-
PloS One 2023Tools that screen for depression and anxiety developed using the Western biomedical paradigm are still used with First Nations peoples globally, despite calls for...
Developing an appropriate depression and anxiety screening tool for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia: Protocol for a Delphi study.
Tools that screen for depression and anxiety developed using the Western biomedical paradigm are still used with First Nations peoples globally, despite calls for cross-cultural adaption. Recent work by the research team found that tools used to screen for depression and anxiety were not appropriate for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area (NPA). of Australia. Consequently, the objective of this Delphi study is to gain consensus from an expert mental health panel to inform the development of an appropriate depression and anxiety screening tool(s). A Delphi study with Australian expert panellists will be used to reach consensus about whether an existing screening tool should be used or whether adaption or new tool development should take place. Three sequential rounds of anonymous online surveys will be used to reach consensus. The first round will seek consensus about the tool(s). Subsequent rounds will seek consensus on the development of the tool(s) identified in round one. Panellists will be identified using a combination of authorship of related publications, established national clinical or research profile in First Nations mental health, and/or by peer referral. Consensus will be reached when 75% of the panel agree. When agreement is not reached suggestions will be taken to the next round. If agreement is not achieved by the third round, the Steering Committee will make any outstanding decisions. Dissemination of the findings through continuing community engagement, conference presentations and publications will be led by Torres Strait Islander members of the research team.
Topics: Humans; Anxiety; Australia; Australian Aboriginal and Torres Strait Islander Peoples; Delphi Technique; Depression; Health Services, Indigenous
PubMed: 38060486
DOI: 10.1371/journal.pone.0292162 -
BMC Primary Care Oct 2023For diagnostic research on appendicitis in registration data, insight is needed in the way GPs generate medical records. We aimed to reach a consensus on the features... (Review)
Review
BACKGROUND
For diagnostic research on appendicitis in registration data, insight is needed in the way GPs generate medical records. We aimed to reach a consensus on the features that GPs consider important in the consultation and medical records when evaluating a child with suspected appendicitis.
METHODS
We performed a three-round Delphi study among Dutch GPs selected by purposive sampling. An initial feature list was created based on a literature search and features in the relevant Dutch guideline. Finally, using a vignette describing a child who needed later reassessment, we asked participants to complete an online questionnaire about which consultation features should be addressed and recorded.
RESULTS
A literature review and Dutch guideline yielded 95 consultation features. All three rounds were completed by 22 GPs, with the final consensus list containing 26 symptoms, 29 physical assessments and signs, 2 additional tests, and 8 further actions (including safety-netting, i.e., informing the patient about when to contact the GP again). Of these, participants reached consensus that 37 should be actively addressed and that 20 need to be recorded if findings are negative.
CONCLUSIONS
GPs agreed that negative findings do not need to be recorded for most features and that records should include the prognostic and safety-netting advice given. The results have implications in three main domains: for research, that negative findings are likely to be missing; for medicolegal purposes, that documentation cannot be expected to be complete; and for clinical practice, that safety-netting advice should be given and documented.
Topics: Humans; Child; General Practitioners; Delphi Technique; Appendicitis; Prognosis; Physical Examination; Acute Disease
PubMed: 37872491
DOI: 10.1186/s12875-023-02167-6 -
International Journal of Public Health 2024This Delphi study intended to develop competencies for transformational leadership in public health, including behavioral descriptions (descriptors) tailored to...
This Delphi study intended to develop competencies for transformational leadership in public health, including behavioral descriptions (descriptors) tailored to individuals and their contexts. The study involved five rounds, including online "e-Delphi" consultations and real-time online workshops with experts from diverse sectors. Relevant competencies were identified through a literature review, and experts rated, ranked, rephrased, and proposed descriptors. The study followed the Guidance on Conducting and REporting DElphi Studies (CREDES) and the COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guidelines. Our framework comprises ten competencies for transformational public health leadership (each with its descriptors) within four categories, and also describes a four-stage model for developing relevant competencies tailored to different contexts. Educators responsible for curriculum design, particularly those aiming to align curricula with local goals, making leadership education context-specific and -sensitive, may benefit from the proposed framework. Additionally, it can help strengthen links between education and workforce sectors, address competency gaps, and potentially reduce the out-migration of graduates in the health professions.
Topics: Humans; Clinical Competence; Curriculum; Delphi Technique; Leadership; Professional Competence; Public Health
PubMed: 38481704
DOI: 10.3389/ijph.2024.1606267 -
Frontiers in Public Health 2024Progress has been made in understanding trans health needs, but research priorities are often set by policy or healthcare professionals without trans input, which may...
PURPOSE
Progress has been made in understanding trans health needs, but research priorities are often set by policy or healthcare professionals without trans input, which may not reflect public needs. Our study sought to identify trans health research priorities in France from both researchers and the trans community.
METHODS
Expert stakeholders (health and social sciences professionals, trans individuals, and their families) answered a three-round Delphi survey on trans health research priorities. The first round involved an open-ended questionnaire, analyzed qualitatively. In the second round, participants ranked research propositions from round one using a Likert scale. The study's second phase involved a two-hour workshop with experts and trans individuals.
RESULTS
53 participants (32% trans individuals/relatives, 60% health professionals) contributed 217 responses to open-ended questions, leading to 44 research priorities. After the two voting rounds, a total of five proposals reached a strong consensus cut-off and were considered as the main research priorities: evaluation of the effect of puberty blocker use in trans children and adolescents (95%), evaluation of the effect of supporting trans children and adolescents (92%), study of the support systems available for trans youth and their parents (86%), persistence of trans identity around puberty (prevalence, persistent persons characteristics) (86%), and needs assessment survey of the support for adolescents and their families (83%). Thirteen other proposals were considered moderate priorities.
CONCLUSION
The main consensus in our French study concerned research on trans-youth care and support needs. Our results may guide further trans-health research that meets the public's needs and desires.
Topics: Humans; Delphi Technique; Female; Male; Surveys and Questionnaires; Research; France; Adult; Transgender Persons; Middle Aged; Adolescent; Health Priorities
PubMed: 38680933
DOI: 10.3389/fpubh.2024.1307531 -
The Journal of Manual & Manipulative... Feb 2024To establish priority gaps related to contextual factors (CFs) research and force-based manipulation (FBM).
OBJECTIVE
To establish priority gaps related to contextual factors (CFs) research and force-based manipulation (FBM).
METHODS
A three-round Delphi following recommended guidelines for conducting and reporting Delphi studies (CREDES) involving international and interdisciplinary panelists with expertise in CFs and FBM. Round 1 was structured around two prompting questions created by the workgroup. Ranking of each priority gap was done by calculating composite scores for each theme generated. Consensus threshold was set with an agreement ≥75% among panelists. Median and interquartile range were calculated for each priority gap to provide the central tendency of responses. Wilcoxon rank-sum test was used to evaluate the consistency and stability of responses between rounds 2 and 3.
RESULTS
Forty-six panelists participated in all three rounds of the Delphi. Consensus was reached for 16 of 19 generated themes for priority gaps in CFs research and FBM. The ranking of each identified gap was computed and presented. Wilcoxon rank-sum test was non-significant ( > .05), demonstrating consistency and stability of results between rounds.
CONCLUSION
The result of this Delphi provides international and interdisciplinary consensus-based priority gaps in CFs research and FBM. The gaps identified can be used to generate future research inquiries involving CFs research and FBM.
Topics: Delphi Technique; Consensus
PubMed: 37697816
DOI: 10.1080/10669817.2023.2255820 -
Injury Prevention : Journal of the... Mar 2024Expanding support for drowning prevention is evidenced by interlinked Resolutions at the United Nations (2021) and World Health Assembly (2023). While progress has...
BACKGROUND
Expanding support for drowning prevention is evidenced by interlinked Resolutions at the United Nations (2021) and World Health Assembly (2023). While progress has accelerated, a universally agreed definition for drowning prevention remains absent. Here, we aim to develop a conceptual definition of drowning prevention using the Delphi method.
METHODS
First, we conducted a document review to guide our development and consensus-building process. Then, we formed an advisory group and recruited participants with diverse expertise to contribute to Delphi-method surveys. In the first round, participants selected from draft concepts to build a definition and delineate between the terms drowning prevention and water safety. In the second round, we presented a codeveloped definition, and three statements based on first-round findings. We then sought participant feedback where ≥70% support was considered consensus-based agreement.
RESULTS
Participants (n=134) were drawn from community (7.46%), policy (26.87%), research (40.30%) and technical backgrounds (25.37%), and low-income and middle-income countries (38.06%). In the first- round, half (50.74%) disagreed with the proposition that drowning prevention was synonymous to water safety, while 40.30% agreed. The second- round achieved consensus-based agreement (97.27%) for the definition: Drowning prevention is defined as a multidisciplinary approach that reduces drowning risk and builds resilience by implementing evidence-informed measures that address hazards, exposures and vulnerabilities to protect an individual, community or population against fatal and non-fatal drowning.
CONCLUSION
The Delphi method enabled the codevelopment of our conceptual definition for drowning prevention. Agreement on the definition forms the basis for strengthened multisectoral action, and partnerships with health and sustainable development agendas. Defining drowning prevention in terms of vulnerability and exposure might increase focus on social determinants and other upstream factors critical to prevention efforts.
Topics: Humans; Drowning; Delphi Technique; Surveys and Questionnaires; Consensus; Water
PubMed: 37945328
DOI: 10.1136/ip-2023-045085 -
Digestive and Liver Disease : Official... Feb 2024Increasing infectious rate estimates and low microbiological surveillance affect safety of gastrointestinal endoscopy globally. Single use endoscopes and accessories...
BACKGROUND/OBJECTIVE
Increasing infectious rate estimates and low microbiological surveillance affect safety of gastrointestinal endoscopy globally. Single use endoscopes and accessories have been claimed to improve safety, but there is lack of data on their indication and sustainability. We aimed to identify a series of best practice recommendations for the use of single use endoscopes and accessories using a modified Delphi.
METHODS/DESIGN
Consensus statements for the use of single use endoscopy and accessories were developed using a modified Delphi process, utilizing an international endoscopist expert panel of 62 experts from 33 nations. The main steps in the process were selecting the consensus group, conducting systematic literature reviews, developing statements, and anonymous voting on the statements until consensus was reached. High-risk patients were defined as those with multi-drug-resistant infections, immunosuppressive medication or chemotherapy, post-transplantation, or with severe neutropenia.
RESULTS
Of the 26 statements that were voted upon through two rounds, 17 statements reached consensus. Category 1: single use accessories (8 statements), related to defining recommendations for the use of single use accessories in all patient populations or high-risk patients. Category 2: clinical indication for single use endoscopes (9 statements), including indications to high-risk patients, protecting the endoscope apparatus and contamination measures in endoscopy units. Category 3: technical factors (4 statements), related to superior performance and technical specifications with the new innovation. Category 4: environmental issues (2 statements), concerning mechanisms that reduce the detrimental burden to the environment. Category 5: financial implications (3 statements), related to healthcare policies, cost neutrality and other financial associations of single use endoscopy.
CONCLUSIONS
This is the first international initiative in determining clinical indications for single use endoscopy and accessories. The study's findings should serve as a framework for future physicians to guide future research and aid the proper evidence-based indications for the implementation of single use endoscopes in clinical practice.
Topics: Humans; Delphi Technique; Endoscopy, Gastrointestinal; Consensus
PubMed: 37558571
DOI: 10.1016/j.dld.2023.07.026 -
The British Journal of General Practice... May 2024System problems, known as operational failures, can greatly affect the work of GPs, with negative consequences for patient and professional experience, efficiency, and...
BACKGROUND
System problems, known as operational failures, can greatly affect the work of GPs, with negative consequences for patient and professional experience, efficiency, and effectiveness. Many operational failures are tractable to improvement, but which ones should be prioritised is less clear.
AIM
To build consensus among GPs and patients on the operational failures that should be prioritised to improve NHS general practice.
DESIGN AND SETTING
Two modified Delphi exercises were conducted online among NHS GPs and patients in several regions across England.
METHOD
Between February and October 2021, two modified Delphi exercises were conducted online: one with NHS GPs, and a subsequent exercise with patients. Over two rounds, GPs rated the importance of a list of operational failures ( = 45) that had been compiled using existing evidence. The resulting shortlist was presented to patients for rating over two rounds. Data were analysed using median scores and interquartile ranges. Consensus was defined as 80% of responses falling within one value below and above the median.
RESULTS
Sixty-two GPs responded to the first Delphi exercise, and 53.2% ( = 33) were retained through to round two. This exercise yielded consensus on 14 failures as a priority for improvement, which were presented to patients. Thirty-seven patients responded to the first patient Delphi exercise, and 89.2% ( = 33) were retained through to round two. Patients identified 13 failures as priorities. The highest scoring failures included inaccuracies in patients' medical notes, missing test results, and difficulties referring patients to other providers because of problems with referral forms.
CONCLUSION
This study identified the highest-priority operational failures in general practice according to GPs and patients, and indicates where improvement efforts relating to operational failures in general practice should be focused.
Topics: Humans; General Practice; Delphi Technique; Consensus; England; Quality Improvement; State Medicine; General Practitioners; Female; Male
PubMed: 38621805
DOI: 10.3399/BJGP.2023.0321 -
International Nursing Review Dec 2023The International Council of Nurses and the World Health Organization have prioritized evidence-based nursing and midwifery practice derived from nurse-led research....
BACKGROUND
The International Council of Nurses and the World Health Organization have prioritized evidence-based nursing and midwifery practice derived from nurse-led research. However, in a low-resource country like Kenya, there is a need to identify research priorities to optimize utilization of limited existing research infrastructure and funding. Kenya lacks a nursing and midwifery research strategy to guide research prioritization.
INTRODUCTION
The goal of this study was to identify and describe nursing and midwifery research priorities for Kenya.
METHODS
A cross-sectional Delphi survey using two iterative rounds of electronic data collection was used to reach a consensus about priorities for nursing and midwifery research in Kenya. NVivo-12 was used to analyze the qualitative data to identify categories, sub-themes, and themes; descriptive statistics were used to analyze quantitative data.
RESULTS
Participants included 159 nurse managers, administrators, and educators representing regional, county, and national referral, private, and faith-based hospitals, nurse training schools, research institutions, and nursing organizations in Kenya. Staffing challenges, motivation, remuneration, and funding for higher education were ranked as the top critically important issues using a cutoff point of ≥ 70% agreement.
CONCLUSION
There is a need for the development of a National Framework for Nursing and Midwifery Research Priorities in Kenya to guide research that builds excellence in meeting nursing and midwifery human resource concerns and ultimately improves patient care practices and outcomes.
IMPLICATIONS FOR NURSING AND NURSING POLICY
The objective of Kenya's health goals delineated within three key national health documents cannot be attained without adequate numbers of nursing and midwifery professionals and policies that address nursing and midwifery staffing challenges, remuneration for employment, and improved funding for higher education.
Topics: Pregnancy; Humans; Female; Kenya; Midwifery; Cross-Sectional Studies; Nurse Administrators; Research; Delphi Technique; Nursing Research
PubMed: 37837277
DOI: 10.1111/inr.12893 -
BMC Nephrology Oct 2023The aim of this study was to develop and refine the content and design of an internet-based support and education program for patients awaiting kidney transplantation...
AIMS
The aim of this study was to develop and refine the content and design of an internet-based support and education program for patients awaiting kidney transplantation from deceased donors.
DESIGN
A Delphi process was used.
METHODS
A prototype internet-based intervention was drafted, based on previous research. The intervention included educational and psychological support to manage the uncertain waiting time and specific education enabling preparation for transplantation and adjustment to life after transplantation. In a two-round Delphi process, patients who had received a kidney transplant from a deceased donor within the last 2 years (n = 27), significant others (n = 6), health-care personnel with renal (n = 20) or transplant (n = 14) expertise, rated importance of content and design aspects of the prototype intervention on a 5-point scale using web questionnaires. A median of ≥ 3 was considered as consensus. Quantitative data was analyzed using descriptive statistics. Free text answers were encouraged and analyzed using deductive content analysis. The STROBE-checklist was used.
RESULTS
Consensus was reached for all suggested content and design items in round 1, with median ratings of 4 or 5. Qualitative analysis from round 1 suggested four new content and design items which were rated in round 2, on all which consensus was reached; information about life with young children as relatives, expansion of kidney transplantation specific information, program extension by one week and individualization by making information available based on individual needs.
CONCLUSION
There was consensus among heterogenous experts regarding suggested educational and psychological support content and design aspects, and additional content and design aspects were identified for an internet-based support and education program for patients awaiting kidney transplantation from deceased donors.
Topics: Child; Humans; Child, Preschool; Kidney Transplantation; Delphi Technique; Tissue Donors; Surveys and Questionnaires; Internet
PubMed: 37880582
DOI: 10.1186/s12882-023-03364-2