Rounds Of Consultation Research Articles

A theoretical model for brisk walking- and running-induced lower urinary tract symptoms (BRUTS) and the development of the BRUTS-questionnaire (BRUTS-Q): A focus group and Delphi study.

Existing questionnaires provide limited information on the nature, severity and context surrounding lower urinary tract symptoms (LUTS) experienced during running, jogging and brisk walking. The aims of this study were to develop a theoretical model of the experience of LUTS by females participating in gait-based exercise activities and to use this model to generate a questionnaire to evaluate the presence, symptoms and bother associated with LUTS experienced by females during gait-based activities. A theoretical model was developed through a review of the literature and refined through a focus group consultation including pelvic health physiotherapists, females who experienced leakage during exercise and academic researchers who studied female LUTS. A draft questionnaire was developed using key constructs identified in the model by the focus group. A new expert panel was recruited, which included physiotherapists, women with self-reported gait-induced LUTS and urogynecologists. This panel followed a DELPHI process to evaluate the relevance and completeness of the constructs within the questionnaire. Two rounds of consultation were required to reach consensus on the completeness of included constructs as well as the inclusion and wording of questions. The resulting questionnaire contains questions related to five key constructs: physical activity characteristics, symptoms of urgency, urgency urinary incontinence, stress urinary incontinence experienced during exercise and management/mitigation strategies adopted by respondents. The content validity of the brisk walking- and running-induced lower urinary tracts symptoms questionnaire has been established. The next steps are to ensure that the questionnaire has adequate comprehensibility, followed by adequate measurement properties.

Psychometric validation of the Chinese version of the longer-term Unmet Needs after Stroke monitoring tool for stroke patients

Purpose This study aimed to translate, adapt, and test the psychometric properties of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool for Chinese stroke patients. Materials and Methods The LUNS monitoring tool was translated and cross-culturally adapted using the Functional Assessment of Chronic Illness Therapy translation methodology and two rounds of expert consultation. A cross-sectional study was conducted to test the validity and reliability of the Chinese version of the tool from April to October 2023 in Xi’an. Results The Chinese version of the LUNS monitoring tool had a Cronbach’s alpha value of 0.702 and the ICC was 0.732 (p < 0.001). The I-CVIs were above 0.90 and the S-CVI/Ave was 0.983. The factor analysis extracted eight factors, collectively accounting for 66.283% of the data variance. The correlation coefficient between the LUNS and WSO needs assessment questionnaire was 0.105 (p = 0.019). Conclusions The study confirmed good reliability and validity of the Chinese version of the LUNS monitoring tool in measuring the prevalence and level of unmet need in stroke patients. It will help identify the unmet needs of stroke patients, and to guide rehabilitation service response during individual patient consultations, facilitate service development, and inform commissioning decisions.

Construction of a Competency Evaluation Indicator System for Specialist Nurses in Liver Transplantation: A Delphi Study.

Liver transplantation specialist nurses provide comprehensive and safe care for liver transplant patients, which requires them to have a wide range of competencies. However, at present, there is no comprehensive understanding of the competency of liver transplantation specialist nurses in China, and there is a lack of comprehensive evaluation indicators. The purpose of this study was to construct a competency evaluation indicator system for specialist nurses in liver transplantation. Utilizing the "Iceberg model" of competency, the indicator system for evaluating the competency of liver transplant specialist nurses was developed through literature review, semi-structured interviews, and two rounds of Delphi expert consultation. Twenty nursing and medical experts in liver transplantation were consulted over two rounds. The effective response rates for the expert consultation questionnaires were 90.91% and 100.00% for the first and second rounds, respectively. The coefficient of expert judgment was 0.920, the coefficient of familiarity was 0.880, and the authority coefficient was 0.900. The value range of the coefficient of variation in the second round was 0.00-0.16, both <0.25, indicating that the degree of coordination of expert opinions was high. The final competency evaluation index system for liver transplant specialist nurses encompassed 6 primary indicators, 17 secondary indicators, and 59 tertiary indicators, including professional knowledge, professional skills, social role, self-concept, personality quality, and motivation. The developed competency evaluation indicator system for liver transplant specialist nurses possesses scientific validity and reliability, offering a reference for the training and assessment of liver transplant specialist nurses.

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

The commonly used international patient-reported outcome scales for breast cancer were developed before the advent of multiple targeted therapies and immunotherapies, rendering them potentially insufficient for current clinical practices. Therefore, it is necessary to develop a specific patient-reported outcome scale tailored for breast cancer patients in China to optimize the management model for these patients. A comprehensive literature search was performed in the PubMed, Embase, Wanfang, and CNKI databases to extract dimensions and items for a potential patient-reported outcome scale. The Delphi method was used to modify, add, subtract, and adjust the language of items until the experts reached a consensus on the first draft. This draft was further refined using a cognitive test and a presurvey. The optimized scale was used for a formal survey, and the items were further analyzed and screened using metrics such as the coefficient of variation, correlation coefficient, internal item consistency, factor analysis, reliability, and validity. A total of 10,954 articles were analyzed, and 237 were used to create a pool of 277 patient-reported outcome items. Through two rounds of Delphi expert consultation, the experts' authority coefficients were 0.739 and 0.826. After a cognitive test, several items were adjusted to enhance understanding. Further adjustments were made following a presurvey of 200 advanced breast cancer patients, resulting in a 38-item patient-reported outcomes scale, termed NCC-BC-A. In the national formal survey, 588 advanced breast cancer patients participated. Principal component analysis showed good consistency among the items and sufficient difference between the dimensions. The results were normally distributed with good variation. The Cronbach's α coefficient of the scale was 0.925 and the test-retest reliability was 0.9041. The NCC-BC-A scale has high validity and reliability. It comprehensively considered the characteristics of systemic treatment for breast cancer, and the specific context within China. Its implementation may help clinicians to pay more attention to quality of life of breast cancer patients and to optimize the system for managing this condition.

Constructing a Competency Training Index System in Public Health Emergencies for Community Nurses.

A competency training index system was designed in public health emergencies for community nurses. The purpose of this approach is to provide community nurses with guidelines for standardized training programs on how to respond to public health emergencies. Through semi-structured interviews, a literature review, and team discussion, the first draft of competency training index system in public health emergencies for community nurses was formed. The Delphi method was used for two rounds of expert consultation to screen, modify and determine indicators. Finally, the analytic hierarchy process was utilized to calculate the weights of indicators at all levels. A total of 15 expert consultants were included. The effective recovery rate of the two rounds of expert consultation questionnaire was 100%, the expert authority coefficient was 0.880, 0.887, and the Kendall coordination coefficient was 0.172 and 0.171 (p < 0.001). Expert opinions have determined that the final revised competency index system in public health emergencies for community nurses training consists of 2 primary indicators, 10 secondary indicators, and 46 tertiary indicators. The study has developed a competency training index system in public health emergencies for community nurses. This system can serve as a foundation for standardized training in community health service institutions. It is characterized by its high demand, scientific approach, reliability, and rationality.

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

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

Development and Psychometric Evaluation of the Sexual Life Quality Evaluation Tool for Patients With Coronary Heart Disease.

Patients with coronary heart disease (CHD) will have a series of sexual problems, and their sexual life quality can be affected. However, a standardised evaluation tool for patients with CHD was lacking. Therefore, this study aimed to develop a sexual life quality questionnaire for patients with CHD and to evaluate its psychometric properties. Based on previous phenomenological studies, literature analysis and group discussion, questionnaire items were formed. After two rounds of expert consultation and pre-survey, the questionnaire items were modified. Items were screened by item analysis. Exploratory factor analysis and confirmatory factor analysis were used to explore and confirm the structure of the questionnaire. Content validity and criterion validity were evaluated using the expert consultation and correlation analysis, respectively. The questionnaire reliability was evaluated using internal consistency, split half reliability, and test-retest reliability. The sexual life quality questionnaire of patients with CHD was developed, which included two versions: male version and female version. The male version of the questionnaire contains 3 dimensions and 20 items, while the female version contains 3 dimensions and 17 items. After reliability and validity test, the two versions of the questionnaire have good reliability and validity. In this study, the sexual life quality questionnaire of patients with CHD was developed and its psychometric properties were confirmed, which can be used to evaluate the sexual life quality of patients with CHD. The development of a sexual life quality evaluation tool for patients with coronary heart disease to provide objective and quantitative tools for clinical staff to evaluate patients' sexual life status. Patients were invited to participate in a questionnaire survey for this study.

Study on the index system for field epidemiological investigations of viral respiratory infectious diseases

The study used the Delphi method to conduct two rounds of expert consultations involving 23 experts nationwide, aiming to establish the comprehensive index system for field epidemiological investigations of viral respiratory infectious diseases and determine the weights assigned to each index through the hierarchical analysis. Both rounds of consultation witnessed a 100% participation rate among all experts, with a coefficient of authority (Cr) reaching 0.89. The Kendall's W coefficients for assessing the importance and feasibility in both rounds were 0.108, 0.234, 0.439 and 0.427, respectively. Finally, an index system consisting of seven first-level indicators, 18 second-level indicators, and 36 third-level indicators was constructed for the technical guidelines governing field epidemiological investigations into viral respiratory infectious diseases, and the weight of each indicator was established. The index system constructed in this study has a high degree of scientificity, reliability and operability, but it still needs to be further adjusted and improved in combination with the epidemiological characteristics of viral respiratory infectious diseases.

Construction of a Home Hospice Care Program for Older Adults at the End of Life with Chronic Diseases in China: A Delphi Method.

With the increasing aging of the population and the increasing incidence of chronic diseases in China, home hospice care services can meet the desire of the older adult with chronic diseases to receive care and die at home. In order to ensure the real application of hospice in families, the goal of the study was to construct a home hospice care program for the older adult at the end of life with chronic diseases based on Harmony Nursing Theory (composed of three parts: harmony needs assessment, harmony mechanism establishment and interpersonal interaction). Through literature review, a qualitative interview and group discussion, the first draft of a home hospice care program for the older adult at the end of life with chronic diseases based on the harmony nursing theory was developed, which was further revised and finalized by combining the Delphi method of expert correspondence with 19 experts and a pilot study with a home hospice care team. A total of two rounds of expert correspondence were conducted. In the first round, 21 questionnaires were distributed and 19 were returned, yielding a recovery rate of 90.48%. In the second round, 19 questionnaires were distributed, and 19 questionnaires were collected. The recovery rate was 100%. The authority of the two rounds of expert correspondence was 0.96, and Kendall's coefficient of concordance (W) was 0.268 and 0.310, respectively. After the first round of Delphi expert consultation, 3 items were deleted, and 12 items were revised. In the second round of Delphi expert consultation, two items were revised. The final version of the home hospice program includes 4 first-level items, 20 second-level items, and 59 third-level items. The home hospice care program based on harmony nursing theory is authoritative and scientific and can provide a reference for the practice of home hospice care for the older adult with chronic diseases.

Development of an evaluation system for rational drug use in patients with chronic kidney disease using the Delphi method.

Chronic kidney disease (CKD) stages 3-4 present a significant clinical challenge due to the absence of a systematic approach to managing associated medication-related problems (MRPs). This lack of a structured framework hinders the timely identification and effective intervention for these complications, potentially compromising patient safety and prognosis. This study aims to leverage the Delphi method to establish an evaluation index for a rational drug use evaluation system dedicated to CKD patients in stages 3-4. This system will function as a platform for the continuous identification and management of MRPs, ultimately contributing to improved medication safety and patient outcomes. This research uses the modified Delphi technique to develop an evaluation system for rational drug use in patients with chronic kidney disease. The initial questionnaire was developed by literature review for patients with chronic kidney disease. Twenty-six senior experts formed a panel in order to evaluate items across two Delphi rounds. Consensus was defined as at least 95% agreement (first round) and 85% agreement (second round), agreeing with an average score of at least 4.5 (first round) and 4.0 (second round). Items that fulfill the stipulated criteria are eligible for inclusion in the consensus list. All experts participated in both rounds (100% response rate). Consensus was achieved on three patient-related items in the first round of 34 items. Based on expert feedback, 18 revised items were included in the second round after refining, restructuring, and removing some elements. Following two rounds of consultation, 20 items achieved consensus, encompassing aspects such as drug selection, dosage assessment, treatment duration, prescription and dispensing practices, patient-related factors, and other relevant considerations. This study has successfully identified 20 key evaluation indicators for a rational drug use evaluation system specifically designed for CKD patients in stages 3 and 4. This system will serve as a tool for continuous MRP identification and timely intervention, ultimately enhancing medication safety and patient prognosis.

Construction of a Continuous Nursing Quality Evaluation Indicator System for Inflammatory Bowel Disease Patients Based on Donabedian's Three-Dimensional Quality Structure

Objective To construct a continuous nursing quality evaluation indicator system for inflammatory bowel disease patients and provide a basis for the evaluation of continuous nursing quality. Methods On the basis of Donabedian's three-dimensional (structure,process,and outcome) quality structure,we employed literature review,qualitative interview,Delphi method,and hierarchical analysis to determine the content and weights of indicators of continuous nursing quality for the patients with inflammatory bowel disease. Results A total of 15 experts completed 2 rounds of consultation,which had the questionnaire recovery rates of 100%,the expert authority coefficients of 0.930 and 0.919,and the Kendall harmony coefficients of 0.149 and 0.177 (both P<0.001),respectively.The established nursing quality evaluation indicator system included 3 first-level indicators,10 second-level indicators,and 39 third-level indicators. Conclusion The continuous nursing quality evaluation indicator system for the patients with inflammatory bowel disease that was constructed in this study was reasonable,reliable,and practical,providing reference for evaluating the continuous nursing quality for the patients with inflammatory bowel disease.

Construction of Preoperative Assessment Program for Day Surgery in Geriatric Cataract Patients: An Evidence-Based Delphi Study

PurposeTo construct a scientific cataract day surgery preoperative assessment program to provide a scientific assessment tool for health care providers. DesignLiterature review, two-round e-Delphi study, and quantitative studies. MethodsWith the recommended opinions of clinical practice guidelines for cataract surgery as the guiding framework, an item pool was formed on the basis of literature review and guideline content analysis, and the dimensions and items of evaluation program were determined by two rounds of correspondence consultation using Delphi expert method. Then, 315 patients from an ophthalmic hospital were selected for investigation to analyze its reliability and validity. FindingsThe positive coefficients for the 2 rounds of correspondence with experts were 100.00% and 95.83%, and the authority coefficients were 0.90 and 0.89. Kendall's coordination coefficient W values of 0.29 and 0.24 for the first and second rounds and the differences were statistically different (P < .05). The coefficient of variation was 0.14 and 0.10, respectively. The formal assessment items included 3 first-level indicators, 12 secondary-level indicators, and 48 tertiary indicators, with an overall Cronbach's coefficient of 0.66 and cumulative variance contributions of 69.19%, 65.84%, and 57.15% for the 3 first-level indicators. ConclusionThe high reliability of the preoperative cataract day surgery program compiled by applying evidence-based analysis and the Delphi method can provide scientific guidance to clinical nurses for preoperative assessment, which in turn ensures patient safety and improves the quality of patient access services.

Establishing Nursing-Sensitive Quality Indicators for the Central Sterile Supply Department: A Modified Delphi Study.

Previous studies have shown that improving quality management in the central sterile supply department (CSSD) is an effective measure to control and decrease hospital-acquired infections. This study aimed to establish nursing-sensitive quality indicators for CSSD nursing in China. We drafted nursing-sensitive quality indicators on the basis of the Structure-Process-Outcome model, and then conducted 2 rounds of consultation with experts using a modified Delphi method to determine the indicators and scientific methods of measurement. We identified five CSSD nursing-sensitive quality indicators. Recovery rates of the 2 rounds of valid questionnaires were 100%. Expert authority coefficients were 0.810 and 0.902, respectively. Kendall's coefficients of concordance were 0.168 and 0.210, respectively ( P < .05). Evidence-based nursing-sensitive quality indicators for the CSSD were established.

Construction of an index system of core competence assessment for sleep medicine nurse specialists in China: a Delphi study

AimTo construct an evaluation index system for the core competence of nurses in sleep medicine specialties.BackgroundSpecialized nurses in sleep medicine must handle treatment, nursing, and management well, which requires nurses to have excellent competence in knowledge, skills, and ability. However, a competency evaluation system for sleep medicine nurses has not been established in China.MethodsWe used a literature review and an expert meeting to establish a draft indicator system. Subsequently, two rounds of correspondence were conducted with 27 experts from 5 provinces using the Delphi method to solicit their opinions on the core competency evaluation indicators for sleep medicine nurse specialists and to qualitatively evaluate the experts’ scores. The consensus was defined in advance as a mean score of 4.0 or above, with at least 75% agreement among participants. In this way, the final indicator framework was determined.ResultsThe final evaluation indexes of the core competencies for sleep medicine Nurse Specialists included 6 first-level indexes (Practical ability, Theoretical Knowledge, Critical thinking, Communication and coordination, Nursing Management, and Professional Development), 16 s-level indexes, and 64 third-level indexes. The effective response rates of the two expert consultation rounds were 100%. The expert authority coefficients were 0.878 and 0.865 in the first and second rounds of consultation, respectively. In the second round of consultation, the first, second, and third indexes of Kendall’s coefficient of concordance were 0.373, 0.351, and 0.286, respectively (P < 0.05).ConclusionThe core competence evaluation index system for sleep medicine nurses established in this study is scientific and reliable and can provide a theoretical reference for the training, assessment, and evaluation of sleep medicine nurses in the future.Implications for nursing managementThe evaluation index system of sleep medicine nurses’ core competence will provide an effective practical framework for nursing management to evaluate, train, and examine the core competence of sleep medicine nurses.

Delphi method investigation and research on the revision of Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013)

Objective: To explore the expert opinions on the revision of the Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) . Methods: In March 2023, the improved Delphi expert consultation method was adopted, in the first round of consultation, a pre-survey was conducted on 20 experts, and the questionnaire was improved according to the experts' opinions. Then, a second round of expert consultation questionnaire was formed to conduct a questionnaire survey and consultation of 50 experts engaged in occupational disease diagnosis and related work. The feedback of experts was collected and analyzed. Results: The average score for the scientificity and progressiveness of the main technical content of the original standard was 3.33, and the average score for the rationality and operability of the main technical content of the original standard was 3.25. The importance of individual indicators with specific connotations were ranged from 4.20 to 4.45, with coefficients of variation <0.25, and the experts' opinions were relatively concentrated. The experts have provided feedback indicating that the original standard had issues such as lack of continuity in diagnostic gradation, the need to integrate biomarkers with urinary and hair arsenic levels, a scarcity of objective diagnostic indicators, the removal of exposure response from the main text, and a low level of consistency in standard usage. These issues need to be revised urgently. Conclusion: The Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) should be revised based on experts' feedback and suggestions to meet the current real demand for occupational arsenic poisoning diagnosis.

Formulation of the Best Practice Evidence-Based Nutrition Management Protocol for Nasopharyngeal Carcinoma Patients Undergoing Chemoradiotherapy

To formulate a nutrition management protocol and processes for nasopharyngeal carcinoma patients undergoing chemoradiotherapy. A nutrition management protocol and the process for nasopharyngeal carcinoma patients undergoing chemoradiotherapy were formulated on the basis of literature review and the Delphi expert consensus method. Literature analysis and two rounds of Delphi expert consultations via correspondence were conducted. The final protocol subsequently derived included 7 first-level items and 36 second-level items. The first-level items included the establishment of a nutrition management team, nutritional risk screening and nutritional status assessment, health education, the timing and method of nutritional treatment, energy and nutrient supply, nutritional monitoring, and follow-up after discharge. After summarizing the best evidence for the nutritional management protocol and classifying the evidence by different grades, the construction process of the nutrition management team and the nutrition management processes for the pre-cancer treatment period, the tumor treatment period, and the post-discharge follow-up period were formulated. The nutritional management protocol and the relevant processes for nasopharyngeal carcinoma patients undergoing chemoradiotherapy formulated in this study demonstrate a certain level of scientific validity and reliability and can be further tested and applied in clinical practice.

Building an evaluation index system of musical collaborative capacity for China’s compulsory music education: Using a combined Delphi method and Analytic Hierarchy Process approach

The latest version of China’s National Compulsory Education Curriculum Programme and Standards 2022 (hereafter CECPS 2022) emphasises the cultivation of students’ collaborative capacities, mentioning ‘ carrying out the core literacy effectively’. From the perspective of music education, this study summarises the requirements for collaborative activities in compulsory courses of the music discipline within CECPS 2022 in the light of Social Interdependence Theory, and builds an Evaluation Index System of Collaborative Capacity (hereafter EISMCC) by employing the Delphi method and an Analytic Hierarchy Process approach. After 3 rounds of expert consultations and revisions, it was found that EISMCC in compulsory music education is comprised of 3 first-level indices, 7 second-level indices and 20 third-level indices. The index framework and the results of the weight distribution with reliable quality reflect the experts’ emphasis on the process, goal orientation and synergistic interaction of collaborative activities in music learning. The whole system considers people’s general understanding of collaborative capacity, the calls within CECPS 2022 for collaborative music activities, and the practical demands of music teaching in compulsory education. This study provides a theoretical basis, a design process paradigm, practical guidance and a valid tool for the evaluation of collaborative capacity in compulsory education.

Development of an emergency science popularization capacity index system for nurses in China-A Delphi study.

To construct a popularization of an emergency science capacity index system for nurses based on the iceberg model. A mixed-method research design incorporating quantitative and qualitative components was used. In this study, the first draft of the questionnaire was developed through literature analysis and semi-structured interviews. According to the Delphi expert inclusion criteria, 20 experts with rich experience in the field of science popularization were selected, and the system of emergency science popularization ability of nurses was ultimately developed through two rounds of consultation according to the Delphi method. The weights of various indicators were determined through hierarchical analysis. Following two rounds of Delphi surveys, a total of 3 primary, 6 secondary, and 26 tertiary indicators were identified. The indicators were found to be highly significant, with variation coefficients ranging from 0.063 to 0.140. The Kendall's harmonization coefficients for the primary, secondary, and tertiary indicators were 0.350, 0.341, and 0.146, respectively. The popularization of the emergency science capacity system has a certain scientific and practical significance, which is of guidance to the competency of nurses in public health emergencies. No patient or public contribution. This study did not involve patients, service users, caregivers, or members of the public.

Validation of the personal suicide stigma questionnaire among adolescents with suicide attempts in mainland China.

The study aimed to translate and culturally adapt the personal suicide stigma questionnaire (PSSQ) into simplified Chinese and evaluate its psychometric properties among adolescents who have attempted suicide in mainland China. Following Brislin's translation model and using purposive sampling, we surveyed 440 adolescents who had attempted suicide at Hangzhou Seventh People's Hospital in Zhejiang Province, China. Content validity was determined by a panel of experts, and the construct validity of the scale was assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), convergent validity, and discriminant validity. Reliability analysis was evaluated using Cronbach's α coefficient, test-retest reliability, and half-split reliability. The Chinese version of the PSSQ consists of three dimensions and 14 items. After two rounds of expert consultation, the item-content validity index for all items exceeded 0.70, and the scale-content validity index exceeded 0.90. EFA extracted three factors and retained all 14 items. The CFA indicators demonstrated a good fit. The Cronbach's α coefficient of the scale was 0.880, the half-split reliability was 0.681, and the test-retest reliability was 0.862. It is evident that the PSSQ and its subscales demonstrate stable structural validity and good internal consistency in measuring self-stigma among individuals with suicidal tendencies, indicating that the PSSQ is a reliable tool for assessing the degree of personal stigma in Chinese adolescents who have attempted suicide. This study ensured the linguistic and cultural appropriateness of the Chinese version of the PSSQ through cross-cultural adaptation and validation of its reliability and validity, thereby enhancing the accuracy and reliability of assessing personal stigma among Chinese adolescents who have attempted suicide. The validation of the Chinese version of the scale not only enriches the research tools available for studying personal stigma related to suicide in mainland China, but also provides a reliable quantitative tool for future research on the psychological states of individuals who have attempted suicide, the impact of stigma, and the effectiveness of interventions.

Preliminary Validation of a Clinical Reasoning Theory-Based Assessment Rubric: An e-Delphi Study.

Questions persist regarding the evaluation of cognitive processes related to clinical reasoning when resolving situations in a learning by concordance tool. This Delphi technique study aimed to validate a clinical reasoning assessment rubric based on script theory. Seventeen experts participated in the study. Two rounds of consultation were conducted to obtain a consensus on the accuracy and clarity of the rubric descriptors (clarity index and content validity index ≥ 0.9). The results inform future research procedures and the intended use of the rubric to facilitate evaluator inferences, provide student feedback, and support the development of learners' clinical reasoning.