Second Round Of Consultation Research Articles

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.

The development of a performance evaluation index system for Chinese Centers for Disease Control and Prevention: a Delphi consensus study

BackgroundThe performance evaluation of the Centers for Disease Control and Prevention (CDC) is crucial for enhancing the quality of public health services. With the ongoing reform of the CDC system in China, the existing performance evaluation system faces challenges. This study used the Delphi method to develop a new performance evaluation system for China’s provincial, city, and county-level CDC.MethodsFollowing the “Structure-Process-Outcome” model, assessment indicators were systematically collected. Indicators were modified and screened through two Delphi rounds based on CDC responsibilities, health development, and national policies. Twenty-four experts provided ratings and recommendations, and the research team evaluated questionnaire reliability, expert positivity, expert authority, and opinion consistency.ResultsThe preliminary index system identified through the literature review and pre-survey included 11 primary, 30 secondary, and 64 tertiary indicators. After the first round of consultation, two secondary indicators and 11 tertiary indicators were removed and 22 tertiary indicators were added. After the second round of consultation, three secondary indicators and 11 tertiary indicators were removed and three tertiary indicators were added, at which point the p-value of the test for Kendall’s coefficient of concordance W was < 0.001 and the coefficient of variation was within acceptable limits (< 0.25), so the consultation was concluded. The final index system included 11 primary, 25 secondary, and 67 tertiary indicators.ConclusionsThis study responded to the CDC system reform by developing a comprehensive performance evaluation index system for provincial, city, and county-level CDC in China. The index system is both scientifically grounded and practical, serving as an effective tool for promoting the high-quality work of CDC organizations.

Construction of an index system of core competence assessment for otolaryngology nurse specialists in China: A Delphi study

BackgroundClinical nurse specialists play a vital role in the work quality, patient safety and team development of nurses. However, there is currently no prior study constructing the index of core competence assessment for otolaryngology Nurse Specialists. ObjectivesTo establish an index system for the evaluation of Chinese otolaryngology Nurse Specialists' core competence. DesignA Delphi study. SettingsThe study was mainly conducted in a university-affiliated hospital in China. ParticipantsTwenty-two experts with otolaryngology knowledge and practical experience from different regions and organizations in China. MethodsWe used literature reviews and expert meetings to establish a draft index system . Subsequently, a two-round Delphi survey was utilized to consult opinions from 22 experts about the index for the evaluation of otolaryngology nurse specialists' core competence and provide qualitative comments on their ratings. Consensus was predefined as a mean important score of 4.0 or above and a coefficient of variation is not above 0.25 among the participants. ResultsThe final evaluation indexes of the core competencies for otolaryngology Nurse Specialists included 5 first-level indexes (clinical competence, critical thinking competence, leadership, professional development competence, professionalism), 19 second-level indexes, and 85 third-level indexes. The effective response rates of the two expert consultation rounds were 100 %. The expert authority coefficients were 0.864 and 0.859 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 0.357, 0.330, and 0.232, respectively (P < 0.001). ConclusionsThe constructed evaluation indexes of the core competencies of otolaryngology Nurse Specialists are scientific, reasonable, comprehensive, and specific and may provide references for the training and evaluation of otolaryngology Nurse Specialists.

Development of a Perioperative Enteral Nutrition Program for Gastric Cancer Surgery

Objective: This study aimed to summarize the current evidence-based approach to perioperative enteral nutritional (EN) program for gastric cancer (GC) surgery and to develop a staged and operable EN management scheme based on the evidence to provide clinical guidance for improving perioperative EN management in patients with GC. Methods: First, we synthesized expert consensuses, systematic reviews, and guidelines related to GC patients who had undergone surgery, based on a review of the literature and expert meetings. Subsequently, after carefully evaluating and selecting relevant EN management data, we created a preliminary draft of a perioperative EN program. Following Delphi expert consultations, the final version of the perioperative EN program was constructed after revision. Results: After two rounds of consultation, the expert opinions tended to be consistent. The expert positive coefficient was 1.00, and the expert authority coefficient was 0.90. After the second round of consultation, the coefficient of variation of the importance score ranged from 0.05 to 0.20, and the coefficient of variation of the feasibility score ranged from 0.09 to 0.23. The Kendall harmony coefficients were 0.338 and 0.392, and the difference between them was statistically significant (p < 0.001). The final practice plan includes 4 first-level, 16 s-level, and 64 third-level items. Conclusions: The perioperative EN program constructed in this study is comprehensive in content, feasible, and evidence-based, and can provide insights for clinical improvement.

The Mana Kai Framework: a degrowth lens

The Mana Kai Framework is a set of values, goals and objectives to improve the food provisioning system in Aotearoa New Zealand, developed through a round of nationwide consultations, with the ultimate purpose of informing a national food strategy. This article builds upon Mana Kai, finding that the consultation process assumed only a growth economy in future; a second round of consultation using a degrowth lens, it is argued, would produce a valuable alternative framework. This could prove fruitful towards the stated Mana Kai aspiration to ignite a social movement to drive significant systemic change, and could, alongside the existing framework, inform a national food strategy that is ready for growth and degrowth futures, both of which are plausible, thereby ensuring a more resilient food system in Aotearoa New Zealand.

Expert consistency evaluation on nutrition and health knowledge questionnaire items for Chinese adults

To establish nutrition knowledge questionnaire items for Chinese adults by Delphi consensus study. The framework system and preliminary items of nutrition knowledge questionnaire were established through literature review and experts consultation, considering the nutrition status and problems of Chinese people. Delphi method was used to conduct consensus analysis with 11 experts in related field involved to determine the nutrition knowledge questionnaire items. The active coefficients of consultation in two rounds were both 100%(11/11), and the authority coefficients of experts were 0.900. The average scores of all items were(4.67±0.28) and(4.80±0.21), the variation coefficients were 0.06 and 0.04, and the Kendall harmony coefficients were 0.261(χ~2=39.645, P=0.004) and 0.324(χ~2=43.122, P=0.001), respectively. After the second round of consultation, all selected items met the inclusion criteria. Finally, 20-item nutrition knowledge questionnaire were determined, including five dimensions of dietary recommendations, food characteristics, nutrition and health, food choices and food safety. The Delphi consensus of nutrition knowledge questionnaire items for Chinese adults were basically achieved.

Construction of pelvic floor muscle rehabilitation training program for patients undergoing laparoscopic radical prostatectomy.

BackgroundLaparoscopic radical prostatectomy (LRP) is the standard treatment for early localized PCa, of which urinary incontinence is the most common postoperative complication. Pelvic floor muscle rehabilitation training is recognized as the first line of intervention measures, but the existing rehabilitation training programs are not clear in the formulation process, the content is not unified, and the clinical operability is not strong. In order to better guide clinical pelvic floor muscle rehabilitation training after LRP and prevent and control urinary incontinence, this study constructed a pelvic floor muscle rehabilitation training program for LRP patients.MethodsLiterature analysis, qualitative interview, and an expert group meeting method were used to form the draft of pelvic floor muscle rehabilitation training program for LRP patients. On this basis, after 2 rounds of Delphi expert consultation, the research team modified and improved the program.ResultsThe consultation experts involved in the 2 rounds were the same, 15 questionnaires were sent out, and 15 were recovered with an effective recovery of 100%. The expert authority coefficient was 0.87. In the second round of consultation, Kendall’s harmony coefficient was 0.14 (P<0.001), the mean coefficient of variation of expert opinion was 0.07 (P<0.001), and the mean value of importance assigned to each item was 4.53–5.00 points. Finally, the pelvic floor muscle rehabilitation training program for LRR patients was formed. Including rehabilitation training evaluation, rehabilitation training advanced time and content, rehabilitation training form of three first-level indicators, 12 second-level indicators, 53 third-level indicators.ConclusionsThe pelvic floor muscle rehabilitation training program for LRP patients developed in this study is scientific, reliable, safe and feasible, which can provide reference for clinical pelvic floor muscle rehabilitation training after LRP and prevention and control of urinary incontinence.

Design of Breakdown and Checklist for Continuous Renal Replacement Therapy

Objective. This study aimed to improve the quality of continuous renal replacement therapy (CRRT). Methods. A pool of candidate indicators was established using literature retrieval, panel discussion, and experience summary. The first round of consultation was performed with the selected 18 experts by the Delphi method. Then, the checklist was modified according to the experts’ opinions for the second round of consultation to prepare the final checklist. Results. The positivity coefficients of experts in the two rounds of consultation were 100% and 88.9%, respectively, with the authority coefficient of 0.88. The Kendall coordination coefficients of the primary and secondary indicators were 0.296 and 0.303, respectively ( P &lt; 0.05 ). Finally, the breakdown and checklist were prepared, which involved 16 primary indicators and 56 secondary indicators. Conclusion. The scientific and reasonable breakdown and checklist prepared based on a consultation can provide scientific guidance for nursing during CRRT, reduce the incidence of adverse events, and improve work efficiency and satisfaction of medical care.

Development of core recommendations on physical activity for Chinese students aged 7-18 years based on Delphi method and analytic hierarchy process

Objective To construct core information about physical activities of Chinese students aged 7-18 years, so as to provide a reference for impoving the level of adolescents' physical activities. Methods Canadian 24-Hour Movement Guidelines for Children and Youth was used as a framework, the preliminary core recommendations on physical activity for Chinese students aged 7-18 years were developed based on qualitative research. Recommendations covered three scales, including physical activity, sedentary behaviour and sleep. Physical activity included four subscales of frequency, intensity, duration and type, while sedentary behaviour and sleep only included one subscale. Three rounds of consultation were conducted using Delphi method. In the second round of consultation, the results of 2014 Chinese National Surveys on Students Constitution and Health were presented to experts for reference. In the third round of consultation, experts need to rank the importance of seven items of physical fitness under the physical activity type subscale by age group through analytic hierarchy process. Results Totally 25, 25, and 18 experts were consulted in three rounds respectively. The questionnaire response rates in 3 rounds were 100.0%, 100.0%, and 94.4%, respectively. The authority coefficients were 0.92, 0.93, and 0.91. The harmony coefficients were 0.63(χ2=237.10, P Conclusion The development of core recommendations on physical activity for Chinese students aged 7 to 18 might help improve physical activity levels and promote health of children and adolescents.

Establishment of nutrition literacy core items for Chinese lactating women

Objective: To establish the nutrition literacy core items for Chinese lactating women. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. E-Delphi method was used to determine the nutrition literacy items. 11 experts in the field of maternal and child nutrition, obstetrics and gynecology, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, authority coefficient and harmony coefficient were evaluated and analyzed to generate the final list of nutrition literacy items. Results: The active coefficients of consultation in two rounds were 81.8% (9/11) and 87.5% (8/9). The authority coefficients were (0.86±0.11) and (0.85±0.06). The average scores of importance were (4.03±1.24) and (4.64±0.50)and the harmony coefficients were 0.556 (χ²=163.42, P<0.001) and 0.40 (χ²=64.41, P<0.001). After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of 3 scales (basic knowledge and concept, lifestyles and dietary behaviors, and basic skills), 10 subscales (basic nutrition concept, food and nutrition knowledge, feeding knowledge, lifestyles, dietary behaviors, feeding behaviors, weight management, complementary food production, acquisition, understanding and application of nutrition information, judgement of nutrition information, and nutrition decision making) with 24 items in total. Conclusions: The framework system and core items of nutrition literacy were established for Chinese lactating women based on E-Delphi method. The experts involved in the consultation process presented a performance with good representativeness, enthusiasm and authority. All experts' opinions are coordinated and unified, which could satisfy the demand of developing nutrition literacy core items for target population.

Establishment of nutrition literacy core items for Chinese old people

Objective: To establish the nutrition literacy core items for older people in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. Content validity test was used to determine the nutrition literacy items. Seven experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of expertstowards the items, active coefficient, and content validitywere evaluated and analyzed to generate the final list of nutritionliteracy items. Results: A total of 85.7% (6/7) of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96. In the content validity evaluation, the correlation I-CVI value of each item was above 0.90 and theκvalue was above 0.74. The evaluation result was excellent. After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), twelve subscales (reasonable nutrition, healthy weight, environment of dining, food classification, nutrition and disease, eat regularly, balanced diet, exercise health, information getting, household food measurement, reading nutrition label and calculating, and food safety)with 20 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese older people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.

Establishment of nutrition literacy core items for Chinese pregnant women

Objective: To establish the nutrition literacy core items for Chinese pregnant women. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. E-Delphi method was used to determine the nutrition literacy items.11 experts in the field of maternal and child nutrition, obstetrics and gynecology, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, authority coefficient and harmony coefficient were evaluated and analyzed to generate the final list of nutrition literacy items. Results: The active coefficients of consultation in two rounds were 81.8% (9/11) and 87.5% (8/9).The authority coefficients were (0.86±0.11) and (0.85±0.06).The average scores of importance were (4.32±0.84) and (4.58±0.57) and the harmony coefficients were 0.387 (χ²=90.472, P<0.001) and 0.290 (χ²=46.752, P=0.002) respectively. After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of 3 scales (basic knowledge and concept, lifestyles and dietary behaviors, and basic skills), 10 sub-scales (basic nutrition concept, food and nutrition knowledge, nutrition and disease knowledge, lifestyles, dietary behaviors, preparation for breastfeeding, gestational weight management, gestational disease management, acquisition, understanding and application of nutrition information, judgement of nutrition information, and nutrition decision making) with 24 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese pregnant women based on E-Delphi method. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority. All experts' opinions are coordinated and unified, which could satisfy the demand of developing nutrition literacy core items for target population.

Algorithms for prevention and treatment of incontinence-associated dermatitis

Objective: To build and validate algorithms for prevention and treatment of incontinence-associated dermatitis. Method: A methodological study. An integrative review of articles published from 2009 to 2019 was carried out after a literature search in the main Health Sciences databases for the construction of the algorithms. The algorithms were evaluated by 27 nurses using the Delphi technique. The content validity index was used for data analysis. Results: The judges evaluated the algorithms from inadequate to adequate in the first round of consultation, and from adequate to totally adequate in the second round of consultation. The global content validity index was 0.923 in the first consultation and 1.0 in the second consultation. Conclusion: After reviewing the literature, the algorithms were constructed and validated by professionals with experience in the area, reaching agreement among the judges in the second round of consultation.

Algorithms for prevention and treatment of incontinence-associated dermatitis

Objetivo: Construir e validar algoritmos para a prevenção e o tratamento da dermatite associada à incontinência. Método: Estudo metodológico. Para o desenvolvimento dos algoritmos, foi realizada revisão integrativa de artigos publicados de 2009 a 2019 encontrados nas principais bases de dados em ciências da saúde. A avaliação dos algoritmos foi realizada com 27 enfermeiros, utilizando a técnica de Delphi. Para a análise de dados, foi adotado o índice de validade de conteúdo. Resultados: Os juízes consideraram os algoritmos entre inadequados e adequados na primeira avaliação e entre adequados e totalmente adequados na segunda avaliação. O índice de validade de conteúdo geral foi de 0,923 na primeira avaliação e 1,0 na segunda avaliação. Conclusão: Após revisão da literatura, os algoritmos foram construídos e validados por profissionais com experiência na área, obtendo concordância entre os juízes na segunda avaliação.

Construction of the continuous nursing need index system based on discharge readiness for patients with spinal cord injury

Objective To construct the continuous nursing need index system based on discharge readiness for patients with spinal cord injury so as to guide the clinical nursing practice. Methods From January 2017 to July 2018, this study selected 115 spinal cord injury inpatients of Spine Surgery Department at a ClassⅢ Grade A hospital in Qingdao as subjects by convenience sampling. The Readiness for Hospital Discharge Scale (RHDS) was used to investigate those patients. According to the investigation results, this study primarily built the continuous nursing need index system for spinal cord injury patients. Delphi method was used to select 25 experts for two rounds of consultation so as to establish the final the continuous nursing need index system for spinal cord injury patients. Results Among 115 spinal cord injury patients, the total score and item average score of RHDS were (60.39±22.12) points and (5.27±2.75) points respectively. Among two rounds of consultation, the authoritative coefficients of experts were 0.78 and 0.81 respectively, and the coordination coefficients were 0.343 and 0.423. In the second round of consultation, the variation coefficients ranged from 0.09 to 0.18. The final the continuous nursing need index system for spinal cord injury patients included 5 first-level indexes and 33 second-level indexes. Conclusions The continuous nursing need index system for spinal cord injury patients has a high level of authoritative coefficients and is scientific practical which can provide a basis for discharge health instruction in spinal cord injury patients and promote the safe transition in hospital-community-family as well as comprehensive rehabilitation. Key words: Spinal cord injuries; Continuous nursing; Discharge readiness; Nursing needs; Delphi method

Construction of quality evaluation index system for blood purification nursing care in ICU

Objective To construct a comprehensive, systematic and quantifiable quality evaluation index system for blood purification care in ICU. Methods The contents of the evaluation index system for blood purification care in ICU were determined by reviewing the literature, discussion of the research group and two rounds of Delphi expert consultation. Results The response rate of the two rounds of experts was 100%. The authoritative coefficients of the two rounds of experts were 0.908 and 0.965 respectively. The coordination coefficient of the indicators of the second round of consultation results was 0.210-0.292, P<0.05 or 0.01. The quality evaluation index system for blood purification care included 3 first-class indicators, 16 second-class indicators, and 56 third-class indicators. Conclusions The enthusiasm, authority, concentration of opinions and degree of coordination of the consulting experts are relatively high. The constructed evaluation system for the quality of blood purification care indicators can be used for reference in the implementation, training and quality control. Key words: Intensive care units; Blood purification; Continuous renal replacement therapy; Quality evaluation index; Delphi technique

ISO 14001:2015 and ISO 9001:2015: analyse the relationship between these management systems standards and corporate sustainability

Abstract Two of the main standards of management systems known worldwide have undergone revision recently, namely: the ISO 9001 (Quality Management System) and the ISO 14001 (Environmental Management System). The new versions were published in September, 2015. In view of the changes which have taken place, the aim of this study is to analyse the relationship between these management systems standards with corporate sustainability. To achieve this objective, first the corporate sustainability requirements were identified based on the Corporate Sustainability Index, Ethos Indicators and the Global Reporting Initiative. The dimensions of corporate sustainability were divided into the following: social, environmental, economic, socio-environmental, socio-economic, economic-environmental and economic-social-environmental. Afterwards, two matrices were constructed for each standard in order to relate their requirements with the corporate sustainability ones. In the first round of analysis, matrices were sent to two specialists in the areas studied and then the results were compared. Relationships were classified as strong, weak or null. They identified some divergences among the answers from the experts. In order to solve the doubts, the second round of consultation was held with three experts. After receiving the experts´ responses, their responses was calculated through mode the Consolidated Relationship Matrices were built based on the consolidated responses from the experts. The ISO 14001:2015 showed a strong relationship with the environmental, social, socio-environmental, socio-economic, economic-environmental and economic-environmental-social dimensions and null with the economic dimension. Regarding the ISO 9001:2015, it can be observed that most of the sustainability requirements grouped into socio-economic and economic-environmental-social dimensions showed a strong relationship with the standard. The social and economic-environmental dimensions presented a weak relationship and in the environmental and economic dimensions there was a null relationship. The socio-environmental dimension presented weak and null relationships. It can be concluded that the ISO 9001 and ISO 14001 standards contribute to corporate sustainability, however, they alone do not ensure that all the requirements of the sustainability recommended by the Corporate Sustainability Index, Ethos Indicators and Global Reporting Initiative will be achieved.

Development on a hip functional score of adults based on patient-reported outcomes

Objective To develop a simple and patient-reported scoring system for evaluating the efficacy of functional reconstruction of adult hip diseases. Methods A candidate indicators list to evaluate hip function was established through literatures review and panel discussion. Using two rounds of Delphi method, experts were invited to judge and score the importance of screening indicators including pain, daily living ability, activity level, labor ability and self-assessment score of the overall hip status,with explanation of the degree of similarity and the basis for determination. In the second round of consultation, the content of integrity and rationality of the scale were added for evaluation. The final indexes of the scale were determined according to the boundary value of the indexes (average value, full frequency, coefficient of variation). The positive coefficient, authoritative coefficient, and coordination coefficient of the two rounds were calculated, and then the weights of each index was identified to form the final rating scale. Results Two rounds of Delphi reclaimed 25 and 24 experts’ responses, which from 28 and 25 questionnaires, and the positive coefficients of the two rounds experts were 89.3% and 96%, respectively. The authoritative coefficient of the first and second level indicators were generally above 0.85; and both of the expert coordination coefficient with the index importance (so called as Kendall coefficient) were above 0.3, and the second round of the coefficient was higher than the first one, and it indicated the final one was better at the consistency. The candidate index of bus in the mobility was rejected in accordance with the threshold of the boundary value on the importance. Finally, it was determined that the hip scoring system (Shanghai Sixth People’s Hospital, SSPH) consisted of two parts: the first part had ten indicators out of four dimensions such as pain, daily living ability, activity level, and labor ability; and the weight scores of these four aspects were 45, 25, 21, 9, respectively. The second part was the patient's self-evaluation score for the overall status of the hip (VAS, out of 100 points); the total score was the sum of the two parts, and the final weights accounted for 85% and 15% between the two parts respectively. Conclusion The SSPH hip score based on patient-reported outcomes formed by the Delphi is simple and feasible, and it can be used as a reference for evaluating the clinical efficacy of hip functional reconstruction. Key words: Delphi technique; Hip joint; Outcome assessment (Health Care)

A nurses' alarm fatigue questionnaire: development and psychometric properties.

Alarm fatigue can adversely affect nurses' efficiency and concentration on their tasks, which is a threat to patients' safety. The purpose of the present study was to develop and test the psychometric accuracy of an alarm fatigue questionnaire for nurses. This study was conducted in two stages: in stage one, in order to establish the different aspects of the concept of alarm fatigue, the researchers reviewed the available literature-articles and books-on alarm fatigue, and then consulted several experts in a meeting to define alarm fatigue and develop statements for the questionnaire. In stage two, after the final draft had been approved, the validity of the instrument was measured using the two methods of face validity (the quantitative and qualitative approaches) and content validity (the qualitative and quantitative approaches). Test-retest, Cronbach's alpha, and Principal Component Analysis were used for item reduction and reliability analysis. Based on the results of stage one, the researchers extracted 30 statements based on a 5-point Likert scale. In stage two, after the face and content validity of the questionnaire had been established, 19 statements were left in the instrument. Based on factor loadings of the items and "alpha if item deleted" and after the second round of consultation with the expert panel, six items were removed from the scale. The test of the reliability of nurses' alarm fatigue questionnaire based on the internal homogeneity and retest methods yielded the following results: test-retest correlation coefficient=0.99; Guttman split-half correlation coefficient=0.79; Cronbach's alpha=0.91. Regarding the importance of recognizing alarm fatigue in nurses, there is need for an instrument to measure the phenomenon. The results of the study show that the developed questionnaire is valid and reliable enough for measuring alarm fatigue in nurses.

Study on developing a Brief Version of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB-SF)

To develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time. 20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions. Two rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity. The brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.