Building a personalized patient education model for general practice by Delphi method

Interventions to improve patient health education competence among nursing personnel: A scoping review

AIM

To determine what intervention strategies have been used in interventions aimed at improving the patient health education competence of nursing personnel.

BACKGROUND

There is a growing body of research on educational interventions for improving nursing personnel's patient health education competence, but there are significant differences in the teaching objectives, content and methods of these studies, as well as a lack of standardized educational strategies.

DESIGN

The scoping review was based on the Joanna Briggs Institute methodology.

METHODS

In this study, six databases and the gray literature source, the Google search engine, were searched. A search strategy was developed based on the three-step search method recommended by the Joanna Briggs Institute. Two researchers independently performed study selection and data extraction.

RESULTS

22 articles reported on the specifics of educational interventions. The duration of these interventions ranged from a minimum of 1.5 hours to a maximum of 3 months. Most interventions employed face-to-face courses as the teaching model. The studies included a variety of teaching methods, with the most frequently mentioned being lectures, discussions, demonstrations, simulations and role-playing. However, most studies lacked specific teaching objectives and none described the educational content of the implementation process. Additionally, none of the studies developed educational content based on a competence framework for patient health education. Few studies reported on long-term effects.

CONCLUSION

The diverse intervention strategies demonstrated in these studies could serve as valuable evidence to guide the development of relevant educational programs and facilitate the design of future high-quality educational interventions.

Construction of the medical virtual teaching and research office evaluation system in China based on the context, input, process, product model: a Delphi study

BACKGROUND

As new-formed basic-level teaching organizations, medical virtual teaching and research offices (VTROs) have been established in China since 2021. There still a lack of a comprehensive standard for them. The aim of this study was to construct a comprehensive system for evaluation of the medical VTROs.

METHODS

The authors developed an initial draft of the VTROs evaluation system, based on the context, input, process, product model and a literature review. A total of 19 experts were invited to provide supportive advice and modification suggestions on the evaluation system in two Delphi rounds, and calculated coefficient value, consistency ratio, and weight for each first-, second-, and third-level indices.

RESULTS

The CIPP model-based evaluation system developed included the subject and course categories. The subject category had 4 first-level indices, 14 s-level indices, and 46 third-level indices, while the course category had 4 first-level indices, 13 s-level indices, and 49 third-level indices. The recovery rates for two rounds were 94.7% and 89.5%. Coefficient value for the two subscales ranged from 0.097 to 0.207 in the second round, while weighted quality index values were established at all levels, with a consistency ratio < 0.1.

CONCLUSIONS

The VTROs evaluation system is CIPP-oriented, comprehensive, and reliable. It can serve a guide for construction, implementation, and evaluation of VTROs in medical field.

Living with a permanent ostomy: a descriptive phenomenological study on postsurgical experiences in patients with colorectal cancer

OBJECTIVES

To explore the postsurgery lived experiences of patients with colorectal cancer with a permanent ostomy for informing initiatives to improve patient care and future quantitative research.

DESIGN

A descriptive qualitative phenomenological study.

SETTING

We conducted this study in the Colorectal Cancer Division at the Cancer Center of West China Hospital, Sichuan University, a premier institution renowned for its comprehensive cancer care and research.

PARTICIPANTS

12 patients who had undergone surgeries for colorectal cancer with a permanent ostomy.

RESULTS

Our interviews revealed profound adjustments in the lives of colorectal cancer survivors living with permanent ostomies. Participants articulated a transition to a 'new normal', characterised by extensive daily life adjustments, psychological adaptation and ongoing management challenges. Key themes identified included the adaptation to a reshaped daily routine and altered perceptions of quality of life. Many faced substantial challenges in stoma care, requiring significant learning and adaptation. Psychological adaptations were marked by a redefinition of body autonomy and personal identity, alongside a recalibration of social interactions and privacy. The need for robust professional guidance and a comprehensive social support system was universally emphasised.

CONCLUSIONS

Patients with colorectal cancer with permanent ostomies navigate significant changes in their lives postsurgery, undertaking a complex process of reconstructing and adapting to a new normalcy. They recalibrate their physical, psychological and social well-being, demonstrating resilience and adaptability in the face of these challenges. Their pervasive expression of needs for information and support may reflect gaps in the existing patient education and support measures and communication strategies. Healthcare professionals and policy-makers should adopt a patient-centred approach acknowledging the multifaceted nature of postsurgery recovery and adaptation by fostering open communication, tailoring personalised education and facilitating supportive community networks.

Development of an evaluation list for older adult community-based rehabilitation needs through a Delphi method

Older adults' functional and intrinsic abilities may decline with increasing age. The positive effects of comprehensive community-based rehabilitation services to maintain physical, mental, and social function are essential. Nevertheless, few tools are available to assess the community-based rehabilitation needs of older adults. Therefore, we aimed to construct a list for the comprehensive evaluation of community-based rehabilitation needs of older adults. The International Classification of Functioning, Disability, and Health (ICF) was used to construct a first draft of the assessment list. From September to November 2023, 18 experts from five provinces and nine tertiary hospitals and institutions of higher education in China participated in this Delphi study. The older adult community-based rehabilitation needs evaluation list included six dimensions and 29 items. The weights of the six dimensions, from high to low, included mental function rehabilitation need (0.30), body function rehabilitation need (0.24), social participation need (0.18), individual activity rehabilitation need (0.14), environmental rehabilitation need (0.09) and rehabilitation information need (0.05). Using the Delphi method, an assessment list of older adult community-based rehabilitation needs based on ICF was developed. Future work should evaluate the list's reliability and validity and its application in managing community-based rehabilitation for older adults.

Development of an Evaluation System for the Prophylactic Use of Antimicrobial Drugs in the Perioperative Period of Class I Surgical Incisions in Neurosurgery

BACKGROUND

This study aimed to establish a precise preoperative high-risk factor scoring system and algorithm for antibiotic prophylaxis decision-making, provide guidance for the judicious use of AMP, refine interventions, and ensure the appropriate application of AMP for class I incisions in neurosurgery.

METHODS

According to PRISMA guidelines, literature searches, study selection, methodology development, and quality appraisal were performed. The quality of evidence across the study population was assessed using the Newcastle-Ottawa Scale. A two-round Delphi expert consultation method involved 15 experts from leading tertiary hospitals in China. Establishing an algorithm of SOPs for perioperative antimicrobial prophylaxis in Class I neurosurgical incisions.

RESULTS

Thirteen studies, encompassing 11,936 patients undergoing clean neurosurgical procedures, were included. 791 patients experienced SSI, resulting in an average incidence of 6.62%. Identified risk factors significantly associated with an increased incidence of postoperative SSI (P < 0.05) included emergency surgery, preoperative hospitalization ≥7 days, intraoperative blood loss ≥300 mL, operation time ≥4 hours, diabetes mellitus, cerebrospinal fluid leakage, and repeat surgery. Sensitivity analysis demonstrated robust results for emergency surgery, intraoperative blood loss ≥300 mL, operation time ≥4 hours, cerebrospinal fluid leakage, and repeat surgery. Established a risk assessment system for Class I neurosurgical incisions by the Delphi method. Additionally, we have formulated an algorithm of SOPs for perioperative antimicrobial prophylaxis in Class I neurosurgical incisions.

CONCLUSIONS

The established index for AMP utilization and SOPs in the preoperative period of class I neurosurgical incisions proves valuable, contributing to improved patient outcomes in neurosurgical procedures.

Development of the assessment standards of the International Classification of Functioning, Disability, and Health (ICF) Geriatric Core Set through a modified Delphi method

BACKGROUND

There is currently a lack of functional assessment tools based on the International Classification of Functioning, Disability, and Health (ICF) theoretical framework that are specific for older adults.

OBJECTIVE

The aim of the present study was to develop Chinese assessment standards of the ICF Geriatric Core Set for functional evaluation of older adults.

METHODS

A two-stage study process was conducted to develop the assessment standards of the ICF Geriatric Core Set: establishment of candidate assessment standards, and a modified Delphi consensus process including a pilot survey and two-round formal expert survey. Thirty participants in the field of ICF and geriatric rehabilitation were recruited. The suitability of the assessment standards in the questionnaires was rated using a Likert 5-level scoring method. The arithmetic mean, the full mark ratio and the coefficient of variation (CV) were used as screening indicators for the assessment standards, and modification was made for several standards, in line with the Delphi results and the expert panel discussion.

RESULTS

Thirty-three candidate assessment standards belonging to 17 categories were generated. A total of 26 and 24 experts in the field of ICF and geriatric rehabilitation participated in the two-round survey, respectively. Five standards belonging to four categories entered into the second-round survey directly, five standards belonged to five categories entered with minor modification, and nine standards belonging to seven categories were redesigned based on the literature and discussion of the expert panel. In the second-round survey,15 assessment standards belonging to 15 categories met the screening requirements and four assessment standards belonged to the two remaining categories that needed a criterion and which the expert panel discussed for the final decision.

CONCLUSIONS

Using the modified Delphi method, the assessment standards of the ICF Geriatric Core Set have been developed.Future work should focus on the reliability and validity of the the assessment standards and their application to the health management of older adults.