Nominal Group Research Articles

Diseño, validación y evaluación del programa formativo para docentes: clima emocional y motivacional en el aula (CEYM)

The climate generated by teachers is related to positive consequences in the school context. Given the lack of training in this area, we decided to design, validate and evaluate an intervention programme on emotional and motivational climate for teachers. Firstly, the programme was designed through a nominal group of seven experts. Secondly, its content was validated and its internal consistency was analysed through the opinion of 25 experts. Finally, the programme was applied by assessing the improvement of the emotional and motivational climate through specific observation tools for this purpose. The programme consists of a series of trainings that provide teachers with strategies and resources that can be applied in the classroom. The results have shown that the "Emotional and Motivational Climate-CEYM" programme is a valid and reliable training proposal for improving the emotional and motivational climate generated by teachers.

Combatting the Academic Dishonesty in Higher Education: A Nominal Group Technique Approach

Combatting the Academic Dishonesty in Higher Education: A Nominal Group Technique Approach

Combining GLP-1 Receptor Agonists and SGLT2 Inhibitors in Type2 Diabetes Mellitus: A Scoping Review and Expert Insights for Clinical Practice Utilizing the Nominal Group Technique.

Treating type2 diabetes has shifted from a gluco-centric approach to broader cardio-renal-metabolic strategy, driven by the use of disease-modifying medications. Traditionally, diabetes management has relied on stepwise medication addition based on failures in glucose control. However, the benefits and risks of combining glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose cotransporter2 inhibitors (SGLT2is) remain inadequately understood. This study conducted a scoping review to examine the available clinical research on the benefits and risks of combining GLP1-RAs and SGLT2is. Additionally, the nominal group technique was used to gather insights from medical experts from different areas regarding the combined therapy's daily clinical use, concerns, and limitations. The review followed the guidelines outlined in the Joanna Briggs Institute Reviewer's Manual and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). The final report includes 50 studies. The most common designs are observational studies. The median (IQR) number of patients across studies was 355 (1295). Studies reporting metabolic outcomes were the most common. The follow-up time ranges from 1.5 to 60months. Although limited, the available evidence seems to support the combined use of GLP1-RAs and SGLT2is. The experts agreed that the underlying mechanisms appear synergistic rather than antagonistic for most outcomes. Combining medical therapy is common in diabetes treatment and may occur naturally in everyday practice. Limited evidence suggests that combined SGLT2is/GLP1-RAs therapy can potentially improve most but not all outcomes. Quality evidence and better-defined outcomes are paramount to guide the selection of patients for combined therapy.

Strategies to improve participation in exercise programmes during chemotherapy: a modified nominal group technique.

Exercise can help people manage many of the side effects of chemotherapy treatment. Clear guidelines exist outlining the benefits of exercise during chemotherapy and recommended dosage; however, achieving these guidelines remains problematic. The purpose of this study is to reach an agreement on suitable strategies to improve recruitment, adherence, and retention rates to exercise programmes during chemotherapy with the involvement of key stakeholders. This study used a modified nominal group technique (NGT). Participants included individuals with a lived experience of chemotherapy and healthcare professionals working in oncology. Three workshops were carried out, two in-person and one online. The in-person workshops addressed the first four stages of the NGT, introduction, idea generation, round-robin recording, and group discussion. Voting and ranking of ideas occurred during the online workshop. Nineteen individuals took part in this study, including 12 people with a lived experience of chemotherapy and seven healthcare professionals. The highest-ranked strategy to improve recruitment was to inform individuals about the benefits of exercise at the time of receiving their treatment plan, with 53% of first preference votes. Participants also agreed that direct instruction from their oncologist would have the greatest impact on successful recruitment to an exercise programme, receiving 47% of first preference votes. To enhance exercise adherence, an in-person exercise programme delivered in an exercise facility received 46% of first preference votes. Finally, 43% of participants agreed that the provision of a pedometer would support retention, and 86% of people wanted to receive weekly phone calls/check-ins. This study provides strategies to overcome barriers to recruitment, adherence, and retention to exercise programmes during chemotherapy, and will help to optimise participant engagement for future interventions. The involvement of key stakeholders in this study will contribute towards ensuring that future interventions are pragmatic and patient-centred.

Building consensus: development of a best practice guideline (BPG) for avoiding errors in robotic-assisted spine surgery (RASS).

Building consensus: development of a best practice guideline (BPG) for avoiding errors in robotic-assisted spine surgery (RASS).

The VASCERN-VASCA Working Group Diagnostic and Management Pathways for Capillary Malformations

Objective: VASCERN (https://vascern.eu/) is the European Reference Network for Rare Multisystemic Vascular Diseases. VASCERN-VASCA is the working group within VASCERN that focuses on the study of vascular anomalies. One of the objectives of this group is to establish patient pathways to guide physicians toward efficient diagnostic and management measures. The patient pathway presented here is focused on capillary malformations (CMs). Methods: The Nominal Group Technique, a structured variation of small group discussion was used. Two facilitators were identified: one to propose initial discussion points and draw the pathway and another to chair the discussion. A dermatologist (E. Baselga) was chosen as the first facilitator due to her specific clinical and research expertise. The draft was subsequently discussed within VASCERN-VASCA monthly virtual meetings and biannual face-to-face meetings. Results: The pathway starts from the clinical recognition of a vascular red stain, describing clinical characteristics and location. Depending on the clinical features, a subsequent workup for associated manifestations or complications is suggested. These steps should enable the establishment of 6 subtypes of CMs: (1) nevus simplex; (2) isolated CM, syndromic or nonsyndromic; (3) CM of microcephaly CM syndrome; (4) CM of CM–arteriovenous malformation syndromes; (5) “pseudo” CM of arteriovenous malformation; (6) cutis marmorata telangiectatica congenita. Management according to the recognized phenotype is detailed in subsequent pages of the pathway. A color code is used to differentiate (1) clinical evaluations, (2) investigations, (3) associated genes, and (4) treatments. Actions relevant to all types are marked in separate boxes, for example, when to perform specific imaging. Conclusion: The collaborative efforts of VASCERN-VASCA, a European network of the 14 Expert Centers for Vascular Anomalies, have led to a consensus pathway for CMs. This pathway may help clinicians to guide in the diagnosis and management of CMs, as well as to emphasize the crucial role of multidisciplinary expert centers in the management of these patients. This pathway is available on the VASCERN website (http://vascern.eu/).

Childhood adversity and coping among Indigenous university students in Canada: Considerations when examining adverse childhood experiences.

Adverse childhood experiences (ACEs) are associated with health-risk behaviors and chronic disease development. Although valuable, conventional ACE surveys may fail to adequately capture the range of adversities that some communities experience. The primary objective of this study was to investigate whether First Nations and Metis postsecondary students and staff in Ontario identified domains of ACE not captured by conventional ACE surveys. In addition, this study aimed to identify potential coping strategies or factors. Qualitative interview and focus group methodologies were used; notably, we integrated aspects of the nominal group technique with elements of First Nations Sharing Circles. The data were thematically analyzed and organized by their impact as perceived by participants. Sixteen First Nations and Metis participants (ages 21-38) shared five additional domains of ACE: historical trauma, lack of infrastructure and public services, household and community dysfunction, gender-based adversities, and racial discrimination. Four domains of coping strategies and factors were identified: healing from trauma, improving cultural connections, strengthening social networks, and developing skills and knowledge. Findings highlight the need to appreciate the sociological and historical experiences of communities, not just individuals, when surveying ACE among Indigenous youth. Specifically, when surveying ACE in Indigenous populations, measures should be expanded to include historical trauma, lack of infrastructure and public services, gender-based adversities, and racial discrimination. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The research focus of academicians in analyzing women entrepreneurship intentions: A 40-year scientometric review with thematic analysis and NGT.

The research focus of academicians in analyzing women entrepreneurship intentions: A 40-year scientometric review with thematic analysis and NGT.

Exploring the Subjective Financial Well-Being of Indigenous People Communities in Malaysia

This study explores the subjective financial well-being of Indigenous People in Malaysia. Although the concept of financial well-being is strongly established in past studies, the perception of well-being conceptualization from the indigenous people’s view is still not clear. Fifteen heads of households of Indigenous People from the Mah Meri tribe participated in the study. A qualitative method uses an exploratory research design to present information obtained via the Nominal Group Technique. The results of the study on the concept of subjective financial well-being formed three major themes: (1) sufficiency, (2) comfort, and (3) satisfaction. Based on the study’s findings, most informants have good financial socialization, implying Indigenous communities’ ability to embrace well-being. The implication of this research finding is that knowledge and information regarding the utilization and management of finances ought to be assimilated by the Orang Asli Mah Meri so that they do not become victims of modern-world hedonism and luxury brought about by mainstream society. The contribution of this study to the existing body of knowledge can be seen theoretically from the perspective of multi-linear social change. According to multi-linear theorists, human culture has evolved along multiple lines. Meanwhile, contemporary sociologists argue that social changes or occurrences do not happen in a planned manner.

Prioritisation of functional needs for ICU intelligent robots in China: a consensus study based on the national survey and nominal group technique

ObjectiveThis study aims to define the prioritisation of the needs for an intelligent robot’s functions in the intensive care unit (ICU) from a clinical perspective.DesignThis study introduces a nominal group...

Development of the Philippine National Unified Health Research Agenda 2023–2028

BackgroundEffective health research priority-setting (RPS) is essential for directing resources toward the most pressing health challenges and ensuring that research efforts are aligned with national and global health goals. Various RPS frameworks emphasize structured methodologies, stakeholder engagement, and transparent decision-making to enhance research impact. In the Philippines, the National Unified Health Research Agenda (NUHRA) serves as a strategic roadmap for health research, updated every six years to reflect evolving public health needs.MethodsThis project developed the NUHRA 2023–2028 through bottom-up prioritization, nominal group technique, multicriteria decision analysis, and consensus markers. We conducted 17 regional workshops and 1 national consultation to seek inputs from stakeholders. Generative AI assisted in the process of synthesizing research topics. Evaluation forms were deployed to workshop participants towards improvement of future RPS processes.ResultsThis research prioritization exercise involved over 500 participants across the country, facilitated through 17 regional workshops and 1 national validation meeting. This resulted in 11 research themes with 41 subthemes that represent the interests of health research stakeholders nationwide.ConclusionThe NUHRA 2023–2028 continues to underscore the importance of a unified vision in health research. A notable enhancement in this iteration of the NUHRA is the deliberate use of decision thresholds, ensuring more precise and informed choices. Beyond being a list of research priorities, the NUHRA 2023–2028 is a reflection of the Philippines’ dedication to continually refine its RPS approach, ensuring the NUHRA remains relevant and impactful.

Values, principles and research priorities for the implementation of type 2 diabetes prevention after gestational diabetes: A global consensus from Asia, Africa, Americas, Europe and Oceania.

The implementation of type 2 diabetes prevention after gestational diabetes (GDM) is poor despite research evidence on efficacy. This is limited by the lack of knowledge of the priorities in real-world settings from the perspectives of local clinicians and women with lived experiences, particularly those from underserved populations. We report here a global consensus on the values, principles, and research priorities for the implementation of type 2 diabetes prevention in individuals after gestational diabetes (GDM), from the perspectives of clinicians and women from Asia, Africa, Oceania, the Americas, and Europe. A team of health professionals and researchers from five continents formed the Cardiometabolic Health Implementation Research in Postpartum individuals (CHIRP) team. The CHIRP team undertook a priority setting process using the Modified Delphi and Nominal Group Technique. Health professionals and women with a lived experience of GDM from five continents were invited to participate. Values, principles, and research priorities were voted on by all participants. A total of 100 consumers and health professionals from 11 countries across the five continents participated in the consensus process. The top-ranked values and principles were 'universal access', 'evidence-based', and 'equity-driven'. The top-ranked research priorities were 'stress and mental well-being', 'information on exercise and diet', 'lactation and breastfeeding', 'exercise after childbirth', and 'physical environment for healthy eating'. Addressing mental wellbeing through strategies that are universally accessible, evidence-based, and equity-driven will increase the success of the real-world implementation and knowledge translation of type 2 diabetes prevention in women with a history of GDM in global settings.

Pediatric Randomized Clinical Trials in Community Hospitals: Strategies to Enhance Site Participation and Engagement.

Community hospitals provide the majority of inpatient pediatric care in the United States but face significant barriers to conducting research. More equitable research participation across the spectrum of hospital types that deliver inpatient pediatric care can improve pediatric care quality and generalizability of research findings. Thus, we sought to identify strategies to promote community hospital participation in pediatric randomized clinical trials (RCTs). We convened an interdisciplinary group of 33 panelists with expertise across clinical roles (eg,physicians, nurses), nonclinical partners (eg,parents, clinical trialists), and practice environments (eg,children's and community hospitals). We conducted 2 rounds of consensus building using the nominal group technique. Panelists brainstormed, discussed, and scored strategies in each round. Round 1 was conducted within small groups to broadly identify potential strategies. Round 2 was conducted as a large group to refine and rescore top strategies. We performed descriptive analyses of scores and qualitative content analysis of identified strategies (including member checking). Panelists identified 119 ideas in round 1. The 20 highest scoring ideas from round 1 were presented in round 2, where 19 strategies were scored then refined into 14 specific strategies. We identified 3 overarching domains: (1) policy changes in funding prioritization and scientific review guidelines, (2) systems for providing centralized resources, and (3) research design and planning tailored to community hospital participation. We identified 14 strategies for supporting the conduct of pediatric RCTs in community hospitals. Implementing these strategies will require structural changes to RCT design and recruitment for hospitals, funders, and investigators.

Establishing a research partnership for delivering palliative and end-of-life care for older people in rural and remote areas: a formative mixed-methods study.

Many older people live in rural and remote areas. As the ageing population grows, conditions such as cancer, dementia and stroke will become more prevalent, causing a huge demand for palliative and end-of-life care. However, evidence regarding models of care and interventions in rural and remote areas is limited. A new United Kingdom rural palliative care partnership was funded for 12 months. It aimed to understand the models of palliative and end-of-life care for older people with cancer, dementia and stroke in rural/remote areas across all four nations of the United Kingdom. It also aimed to identify the core priorities for research into rurality and palliative care for older people. The project consisted of three integrated components, including: (1) a scoping review of relevant literature on rural palliative care for older people with cancer, dementia and stroke; (2) stakeholder engagement workshops using a modified Nominal Groups Technique and (3) qualitative interviews with family carers who supported rural-/remote-dwelling older adults towards the end of life. Our scoping review was undertaken in 2022. The search identified 1128 unique citations, of which five papers were included. There were no United Kingdom studies on models of palliative and end-of-life care delivered to older people with cancer, dementia or stroke within rural/remote locations. However, international models of care were identified. Models included technological interventions to reach those in remote locations, the role of palliative care nurses and the use of volunteers. Articles highlighted the importance of not replacing face-to-face care with technology for ease of reaching more people and emphasised the importance of effective interdisciplinary working in rural and remote palliative care. Additionally, three online workshops to develop research capacity, identify models of care, understand issues of rurality and determine research priorities were attended by 15-20 stakeholders. Qualitative interviews were also undertaken with 20 family carers who had supported rural-/remote-dwelling older adults at their end of life. Data identified that rural/remote communities face challenges in accessing palliative and end-of-life care due to issues such as transport to and distance from services, poor broadband coverage and problems with workforce recruitment and retention. Synthesising the data from these methods helped to identify some interventions and models of care for palliative and end-of-life care for older people in rural and remote areas. It also helped us to jointly shape and develop research priorities, which included workforce planning and service composition, facilitating preferred place of death and the role of technology. However, there are gaps in our understanding about how to improve the family carer support as well as digital literacy among older people to help them benefit from technological interventions. Overall, there is a lack of research on palliative and end-of-life care models and interventions provided to older adults with cancer, dementia and stroke in rural and remote settings, especially in the United Kingdom. There is an urgent need to co-design community-based models of palliative and end-of-life care in rural and remote locations, considering the unique challenges of living in these areas. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135350.

Exploration of the multi-level barriers to scaling up methadone for HIV prevention among people who inject drugs in Kazakhstan.

Exploration of the multi-level barriers to scaling up methadone for HIV prevention among people who inject drugs in Kazakhstan.

Development and validation of an indigenous questionnaire for assessing clinician's knowledge towards transfusion medicine and bedside transfusion practices.

Due to the non-availability of formal training during residency for clinicians in transfusion medicine, there is a prevalent knowledge gap for transfusion practices, which leads to increased patient risks and elevated healthcare costs. There is no indigenous questionnaire available, which could be used for knowledge assessment. This study aims to develop and validate an Indigenous questionnaire to assess clinicians' knowledge of transfusion medicine and bedside transfusion practices. The questionnaire was designed using a nominal group technique involving subject experts, considering the type of information required, themes, appropriate wording, layout, and presentation. The questionnaire consisted of 25 knowledge-based questions and 4 general questions. Piloting of the questionnaire was done to check for feasibility, validation, and reliability. Content validity was assessed by six experts using the Content Validity Index (CVI). Reliability was assessed using test-retest and split-half methods, with a sample of 56 participants. Cronbach's alpha and Kappa statistics were used to measure internal consistency and agreement, respectively. The questionnaire displayed acceptable feasibility with a mean difficulty score of 6.93 on a scale of 1-10, with test-retest responses showing near-perfect agreement (kappa value 0.8-0.99). All experts gave more than 70% agreement on the relevance of content, with a mean CVI of 85%. Test-retest reliability showed near-perfect agreement (Kappa 0.8-0.99, p = 0.008) and good internal consistency (Cronbach's α = 0.806). The split-half method yielded a Cronbach's α of 0.89 and an intraclass correlation coefficient of 0.88 (95% CI 0.57, 0.97, p = 0.001) Construct validity was confirmed through factor analysis. The developed indigenous questionnaire is a reliable and valid tool for assessing the knowledge of clinicians towards transfusion medicine and bedside transfusion practices. The detailed, methodical strategy used to prepare and validate the questionnaire ensures its applicability and relevance in various clinical settings and can be easily adopted by others intending to prepare similar questionnaires. The questionnaire is available with the author and, on demand, may be provided for knowledge assessment.

Women’s health and healthcare experiences in the years after gestational diabetes or hypertensive disorders of pregnancy

BackgroundPregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), affect a significant proportion of women in Australia, with long-term implications for cardiovascular disease (CVD) risk. Despite existing preventive measures, participation in ongoing health monitoring remains low. This study aims to explore women’s preferences and experiences regarding preventive healthcare after GDM and HDP, and to identify their unanswered questions about the association between these conditions and future CVD risk.MethodsA participatory, qualitative approach was adopted, involving a Lived Experience Expert Group (LEE Group) to plan, conduct, and interpret focus groups with women who had experienced either GDM or HDP. Participants were recruited through health consumer and community organisations and took part in two focus groups conducted via Zoom. The focus groups involved a stimulus presentation about CVD and GDM or HDP, facilitated group discussion about participants’ health and healthcare since their pregnancy, and Nominal Group Technique to prioritise participants’ questions about their CVD risk. Focus groups were audio recorded and transcripts from each group were analysed thematically. Synthesised Member Checking was used to verify the trustworthiness of findings.ResultsTwelve women participated in the focus groups, with distinct themes emerging from the GDM and HDP focus groups. Participants were previously unaware of the association between their pregnancy complication and increased risk of future CVD and wished to know more. Three themes were generated from the GDM focus groups: ‘a distressing diagnosis’; ‘degrees of diabetes’; and ‘balancing motherhood and self-care’. Two themes were generated from the HDP focus groups: ‘women’s concerns were dismissed’ and ‘wanting follow up at the right time and with the right person’. The ‘top ten’ questions from each group focussed on improving maternity care, preventing CVD, and (for the HDP group) concerns beyond CVD.ConclusionsWomen’s capacity to engage in preventive health after GDM and HDP is influenced by their maternity care experiences and the accessibility of primary care pathways. Future interventions should focus on improving woman-centred maternity care, ensuring seamless transitions to primary care, and addressing the social determinants of health for new mothers.

Introducing optimal performance scenario for an Urban Comprehensive Health Center affiliated with Primary Healthcare Network in Iran

Abstract Background The Urban Comprehensive Health Center (UCHC) is a vital institution that offers healthcare services to the people residing in cities in Iran, and its efficient functioning is critical. Objectives This study aimed to introduce optimal performance scenarios for a UCHC using a new methodology to help managers make more efficient decisions. Methods This empirical study was conducted in 2021 at a UCHC in the south of Tehran City, Iran. The study comprised five phases: collecting information about the center, recording the number of patients and the time taken to provide services, analyzing the current state of the center, creating scenarios, and comparing scenarios to identify the best solution. We used Arena21 software to generate scenarios and quantitative criteria, the nominal group technique to analyze proposed decisions, and qualitative criteria and expert choice. Results We extracted three scenarios. The changes in quantitative criteria in the third scenario compared to the current situation were patients entered (94% increase), patients served (137% increase), patients’ waiting time (−107% decrease), and employee productivity rate (3% increase). Qualitative criteria were presented to validate the scenarios. The scores for the quantitative criteria for the current situation and the first, second, and third scenarios were 111, 141, 347, and 401, respectively. For the qualitative criteria, the scores were 116, 208, 216, and 458, respectively. Conclusions The third scenario was the optimal performance scenario. We recommend using simulation tools, extracting decision methods and proposed scenarios, validating scenarios, and making decisions about them for other UCHCs.

The role of single-pill ACE inhibitor/ccb combination for hypertension: an Algerian view via the nominal group technique.

Around one-third of adults in Algeria have hypertension, but > 40% are unaware they have the disease, and of those receiving treatment, only ~ 20-30% have adequate blood pressure (BP) control. Recommended starting treatment is an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker plus a calcium channel blocker (CCB) or diuretic. A single-pill combination of perindopril/amlodipine (ACEi/CCB) recently became available in Algeria. Twelve Algerian hypertension experts reviewed the clinical evidence regarding this therapeutic combination to determine its potential role for hypertension management in Algeria. The evidence indicated that this combination reduces cardiovascular outcomes and visit-to-visit BP variability, effectively controls 24-hour BP, and is well tolerated. In conclusion, the perindopril/amlodipine SPC provides a valuable new treatment option for hypertension in Algeria.

The Utility of Smart Multiple Daily Injection Systems in Intensive Insulin-Treated People With Diabetes: An Italian Expert Consensus.

Smart systems for multiple daily injections (Smart MDI) integrate continuous glucose monitoring, connected insulin pens, smartphone apps, and cloud-based data storage to provide bolus and corrective dose suggestions, reminders/alerts, automatic tracking and sharing of insulin therapy, and glycemic data to users, caregivers, and providers. This is an expert consensus on the clinical value of Smart MDI and critical points for implementation in adults and children/adolescents with diabetes. A nominal group technique combined with the estimate-talk-estimate approach was employed to achieve consensus among panel members from the Italian Intersociety Technology and Diabetes Study Group with expertise in pediatric and adult diabetes care. The expert consensus indicated that glycemic profiles can be improved by using bolus dose suggestions based on glucose values, planned meals, the insulin-to-carbohydrate ratio, correction factors, and consideration of insulin-on-board. Automatic remote sharing of patient data on glycemia and insulin therapy allows clinicians to make more appropriate and timely therapeutic recommendations based on objective data. Dose tracking, bolus reminders/alerts, and reduced hypoglycemia and associated anxiety achieved through Smart MDI may improve adherence. Smart MDI can reduce treatment burden while improving the daily experiences and glycemic outcomes for adults and children/adolescents with type 1 or type 2 diabetes. However, high-quality clinical data are lacking, and more evidence is needed to compare the effects of Smart MDI and other advanced insulin delivery systems on glycemic and patient-reported outcomes.