Maintenance decision problems generally involve multiple criteria which apparently are best addressed using Multi-Criteria Decision Making (MCDM) tools. This paper describes the use of a hybrid MCDM technique in prior...Maintenance decision problems generally involve multiple criteria which apparently are best addressed using Multi-Criteria Decision Making (MCDM) tools. This paper describes the use of a hybrid MCDM technique in prioritizing maintenance strategy for ship systems. The Hybrid MCDM technique combines Delphi method, AHP and TOPSIS methods. While the Delphi method and AHP are applied in screening of decision criteria and decision criteria weights determination respectively, the TOPSIS method is used in the ranking of alternative maintenance strategies. Five alternative maintenance strategies which include corrected maintenance, scheduled overhaul, scheduled replacement, continuous on-condition task and scheduled on-condition task are considered and the optimum maintenance strategy is selected based on twelve critical maintenance decision criteria. To demonstrate the suitability of the approach a case study of sea water pump of the central cooling system of a marine diesel engine is used.展开更多
Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the...Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the scale by Delphi method. Sixteen experts in medical management, human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the DeLphi consultation questionnaires twice in the consulting round. In the first round, the recovery rate showing the experts＇ positivity was 80%; the coefficient of reliability （Cr） ascertaining the authority of the evaluation was 0.92; the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25%-93.75% respectively; the coefficients of variation （CV） and the Kendall＇s W determining the concordance of the evaluation were 5.06%-52.15% and 0.21-0.24 respectively. In the second round, the recovery rate was 93.75%; the Cr was 0.93; the mean was 3.93-4.93; the full mark ratios were 26.67%-93.33%; the Kendall＇s W was 0.14- 0.31, the CV was 5.25%-23.61%. Via the two-round Delphi study, the scale that included 10 dimensions and 61 items has been improved. Ten dimensions are pre-hospital medical service, guidance, registration, waiting, diagnosis ＆ treatment, paying, inspection ＆ assay, medicine receiving, therapy/injection/transfusion and global evaluation. It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience. The experts have given high agreements about the dimensions which were established with Chinese outpatient process. The dimensions are different from the similar researches about outpatient experience study. In the future, it is necessary to survey the outpatients to test the construct validity, internal consistency reliability and others of the scale to improve the scale.展开更多
Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government ad...Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government administrations and hospitals to formulate unified standards. Methods: After the research team has determined the theme, it will consult the development of A) specialist nursing through the library, Internet and electronic literature database;B) the history of the development of specialist nurses in diabetes and other fields;C) the selection criteria of specialist nurses;D) the training of specialist nurses system, assessment method;E) Specialist nurse certification body, evaluation standards and certification standards and other related documents, literature, books and report materials. The author established the preliminary index system through literature review, specialist interview and group discussion and used Delphi method to organize three rounds of 30 experts’ consultations. Results: A first certification evaluation index system including 8 fundamental indicators, 5 first-level indicators, 19 second-level indicators and 99 third-level indicators was constructed for diabetes nurses. Conclusion: The results of three rounds of expert consultation and demonstration are reliable, and the constructed index system is suitable for comprehensive evaluation of diabetes specialist nurses, which provides a basis for the effective management of nursing resources.展开更多
The Delphi technique is a systematic process of forecasting using the collective opinion of panel members.The structured method of developing consensus among panel members using Delphi methodology has gained acceptanc...The Delphi technique is a systematic process of forecasting using the collective opinion of panel members.The structured method of developing consensus among panel members using Delphi methodology has gained acceptance in diverse fields of medicine.The Delphi methods assumed a pivotal role in the last few decades to develop best practice guidance using collective intelligence where research is limited,ethically/logistically difficult or evidence is conflicting.However,the attempts to assess the quality standard of Delphi studies have reported significant variance,and details of the process followed are usually unclear.We recommend systematic quality tools for evaluation of Delphi methodology;identification of problem area of research,selection of panel,anonymity of panelists,controlled feedback,iterative Delphi rounds,consensus criteria,analysis of consensus,closing criteria,and stability of the results.Based on these nine qualitative evaluation points,we assessed the quality of Delphi studies in the medical field related to coronavirus disease 2019.There was inconsistency in reporting vital elements of Delphi methods such as identification of panel members,defining consensus,closing criteria for rounds,and presenting the results.We propose our evaluation points for researchers,medical journal editorial boards,and reviewers to evaluate the quality of the Delphi methods in healthcare research.展开更多
Objective:The objective of this study is to establish a nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)in Beijing,to provide reference for clinical n...Objective:The objective of this study is to establish a nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)in Beijing,to provide reference for clinical nursing of patients with COVID‑19(mild and common).Methods:Through online communication meeting with nurses who are in the frontline of anti‑epidemic,clinical investigation,literature research,and expert demonstration meeting are carried out to prepare the draft of the standard,and the Delphi method is applied to determine the standard of integrated traditional Chinese and Western medicine care for patients with COVID‑19(mild and common)in Beijing.Results:The nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)was established,which included 5 first‑level indicators,14 second-level indicators and 60 third‑level indicators.After two rounds of Delphi method,the positive coefficients of experts were 96%and 83%,the authoritative coefficients of experts were 0.89 and 0.91,and the Kendall’s coefficient of concordance(W)of experts were 0.12,0.09,0.10,0.13(P<0.05)and 0.44,0.43,0.37,0.39(P<0.05).Conclusion:The standard of integrated traditional Chinese and Western medicine nursing for patients with COVID‑19(mild and common)in Beijing constructed by the Delphi method is scientific and practical,which provides a reference for clinical application of integrated traditional Chinese and Western medicine nursing to fight against COVID‑19 infection.展开更多
Objective： This study sought to investigate the content of the prescription rights and the prescription types of midwives under certain circumstances in China. Methods： The Delphi method was used to consult 18 nursi...Objective： This study sought to investigate the content of the prescription rights and the prescription types of midwives under certain circumstances in China. Methods： The Delphi method was used to consult 18 nursing experts and 14 medical experts, A total of 30 experts finished the consulting. The reliability of the expert opinions was analyzed to determine the specific situations in which midwives may write prescriptions, the content of the prescription rights and the prescription types. Results： In six specific circumstances （uterine contraction fatigue, uterine contractions that are too strong, postpartum hemorrhage, premature rupture of the membranes, normal delivery and neonatal asphyxia）, midwives have the right to prescribe and administer medication, including 20 drugs and 13 auxiliary examinations. Of these drugs and examinations, 51.5% of the drugs and adjuvant examination prescriptions tend to be independent prescriptions, 30.3% tend to be protocol prescriptions, and 18.2% are similar to both types. Conclusions： The midwives should be granted some prescription rights to enhance their autonomy and the professionalism of midwifery.展开更多
The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy ...The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy process(AHP)was used to determine the index weight.A total of 19 experts were included,all with intermediate or higher professional titles.The positive coefficients of experts in the two rounds of consultation were all 100%.The judgment basis of experts is 0.895,the degree of familiarity is 0.842,and the coefficient of authority is 0.868.The Kendall harmony coefficients of the first,second,and third-level indicators were 0.381,0.383,and 0.320,respectively.The expert coordination degree was tested by x^(2) test,the P values were all less than 0.05,indicating that the degree of expert coordination was well.After two rounds of letter inquiry,an evaluation index system of core competence of HCPs with professional accomplishment,theoretical knowledge,basic skills,professional skills,and professional development ability as the main framework was formed,including 5 first-level indicators,18 second-level indicators,and 62 third-level indicators.Based on the Delphi and AHP methods,the index system of HCPs'core competence established has high authority and scientificity,to provide the theoretical basis for the standardized training and comprehensive evaluation of HCPs.展开更多
Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an ear...Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.Methods: Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire(OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance(M) >3.5, and coefficient of variation(CV) <0.25. Reliability of experts' opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.Results: A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.Conclusions: The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.展开更多
Esophageal cancer is one of the common malignant tumors in humans.Traditional Chinese medicine(TCM)has unique advantages in the treatment of esophageal cancer.However,the TCM syndrome classification of esophageal canc...Esophageal cancer is one of the common malignant tumors in humans.Traditional Chinese medicine(TCM)has unique advantages in the treatment of esophageal cancer.However,the TCM syndrome classification of esophageal cancer is not standardized.This Delphi survey aimed to explore the TCM syndrome classification and symptom characteristics of esophageal cancer.Methods:Based on literature research,an expert consultation questionnaire was developed for the study of the TCM syndrome rules of esophageal cancer.Two rounds of questionnaire surveys were conducted among 62 experts across the country.Statistical description and statistical analysis of the mean,coefficient of variation,grade sum,and unimportant percentage of the retrieved data.TCM syndrome rules and diagnostic indicators for esophageal cancer after screening and sorting out the questionnaire items,convening experts to demonstrate.Results:62 valid questionnaires were collected,and the expert positive coefficient was 100%.The Kendall's coefficient of concordance W of the first and second rounds are 0.232 and 0.2334 respectively.In addition,the Kendall's coefficient of concordance W of the second round has been improved compared with the first round,suggesting that experts have a better degree of coordination on the importance of indicators.The common TCM syndromes of esophageal cancer are obtained:"liver-stomach disharmony,phlegm and qi obstruction syndrome","liver and spleen disorders,phlegm accumulating with stagnation syndrome","deficiency of liver and kidney yin,stubborn blood syndrome","deficiency of spleen and kidney yang,stubborn blood syndrome".Conclusion:The TCM syndrome indicators of esophageal cancer has been established.It provides a basis for the standardized research of TCM syndrome diagnosis of esophageal cancer,which is of positive significance for improving the level of clinical diagnosis and treatment.展开更多
<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transpla...<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. <strong>Objective:</strong> This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. <strong>Methods:</strong> A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. <strong>Conclusions: </strong>The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.展开更多
Undoubtedly,noise has become a major hazardous issue in today’s industrial world,with a lot of people suffering from exposure to excessive noise in their work environments.This study was conducted to weigh and priori...Undoubtedly,noise has become a major hazardous issue in today’s industrial world,with a lot of people suffering from exposure to excessive noise in their work environments.This study was conducted to weigh and prioritize noise control methods in an Iranian tire manufacturing complex in Iran.The Delphi method and the Technique for Order Preference by Similarity and an Ideal Solution(TOPSIS)were utilized for this purpose.This cross-sectional,descriptive study was conducted in the baking hall of an Iranian tire manufacturing factory in 2016.To weigh and prioritize noise control methods,Analytic Hierarchy Process(AHP)and TOPSIS were applied.In total,4 criteria and 8 alternatives were examined.An AHP and TOPSIS questionnaire was then designed to prioritize noise control methods in the light of the objectives,criteria,and alternatives.Then,the collected data were fed into Expert Choise.V.11 and Excel and data analysis was carried out using TOPSIS.The results of data analysis indicated that the inconsistency rate in all the cases was smaller than 10%,hence the consistency of the responses was verified.According to the TOPSIS results and experts’opinions about the criteria,implementation and maintenance cost(with a weight of 0.481)and method effectiveness and efficiency(with a weight of 0.046)had the highest and lowest priority respectively.Based on the weights TOPSIS,the appropriate methods for controlling noise in tire manufacturing are designing and manufacturing silencer,requiring people in charge to quickly fix the leaks and change baking press washers on time.展开更多
Objective:To develop nursing adverse events’reporting content of hospital.Methods:The study included two phases.The first phase was to develop the category and definition of nursing adverse events that need to be rep...Objective:To develop nursing adverse events’reporting content of hospital.Methods:The study included two phases.The first phase was to develop the category and definition of nursing adverse events that need to be reported through an expert meeting.The second phase was to develop every nursing adverse event’s reporting content by using the Delphi method.In total,8 experts attended the meeting and 15 experts conducted two rounds of consultation letter.Results:Nursing adverse events that need to be reported of hospital include pressure sore,fall/falling from bed,unplanned extubation,medication error,and accident.Reporting content of these events in detail had also been obtained,which was helpful for cause analysis systematically.Conclusions:The reporting content of the nursing adverse event of hospital is established,and it is a basis for further study of the development of nursing adverse event reporting and feedback system.展开更多
文摘Maintenance decision problems generally involve multiple criteria which apparently are best addressed using Multi-Criteria Decision Making (MCDM) tools. This paper describes the use of a hybrid MCDM technique in prioritizing maintenance strategy for ship systems. The Hybrid MCDM technique combines Delphi method, AHP and TOPSIS methods. While the Delphi method and AHP are applied in screening of decision criteria and decision criteria weights determination respectively, the TOPSIS method is used in the ranking of alternative maintenance strategies. Five alternative maintenance strategies which include corrected maintenance, scheduled overhaul, scheduled replacement, continuous on-condition task and scheduled on-condition task are considered and the optimum maintenance strategy is selected based on twelve critical maintenance decision criteria. To demonstrate the suitability of the approach a case study of sea water pump of the central cooling system of a marine diesel engine is used.
文摘Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the scale by Delphi method. Sixteen experts in medical management, human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the DeLphi consultation questionnaires twice in the consulting round. In the first round, the recovery rate showing the experts＇ positivity was 80%; the coefficient of reliability （Cr） ascertaining the authority of the evaluation was 0.92; the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25%-93.75% respectively; the coefficients of variation （CV） and the Kendall＇s W determining the concordance of the evaluation were 5.06%-52.15% and 0.21-0.24 respectively. In the second round, the recovery rate was 93.75%; the Cr was 0.93; the mean was 3.93-4.93; the full mark ratios were 26.67%-93.33%; the Kendall＇s W was 0.14- 0.31, the CV was 5.25%-23.61%. Via the two-round Delphi study, the scale that included 10 dimensions and 61 items has been improved. Ten dimensions are pre-hospital medical service, guidance, registration, waiting, diagnosis ＆ treatment, paying, inspection ＆ assay, medicine receiving, therapy/injection/transfusion and global evaluation. It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience. The experts have given high agreements about the dimensions which were established with Chinese outpatient process. The dimensions are different from the similar researches about outpatient experience study. In the future, it is necessary to survey the outpatients to test the construct validity, internal consistency reliability and others of the scale to improve the scale.
文摘Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government administrations and hospitals to formulate unified standards. Methods: After the research team has determined the theme, it will consult the development of A) specialist nursing through the library, Internet and electronic literature database;B) the history of the development of specialist nurses in diabetes and other fields;C) the selection criteria of specialist nurses;D) the training of specialist nurses system, assessment method;E) Specialist nurse certification body, evaluation standards and certification standards and other related documents, literature, books and report materials. The author established the preliminary index system through literature review, specialist interview and group discussion and used Delphi method to organize three rounds of 30 experts’ consultations. Results: A first certification evaluation index system including 8 fundamental indicators, 5 first-level indicators, 19 second-level indicators and 99 third-level indicators was constructed for diabetes nurses. Conclusion: The results of three rounds of expert consultation and demonstration are reliable, and the constructed index system is suitable for comprehensive evaluation of diabetes specialist nurses, which provides a basis for the effective management of nursing resources.
文摘The Delphi technique is a systematic process of forecasting using the collective opinion of panel members.The structured method of developing consensus among panel members using Delphi methodology has gained acceptance in diverse fields of medicine.The Delphi methods assumed a pivotal role in the last few decades to develop best practice guidance using collective intelligence where research is limited,ethically/logistically difficult or evidence is conflicting.However,the attempts to assess the quality standard of Delphi studies have reported significant variance,and details of the process followed are usually unclear.We recommend systematic quality tools for evaluation of Delphi methodology;identification of problem area of research,selection of panel,anonymity of panelists,controlled feedback,iterative Delphi rounds,consensus criteria,analysis of consensus,closing criteria,and stability of the results.Based on these nine qualitative evaluation points,we assessed the quality of Delphi studies in the medical field related to coronavirus disease 2019.There was inconsistency in reporting vital elements of Delphi methods such as identification of panel members,defining consensus,closing criteria for rounds,and presenting the results.We propose our evaluation points for researchers,medical journal editorial boards,and reviewers to evaluate the quality of the Delphi methods in healthcare research.
文摘Objective:The objective of this study is to establish a nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)in Beijing,to provide reference for clinical nursing of patients with COVID‑19(mild and common).Methods:Through online communication meeting with nurses who are in the frontline of anti‑epidemic,clinical investigation,literature research,and expert demonstration meeting are carried out to prepare the draft of the standard,and the Delphi method is applied to determine the standard of integrated traditional Chinese and Western medicine care for patients with COVID‑19(mild and common)in Beijing.Results:The nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)was established,which included 5 first‑level indicators,14 second-level indicators and 60 third‑level indicators.After two rounds of Delphi method,the positive coefficients of experts were 96%and 83%,the authoritative coefficients of experts were 0.89 and 0.91,and the Kendall’s coefficient of concordance(W)of experts were 0.12,0.09,0.10,0.13(P<0.05)and 0.44,0.43,0.37,0.39(P<0.05).Conclusion:The standard of integrated traditional Chinese and Western medicine nursing for patients with COVID‑19(mild and common)in Beijing constructed by the Delphi method is scientific and practical,which provides a reference for clinical application of integrated traditional Chinese and Western medicine nursing to fight against COVID‑19 infection.
文摘Objective： This study sought to investigate the content of the prescription rights and the prescription types of midwives under certain circumstances in China. Methods： The Delphi method was used to consult 18 nursing experts and 14 medical experts, A total of 30 experts finished the consulting. The reliability of the expert opinions was analyzed to determine the specific situations in which midwives may write prescriptions, the content of the prescription rights and the prescription types. Results： In six specific circumstances （uterine contraction fatigue, uterine contractions that are too strong, postpartum hemorrhage, premature rupture of the membranes, normal delivery and neonatal asphyxia）, midwives have the right to prescribe and administer medication, including 20 drugs and 13 auxiliary examinations. Of these drugs and examinations, 51.5% of the drugs and adjuvant examination prescriptions tend to be independent prescriptions, 30.3% tend to be protocol prescriptions, and 18.2% are similar to both types. Conclusions： The midwives should be granted some prescription rights to enhance their autonomy and the professionalism of midwifery.
文摘The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy process(AHP)was used to determine the index weight.A total of 19 experts were included,all with intermediate or higher professional titles.The positive coefficients of experts in the two rounds of consultation were all 100%.The judgment basis of experts is 0.895,the degree of familiarity is 0.842,and the coefficient of authority is 0.868.The Kendall harmony coefficients of the first,second,and third-level indicators were 0.381,0.383,and 0.320,respectively.The expert coordination degree was tested by x^(2) test,the P values were all less than 0.05,indicating that the degree of expert coordination was well.After two rounds of letter inquiry,an evaluation index system of core competence of HCPs with professional accomplishment,theoretical knowledge,basic skills,professional skills,and professional development ability as the main framework was formed,including 5 first-level indicators,18 second-level indicators,and 62 third-level indicators.Based on the Delphi and AHP methods,the index system of HCPs'core competence established has high authority and scientificity,to provide the theoretical basis for the standardized training and comprehensive evaluation of HCPs.
基金supported by Nursing Research Program of Shanghai Nursing Association(No.2016SD-B03)
文摘Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.Methods: Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire(OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance(M) >3.5, and coefficient of variation(CV) <0.25. Reliability of experts' opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.Results: A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.Conclusions: The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.
基金the Key scientific research projects of higher education institutions in Henan Province(20A360005)The consulting service costs was paid by the Henan Science and Technology Research and Social Development Project(202102310497)National Chinese Medicine Leading Talents Support Program-Qi Huang Scholars(Guo Chinese Medicine Ren Jiao Han[2018]No.284 and Special Scientific Research Project of National Clinical Research Base of Traditional Chinese Medicine(2019JDZX001,2019 JDZX028).
文摘Esophageal cancer is one of the common malignant tumors in humans.Traditional Chinese medicine(TCM)has unique advantages in the treatment of esophageal cancer.However,the TCM syndrome classification of esophageal cancer is not standardized.This Delphi survey aimed to explore the TCM syndrome classification and symptom characteristics of esophageal cancer.Methods:Based on literature research,an expert consultation questionnaire was developed for the study of the TCM syndrome rules of esophageal cancer.Two rounds of questionnaire surveys were conducted among 62 experts across the country.Statistical description and statistical analysis of the mean,coefficient of variation,grade sum,and unimportant percentage of the retrieved data.TCM syndrome rules and diagnostic indicators for esophageal cancer after screening and sorting out the questionnaire items,convening experts to demonstrate.Results:62 valid questionnaires were collected,and the expert positive coefficient was 100%.The Kendall's coefficient of concordance W of the first and second rounds are 0.232 and 0.2334 respectively.In addition,the Kendall's coefficient of concordance W of the second round has been improved compared with the first round,suggesting that experts have a better degree of coordination on the importance of indicators.The common TCM syndromes of esophageal cancer are obtained:"liver-stomach disharmony,phlegm and qi obstruction syndrome","liver and spleen disorders,phlegm accumulating with stagnation syndrome","deficiency of liver and kidney yin,stubborn blood syndrome","deficiency of spleen and kidney yang,stubborn blood syndrome".Conclusion:The TCM syndrome indicators of esophageal cancer has been established.It provides a basis for the standardized research of TCM syndrome diagnosis of esophageal cancer,which is of positive significance for improving the level of clinical diagnosis and treatment.
文摘<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. <strong>Objective:</strong> This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. <strong>Methods:</strong> A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. <strong>Conclusions: </strong>The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.
基金This study was approved by the Ethics Committee of Kerman University of Medical Sciences.Ethics code(IR.KMU.REC.1397.392).
文摘Undoubtedly,noise has become a major hazardous issue in today’s industrial world,with a lot of people suffering from exposure to excessive noise in their work environments.This study was conducted to weigh and prioritize noise control methods in an Iranian tire manufacturing complex in Iran.The Delphi method and the Technique for Order Preference by Similarity and an Ideal Solution(TOPSIS)were utilized for this purpose.This cross-sectional,descriptive study was conducted in the baking hall of an Iranian tire manufacturing factory in 2016.To weigh and prioritize noise control methods,Analytic Hierarchy Process(AHP)and TOPSIS were applied.In total,4 criteria and 8 alternatives were examined.An AHP and TOPSIS questionnaire was then designed to prioritize noise control methods in the light of the objectives,criteria,and alternatives.Then,the collected data were fed into Expert Choise.V.11 and Excel and data analysis was carried out using TOPSIS.The results of data analysis indicated that the inconsistency rate in all the cases was smaller than 10%,hence the consistency of the responses was verified.According to the TOPSIS results and experts’opinions about the criteria,implementation and maintenance cost(with a weight of 0.481)and method effectiveness and efficiency(with a weight of 0.046)had the highest and lowest priority respectively.Based on the weights TOPSIS,the appropriate methods for controlling noise in tire manufacturing are designing and manufacturing silencer,requiring people in charge to quickly fix the leaks and change baking press washers on time.
文摘Objective:To develop nursing adverse events’reporting content of hospital.Methods:The study included two phases.The first phase was to develop the category and definition of nursing adverse events that need to be reported through an expert meeting.The second phase was to develop every nursing adverse event’s reporting content by using the Delphi method.In total,8 experts attended the meeting and 15 experts conducted two rounds of consultation letter.Results:Nursing adverse events that need to be reported of hospital include pressure sore,fall/falling from bed,unplanned extubation,medication error,and accident.Reporting content of these events in detail had also been obtained,which was helpful for cause analysis systematically.Conclusions:The reporting content of the nursing adverse event of hospital is established,and it is a basis for further study of the development of nursing adverse event reporting and feedback system.
