ± 0.48 to 0.81 ± 0.54 (t = -3.746, p < 0.001); from 140.63 ± 9.02 to 52.75 ± 7.27 (Z = 12.406, p < 0.001); and the “positive pain beliefs”, “quality of life” scores increased from 55.13 ± 4.54 to 66.00 ± 4.70 (Z = -6.983, p < 0.001); from 66.97 ± 15.01 to 86.69 ± 8.42 (Z = 7.283, p < 0.001). The qualitative data also indicated that CPBMP was well acceptable.ConclusionOur study showed the acceptability and preliminary outcomes of CPBMP patients. CPBMP improves the pain experience of Chinese oral cancer patients and provides a reference for cancer pain management in the future.Trial registrationThe feasibility study has already been registered on the Chinese Clinical Trial Registry (ChiCTR) (www.chictr.org.cn) in 11/09/2021. (ChiCTR2100051065).

Constructing an emergency preparedness evaluation index system for public use during major emerging infectious disease outbreaks: a Delphi study

BackgroundThe major emerging infectious diseases (MEIDs) have occurred frequently and become increasingly serious in the world. Sufficient personal emergency preparedness is critical for the general people in efficiently responding to and recovering from MEIDs. Nevertheless, few specific indicators are available for assessing the individual emergency preparedness of the general public during these periods. Therefore, the aim of this study was to construct an index system for comprehensively evaluating the personal emergency preparedness of the public regarding MEIDs.MethodsBased on the global national-level emergency preparedness index framework and a literature review, a preliminary index system was constructed. From June 2022 to September 2022, a panel of 20 experts from nine provinces and municipalities across multiple research areas participated in this Delphi study. They rated the importance of pre-defined indicators using a five-point Likert scale and provided their qualitative comments. According to the feedback of each round of experts, the indicators of the evaluation index system were revised.ResultsAfter two rounds of expert consultation the evaluation index system reached a consensus, containing five first-level indicators, cooperating with prevention and control work, improving emergency response capacity, securing supplies and equipment, preparing economic resources, maintaining physical and mental health with affiliated 20 s-level indicators and 53 third-level indicators. The expert authority coefficient of consultation was 0.88 and 0.90. The Kendall’s coefficient of concordance of expert consultations was 0.294 and 0.322, respectively. The differences were statistically significant (P < 0.05).ConclusionA valid, reliable and scientific evaluation index system was established. This personal emergency preparedness index system, as a precursor form, will further lay the foundation for the formation of an assessment instrument. At the same time, it could provide a reference for future education and training of emergency preparedness for the general public.

Development and validation of a NCC-BC-A scale to assess patient-reported outcomes for advanced breast cancer patients in China.

e13125 Background: The primary therapeutic objectives for advanced breast cancer (ABC) are to extend patients’ survival time and to maintain their quality of life (QoL). Patient-reported outcomes (PROs) symptom could improve communication with physicians, and decreased utilization of unplanned healthcare. However, localized PROs scales for ABC were seldomly used in China. This study aimed to develop a specific PROs scale for ABC patients in China and optimize the management model for breast cancer. Methods: A literature search was conducted in PubMed, Embase, Wanfang, and CNKI databases, and the dimensions and items of the scale in the literature were extracted for the item pool. Delphi method was used to modify, add, subtract, and adjust the language of scale items until the experts' suggestions or opinions reached a consensus, and the first draft of the scale was formed. The first draft of the scale was further optimized by cognitive test and pre-survey. The optimized scale was used for formal survey, and the items of the scale were further analyzed and screened by coefficient of variation, correlation coefficient, internal item consistency, factor analysis, reliability, and validity. All tests were two-sided tests, and the test level was α=0.05. Results: A total of 10945 articles were analyzed, and 237 were finally included to form an item pool containing 277 PRO items. Two rounds of Delphi expert consultation were conducted, and the average authority coefficient of experts was Cr&gt;0.7. Based on the results of cognitive test, the corresponding items were revised by language description to facilitate understanding. After adjustments according to the pre-survey of 200 ABC patients, the PROs scale NCC-BC-A was finally formulated with a total of 38 items, including 9 physiological dimension items, 4 psychological dimension items, 9 social dimension items, 11 treatment-evaluation items, 4 overall self-evaluation dimension items, and 1 other dimension. A total of 588 ABC patients participated in the national formal survey of NCC-BC-A with the average answer time of 6 minutes, and no floor or ceiling effects were observed. A series of statistical tests were conducted on the result. A principal component analysis revealed that the items in PROs scale have great consistency while preserving enough differences between different dimensions. The results were tested to be normally distributed with good variation. Also, the PROs scale survey result has an excellent Cronbach's α coefficient of 0.925 and an excellent test-retest reliability of 0.9041. Conclusions: The PROs scale NCC-BC-A has high validity and reliability, can objectively measure the QoL of ABC patients. NCC-BC-A fully considered the characteristics of treatment status for ABC patients, and the realistic situation in China, which may help clinicians to pay more attention to QoL of ABC patients and to optimize management system for ABC.

Development and validation of medical adhesive-related skin injury risk assessment scale at peripherally inserted central catheter insertion site in oncology patients.

To construct a risk assessment scale for medical adhesive-related skin injuries (MARSI) at the peripherally inserted central catheter (PICC) insertion site in oncology patients and test its reliability and validity. The STARD 2015 statement guided this study. Literature research and a modified Delphi method were adopted in this study. A total of 31 experts participated in two rounds of consultation to build the assessment scale. A convenient sampling method was used to select 195 oncology patients at the PICC clinic from January to June 2022. Inter-rater reliability was used to test the reliability of the scale. Validity was evaluated using the content validity index (CVI) and predictive validity. After the two rounds of consultation, the assessment scale with five dimensions and 13 primary entries and 36 secondary entries was developed, and the expert authority coefficients for both were 0.90. The inter-rater reliability was 0.968. The CVIs of the items ranged from 0.83 to 1.00. The area under the subject's work characteristic curve was 0.757, and the sensitivity and specificity of the scale were 80.0% and 65.6%, respectively, at a cutoff score of 15.5.

Construction of the Upper Limb Vocational Ability Assessment System: Based on ICF

<i>Objective</i>: To initially construct a comprehensive assessment system for upper extremity occupational competence based on the International Classification of Functioning, Disability and Health (ICF), and to provide a reference for the development of comprehensive intervention programs covering physiology, psychology, function and social participation for patients with upper extremity injuries. <i>Methods</i>: Taking the comprehensive ICF core set for vocational rehabilitation as the basic framework, using the Delphi expert correspondence method, after a two-round email-based survey with experts who are experience in clinical, vocational rehabilitation, rehabilitation, nursing. Combined with the statistical results and expert opinions, the index of the ICF upper limb vocational ability evaluation system was finally established. <i>Results</i>: The effective recovery rates of the two rounds of expert correspondence were 95% and 100%; the expert authority coefficients (Cr) were 0.807 and 0.805, and the Kendall coordination coefficients were 0.290 and 0.374 (P<0.001). The average importance value ranged from 3.52-4.48. The variation coefficients ranged from 0.103-0.222, The ICF upper limb vocational ability assessment system include 4 first-level indicators and 41 second-level indicators. <i>Conclusion</i>: The construction process of the ICF upper limb vocational ability assessment system is scientific and reliable, which promotes the clinical application and promotion of the brief version of the ICF core combination, and provides reference for the formulation of the ICF assessment combination for other diseases.

Construction of a Quality Evaluation system for Emergency Pre-examination and Triage under the Normalization of the COVID-19 Epidemic based on the SERVQUAL Model

Background: The effect of emergency epidemic prevention and control and the quality of emergency pre-testing and triage under the normalization of COVID-19 epidemics was evaluated by quality evaluation system based on the SERVQUAL model. Objectives: This study aimed to develop a quality evaluation system for emergency pre-test and triage under a normal COVID-19 epidemic, based on the SERVQUAL model. Methods: Based on the SERVQUAL model, a quality evaluation system of emergency pre-examination and triage under the normalization of the COVID-19 epidemic was developed. Two rounds of expert consultation were conducted by the Delphi method, involving 15 experts. Results: The recovery rates for the two rounds of expert consultation were 100 %, the expert authority coefficient was 0.954, and the Kendall coordination coefficients were 0.273 and 0.182. The coefficients of variation of the three-level indicators of the two rounds of expert consultation were 0.003-0.275 and 0.052-0.125, respectively. An evaluation system including 5 first-level indicators, 14 second-level indicators, and 42 third-level indicators of 5 dimensions (tangibility, reliability, responsiveness, assurance, and empathy) of the SERVQUAL model was established. Conclusion: Based on the SERVQUAL model, a quality evaluation system for emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation was completed. It reflected the medical services, triage, and epidemic prevention and control required to provide the requisite quality of emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation. It provided a reference for the quality supervision of emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation.

Development of a system of integrated assessment of efficiency of cardiac care in the Russian Federation regions

Highlights. Methodology for the development of a system of indicators for the integral assessment of effectiveness and efficiency of cardiac care (cardiovascular surgery) in the subjects of the Russian Federation is proposed and tested.Indicators, such as the length of stay, the number of operations on the heart and blood vessels, the number of ambulatory patients have high overall rating and consistency of expert opinions.Aim. To develop a system of indicators for assessment of the effectiveness of cardiac care, cardiovascular surgery in particular, in the Russian Federation regions.Methods. The study using expert surveys was conducted in the form of a structured interview. At the first stage, the primary selection of indicators was carried out using the annual public and field reports of the national medical research center. At the second stage, experts were selected and the level of expert competence was assessed. In total, out of 14 interviewed specialists, 10 were defined as experts. The average expert authority coefficient was 0.89. To quantify the degree of agreement between the experts` answers, Kendall's coefficient of concordance (W) was calculated. The significance of differences was assessed using the nonparametric Friedman test.Results. The following indicators are recommended as indicators for rating efficiency of cardiac care in the regions of the Russian Federation: mortality after heart surgery, vascular surgery and percutaneous coronary interventions; mortality from diseases of the circulatory system; the number of ambulatory patients; the ratio of the number of endovascular interventions to the total number of discharged patients who suffered from acute coronary syndrome.Conclusion. The selected indicators can be used both for the rating of the constituent entities of the Russian Federation, and in the development of federal projects or ministerial target programs. The results of the study can also be used to organize a system for monitoring the effectiveness of the implementation of these projects and programs.

Development and validation of the regarding infection prevention and control among environmental service workers on knowledge, attitudes, practise, and experience questionnaire.

This study aimed to develop and test the validity and reliability of the Knowledge, Attitudes, Practise, and Experience regarding Infection Prevention and Control-associated Questionnaire for environmental service workers. This study was a development and validation study of a questionnaire using multiple methods, including literature review, questionnaire survey, and Delphi technique. Phase I of the study entailed the development of items through an extensive literature review and two round Delphi process with 15 experts specialised in infection prevention and control, environmental service worker management, or scale construction to examine the content validity of the questionnaire. Phase II involved administering the questionnaire to a convenience sample of 1,176 environmental service workers from the public hospital from 13 provinces in China to evaluate its construct validity and reliability. In the two rounds of Delphi consultation, the recovery rate were 93.75 and 100%. Moreover, the expert authority coefficient was 0.93, and the coordination coefficients of expert opinions in the first round were as follows: correlation of 0.204 and importance of 0.249 for the first-level index; correlation of 0.128 and importance of 0.142 for the secondary index. In round two, the coordination coefficients of expert opinions were as follows: correlation of 0.221 and importance of 0.221 for the first-level indicators; correlation of 0.096 and importance of 0.101 for the secondary index. The results for the index were P < 0.05 for the two rounds. The pilot survey shows the instrument was excellent content validity (S-CVI/Ave = 0.989). The overall internal consistency was excellent (Cronbach's α = 0.967). The questionnaire ultimately comprised four first-level indices (knowledge, attitudes, practise, and experience) and 49 second-level indices. The Questionnaire demonstrated good reliability and validity and is effective in measuring levels of infection prevention and control-related knowledge, attitudes, practise, and experience among environmental service workers. It will provide a tool for future national investigations of the current infection prevention and control situation among environmental service workers. Future research should explore determinants of environmental service workers' knowledge, attitudes, practise, and experience and associations between infection prevention and control knowledge, attitudes, practises, and experience.

How to establishing an indicators framework for evaluating the performances in primary TB control institutions under the new TB control model? Based on a Delphi study conducted in Guangxi, China

BackgroundIn China, the new TB control model of trinity form had been implemented in all parts, and the comprehensively evaluation to the performances in primary TB control institutions were closely related to the working capacity and quality of TB service, but there was still no an unified evaluation indicators framework in practice and few relevant studies. The purpose of this study was to establish an indicators framework for comprehensively evaluating the performances in primary TB control institutions under the new TB control model of trinity form in Guangxi, China.MethodsThe Delphi method was used to establish an indicators framework for comprehensively evaluating the performances in primary TB control institutions under the new TB control model of trinity form, and the analytic hierarchy process(AHP) was used to determine the weights of all levels of indicators, from September 2021 to December 2021 in Guangxi, China.ResultsA total of 14 experts who had at least 10 years working experience and engaged in TB prevention and control and public health management from health committee, CDC, TB designated hospitals and university of Guangxi were consulted in two rounds. The average age of the experts were (43.3 ± 7.549) years old, and the effective recovery rate of the questionnaire was 100.0%. The average value of authority coefficient of experts (Cr) in the two rounds of consultation was above 0.800. The Kendall’s harmony coefficient (W) of experts’ opinions on the first-level indicators, the second-level indicators and the third-level indicators were 0.786, 0.201 and 0.169, respectively, which were statistically significant (P < 0.05). Finally, an indicators framework was established, which included 2 first-level indicators, 10 second-level indicators and 37 third-level indicators. The results of analytic hierarchy process (AHP) showed that the consistency test of all levels of indicators were CI < 0.10, which indicating that the weight of each indicator was acceptable.ConclusionThe indicators framework established in this study was in line with the reality, had reasonable weights, and could provide a scientific evaluation tool for comprehensively evaluating the performances in primary TB control institutions under the new TB control model of trinity form in Guangxi, China.

Development of the health literacy assessment instrument for chronic pain patients: A Delphi study.

To develop health literacy assessment instrument for patients with chronic pain. Qualitative methods based on Delphi technique, assessed against the CREDES checklist. A 2-round Delphi method was adopted in this study. The panel consisted of 19 experts. The health literacy assessment instrument for chronic pain patients was constructed, which contained 3 dimensions (functional health literacy, interactive health literacy and critical health literacy) and 41 items. The positive coefficients of two rounds Delphi were 100.00% and 89.5%, respectively. The authority coefficient of experts was 0.848 and 0.858, respectively. The coordination coefficients of dimension and items were 0.222 and 0.364, respectively. The health literacy assessment instrument dimensions and items for patients with chronic pain based on a Delphi method are valid. This instrument is suitable for investigating the health literacy level of patients with chronic pain.

Construction of early warning indicators of in-hospital cardiac arrest in adult inpatients

To establish early warning indicators for Chinese nurses to recognize in-hospital cardiac arrest (IHCA) of adult inpatients. Computer retrieval of Chinese and English databases such as CNKI, Wanfang Database, VIP, National Medical Library of the United States PubMed Database, Web of Science, Embase Database of the Netherlands Medical Abstracts, Cochrane Library Database and other international guidelines collaboration network (GIN), National Institute for Health and Clinical Optimization (NICE), Scottish Intercollegiate Guidelines Network (SIGN), BMJ best clinical practice and other guidelines was performed. The retrieval time limit for respiratory and cardiac arrest early warning indicators or risk identification related content of the adult inpatient in the professional website was until June 30, 2020. After literature research and expert group analysis, the research group drew up an expert correspondence questionnaire, and selected 32 medical and nursing experts from Beijing, Tianjin, Jilin, Shandong, Shaanxi, Sichuan, Zhejiang and other grade three first-class general hospitals from July to September 2022. The Delphi method was used to conduct two rounds of expert correspondence, forming the final version of the early warning index of cardiac arrest in adult inpatients. Five first-level indicators, 23 second-level indicators and 41 third-level indicators including vital signs, consciousness and pupils, postoperative blood drainage volume, lab results and other five aspects were initially formed. The effective response rates of the two rounds of expert correspondence were 100% (32/32) and 93.75% (30/32), respectively, the Kendall coordination coefficients W of the first round and the second round were 0.340 and 0.462, respectively, the expert authority coefficients Cr were 0.88 and 0.89, respectively, the mean value of importance assignment was 3.94-5.00, 4.07-5.00, and the coefficient of variation was 0-0.16, 0-0.14, with statistically significant differences (all P < 0.05). Finally, 5 primary indicators, 23 secondary indicators and 43 tertiary indicators were formed, including five aspects of vital signs, consciousness and pupils, postoperative blood drainage, lab results, symptoms and chief complaints. The expert consultation on the early warning indicators of IHCA for adult patients tends to be consistent and scientific, which is applicable to help nurses detect the changes of patients' condition as early as possible.

Quality indicators for the care of older adults with disabilities in long-term care facilities based on Maslow’s hierarchy of needs

PurposeThis study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities (LTCFs) based on Maslow’s hierarchy of needs. MethodsThe draft of the quality indicators was drawn up based on a literature review and research group discussion. The quality indicators were finalized by two rounds of expert consultation (involving 15 experts) using the Delphi method. The Analytic Hierarchy Process was applied to calculate the indicators’ weight. ResultsThe response rates of the two rounds of consultation were 100% and 93%, and the expert authority coefficients were 0.86 and 0.87. After two rounds of consultation, the expert opinion coordination coefficients of the first-, second- and third-level indicators were 0.42, 0.25, and 0.96, respectively (P < 0.05), and the variation coefficient was ≤0.25. The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level, 19 second-level, and 107 third-level indicators. ConclusionThe quality indicators for the care of older adults with disabilities in LTCFs are reliable, scientific, comprehensive, and practical and specify the content of person-centered care needs. This can provide a reference for evaluating and improving care quality in LTCFs.

Construction on teaching quality evaluation indicator system of multi-disciplinary team (MDT) clinical nursing practice in China: A Delphi study

AimTo construct an evaluation indicator system for nursing multi-disciplinary team (MDT) clinical practice in China and to provide quantifiable indicators for MDT clinical teaching courses. MethodsBased on relevant literature retrieval and analysis, a evaluation indicator system of nursing MDT clinical teaching quality was preliminarily constructed using the Donabedian. Structure-Process-Outcome model as theoretical guidance. Then, a final indicators content was formed after two rounds of expert consultation and Analytic Hierarchy Process (AHP) was used to determine the weight of indicators at all levels. ResultsThe effective response rate of the questionnaires in two rounds were 95.23% (20/21) and 100% (20/20) respectively, the expert authority coefficient (Cr) were 0.838 and 0.853 respectively and the Kendall's coefficient of concordance (Kendall's W) of indicators at all levels were 0.137–0.612 (P < 0.05). The final evaluation index system consisted of three one-class indicators, 8 s-class indicators and 28 third-class indicators. ConclusionThe study constructed a comprehensive set of evaluation indicator system of nursing MDT clinical practice, which was scientific and reliable and provides reference for the clinical teaching quality evaluation of MDT nursing.

Using the Delphi method to establish pediatric emergency triage criteria in a grade A tertiary women’s and children’s hospital in China

BackgroundWe aimed to establish simplified and quantifiable triage criteria in pediatric emergency care, improving the efficiency of pediatric emergency triage and ensuring patient safety.MethodsWe preliminarily determined the pediatric emergency triage criteria with references to pediatric emergency department characteristics and internationally recognized triage tools after literature review and discussion. The final determination of the triage criteria was reached after two rounds of Delphi surveys completed by18 experts from 3 hospitals in China.ResultsBoth round 1 and round 2 surveys had a 100% response rate. The overall expert authority coefficient in the two rounds of surveys was 0.872. The experts had 100% enthusiasm for participating in the surveys. Kendall’s coefficients of concordance for conditions/symptoms in patients triaged to level 1, 2, 3, and 4 were 0.149, 0.193, 0.102, and 0.266, respectively. All p-values were less than 0.05. The coefficients of variation in conditions/symptoms, vital signs, and the Pediatric Early Warning Score (PEWS) ranged between 0.00 and 0.205, meeting the inclusion criteria. The pediatric emergency triage criteria containing conditions/symptoms, vital signs, PEWS scores, and other 4 level 1 indicators, 51 level 2 indicators and 23 level 3 indicators were built. The maximum waiting time to treatment for the patients triaged to level 1, 2, 3, and 4 was immediate, within 10 min, within 30 min, and within 240 min, respectively.ConclusionThe pediatric emergency triage criteria established in this study was scientific and reliable. It can be used to quickly identify the patients requiring urgent and immediate care, thereby ensuring the priorities for the care of critically ill patients.

Developing a third-degree burn model of rats using the Delphi method

Animal experiments play an essential role in advances in the research and treatment of burns. Currently, researchers often rely on personal experience or the literature to complete the construction of animal disease models, which may lead to a lack of scientific rigor and a wide range of animal disease models with reference value. The purposes of this study were to establish a third-degree burn model of rats using the Delphi method to provide a reference. Two rounds of a Delphi expert consultation survey were conducted on experts (n = 13) in this study, and then the boundary value method was used to screen, modify and supplement the indicators. Next, the indicator weight was determined by dividing the boundary value, and finally, the index system of the rat model of third-degree burns was established. The statistical analysis results show that the positive coefficients of the two rounds of expert consultation are 100% and 88.67% respectively. The expert authority coefficient values were 0.73 and 0.67, respectively, and the expert coordination coefficient test was P < 0.001. According to the experts' suggestion, the third-degree burn model of rats with 8 first-degree indexes, 14 second-degree indexes and 46 third-degree indexes was finally established. According to the characteristics and quality requirements of animal models, this study constructs a rat model of third degree burns, which is expected to expressively improve the overall proficiency of burn research quality.

Development of humanistic nursing practice guidelines for stroke patients.

PurposeTo construct humanistic nursing practice guidelines suitable for stroke patients.DesignThis study was a development and validation study of guidelines using multiple methods, including literature review, qualitative research, questionnaire survey, thematic discussion, and Delphi expert consultation.MethodsTwenty-five experts from seven provinces and municipalities in China were interviewed over two rounds from December 2020 to February 2021. The first-level index was scored for importance and rationality, while the second-level index was scored for importance and feasibility using a five-point Likert scale. Delphi data was collected via a paper version of the questionnaire. The coefficients of variation and coordination were used to represent the degree of dispersion of expert opinions.FindingsIn the two rounds of letter consultation, the questionnaire's recovery and effective rates were both 100%, while the opinion submission rates of the two rounds were 84 and 52%, respectively. Moreover, the expert authority coefficient was 0.91, and the coordination coefficients of expert opinions in the first round were as follows: importance of 0.03 and rationality of 0.07 for the first-level index; importance of 0.09 and feasibility of 0.11 for the secondary index. In round two, the coordination coefficients of expert opinions were as follows: importance of 0.04 and rationality of 0.05 for the first-level indicators; importance of 0.12 and feasibility of 0.10 for the secondary index. The results for the secondary index were P < 0.001 for the two rounds. The humanistic nursing practice guidelines for stroke patients that were ultimately formed included five first-level indicators (physiological care, safety care, emotional care, dignity care, and rehabilitation needs) and 46 s-level indicators.ConclusionOur results show that the “Practice Guidelines for Humanistic Nursing for Stroke” established by experts adopts Maslow's hierarchy of needs as its structural framework. It meets people's basic needs and can provide a reference for the construction of a humanistic nursing specialty practice for stroke patients.Clinical relevanceHumanistic nursing guidelines for stroke could provide a reference for the construction of humanistic nursing practice in the stroke specialty.Clinical resourcesCopeptin and long-term risk of recurrent vascular events after transient ischemic attack and ischemic stroke: population-based study https://pubmed.ncbi.nlm.nih.gov/26451023/. Effectiveness and usage of a decision support system to improve stroke prevention in general practice: a cluster randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/28245247/. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association https://pubmed.ncbi.nlm.nih.gov/27145936/.

Developing a professional-practice-model-based nursing organizational informatics competency model

BackgroundThe development of nursing informatics started late in China. There is an urgent need to develop a clinical practice model that can guide nursing managers in constructing an organizational nursing informatics competency. ObjectiveThe objective of this study was to develop a nursing organizational informatics competency model based on the Professional Practice Model (PPM) and to provide a reference for training in clinical nursing informatics in hospitals. MethodsA multidisciplinary team in the hospital was first formed as the working group, consisting of nurses trained with the TIGER (Technology Informatics Guiding Education Reform) Taiwan model and had practical experience in system development. We used an exploration map to help build the prototype of the hospital nursing informatics competency model. Then, a final model was constructed by experienced out-of-hospital experts using the Delphi method. The final model was determined according to the validity analysis. ResultsTen hospital stakeholders were invited to form the multidisciplinary working team to develop the prototype organizational PPM model. Two rounds of Delphi were conducted to twelve experienced nurses' informatics experts outside the hospital by e-mail. The results showed that the questionnaire return rate was 100 %, the expert authority coefficient was 0.84, the general validity of the two rounds of content was 92.46 % and 100 %, respectively, and the coefficient of variation of all items was < 0.3. The final model included five categories, including management strategy and leadership, organizational structure and operation, improvement of the environment for nursing information practice, cultivation of core competence in nursing information, and project management of the nursing information system, with 61 elements in total. ConclusionsWe propose this model to help hospital nursing managers to establish a plan of action to build up organizational clinical informatics competency.

Multidimensional measure of instrumental support in transitional care – design and pilot test of a questionnaire assessing instrumental support among older adults with chronic diseases

BackgroundPrevious studies indicated that poor quantity and quality of instrumental support are one of the main barriers in the application of transitional care. Instrumental support, as one common function of social support, is the provision of financial assistance, material goods, or services. The purpose of our study is to develop an Instrumental Support in Transitional Care Questionnaire (ISTCQ) and use this questionnaire to make an assessment among older adults with chronic diseases.MethodsThe draft questionnaire was examined by 18 experts from different professional fields performing three rounds of content validity testing with the Delphi method. Afterward, we conducted a pilot test recruiting 174 participants as a convenience sample in Nantong, China. The construct validity was confirmed via exploratory factor analysis and reliability was assessed using Cronbach's alpha.ResultsThe authority coefficient of experts was 0.74–0.99 and Kendall harmony coefficient W was 0.381. The exploratory factor analysis indicated that the questionnaire can be interpreted by three factors: namely, anticipated support (items 1, 2, 3, 4), received support (items 5, 6, 7, 8) and support satisfaction (items 9, 10, 11, 12). These three factors (eigenvalues > 1 and factor loading > 0.4) explained 69.128% of the total variance. Furthermore, the calculation of Cronbach's alpha and test–retest reliability have shown good reliability among each dimension of the 12-item questionnaire (Cronbach's alpha 0.711–0.827, test–retest reliability 0.704–0.818).ConclusionResults from the pilot test demonstrated excellent reliability and validity of ISTCQ through each dimension and as an entire.

Construction of Nursing Quality Index System in Assisted Reproduction Hospitals Based on the Model of "Three-Dimensional Quality Structure"

Objective To construct a nursing quality index system for the assisted reproduction hospitals integrating outpatient department,wards,and operating rooms and provide a reference for the application of the system in the quality control of clinical reproductive care. Method On the basis of Donabedian's health care quality model of structure-process-outcome,we established a nursing quality index system for assisted reproduction hospitals via literature retrieval,semi-structured interviews,Delphi method,and analytic hierarchy process. Results The two rounds of expert's questionnaire survey demonstrated the response rates of 100% and 92%,the expert authority coefficients of 0.911 and 0.919,and the Kendall coefficients of concordance of 0.228 and 0.253,respectively (all P<0.001).The nursing quality index system for assisted reproduction hospitals was established,which consisted of 3 first-level indicators,13 second-level indicators,and 39 third-level indicators. Conclusion The nursing quality index system of assisted reproduction hospitals is comprehensive,systematic and reasonable,which can be used as quality management standard and provide a reference for clinical application.

Development and initial validation of a clinical measure to assess symptoms of post-stroke depression in stroke patients at the rehabilitation stage

BackgroundThe high incidence of post-stroke depression (PSD) during rehabilitation exerts a negative effect on the treatment and functional recovery of patients with stroke and increases the risk of mortality. It is necessary to screen PSD in the rehabilitation stage and thus provide effective intervention strategies. However, existing measurements used to assess PSD in the rehabilitation stage in patients with stroke lack specificity. This study aimed to develop a clinical measure to assess symptoms of PSD in the rehabilitation stage.MethodsThe research team created the initial items through a literature review and semi-structured interviews of patients with stroke. Then, the symptom-related items were estimated by three panels: healthcare professionals (N = 41), Delphi experts (N = 15), and patients with stroke in the rehabilitation stage (N = 30).ResultsThe literature review and semi-structured interview produced 51 symptom-related items including six domains, and the items were reduced to 47 by the healthcare professionals. The symptom-related items were further reduced to 33 items by a two-round Delphi consultation. The initiative coefficients of the two Delphi rounds were 71.4 and 100%, the expert authority coefficients were both 0.85, Kendall’s W were 0.152 and 0.408 (p < 0.01), and the coefficient of variation (CV) were 0.05–0.32 and 0.00–0.18, respectively. The item-level content validity index (I-CVI) was 0.53–1.00, the scale-level CVI/universal agreement (S-CVI/UA) was 0.26, and the S-CVI/average (S -CVI/Ave) was 0.85 for the first found Delphi consultation; the I-CVI was 0.67–1.00, the S-CVI/UA was 0.61, and the S-CVI/Ave was 0.97 for the second round Delphi consultation. All content validity indicators have been significantly improved compared with the first round. Using mean ≥ 4 and full score ≥ 0.5, combined with CV ≤ 0.16 as the item criteria, a clinical measure of PSD with 33 items and 6 dimensions (cognition, sleep, behavior, emotion, body, and guilt) was finally formed after two rounds. The patients with stroke made no further revisions after evaluation.ConclusionThe research team developed a specific tool with good content validity to assess the symptoms of PSD in the rehabilitation stage.