ObjectiveTo construct the terminology standard of hospital quality and safety. MethodsThe draft terminology standard was constructed through group discussions, and the final draft terminology standard was formed after one round of Delphi expert consultation and two rounds of expert consensus meetings. ResultsThe recovery rate of the questionnaire was 100%, and the authority coefficient of experts was 0.87. A total of 15 experts were invited to two rounds of expert consensus meetings. The terminology standard for hospital quality and safety (TCHAS 10-1-1-4—2022) was finally released, including 4 first-level categories, 20 second-level categories, and 370 terms in total. ConclusionThe terminology standard of hospital quality and safety developed in this study is scientific and reliable, which can be used as a tool to assist medical institutions in carrying out standardized management.
Objective To scientifically construct a self-management behavior scale for postoperative patients with osteoporotic fractures, in order to assess the self-management behavior level of this patient population. Methods Between November 2022 and February 2023, a scale item pool was constructed using literature analysis and expert panel discussions. A preliminary version of the scale was formed based on feedback from 30 experts and 15 patients. From March 2023 to March 2024, a convenience sampling method was used to survey 230 patients post-osteoporotic fracture surgery from a tertiary hospital in Guangzhou. Cronbach’s α coefficient, split-half reliability, and test-retest reliability were used to assess the reliability of the scale, while content validity and exploratory factor analysis were used to evaluate its validity. Results The developed scale consisted of 5 dimensions and 27 items. The content validity index for each item ranged from 0.933 to 1.000. Exploratory factor analysis extracted 5 common factors, explaining 65.964% of the cumulative variance. The overall Cronbach’s α coefficient, split-half reliability, and test-retest reliability were 0.934, 0.780, and 0.958, respectively. The Cronbach’s α coefficient, split-half reliability, and test-retest reliability for each dimension ranged from 0.849 to 0.897, 0.816 to 0.904, and 0.826 to 0.894, respectively. Conclusions The self-management behavior scale for post-osteoporotic fracture surgery patients demonstrates good reliability and validity. It is a highly authoritative and scientific tool that can be used effectively to assess self-management behaviors in these patients and provide a basis for developing personalized self-management interventions.
Objective To construct a sensitive indicator system for the quality of ambulatory chemotherapy nursing, and provide reference basis for the evaluation and scientific management of ambulatory chemotherapy nursing quality. Method Based on Donabedian’s three-dimensional quality structure model of “structure process result”, through literature review, a preliminary quality indicator system for ambulatory chemotherapy nursing was formulated. The Delphi method was used for two rounds of expert inquiry to determine the sensitive treatment indicator system for ambulatory chemotherapy nursing. The weight of the indicators was calculated using the hierarchical analysis method. Result Fifteen expert inquiry questionnaires were distributed through two rounds of inquiry, and the response rates of the two rounds of expert inquiry questionnaires were all 100%, with expert positivity coefficients of 100% and authority coefficients of 0.90 and 0.94, respectively. The second round of expert inquiry questionnaires Kendall’s coefficient of concordance were between 0.573 and 0.769 (P<0.01). The final constructed quality sensitive indicator system for ambulatory chemotherapy nursing included 3 primary indicators, 8 secondary indicators, and 27 tertiary indicators. The overall Cronbach’s α coefficient for the second round of inquiry questionnaires was 0.853, while the Cronbach’s α coefficients for structural indicators, process indicators, and outcome indicators were 0.879, 0.921, and 0.857, respectively. Conclusions The sensitive indicator system for nursing quality in ambulatory chemotherapy wards constructed has high systematicity, sensitivity, and scientificity, and the weight distribution is reasonable. This indicator system can provide a reference basis for objective evaluation and standardized management of nursing quality in ambulatory chemotherapy.
ObjectivesTo construct a symptom assessment system suitable for surgical lung cancer patients, and to objectively evaluate the types and severity of postoperative symptoms in patients so as to provide evidence-based basis for the treatment of postoperative symptoms of lung cancer patients.MethodsPostoperative symptom items of lung cancer were formed according to previous researches, literature review, the current lung cancer symptom assessment tools, and expert interviews. The Delphi method was used to conduct two rounds of expert consultation and a postoperative symptom inventory was established for lung cancer patients.ResultsNine first-level symptom items were eventually formed: cough, pain, shortness of breath, fatigue, dizziness, nausea or vomiting, subcutaneous emphysema, insomnia, and constipation. The first round of active coefficient and authority coefficient of experts were 85.0% and 0.88, and the second round were 88.2% and 0.87. The Kendall coordination coefficients of the nine first-level symptom items were 0.47 (P<0.001) and 0.43 (P<0.001), respectively.ConclusionsThe evaluation system of postoperative symptom items for lung cancer patients is highly recognized by experts and has good consistency.
Objective To explore the certification management of specialty nurses in China based on the existent problems to provide evidence for practice and decision making for management of the specialty nurses. Methods The modified Delphi technique was applied in this study from July to December 2017. A structured consultation questionnaire based on expert interview and literature review was designed, and modified after preliminary experiment. Then the questionnaires were delivered to 32 nurse experts to complete 3 rounds of Delphi process, which reached consensus gradually. Results The response rates of three round consultations were 96.9% (31/32), 100.0% (31/31), and 96.8% (30/31), respectively. The suggestion rates were 25.8% (8/31), 16.1% (5/31), 0% (0/31), respectively. The familiar coefficient, adjustment coefficient and authority coefficient was 0.82, 0.87 and 0.85, respectively. The experts had the agreement finally for all of the 16 items in the consultation questionnaire, and they formed an expert opinion draft on specialty nurse certification and registration. Conclusion It’s crucial and essential to establish a certification and registration system in China and renew the credentials regularly to promote the management and construction of specialty nurse team.
Objective To construct an index system for the rational use of foods for special medical purposes (FSMP) by medical institutions. Methods Based on the literature review and the survey of 300 medical institutions, we developed a questionnaire for expert consultation and conducted two rounds of expert consultation using Delphi method and consensus meeting method to determine the final index system for the rational use of FSMP in medical institutions. Results After two rounds of expert consultation and expert consensus conference meetings, it was finally determined that medical institutions should reasonably use the FSMP comprehensive evaluation index system, including 3 first-level catalog indicators, 17 second-level catalog indicators, and 13 third-level catalog indicators. Conclusion This index system can help promote the rationalization and standardization of FSMP clinical application in medical institutions in China and improve the quality of clinical nutrition care.
ObjectiveBy establishing a set of evaluation system for thoracoscopic clinical function and applicability, to evaluate and compare the advantages and disadvantages of different brands of thoracoscopes, and to provide some suggestions for the innovation and upgrade of thoracoscopes, especially for the domestic thoracoscopes.MethodsThe project coordination team initially formulated the evaluation index system for the clinical function and applicability of thoracoscope by querying literature and brainstorming. The Delphi expert consultation method was used to distribute questionnaires to the selected experts. Experts provided scores which were based on the importance of each indicator, and clarified the basis of their judgment and the familiarity with the evaluation indicators. After two rounds of screening by Delphi method, a thoracoscopic clinical function and applicability satisfactory questionnaire was formed. The appropriate sample for pre-investigation was selected, and the reliability and validity were tested. The index composition was adjusted based on the results of the test to form a final evaluation scale.ResultsThe project coordination team initially formulated 24 thoracoscope-related evaluation indicators. After two rounds of experts consultation, the item "brightness adjustment" was deleted without any additional entries. The positive coefficients of the experts in the first round and the second round were 100.0% and 80.0%, respectively. The two rounds of authoritative coefficients were 0.86 and 0.90, and the coordination coefficients were 0.272 (P<0.001) and 0.523 (P<0.001), respectively. A total of 140 questionnaires were issued in this pre-investigation. The recovery rate was 100.0% and the effective rate was 90.0%. The Cronbach's α value of the scale was 0.936, and the Spearman-Brown split-half reliability coefficient was 0.972. The factor analysis finally extracted 3 common factors. The total variance of the cumulative interpretation was 70.9%. The three common factors were named "operation related", "image related" and "device related".ConclusionThe evaluation index system developed in this study has good reliability and validity, and can be used as a tool to evaluate the clinical function and applicability of thoracoscopes.
ObjectiveWe constructed a real-world evidence evaluation system to provide reference for obtaining high-quality evidence in evidence-based medicine.MethodsThrough the investigation and analysis of the key factors influencing the real-world research evidence, combined with domestic and foreign literature and evaluation tools, we preliminarily constructed the indicators of the real-world evidence evaluation system, then consulted experts in related fields by the Delphi method, modified and determined the final evaluation indicators. ResultsThe indicators of the final real-world evidence evaluation system included 40 items. The recovery efficiencies of the two rounds of expert consultation were 88.2% and 100%; The expert coordination coefficients were 0.174 (P<0.001) and 0.189 (P<0.001). After the second round of consultation, the mean of Likert scale in the range of 3.73~4.93, and the coefficient of variation varied in the range of 0.05~0.21. ConclusionThe real-world evidence evaluation system constructed in this study has certain reliability and scientificity, which can provide a basis and help for the transformation of real-world research into high-quality evidence.
In the context of the rapid development of contemporary medical industry and the unbalanced development of various subspecialties, expert consensus plays an extremely important role in guiding clinical practice and improving the quality of medical care. However, there are some deficiencies and limitations in the formation process and final report of the expert consensus. Therefore, this paper summarizes and reviews the definition, applications, and functions of expert consensus and the new progress of expert consensus formation methods by fully reviewing the literature, and puts forward the prospect. The purpose is to provide a reference for the production and application of expert consensus related to medical care, improve the outcomes of medical care, and upgrade the quality and level of medical services.
ObjectiveTo systematically review the application status of Delphi method in clinical research of traditional Chinese medicine (TCM).MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect original research and methodological research on Delphi method in TCM from inception to August 30th, 2020. Two reviewers independently screened literature, extracted data, and then, descriptive analysis was performed by using qualitative methods.ResultsA total of 612 articles involving 573 original studies and 39 methodological studies were included, which involved 167 types of diseases. The primary research purposes were disease diagnosis and treatment, syndrome research, scale development, evaluation research, index research, clinical investigation, methodology research, and other 8 categories. 487 papers reported the implementation process and results of Delphi method in varying degrees.ConclusionsDelphi method is widely used in clinical research of TCM, however, there are deficiencies in the specific implementation process.