Nominal Group Discussions Research Articles

El valor de la dimensión espiritual en el final de la vida desde la perspectiva de los profesionales de enfermería

ObjectiveTo determine and interpret the nurse perspective on the spiritual dimension of individuals at the end of life. MethodThis study fits into the qualitative paradigm, and uses the phenomenological-hermeneutical method of interpretation, directed at determining the meaning that people give to their experience and understanding the motives and beliefs that drive actions. The design was of the emerging type, with a flexibility that helped to perform an interdependent discourse analysis. The population studied consisted of 41 professional nurses with responsibility in the areas of health care, management, teaching and research in Huelva: Hospital area (22), home support of palliative care team (1), health centers (17), and University (1). The information has been obtained through nominal group, group discussion, and interview techniques. ResultsIt was found that this dimension is weakly integrated into the nursing image of the care in the process of dying and, therefore, little valued as an important element in the support of the sick person in the terminal phase. DiscussionThe spiritual dimension of care at the end of life is an emerging dimension in the care for people in the process of dying, which requires a specific line of research to determine human needs in more detail, as well as the responsibility of nurses to provide an increasingly comprehensive and committed response.

Development and validation of the coronary heart disease scale under the system of quality of life instruments for chronic diseases QLICD-CHD: combinations of classical test theory and Generalizability Theory.

BackgroundQuality of life (QOL) for patients with coronary heart disease (CHD) is now concerned worldwide with the specific instruments being seldom and no one developed by the modular approach.ObjectivesThis paper is aimed to develop the CHD scale of the system of Quality of Life Instruments for Chronic Diseases (QLICD-CHD) by the modular approach and validate it by both classical test theory and Generalizability Theory.MethodsThe QLICD-CHD was developed based on programmed decision procedures with multiple nominal and focus group discussions, in-depth interview, pre-testing and quantitative statistical procedures. 146 inpatients with CHD were used to provide the data measuring QOL three times before and after treatments. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation analysis, factor analyses, multi-trait scaling analysis, t-tests and also G studies and D studies of Genralizability Theory analysis.ResultsMulti-trait scaling analysis, correlation and factor analyses confirmed good construct validity and criterion-related validity when using SF-36 as a criterion. The internal consistency α and test-retest reliability coefficients (Pearson r and Intra-class correlations ICC) for the overall instrument and all domains were higher than 0.70 and 0.80 respectively; The overall and all domains except for social domain had statistically significant changes after treatments with moderate effect size SRM (standardized response mea) ranging from 0.32 to 0.67. G-coefficients and index of dependability (Ф coefficients) confirmed the reliability of the scale further with more exact variance components.ConclusionsThe QLICD-CHD has good validity, reliability, and moderate responsiveness and some highlights, and can be used as the quality of life instrument for patients with CHD. However, in order to obtain better reliability, the numbers of items for social domain should be increased or the items’ quality, not quantity, should be improved.

Medical student attitudes to the autopsy and its utility in medical education: A brief qualitative study at one UK medical school

Attending postmortems enables students to learn anatomy and pathology within a clinical context, provides insights into effects of treatment and introduces the reality that patients die. Rates of clinical autopsies have declined and medical schools have cut obligatory autopsy sessions from their curricula making it difficult to assess medical student perceptions of, and attitudes towards, the educational value of autopsy. Our aim was to investigate these perceptions by designing a brief qualitative study comprising nominal technique and focus group discussions with Cambridge Graduate Course students, all of whom had attended autopsies. Three general themes emerged from the focus group discussions: the value of autopsy as a teaching tool and ways the experience could be improved, the initial impact of the mortuary and the autopsy itself, and the "emerging patient"-an emotional continuum running from cadaver to autopsy subject and living patient. Educational benefits of autopsy-based teaching included greater understanding of anatomy and physiology, greater appreciation of the role of other health care professionals and an enhanced appreciation of psycho-social aspects of medical practice. Students suggested improvements for ameliorating the difficult emotional consequences of attendance. We conclude that autopsy-based teaching represents a low-cost teaching technique which is highly valued by students and has application to many diverse medical specialties and skills. However, careful preparation and organization of sessions is required to maximize potential educational benefits and reduce any negative emotional impact.

Changes to supervision in community pharmacy: pharmacist and pharmacy support staff views

Pharmacists now offer increasing levels and ranges of clinical, diagnostic and public health services, which may require a pharmacist to be absent from the pharmacy premises. Currently, in the UK, many pharmacy activities legally require the direct supervision and physical presence of the pharmacist. This study aimed to explore the potential for changes to supervision, allowing pharmacist absence, and greater utilisation of pharmacy support staff. Four nominal group discussions were conducted in May 2012 with community pharmacists (CPs), community pharmacy support staff, hospital pharmacists and hospital pharmacy support staff, involving 21 participants. Participants were asked to generate pharmacy activities, which they felt could/could not be safely performed by support staff in the absence of a pharmacist, followed by a discussion of these items and voting using an agreement scale. A written record of the items generated and voting scores was made and the group discussion elements were audio-recorded, transcribed verbatim and analysed thematically. The selling of general sales list medicines, assembly of prescriptions and provision of public health services received a high level of agreement between groups, as activities that could be performed. There was greater disagreement about the safety of support staff selling pharmacy medicines and handing out checked and bagged prescription items to patients. Group discussion revealed some of the main challenges to supervision changes, including CPs' perceptions about their presence being critical to patient safety, reluctance to relinquish control, concerns about knowing and trusting the competencies of support staff, and reluctance by support staff to take greater professional responsibility. The findings of this study aim to inform a future consultation on changes to pharmacy supervision in the UK. The empowerment of pharmacy technicians as a professional group may be key to any future change; this may require clarity of their professional responsibilities, enhanced career progression and appropriate remuneration to match greater responsibility.

Retraction: A Field Experiment Comparing the Outcomes of Three Fraud Brainstorming Procedures: Nominal Group, Round Robin, and Open Discussion

This article was originally published in 2010 in The Accounting Review 85 (3) 911–935; DOI: 10/2308/accr.2010.85.3.911. The authors confirmed a misstatement in the article and were unable to provide supporting information requested by the editor and publisher. Accordingly, the article has been retracted.

Retraction: A Field Experiment Comparing the Outcomes of Three Fraud Brainstorming Procedures: Nominal Group, Round Robin, and Open Discussion

Retraction: A Field Experiment Comparing the Outcomes of Three Fraud Brainstorming Procedures: Nominal Group, Round Robin, and Open Discussion

The hypertension scale of the system of Quality of Life Instruments for Chronic Diseases, QLICD-HY: A development and validation study

AimsThis paper is aimed to develop and validate the hypertension scale of the system of Quality of Life Instruments for Chronic Diseases, QLICD-HY. MethodsThe QLICD-HY instrument was developed based on programmed decision procedures with multiple nominal and focus group discussions and pilot testing. A total of 157 inpatients with hypertension were used to provide the data measuring QOL three times before and after treatment. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation and factor analyses, and t-tests. ResultsCorrelation and factor analyses confirmed good construct validity and criterion-related validity when using Short Form (36) Health Survey (SF-36) as a criterion. Test–retest reliability coefficients (Pearson r and intra-class correlation (ICC)) for the overall instrument score and all domains except for the hypertension-specific domain (SPD) (0.75) were higher than 0.80 with a range of 0.75–0.91; the internal consistency α for all domains except for the hypertension-specific domain (0.66) was higher than 0.70. The overall score and scores for most facets within each domain except for the social domain (SOD) had statistically significant changes (t-tests) after treatment with moderate effect sizes. ConclusionQLICD-HY has good validity, reliability, responsiveness and can be used as the quality-of-life instrument for patients with hypertension.

Assessment of the content validity of Functional Skills Measure after Paralysis with nominal group discussion and revision of its content

Miyasaka H, Kondo I, Kato H, Takahashi C, Uematsu H, Yasui C, Tani A, Miyata M, Wada N, Teranishi T, Wada Y, Sonoda S. Assessment of the content validity of Functional Skills Measure after Paralysis with nominal group discussion and revision of its content. Jpn J Compr Rehabil Sci 2011; 2: 24�30 Purpose: The purposes of this study were to assess the content validity of Functional Skills Measure after Paralysis (FSMAP) and to revise its content to make it appropriate for use in the clinical setting. Methods: Eight occupational therapists (OTs) participated in the questionnaire study. Nominal Group Technique (NGT) was used to measure the content validity. Before using the NGT, we set an 80% agreement as the criterion for consent. If the agreement for an item did not reach this level and the item’s content validity was not high enough, we revised its content. We repeated the same assessment for the revised FSMAP by using a questionnaire. Results: In the fi rst assessment, 8 out of 15 items (including the subitems and descriptions) did not reach the predetermined agreement level. In the second assessment, 1 out of 15 items did not reach the agreement level. We fi nished the assessment process because we judged that the content validity of FSMAP reached a satisfactory level after the revision of this item. Discussion: We think that FSMAP should be revised to make it appropriate for use in the clinical setting after assessing its content validity.

A Field Experiment Comparing the Outcomes of Three Fraud Brainstorming Procedures: Nominal Group, Round Robin, and Open Discussion (Retracted)

ABSTRACT: The current study examines the outcomes of three fraud brainstorming procedures—nominal group, round robin, and open discussion—via a randomized between-participant field experiment involving 150 audit clients and 2,614 auditors who participated in natural, hierarchical audit teams. The results indicate that nominal group and round robin brainstorming resulted in equivalent numbers of unique fraud risks and comparable increases in planned audit hours, while open discussion brainstorming yielded the least number of unique ideas and the smallest increase in planned audit hours. Furthermore, nominal group and round robin brainstorming yielded more changes/additions to the nature and timing of substantive testing than open discussion brainstorming. Study findings offer theoretical and practical insight into fraud brainstorming.

Patient perspective of measuring treatment efficacy: The rheumatoid arthritis patient priorities for pharmacologic interventions outcomes

Collaboration with patients with rheumatoid arthritis (RA) highlights that outcomes important to them include fatigue, coping, and life enjoyment. However, these are not commonly measured in clinical trials. There is little evidence about which outcomes patients would prioritize, or what factors influence patients' prioritization. Our objective was to develop a complementary core set with patients to promote inclusion of their priority outcomes in pharmacologic interventions. Nominal groups were conducted with RA patients to rank 63 outcomes generated from previous in-depth interviews. A multicenter postal survey provided the final selection of core outcomes for the Rheumatoid Arthritis Patient Priorities for Pharmacologic Interventions (RAPP-PI), in which RA patients rated the importance of the priority outcomes from the nominal groups and ranked the top 6. Twenty-six patients participated in 5 nominal group discussions and reduced the 63 initial outcomes to the 32 most important. A total of 254 participants in the survey ranked priority treatment outcomes to form the RAPP-PI: pain, activities of daily living, joint damage, mobility, life enjoyment, independence, fatigue, and valued activities. The 8 priorities represent 3 domains of treatment outcomes: direct impact of RA, psychosocial well-being, and function/participation. Chi-square tests showed that disease severity, disease duration, sex, and patients' perceptions of managing, self-efficacy, and normality influenced the selection of priority treatment outcomes. Collaboration with patients has captured their perspectives of priority outcomes from pharmacologic interventions. Although there is some overlap with professional core outcomes, the additional use of this complementary set will give a broader evaluation of effectiveness of interventions from the key stakeholders: patients.

Exploring Perceived Enablers and Barriers to Social Marketing Use in Public Health Nursing

Public health managers' perceptions of enablers and barriers to social marketing use among public health nurses were examined. Employing qualitative, action research methods, this study incorporated focus groups using nominal group process and group discussion. Eleven public health managers from large urban, small urban, and rural Canadian public health departments participated. Content analysis was conducted on the focus group transcripts, and trustworthiness was strengthened through independent review by participants and subject experts. Several enablers to social marketing use were identified in the areas of educational preparation of nurses and the nature of public health nursing practice. The majority of barriers to social marketing use related to human and financial resources at the system level. In addition, we identified as imperative that managers at those levels responsible for budgetary planning understand the principles of social marketing more fully if they are to be expected to support its use. Social marketing has the potential to positively influence the health behavior of populations. However, if public health nurses and other health-promotion professions are to incorporate this health-promotion strategy more effectively into their practice, issues related to its use must be addressed.

Using Accreditation of Prior Experiential Learning (APEL) to Replace a Practice Placement: A Controversial Option?

The Accreditation of Prior Experiential Learning (APEL) is established in higher education, but there are no studies on its use in occupational therapy. Brunel University wanted to investigate whether APEL could enable occupational therapy students meeting certain criteria to be exempt from the first-year practice placement, and so devised an APEL proposal. Practice placement educators and students were invited to give their opinion on the proposal through a questionnaire; additionally, the students attended a nominal group discussion. Three themes emerged from the six practice placement educators who agreed to participate: logistics, student experience and learning opportunities. The three students who participated valued APEL for confirming and recognising learning from previous experience. The low response impedes establishing any definite views on the topic, but could suggest that APEL is not a controversial option to practice placement educators and students. Further study is required on the adoption of APEL in occupational therapy education.

Sexual behaviour of nursing home residents: staff perceptions and responses

This paper presents the results of a study that investigated nursing home staff perceptions of affectionate and sexual behaviour of residents. Despite growing recognition of the importance of sexual expression among residents and a increasing willingness to discuss the topic, sexual activity for nursing home residents remains an ignored component of life satisfaction. Even when 'sexuality' has been included as part of a resident's plan of care, this may not mean that attention has been paid to maintaining that aspect of their life. Thus, nursing homes can mark the end of many types of freedom for older people. Given that intimate basic care is performed by others and often by members of the opposite sex, loss of sexual freedom may also occur. A grounded theory approach was used to study staff working in nursing homes in Australia and Sweden. Data were generated through interviews and nominal groups with nursing home staff. Thirty women volunteered to be interviewed, and 18 others were involved in the three nominal group discussions; a further five participants were involved as key informants. Staff perceptions and responses to residents' sexual behaviour were found to be influenced by their own level of comfort related to sexuality issues, and the ethos within the organization where they worked. The conceptual paradigm was termed 'Guarding Discomfort' and specified the ways in which staff guard against sexuality discomfort as well as the ways their behaviour fits within different types of organizations. Both staff and nursing home managers need to work toward developing a home environment that is supportive of residents' sexuality rights, that permits sexuality expression and promotes a culture where all people concerned are comfortable with sexuality issues.

Primary Teachers' Beliefs about Family Competence to Influence Classroom Practices

Collaborative, equal partnerships between families and schools have been emphasized in early childhood education. However, researchers and practitioners have most often viewed the partnership from the perspective of what families can learn from the school rather than what school staff can learn from families. This study examined the beliefs of kindergarten, first and second grade teachers regarding families' competence to contribute knowledge to their child's educational process. A mixed method design using nominal group technique, Q methodology and interviews was employed. Thirty-three teachers, from a variety of schools, participated in nominal group discussions as a source of Q statements. Q sorts were conducted with 43 teachers. Results indicated three distinct factors characterizing teachers' attitudes regarding family competence to influence classroom practice. Seven teachers, representing the varied beliefs expressed through the Q sort, were interviewed to clarify the three factors emerging from the Q analysis. The findings suggest the need to consider the beliefs of current, as well as prospective, teachers regarding the frequently neglected "other half" of the partnership, school staff learning from families.

Evaluation of a problem-based curriculum in midwifery

Objective: to evaluate the implementation of a ‘problem-based’ learning (PBL) curriculum within midwifery.Design: a ‘realistic evaluation’ model based on cost-effectiveness models of economics, and incorporating both qualitative and quantitative methodology. The design used historical comparison, comparing students following the new curriculum with a baseline of previous student cohorts and exploring staff and student experiences.Setting: a ‘new’ university, providing a degree-level 18 month pre-registration midwifery programme for an intake of about 40 students per cohort.Participants: all students in the cohort qualifying immediately before the implementation and all those in the first cohort following the new curriculum were invited to participate fully. Assessment outcomes for three cohorts of students qualifying before and the first three cohorts qualifying following the change were analysed. All clinical staff directly involved in mentoring the relevant student groups, all academic staff involved in delivering the new curriculum and the course external examiner were invited to participate.Intervention: the evaluation studied a major change in the way the overall midwifery curriculum was delivered, widely described as PBL.Measurements: students' experiences and perspectives were sought through review of routine evaluation documents, nominal group technique exercises and focus group discussions at about six months following qualification. Clinical staff experiences and perspectives were sought through written structured questionnaires. Academic staff views were sought through personal semi-structured interviews. Participant observation of the process, review of course documents and of staff reflective commentaries were also conducted. Data on student completion rates and final grade were analysed.Findings: although students' views of the curriculum were generally positive, they experienced some discomfort and difficulty in adjustment to a new style of learning. Small group learning, independence and skills in using and conveying information and research evidence were valued aspects of the new approach. Quality of clinical placement experience and university-practice links were an important area of positive experience or concern. Clinical staff views of the curriculum showed considerable stability, with major concerns being the balance of theory and practice time and skills which were not influenced by the curriculum change. At both points, ability to critically evaluate and use evidence in practice was regarded highly. Student outcomes showed some evidence of possible divergence of grades in the new curriculum.Conclusions and implications for practice: the manner and context of implementation of educational change may have important implications for student experiences and outcomes and the experiences of educators. Adequate preparation at all levels for a different, more independent style of learning is important and students are likely to need clear guidance and feedback on their progress in the early stages of the curriculum, to monitor progress and to provide reassurance. Longer-term research is needed to assess the impact of PBL on theory-practice links and on the midwives as practitioners.