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Results for “Delphi Technique”

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PubMed2005

Using a Delphi panel to survey criteria for successful periodontal therapy in anterior teeth.

BACKGROUND: Valuable decision making for periodontal treatment success in situations where there is ambiguous or conflicting information was previously reported using a consensus building method, the Delphi survey, for posterior teeth with chronic periodontitis. This study focuses on outcome measures relevant in assessing therapy of anterior teeth with chronic periodontitis. METHODS: The Delphi panelists were the same American periodontists who participated in the previous Delphi survey evaluating successful therapy in posterior teeth. In this study, panelists determined the level of importance of attachment level, probing depth, mobility, plaque, inflammation, esthetics, pain, and patient satisfaction following periodontal treatment of a single tooth or multiple anterior teeth in a patient with severe chronic periodontitis. The panelists were questioned concerning the relative importance of each outcome measure, a minimally acceptable level considered necessary for success for each outcome measure, and the length of time required for these outcome measures to remain stable. RESULTS: The 35 panelists considered the control of pain, esthetics, and patient satisfaction to be "extremely important" outcome measures for successful periodontal treatment of single or multiple teeth. Attachment levels, probing depths, plaque levels, degree of inflammation, and mobility (for multiple teeth) were considered to be "very important" outcomes. The minimally acceptable reduction in probing depths following 1 year of treatment was 2 mm; whereas 2 mm of attachment gain was considered necessary for successful treatment. The panel also found a Miller degree I mobility as an acceptable outcome for clinical success. Finally, the panel agreed that the 1-year results of treatment should remain stable for a minimum of 5 years. CONCLUSIONS: The Delphi technique proved a practical instrument to transform expert opinion into a group consensus for relevant periodontal outcome measures. Absence of pain, esthetics, and patient satisfaction were outcome measures considered "extremely important" for successful therapy. Although panelists considered attachment loss, probing depths, and mobility somewhat less important outcomes, they wanted an attachment gain of 2 mm and would accept a degree I mobility as long as outcomes remained stable for 5 years. These data suggest that minimal standards for successful therapy of anterior teeth can be established among periodontal practitioners.

Delphi Technique↗

PubMed2003

The influences on and experiences of becoming nurse entrepreneurs: a Delphi study.

There is little known about private practice nursing as an area of advanced practice. As more nurses take the option to develop private practice, the experiences of and influences on nurses currently in private practice might be a useful guide to the pitfalls and difficulties which might be encountered. In addition, an understanding of the experiences of and influences might assist nursing organizations and health services to provide support to nurses who play an integral part in health care delivery in the community. A research study was undertaken utilizing a two-round Delphi Technique to elicit and assess consensus on the reasons for nurses going into business and the experiences they encountered in becoming and being a nurse entrepreneur. The study instrument in round one comprised a questionnaire with statement headings inviting opinions on the influences and experiences of nurses in business. In the second round, levels of agreement were elicited from responders on collated opinions from round one, including statements formed from comments written in round one. The initial questionnaire also included closed questions to obtain a profile of nurses in private practice. Responders were 59 nurses in private practice in round one and 54 nurses in round two. The themes raised could be grouped under headings of influences, advantages/disadvantages, education/experience, skills/knowledge, characteristics and barriers. The level of agreement on the themes was reasonably high. Dissent occurred on issues of increased income, professional image and support structures. This Delphi study has identified key areas of consensus on the experiences of nurses in private practice who have extended their career into the business arena. It has also identified areas in which further work needs to be carried out to understand this work of nurse entrepreneurs.

Australia↗

PubMedDate not supplied

Factors perceived to influence parental decision-making regarding presymptomatic testing of children at risk for treatable adult-onset genetic disorders.

The purpose of this study was to identify those critical factors that genetic nurse experts perceived could influence parental decision-making to seek or to reject presymptomatic testing of their children at risk for treatable adult-onset genetic disorders (neurofibromatosis 2, familial adenomatous polyposis, and von Hippel Lindeau disorder). Perceptions of ISONG genetic nurse specialists were surveyed through a modified Delphi technique and four major themes emerged: personal experience with severity of genetic disorder, receiving accurate information from credible sources, availability of quality treatment, and risk perception. Currently, there is a paucity of extant research that identifies critical factors influencing parental decision-making about this relatively new testing alternative for children. Thus, these experts are an important source of valuable information needed to identify such factors. Findings may be useful to design a qualitative study with parents to investigate this issue.

Adult↗

PubMedDate not supplied

Risk for suicide and risk for violence: a case for separating the current violence diagnoses.

PURPOSE: To identify accurate descriptive terms for risk for violence and risk for suicide and to provide operational definitions for these terms METHODS: The Delphi technique, with two rounds, was used to differentiate the operational definitions that represent risk for suicide from those that represent risk for violence. The expert panel consisted of 23 healthcare professionals with a minimum of a master's degree. In addition to the expert panel, a control group (N = 11) participated to assess content validity. FINDINGS: Thirty-six definitions were agreed upon for suicide, 39 for violence. CONCLUSIONS: These definitions represent the basic distinctions between the two behavioral manifestations.

Adult↗

PubMed1989

Identifying nursing research priorities: a first step in program development.

This study determined nursing research priorities and focused on the development of a nursing research program within a single institution. Of the 715 nurses within the Department of Nursing, 286 (40%) responded to the first round of a two-round Delphi technique, and 137 (48%) responded to the second. The following clinical priorities were determined: prevention and treatment of pressure sores, pain management, treatment of nosocomial infections, and patient education. Nonclinical priorities included staffing and its effects on turnover and patient care, job satisfaction, and factors influencing the quality of nursing care. Serendipitous findings underscored the relevance of the Department of Nursing's conceptual framework to nursing practice and research, revealed the need for dissemination of current research results, and suggested that nurses want to participate in research without assuming responsibility beyond their expertise.

Delphi Technique↗

PubMed1983

GMENAC report on U.S. physician manpower policies: recommendations and reactions.

After four years of study in the United States, the Graduate Medical Education National Advisory Committee (GMENAC) concluded that an excess of approximately 70,000 physicians will exist in 1990. Faced with a future surplus, GMENAC recommends that U.S. medical schools decrease enrollment levels by 10 percent relative to the 1978-79 level and severely restrict entrance of foreign medical graduates. Flaws identified in the GMENAC approach relate to the use of the delphi technique, the future role of nonphysician providers, and a lack of reliable data. The GMENAC report may provide impetus for an abrupt shift from expansionism to reductionism in U.S. physician manpower policy. Long range physician manpower planning has erred in the past, necessitating periodic reevaluation of national policy. A continuing balance between supply and demand, although ideal, can probably never be attained. Thus small adjustments in total supply and specialty mix will always be necessary. The GMENAC report, which is the most comprehensive study of U.S. physician manpower to date, requires serious consideration in this context.

Delphi Technique↗

PubMed2001

The way forward: identifying palliative nursing research priorities within a hospice.

This article presents how practice issues within a hospice were identified as a means of prioritizing areas for research and development. The Delphi technique was employed to facilitate nurses working in the hospice to participate in the study. Forty-six practice issues were identified by the nurses and prioritized as areas of research in the hospice. This enabled comparisons with other studies and the literature to be made. The identified research priorities were then utilized to structure a framework for practice development in the hospice which included the use of weekly nurse meetings, interest groups and nurses studying for degrees and diplomas in order to address systematically the practice issues and develop an evidence-based practice approach.

Attitude of Health Personnel↗

PubMed1996

A study of clinical nursing research priorities of renal specialist nurses caring for critically ill people.

The aim of this pilot research project was to identify priority areas for clinical nursing research for renal specialist nurses practising in general critical care. Research participants in the study included Clinical Nurse Specialists (CNSs) and Clinical Nurse Consultants (CNCs), n = 12. The study sample was national with representation from a number of major metropolitan teaching hospitals in Australia. The Delphi technique was used to obtain the most reliable consensus of the specialist nurses. Research priorities emerged in four areas: 1) clinical research which is of highest value to patients; 2) clinical research which is of highest value to CNSs/CNCs; 3) clinical research which would provide improved community care and 4) research that would be of value for CNSs/CNCs professional needs. In the final phase of the study nine high priorities were identified. The findings of the study suggest directions for clinical nursing research which would benefit renal specialist nurses and their patients.

Adult↗

PubMed1984

Natural history of intestinal parasites in asymptomatic adults.

The need to treat asymptomatic adults who have intestinal parasites should be based on considerations of potential pathogenicity and transmission risk, but such data are sparse in general and unavailable for countries such as the United States, where reinfection is rare. Opinions of North American physicians about the natural history and treatment of 12 parasites detectable by stool examination were assessed using the Delphi technique. In response to the first questionnaire, majority agreement on pathogenic potential was achieved for only 3 of 12 parasites. When the more expert group was queried a second time, majority agreement was achieved for 8 of 12 parasites. Nevertheless, the predicted risk of subsequent disease still varied widely, from 1:10 to 1:1,000 for most parasites, and was unrelated to the perceived need for treatment. Almost all respondents thought asymptomatic adults with any intestinal parasites should always be treated. Transmission risk was judged to be low and was generally appropriate to the life cycle of the parasite.

Adult↗

PubMedDate not supplied

Determining the National Flight Nurses Association's research priorities.

INTRODUCTION: Increased federal attention to nursing research has prompted professional nursing organizations to develop research programs identifying areas of scientific knowledge most needed for professional and clinical practice. The study purpose was to identify the National Flight Nurses Association's (NFNA's) research priorities. METHODS: A two-round Delphi technique was used, with systematic surveys in Round I mailed to 500 NFNA members. Responses from 127 members were coded to form the Round II survey that was completed by members at the NFNA meeting in St. Louis in October 1993. RESULTS: According to frequency scores, issues of highest priority relate to specialty and nonspecialty team, crew configurations, clinical indications for transport, airway management, educational preparation and continuing education. CONCLUSION: Identified priorities support development of research studies and programs that lead to increased knowledge, facilitate collaborative studies and also provide a basis for research funding.

Air Ambulances↗

PubMed1993

Perceived client and program moderators of successful therapeutic community treatment for drug addiction.

Research examining moderators of therapeutic community treatment outcomes has tended to emphasize the importance of length of stay in programs. To this extent the research literature implies a causal role for treatment in the determination of treatment outcomes. Using the Delphi technique, a panel of residents, staff members, and other drug treatment agency staff involved with the Odyssey House therapeutic community in Melbourne were surveyed regarding their perceptions of factors moderating successful treatment in this program. Examination of the perceptions of those involved with the delivery of therapeutic community treatment suggested a strong respect for the importance of client motivational factors in the determination of treatment outcomes. It is suggested that future research in this area could profitably focus on attempts to quantify the separate contribution of treatment and nontreatment factors in explaining treatment outcomes.

Adolescent↗

PubMed2004

Nurse leadership within primary care: the perceptions of community nurses, GPs, policy makers and members of the public.

AIM: The aim of this section of a wider study was to seek the views of community nurses, general practitioners, members of the public and policy makers on nursing leadership in primary care. The wider study aimed to review the role and function of primary care services and community nursing with reference to developments in practice, education, research and policy. BACKGROUND: Key messages, challenges and opportunities for leaders within nursing have been highlighted in the literature and in turn emphasis placed on the positive effect this would have on improved quality of services [Department of Health and Social Services (1998) Valuing Diversity...A Way Forward. Department of Health and Social Service, Belfast]. In order to grasp these opportunities, nursing has to invest in the development of leaders. METHODS: A two round Delphi technique was employed using a focus group approach in round one and a postal questionnaire in round two. Semi-structured interviews were carried out with senior policy makers. RESULTS: Findings show that there was agreement that strong leadership was needed for the development of community nursing but that at present there is confusion and disagreement over whether it exists currently. Other findings focus on problems inherent in identifying future nurse leaders. CONCLUSION: The traditional subservient culture of community nursing is blamed for the perceived inability to nurture strong leaders. Recommendations are made for the development of nurse leaders.

Community Health Nursing↗

PubMed2006

Consensus on diabetes management in primary care.

Diabetes management in Irish Primary Care is in the early stages of development. This study used a Delphi technique with a panel of experts working in diabetes in primary care in order to reach a consensus on its future development. There was strong agreement on the need for multidisciplinary professional advocacy to improve services for people with diabetes. The panel indicated a preference for the development of shared models of care and emphasised the importance of research, audit and professional education. The results of this study can be used by health planners to develop services in a way that reflects the experience and opinion of those working as experts in the field of primary care diabetes.

Delphi Technique↗

PubMed2004

Relationship between malpractice claims and medical care quality.

The purpose of this paper was to examine the relationship between medical malpractice claims and medical care quality in Taiwan. The Delphi technique with an expert panel was used to determine the relationship between malpractice and medical quality. A total of 371 medical malpractice claims were analyzed. Main measures included the rate and strength of malpractice cases associated with quality and the identification of the quality factors influencing the occurrence of malpractice. Results showed that malpractice claims were associated with internal medicine cases, surgery cases, pediatric cases, obstetricc and gynecological cases, physicians' professional competence, nonacceptable outcomes, complications, and poor communication. Concludes that medical malpractice cases could be avoided by increasing physicians' professional knowledge, practical skills, and communication.

Clinical Competence↗

PubMed2006

Communication between CAM and mainstream medicine: Delphi panel perspectives.

Healthcare practitioners' models of health affect their patient interactions and services. We surveyed mainstream (MM), integrative (IM) and CAM providers to investigate their models of health. This study generated ideas for actions to improve MM/CAM communication based on survey findings. Through the Delphi technique, a panel of 14 MM, IM and CAM experts participated in two rounds of questioning regarding survey findings. MM panel members were less supportive of almost all suggestions for actions than IM and CAM members. Suggestions most likely to be implemented were enabling the patient to take an active role in care, establishing understanding between patient and practitioner of treatment and its goals, fostering patients' taking responsibility for their health and communicating about patient assessment in ways understandable to others. Actions to foster better MM/CAM communication promote focus by a team of providers on the patient's goals, functioning and involvement in their care.

Complementary Therapies↗

PubMed1996

Research priorities for nurses caring for persons with multiple sclerosis. Nursing Research Speciality Group of the Consortium of Multiple Sclerosis Centers.

The Delphi technique was used by the Nursing Research Specialty Group of the Consortium of Multiple Sclerosis Centers (CMSC) to obtain consensus on research priorities related to health and nursing care needs of persons with multiple sclerosis (MS) and their families and particular nursing interventions for which effective outcomes needed to be determined. Three rounds of questionnaires were used in obtaining responses from nurses affiliated with the CMSC and nurses affiliated with National MS Affiliated Centers/Clinics and the Veterans Administration Medical Centers (nonCMSC). Round 1, identification of research items, was the basis for developing a 108 item questionnaire for Rounds 2 and 3. Sixteen of 108 research items were selected by 25% or more of the CMSC or nonCMSC nurses. Among the top research priorities identified by both groups of nurses were determining effective programs to promote quality of life and reduce fatigue, stress and emotional difficulties (anger, anxiety, isolation); promote high level of functioning; and develop strategies for effective handling of cognitive deficits. Research priorities identified in this Delphi study provide direction for conducting collaborative research among CMSC and nonCMSC nurses with the aim of improving clinical practice and health outcomes of MS patients.

Cost-Benefit Analysis↗

PubMed1992

Outcome measures for primary health care: what are the research priorities?

A Delphi technique was used to ask general practitioners for their opinions as to which clinical problems and types of measure they thought most appropriate for the development of outcome measures for use in primary health care. The study comprised two rounds of postal questionnaires, targeted at general practitioners in academic departments throughout the United Kingdom and at trainers in the northern region, with the second questionnaire feeding back opinions from the first. Ninety eight participants suggested one or more areas in which outcome measures could be developed, giving a total of 451 suggestions. Consensus produced in the second round indicated that three clinical conditions were preferred for the development of outcome measures: asthma, diabetes and hypertension. Six categories of outcome measures were developed from the responses given in the first round--level of function, level of clinical control, incidence of complications, iatrogenic problems, patient understanding of a condition, and quality of life. Participants gave these measures different levels of importance according to the clinical problem in question. This Delphi study of doctors' opinions is a first step in the development process of appropriate, practicable measures of outcome for use in primary care and has achieved a degree of consensus among general practitioners.

Attitude of Health Personnel↗

PubMed1996

Research priorities for the nursing of children and their families: a Delphi study.

To most effectively address the issues influencing the health care of children while using limited resources, some priorities for research must be established. To date, there has not been a focused effort to systematically identify and describe critical areas of inquiry needed to provide quality pediatric care in the next decade. The purpose of this study was to systematically survey a cross-section of pediatric nurse experts in a variety of settings across the nation. A three-round Delphi technique was used. In the first round, participants responded to three open-ended questions asking them to identify (a) threats affecting children's health, (b) major societal factors that would positively influence children's health in the future, and (c) important research questions in the field. In rounds two and three, respondents rated the importance of those topics. Of two hundred fifty respondents, 75% or more reached consensus on the importance of 35 researchable topics across five categories of research in nursing of children and their families. The focus was on patient-centered research.

Child↗