Nominal Group Technique Discussions Research Articles

Using nominal group technique to compare patients’ and clinicians’ perspectives on symptoms in multiple myeloma to inform the development of a self management tool for patients with relapsed myeloma

Background The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate. Methods One NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patients in four focus groups. Results A total of 18 healthcare professionals working in the area of haematology participated in the NGT discussion; consultants (n=6), haematology registrars (n=2), specialist nurses [Advanced Nurse Practitioner/Clinical Nurse Specialist] (haematology) (n=3), staff nurse (n=1), and “other” health care professionals (n=6). Participants ranged in experience of working with myeloma patients from 2 years to over 27 years. The symptoms voted in highest priority were: Pain, Fatigue, Peripheral Neuropathy, Infection Risk and Steroid Induced Side Effects. Conclusions The NGT was an efficient method for obtaining information to inform a healthcare app.

MY DIABETES APPS: IMPROVING KNOWLEDGE, COMPLIANCE, AND CONTROL IN UNCONTROLLED TYPE 2 DIABETES PATIENTS IN KEDAH, MALAYSIA

Introduction: Usage of mobile applications can be the game changer in managing diabetes patients and reducing the percentage of uncontrolled diabetes cases in Malaysia. This study aimed to measure the effectiveness of the locally developed diabetes mobile applications in improving knowledge, compliance and control of Type 2 Diabetes Mellitus patients. Methods: In the first phase, content of the mobile application was developed using Nominal Group Technique discussion by 11 experts. The produced prototype, My Diabetes Apps© undergone the second phase of pilot study for validation, SKAMA evaluation form. Final third phase interventional study was conducted in two districts in the state of Kedah (Kuala Muda as the control group, Kota Setar as the intervention group), involving eight health clinics. 82 respondents were selected using multi-stage random sampling technique among uncontrolled Diabetes Mellitus patients over four months. Results: Thirteen key contents recommended by the expert panels as mandatorily important for diabetic patients. The mean(±sd) usability score of My Diabetes Apps was 86 (±10.90), indicating the usability of the mobile application. The intervention study found there was significant difference in the mean knowledge score between the control group and the intervention group [F(1.79)=42.27; p<0.001] and mean HbA1C between groups pre and post intervention [F(1.79)= 6.03; p=0.016]. No difference in the mean value of the compliance score between the two groups [F(1.79)=1.58; p=0.212]. Conclusion: My Diabetes Apps© proved to be improve patient knowledge and helpful in diabetic control. Integrating the technology in patient’s care improves patients’ self-efficacy and monitoring of diabetes.

Development of a framework for community health workers to contribute to interprofessional learning teams

Background. Community health workers’ knowledge, skills and training seem to affect their contribution to 4th-year health sciences student teams who are following an interprofessional learning programme aimed at improving two South African rural communities’ health outcomes related to diabetes. Objective. To develop a framework for community health workers to contribute to interprofessional learning teams. Methods. The framework development forms part of previous phases of a multi-method study. The theory of change logic model guided the development of the draft framework, informed by data from two ecogram sessions, five nominal group technique discussions and a scoping review. The final framework was validated by experts during a workshop using forward and backward mapping. Results. The framework addresses the need for community health workers to gain knowledge, skills and training related to diabetes to effectively contribute to interprofessional learning teams. The theory of change process identified community needs and assets, desired results, influential factors, evidence-based strategies and assumptions required to address the problem. Conclusion. The framework focuses on a problem within specific interprofessional learning teams. Collaboration with stakeholders contributed to a rigorous research process, and the validation, refinement and future implementation of the framework. The framework eventually led to the development of an evidence-based training programme comprising knowledge, skills and training strategies related to diabetes. It is predicted that once community health workers have completed this training programme, they will be able to contribute effectively to the interprofessional learning teams.

Identifying barriers and interagency solutions to meeting the needs of families experiencing intimate partner violence (IPV): Home visiting and IPV agency perspectives

BackgroundAddressing intimate partner violence (IPV) among expectant families and caregivers with young children requires that multi-professional systems work collaboratively towards a common goal. IPV services and maternal and infant home visiting programs are two important perspectives to consider in designing interagency strategies. The purpose of this study was to identify shared priorities among home visiting and IPV professionals on IPV-related challenges and interagency solutions to support families with young children. MethodsHome visiting and IPV service providers (n=22) separately completed a structured brainstorming activity during four virtual focus groups using nominal group technique (NGT) to generate, rank, and reach consensus on prioritized barriers and solutions for the service population. The multi-professional study team (including home visiting and IPV partners) grouped and organized the top three prioritized barriers and solutions identified across groups using a pile sort activity. As a reliance measure, NGT discussion transcripts were coded to the final pile sort categories to ensure our presentation of the data was contextualized and supported by original participant responses. ResultsTwenty-four items were sorted into seven piles (three barriers and four solutions). The need to address families’ concrete needs was consistently prioritized across groups and matched with solutions that provide families with immediate financial support. Participants prioritized barriers resulting from client involvement in multiple, complex systems and named interagency process solutions (e.g., cross-systems training, enhanced referral processes) as the corresponding solution. The impact of individual and collective trauma was discussed as a barrier and matched with community-facing development (e.g., healthy relationship education). Policy, advocacy, and funding-oriented solutions were discussed as cross-cutting across all barriers. ConclusionEffective cross-system efforts are warranted to meet the interrelated needs of families impacted by IPV. The study highlights a shared view on prioritized challenges and actionable solutions to inform interagency collaboration among IPV agencies and early childhood home visiting programs. Our findings shed light on the importance of an organized public health approach to target IPV prevention and response.

Checklist for Habitual Physical Activity (CHaPA) for adults 75 years and older: tool development and content and face validation.

Physical activity significantly contributes to older adults' physical and mental health, suggesting that physical activity could enhance healthy life expectancy. Despite its importance for adults aged 75 and older, activity levels among a large proportion of individuals aged 75 and older in Japan do not meet the recommended levels of physical activity, indicating a need for specific strategies tailored to this age group. This study aimed to develop a screening tool that measures daily activities promoting physical activity among older adults and assessed its content and face validity. In Stage 1, we derived constructs pertinent to physical activity from previous literature and formulated an item list based on a prior qualitative study we undertook in Japan that evaluated daily behaviours facilitating physical activity among older adults. During Stage 2, we assessed the content and face validity of the list utilising the Nominal Group Technique (NGT), involving eight experts. The content validity was confirmed through two scoring evaluation rounds, while the face validity was verified through the NGT discussion, focusing on the comprehensibility and appropriateness of the tool. We created a tool with 22 items consisting of three constructs. The NGT participants modified eight of these items for the final assessment, resulting in a finalised tool comprising 22 items that satisfied the adaptation criteria. The content validity of these items was affirmed by median adequacy (>5.0 points) and interquartile range (<1.0 points). The NGT discussion consensus also confirmed satisfactory face validity. The newly developed tool, Checklist for Habitual Physical Activity (CHaPA) for adults 75 years and older, is a valid screening tool to assess the daily behaviours that facilitate physical activity. This self-administered instrument aims to assist older adults who need to start and maintain physical activity daily. Before its widespread public deployment, further investigation of the tool's validity and reliability is necessary.

Determining the research priorities for emergency care within the Western Cape province of South Africa: A consensus study

IntroductionLow- and middle-income countries (LMICs) are disproportionally affected by conditions requiring emergency care but there are limited contextually appropriate studies performed within these settings involving the patient population and healthcare systems they aim to benefit. Over the past five years, researchers in the Western Cape of South Africa have produced approximately 20 % of all emergency care publications from Africa, yet no agreed list of research priorities exists. Establishing research priorities, via recognised consensus methods, can ensure that efforts and resources in LMICs are more appropriately targeted to the need. MethodUsing a modified Delphi study, we invited a range of public and private representatives from different professional emergency care cadres within the Western Cape to identify current evidence gaps and consensus research priorities across the four areas of the WHO Emergency Care Systems framework: scene care, prehospital care, facility-based care, and the emergency care system itself. We then purposively selected eleven experts holding key academic and management positions to form a panel and perform a nominal group technique process to discuss these identified research priorities and establish a final list of priority research questions. ResultForty of the sixty-six (61 %) emergency care professionals invited contributed to the Delphi phase of the study, with representation from all professional cadres. After deduplication, 154 research topics were identified in the first round. In the second round, 94 (61 %) topics were considered research priorities by at least 80 % of participants. Following the nominal group technique discussion, 26 questions were established as consensus research priorities having been ranked as a top ten priority by over 50 % of panellists. ConclusionWe were able to successfully collate expert opinion and identify existing emergency care knowledge gaps within the Western Cape province of South Africa. Key topics identified for future work included questions on current health-seeking behaviour, dispatch, interfacility transfer, and staff burnout.

Principles of Justice, Equity, Diversity, and Inclusion in Health Care Distance Simulation Education: Consensus Building via the Nominal Group Technique.

Health care distance simulation (HCDS) replicates professional encounters through an immersive experience overseen by experts and in which technological infrastructure enriches the learning activity. As HCDS has gained traction, so has the movement to provide inclusive and accessible simulation experiences for all participants. However, established guidelines for best practices in HCDS regarding justice, equity, diversity, and inclusion (JEDI) are lacking. This study aimed to generate consensus statements on JEDI principles in synchronous HCDS education using the nominal group technique (NGT). Professionals with experience in HCDS education were invited to generate, record, discuss, and vote on ideas that they considered best practices for JEDI. This process was followed by a thematic analysis of the NGT discussion to provide a deeper understanding of the final consensus statements. An independent group of HCDS educators individually reviewed and recorded their agreement or disagreement with the consensus statements created by the NGT process. Eleven independent experts agreed on 6 key practices for JEDI in HCDS. Educators need to (1) be aware of JEDI principles, (2) be able to define and differentiate JEDI, (3) model JEDI in their environment, (4) have expertise and comfort facilitating conversations and debriefing around JEDI issues, (5) be advocates within their organizations to ensure equitable educational experiences, and (6) achieve JEDI without compromising educational objectives. Experts were divided on the approach to technology to ensure equitable learning experiences: some believed that the most basic technology accessible to all learners should be used, and some believed that the technology used should be determined by the competency of the students or faculty. Structural and institutional barriers in HCDS education persist despite agreement on key JEDI practices. Conclusive research is needed to guide the optimal policy in HCDS toward creating equitable learning experiences while bridging the digital divide.

Identifying enablers and barriers to the implementation of Functional family Therapy – Child Welfare (FFT-CW®) into the routine delivery of child protection services in New South Wales, Australia

BackgroundFunctional Family Therapy – Child Welfare (FFT-CW®) aims to reduce the risk of child maltreatment and out-of-home care entry for vulnerable children. ObjectiveTo identify enablers and barriers to implementing FFT-CW® into the routine delivery of child protection services from policy and service provider perspectives. Participants/settingEighteen program and policy experts, and 54 service providers, involved in the delivery of FFT-CW® across 6 districts in New South Wales, Australia. MethodsSemi-structured interviews with policy and program experts, and four discussion groups with service providers using nominal group technique (NGT). Interview data were thematically analyzed to identify enablers and barriers. An adapted Consolidated Framework for Implementation Research (CFIR) scoring system was used to quantify themes, with scores of −2 assigned for barriers, 0 for neutral, and 2 for enablers. NGT was used to generate and rank enablers and barriers of program implementation with service providers. ResultsThe semi-structured interviews generated 16 themes, from which three enablers and four barriers were identified using CFIR scoring. The NGT discussions generated nine enablers and eight barriers. Key enablers common to both interviews and NGTs were FFT-CW’s therapeutic and empowering approach, model purveyor training and support, and the supervision and feedback provided to service providers. Key barriers included referral difficulties, staff burnout, turnover and training logistical challenges, and problems with data collection and the safety impacts of outcome measures on participants. ConclusionsSustained uptake of FFT-CW® is likely feasible and evaluating its effectiveness within the routine delivery of NSW child protection services is warranted.

Identifying the important outcomes to measure for pharmacy-led, clinical services within primary care: A nominal group technique approach.

The introduction of clinical pharmacy services is part of a multi-disciplinary approach to reduce pressure on primary care. Ascertaining the impact of clinical pharmacists in general practice is vital to ensure intended benefits are achieved. However, this is complicated by poor quality evidence, multiple interventions, and a lack of agreement regarding outcome measures. To develop an outcomes framework for clinical pharmacy services delivered in Scottish general practice using a consensus methodology. A modified nominal group technique (NGT) was conducted using Microsoft Teams and Qualtrics. This involved a pre-NGT questionnaire, silent generation of ideas, round robin, discussions, ranking, and a final consensus exercise. A selective sampling strategy recruited experienced pharmacists from Scottish health regions. NGT ranking results were used to signify relative importance of the outcome areas. NGT discussions underwent inductive thematic analysis to explore key areas considered. Overall, 13 (median: 24 years of experience) pharmacists participated, representing 11 of 14 Scottish regions. In total, 21 outcome areas, derived from the literature and a pre-NGT questionnaire, were considered during the NGT ranking exercise. Consensus identified five important outcome areas: Patient Experience, Medication Related Adverse Events, Cost-Effectiveness, Medication Optimisation, and Health Related Quality of Life. Thematic analysis highlighted the importance of the outcome framework's target audience, factors influencing the interpretation of outcomes, and the feasibility of the associated outcome measures. The five key outcome areas will facilitate evidence-based decisions regarding service delivery. Future work should develop a measurement plan, involving routinely collected sources of outcomes data. The feasibility of collecting outcomes in the real-world context should be considered, identifying measures which are easy to collect within existing data infrastructures. This paper describes a replicable method to gain consensus for a national approach to data collection from a strong theoretical basis using an online methodology.

Undertaking Research Using Online Nominal Group Technique: Lessons from an International Study (RESPACC).

Background: Nominal group technique (NGT) is a well-established research method for establishing consensus. Owing to the COVID-19 pandemic, research methods need to be adapted to engage with participants online. Objective: To determine the feasibility and acceptability of adapting NGT to an online format. Setting: Palliative care clinicians (n = 31) in Greece, Romania, and Spain. Methods: NGT discussions were used to elicit palliative care clinicians' opinions, and to rank priorities regarding their understanding and needs about clinical research. Preliminary online training of country-based facilitators was followed by content analysis of debriefing reports to capture learning related to the online NGT format. Results/Implementation: Three NGT sessions used online platforms (Zoom/MS Office/Mentimeter) for the meetings. Analysis of the facilitator reports generated three themes: preparation/facilitation/timing; optimizing technology; and interactions. Conclusions: Conducting NGT meetings online is viable and may be advantageous when compared with traditional face-to-face meetings, but requires careful preparation for participants to contribute effectively.

Using nominal group technique to compare patients' and clinicians' perspectives on symptoms in multiple myeloma to inform the development of a self management tool for patients with relapsed myeloma.

The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate. One NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patients in four focus groups. A total of 18 healthcare professionals working in the area of haematology participated in the NGT discussion; consultants (n=6), haematology registrars (n=2), specialist nurses [Advanced Nurse Practitioner/Clinical Nurse Specialist] (haematology) (n=3), staff nurse (n=1), and "other" health care professionals (n=6). Participants ranged in experience of working with myeloma patients from 2 years to over 27 years. The symptoms voted in highest priority were: Pain, Fatigue, Peripheral Neuropathy, Infection Risk and Steroid Induced Side Effects. The NGT was an efficient method for obtaining information to inform a healthcare app.

Recommendations of behavioural facilitators for success in a physiotherapy clinical practice module: Successful students' perspectives.

BackgroundStudents struggle to bridge the gap between theory and application thereof in clinical settings. Exploring the behaviours of students who have been shown to be successful in the clinical practice module of physiotherapy could provide an insight into what facilitated their success. Sharing this information with other students could assist with decreasing anxiety and improving student success.ObjectivesThe objective of this study was to explore behaviours that facilitate student success in a physiotherapy clinical practice module from the perspective of high-achieving students.MethodData were collected at the University of the Western Cape’s physiotherapy department in South Africa. Ten students with the highest marks in clinical practice from the 2016 and 2017 final-year cohorts were purposively selected and invited to participate in two different Nominal Group Technique (NGT) discussions. In total, 14 students consented to participate in the study. A demographic and socio-economic status questionnaire and an NGT discussion were used to collect data. Participants analysed the NGT discussion data themselves by ranking facilitators in order of priority.ResultsDoing pre-block preparation, self-reflection and having a good rapport with patients as well as personal motivation and coping strategies were identified as the most important behavioural facilitators for physiotherapy students’ success in a clinical practice module.ConclusionClinical practice is considered to be the most stressful module for undergraduate physiotherapy students. Considering this, recommendations from previously successful students could contribute towards the success of present and future students and in decreasing the stress associated with clinical practice.Clinical implicationsRecommendations from students on behavioural facilitators that enabled them to be successful in a physiotherapy clinical practice module can assist future students entering clinical practice to be successful in this stressful module. This information is also useful for clinical educators to assist students who struggle, and to recommend potential changes or improvements to the current physiotherapy clinical practice module.

Usable Mobile App for Community Education on Colorectal Cancer: Development Process and Usability Study.

BackgroundParticipation in colorectal cancer screening is still low among Malaysians despite the increasing trend of incidence, with more than half of the new cases being detected in the advanced stages. Knowledge improvement might increase screening participation and thus improve the chances of disease detection. With the advancement of communication technology, people nowadays prefer to read from their mobile phone using a Web browser or mobile apps compared with the traditional printed material. Therefore, health education and promotion should adapt this behavior change in educating the community.ObjectiveThis study aimed to document the process of designing and developing a mobile app for community education on colorectal cancer and assess the usability of the prototype.MethodsThe nominal group technique (NGT) was used for the content development of the mobile app. NGT involving community educationists and clinicians combined with community representatives as the target users identified relevant health information and communication strategies including features for a user-friendly mobile app. The prototype was developed using framework Ionic 1, based on the Apache Cordova and Angular JS (Google). It was published in the Google Play store. In total, 50 mobile phone users aged 50 years and above and who had never been diagnosed with any type of cancer were invited to download and use the app. They were asked to assess the usability of the app using the validated Malay version of System Usability Scale Questionnaire for the Assessment of Mobile Apps questionnaire. The One-sample t test was used to assess the usability score with a cut-off value of 68 for the usable mobile app.ResultsThe Colorectal Cancer Awareness Application (ColorApp) was successfully developed in the local Malay language. The NGT discussion had suggested 6 main menus in the ColorApp prototype, which are Introduction, Sign and Symptoms, Risk Factors, Preventive Measures, Colorectal Cancer Screening Program, and immunochemical fecal occult blood test kit. A total of 2 additional artificial intelligence properties menus were added to allow user-ColorApp interaction: Analyze Your Status and ColorApp Calculator. The prototype has been published in the Google Play store. The mean usability score was 72 (SD 11.52), which indicates that ColorApp is a usable mobile app, and it can be used as a tool for community education on colorectal cancer.ConclusionsColorApp mobile app can be used as a user-friendly tool for community education on colorectal cancer.

You Don't Know What You Don't Know: Using Nominal Group Technique to Identify and Prioritize Education Topics for Regional Hospitals.

Our 121-bed children's hospital is a quaternary care referral center for a 33-county region. Referring hospitals asked for Pediatric Acute Care Education Sessions (PACES). To determine which topics to prioritize for these sessions, nominal group technique (NGT) methods were used to obtain stakeholder-prioritized consensus on education topics. Five NGT sessions were conducted over 6 weeks at referring hospitals throughout central and northern California. Each session lasted ∼90 minutes and engaged a diverse multidisciplinary group of stakeholders. At these sessions, stakeholders answered the question "What are your top 5 clinical topics that should be prioritized by PACES?" NGT numeric ranking methods were used to determine prioritized topics. A thematic analysis was performed on the session transcripts. The 5 sessions had 43 total participants, including nurses, respiratory therapists, physicians, and administrators. The top 4 prioritized topics were sepsis, diabetic ketoacidosis, respiratory failure or support, and bronchiolitis and/or respiratory syncytial virus. Unique education needs for each hospital were also uncovered in the NGT discussion. Three qualitative themes emerged from the discussion: diverse educational needs, the need for guidelines on telemedicine and transfer, and relationship building. The use of NGT to engage multisite, multidisciplinary stakeholders helped to inform an education program. The use of NGT methods provided rich information that would not have been obtained through surveys alone and helped facilitate relationship building. The PACES group was able to identify and prioritize education topics of interest to referring community hospitals.

Using nominal group technique to inform the development of a self-management app for patients with relapsed myeloma

Background: The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate. Methods: One NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patients in four focus groups. Results: A total of 18 healthcare professionals working in the area of haematology participated in the NGT discussion; consultants (n=6), haematology registrars (n=2), specialist nurses [Advanced Nurse Practitioner/Clinical Nurse Specialist] (haematology) (n=3), staff nurse (n=1), and “other” health care professionals (n=6). Participants ranged in experience of working with myeloma patients from 2 years to over 27 years. The symptoms voted in highest priority were: Pain, Fatigue, Peripheral Neuropathy, Infection Risk and Steroid Induced Side Effects. Conclusions: The NGT was an efficient method for obtaining information to inform a healthcare app.

Validation of a Career Guidance Brochure for Student Nurses Using the Nominal Group Technique.

Background:Nursing is a career which, especially for male students, requires one making an informed choice prior to pursuing it. A mixed-method, qualitative study, investigating the professional socialization process of male student nurses in Malawi found that most students did not make an informed choice regarding their selected career. This resulted in some of them facing many challenges which compromised their academic performance, and in some cases, contributed to high attrition rates. An “unmet need” for career guidance was identified by the study participants. Further, the study participants made recommendations on the need to address the unmet need for career guidance. A brochure entitled “A career in nursing and midwifery in Malawi” was designed. This article reports on the validation of the brochure.Objective:The goal of the study was to validate the brochure utilising the Nominal Group Technique.Methods:The validation exercise was part of the mixed method study. Five steps of the Nominal Group Technique (NGT) were utilised, as expounded by Vigra-Atkins, aimed at evaluating the content contained in the brochure. Study participants in four nursing colleges (n = 37) participated by studying the draft brochure and identifying strong and weak areas for improvements. Responses were ranked based on group consensus.Findings:A total of five groups were involved in NGT discussions. Four of the five groups found the brochure relevant and motivating to prospective students. However, two groups suggested that pictures needed to be more gender sensitive.Conclusion:Through the NGT, the brochure was commended by the majority of the participants as being clear and relevant in terms of giving information necessary for a nursing career choice. Finally, the authors recommend the use of the NGT compared to other group-based research techniques, considering the benefits the NGT offers.

Use of the nominal group technique to identify stakeholder priorities and inform survey development: an example with informal caregivers of people with scleroderma

ObjectivesThe nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment surveys. The objective was to demonstrate the use of NGT discussions to develop survey items on...

An exploration of the roles and the effect of role expectations on the academic performance of first year occupational therapy students: a University of the Free State case study

First-year students in occupational therapy enter higher education and take on different roles while engaging in occupations such as academics, instrumental activities of daily living (IADL) and social participation. Some of the roles are new and pose challenges to students which in turn influence their academic performance. A qualitative research approach was applied by making use of a case study research design to explore possible factors that influence the students' academic performance. Eighteen first-year occupational therapy students from the University of the Free State were randomly selected to take part in the study. Data were collected from documentation and Nominal Group Technique discussions. The aim of this article is to report on some of the significant findings from the initial study, namely the roles students adopt to meet the challenges during their first year at university. Four roles were identified: role of a student, role of an independent young adult, role of a friend and role of a member of a campus residence. The identification of these roles should make educators take note of the need for support to the first-year student on a departmental as well as faculty level. Key words: Academic performance; First-year Occupational Therapy students; Occupational engagement, role fulfilment

PMS63 Assessment of the Osteoporosis Self-Efficacy Scale in Relation to Osteoprotective Behaviors among Type 2 Diabetics Patients in North Malaysia

test the feasibility of using the nominal group technique (NGT) to select attributes for DCEs. METHODS: Patients group discussions (4-8 participants) were conducted in Belgium and the Netherlands to prioritize a list of twelve potentially important attributes for osteoporosis drug therapy that were retrieved from literature review and expert discussions. The NGT consisted of three steps: 1) an individual ranking of the twelve attributes by importance from 1 to 12; 2) a group discussion on each of the attributes including a group review of the aggregate score of the initial rankings; and 3) a second ranking task of the same attributes. The selection of attributes for the DCE was based on groups’ ranking and NGT discussions followed by experts’ discussion. RESULTS: In total, 26 osteoporotic patients participated in five nominal group sessions. Most (80%) patients changed their ranking after the discussion. However, the average initial and final ranking did not markedly differ, with two exceptions. In the final rank, the most important medication attributes were effectiveness, side-effects, frequency and mode of administration. It was also observed that some (15%) patients did not correctly rank from 1 to 12, and the order of attributes did play a role in the ranking. CONCLUSIONS: The nominal group technique is feasible and useful for selecting attributes for DCE, although the ranking task may be cognitively difficult and attributes order should vary over different NGT sessions.