scholarly journals Developing a midwifery service task list for Chinese midwives in the task-shifting context: a Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044792
Author(s):  
Chunyi Gu ◽  
Helena Lindgren ◽  
Xiaojiao Wang ◽  
Zheng Zhang ◽  
Shuang Liang ◽  
...  
Keyword(s):  
Delphi Study ◽  
High Reliability ◽  
Task Shifting ◽  
Scope Of Practice ◽  
Extensive Literature ◽  
University Hospitals ◽  
Effective Response ◽  
Midwifery Practice ◽  
Task List ◽  
Core Components

ObjectiveTo develop and validate a midwifery-led task list in the task-shifting context.DesignAn extensive literature review followed by a two-iterative Delphi survey.SettingTwenty university hospitals, three non-university hospitals and four university colleges from nine provincial regions of China.ParticipantsPurposive non-probability sampling of a national panel of experts in maternal healthcare, obstetrics, nursing and midwifery. Experts in the panel were asked to rate each midwifery service item regarding importance, feasibility and advancement on a 5-point scale, in order to determine those best suited for midwifery-led practice in China.ResultsTwo rounds of Delphi surveys were completed before consensus was achieved, with effective response rate ranging from 96.4% (27/28) to 100% (27/27), indicating a high positive coefficient of the experts. The authority coefficient of experts was 0.882, indicating the high reliability of this study. The Kendall harmony coefficient (W) in the two rounds of consultations was 0.196 (p<0.001) and 0.324 (p<0.001), respectively. A detailed, three-level midwifery-led task list was developed, including 3 domains of midwifery practice (first-level indicators), 13 types of task (second-level indicators) and 58 midwifery service items (third-level indicators). The 3 domains of midwifery practice involved the appropriate scope of practice for Chinese midwives, including antenatal care, intrapartum care and postnatal care. The 58 service items embraced core components of caring task in the Chinese midwifery profession.ConclusionThis study outlines the first midwifery-led task list that defines clearly the Chinese midwives’ scope of practice. It will provide a foundational framework for future midwifery practice in China and abroad, and can be used to inform the design of midwifery-led task shifting interventions in various maternity settings.

scholarly journals ‘Oh, she is just a nurse’ Re-imagining the role of the nursing workforce in Uganda after a decade of ART scale-up (2004-2014)

2020 ◽  
Author(s):  
Henry Zakumumpa
Keyword(s):  
Mixed Methods ◽  
Disease Management ◽  
Scale Up ◽  
Task Shifting ◽  
Health Facilities ◽  
Hiv Care ◽  
Scope Of Practice ◽  
Nursing Workforce ◽  
Hiv Disease

Abstract Background The expanding roles and increasing importance of the nursing workforce in health services delivery in resource-limited settings is not adequately documented and sufficiently recognized in the current literature. Drawing upon the theme of 2020 as the international year of the nurse and midwife, we set out to describe how the role of nurses had expanded tremendously in health facilities in Uganda during the era of anti-retroviral therapy (ART) scale-up between 2004 and 2014.Methods A mixed-methods study was conducted in two phases. Phase One entailed a cross-sectional health facility survey (n=195) to assess the extent to which human resource management strategies (such as task shifting) were common. Phase Two entailed qualitative case-studies of 16 (of the 195) health facilities for an in-depth understanding of the strategies adopted (e.g. nurse-centred HIV care). We adopted a qualitatively-led mixed methods approach whereby core thematic analyses were supported by descriptive statistics.Results We found that nurses were the most represented cadre of health workers involved in the overall leadership of HIV clinics across Uganda. Most of nurse-led HIV clinics were based in rural settings although this trend was fairly even across all settings (rural/urban/peri-urban). A number of health facilities in our sample (n=36) deliberately adopted nurse-led HIV care models. Nurses were empowered to be multi-skilled with a wide range of competencies across the HIV care continuum right from HIV testing to mainstream clinical HIV disease management. In several facilities, nursing cadre were the backbone of ART service delivery. A select number of facilities devised differentiated models of task shifting from physicians to doctors to nurses in which the latter handled patients who were stable on ART.Conclusion Overall, our study reveals a wide expansion in the scope-of-practice of nurses during the initial ART scale-up phase in Uganda. Nurses were thrust in roles of HIV disease management that were traditionally the preserve of medical doctors. Our study underscores the importance of reforming regulatory frameworks governing nursing workforce scope of practice in Uganda such as the need for evolving a policy on task shifting which is currently lacking in Uganda.

Evaluating children’s websites from an information visualization perspective: findings of a comparative mixed-methods study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yaghoub Norouzi ◽  
Hamid Keshavarz ◽  
Zahra Jafari Athar
Keyword(s):  
Mixed Methods ◽  
Conceptual Model ◽  
Information Visualization ◽  
Interface Design ◽  
Evaluation Method ◽  
High Reliability ◽  
Comparative Approach ◽  
Extensive Literature ◽  
Content Type ◽  
Reliability Indicators

Purpose This study aims to evaluate the selected children’s websites in terms of information visualization features based on the criteria existing in the related literature and expert scrutiny. Design/methodology/approach A mixed-methods (qualitative-quantitative) study was conducted with a descriptive-comparative approach. A set of 80 English websites, as well as 24 quality Persian websites, were selected constituting a sample size of 104 websites. A conceptual model was developed from an extensive literature review on information visualization in children’s websites. In the quantitative part, a checklist derived from the conceptual model and based on the heuristic evaluation method was distributed among 20 related experts, the data of which were then analysed through Partial Least Squares using SmartPLS 3.0. Findings Confirmatory factor analysis showed high-reliability indicators and fit indices in measurement and structural models showing that the conceptual model had the necessary validities among the expert evaluators. Path coefficients showed that layout design and user interface design were the first and last priorities among the dimensions. It was also found that English websites were much more successful than Persian websites in supporting the features of information visualization. Originality/value The current study has implications for the effective use of standard features related to information visualization in children’s websites usable for designers, media specialists, parents, instructors and librarians, which would also make the children more engaged to better use, learn and interact with the websites.

Docendo discimus: Forwarding Seeing the Patient as a Person to the Future Generation of Physicians

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J T V Greenbrook ◽  
M Ioannou
Keyword(s):  
Clinical Teaching ◽  
Future Generation ◽  
Hippocratic Oath ◽  
Human Dimensions ◽  
University Hospitals ◽  
Structured Interviews ◽  
Ethical Perspective ◽  
Reciprocal Effect ◽  
Clinical Teachers ◽  
Core Components

Abstract Background Forwarding the finest traditions of a calling, and upholding core components of the Hippocratic Oath, requires forwarding seeing each patient as a unique and autonomous person to future generations of physicians. Whilst clinical teaching is paramount in fostering this ethical perspective in applied contexts, limited empirical research has addressed how and why clinical teachers forward seeing the patient as a person in teaching. The present study endeavored to address this gap. Methods Qualitative semi-structured interviews were conducted with 17 randomly sampled clinical teachers, from two major university hospitals in Sweden. Data was analyzed through the phenomenological method. Results Two themes emerged: (1) Forwarding seeing the patient as a person by conveying the perspective, including the categories highlighting practical benefits in context, displaying humility and rendering the abstract salient, awareness of clinical teachers' impact on pathway development, and protecting core Hippocratic values in medical education; and (2) the need for active engagement in fostering the perspective, including the categories observing own development on a continuum, requiring constant reminders in applied contexts, finding inspiration through interaction, and the need for dedication and resolve. Conclusions Emblematic of the Latin proverb docendo discimus [by teaching, we learn], exemplifying the Hippocratic Oath in applied contexts further fueled and fostered the clinical teacher's own ethical perspective. This observed process accents how focus in teaching is contingent on, and promoting of, clinical teachers' own development and further engagement with the human dimensions of care. Cumulatively, past and present exemplars shape clinical teachers' professional identity and ability to engage with seeing the patient as a person, in turn enhancing the dedication needed to lead by example and revive the core components of the Hippocratic Oath in clinical teaching. Key messages Forwarding seeing the patient as a person in teaching is contingent on, and promoting of, clinical teachers’ own development and further engagement with the human dimensions of care. “Docendo discimus [By teaching, we learn]” – The reciprocal effect of fostering the ethical perspective in teaching requires seeking exemplars, to serve both as reminders and sources of inspiration.

scholarly journals Development of a Care Bundle for Stroke Survivors with Psychological Symptoms: Evidence Summary and Delphi Study

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Yiting Chen ◽  
Zheng Li ◽  
Jian Peng ◽  
Lanjun Shen ◽  
Juan Shi
Keyword(s):  
Delphi Study ◽  
Psychological Symptoms ◽  
Assessment Tools ◽  
Care Bundle ◽  
Stroke Survivors ◽  
Depression And Anxiety ◽  
Stroke Patients ◽  
Eligibility Criteria ◽  
Effective Response ◽  
Evidence Summary

Background. Psychological symptoms such as depression and anxiety are quite common among stroke survivors and have great negative impacts on patients. Objective. To develop a care bundle through reviewing and integrating care strategies for psychological symptoms after stroke and then improve the bundle by Delphi study. Methods. A structured search of the literature was performed to identify studies evaluating interventions for stroke patients with psychological symptoms such as depression and anxiety. Two trained researchers screened papers through the titles, abstracts, and full-texts independently. All studies complying with the eligibility criteria were appraised using quality assessment tools. Related interventions with evaluated evidence levels formed the preliminary bundle. Afterward, the Delphi study was carried out to improve the bundle, and the experts were contacted by e-mail. Ten clinical experts specialized in stroke and psychological rehabilitation were recruited. The reliability of experts was represented by the effective response rate and authority coefficient (Cr). The consensus was deemed to be reached when the mean score for item importance is all equal or above 3.50 and the coefficient of variation (CV) is all equal or below 0.20. The Kendall coefficient W test was adopted to evaluate the consensus on agreement among the experts as well. Data analysis was performed using SPSS V.22.0. Results. Through a systematic evidence summary and two-round Delphi study, the items that were given high scores and got consensus by experts were chosen for the bundle. The iDAME bundle consisted of five interventions eventually: maintaining Interaction, tailored Diet, Acupressure, mindfulness Meditation, and physical Exercise. Conclusion. The development of an evidence-based and consensus-based iDAME bundle which integrated western and traditional Chinese medicine intervention was described. Evidence summary made the bundle become scientific, while the Delphi study made it more maneuverable. Based on these results, the bundle would be potentially implemented in stroke patients for their psychological symptoms.

scholarly journals Development and validation of a questionnaire to assess Unaccompanied Migrant Minors’ needs (AEGIS-Q)

2020 ◽  
Author(s):  
Maria Luisa Di Pietro ◽  
Drieda Zaçe ◽  
Leuconoe Grazia Sisti ◽  
Emanuela Maria Frisicale ◽  
Alice Corsaro ◽  
...  
Keyword(s):  
Physical Health ◽  
High Reliability ◽  
Personal Data ◽  
Well Being ◽  
Psychological Needs ◽  
Social Needs ◽  
Data Migration ◽  
Extensive Literature ◽  
Final Version ◽  
Being There

Abstract Background While many studies focus on specific aspects of Unaccompanied Migrant Minors’ (UMMs) health, especially mental well-being, there is a lack of tools comprehensively assessing their needs. To fill this gap, we developed and validated a questionnaire to thoroughly assess unAccompaniEd miGrant mInorS’ physical, psychological, legal, spiritual, social and educational needs (AEGIS-Q). Methods This work consisted of three stages. The first one involved an extensive literature review. Given the results of the review, a first draft of the questionnaire was developed and submitted to a panel of experts for validation (Delphi method-second stage). During the third stage, the final version of the questionnaire was pilot-tested in a sample of 18 UMMs. Results The questionnaire, drafted based on the results of the review, consisted of sections covering personal data, migration profile, physical health needs and access to healthcare, psychological needs, legal needs, spiritual needs and educational and social needs of UMMs. After two Delphi rounds, the final version of the questionnaire, consisting of 83 questions, was structured. The pilot study had a response rate of 89–100%. We found substantial reliability for most of the sections in the questionnaire, including physical health (α=0.652), legal (α=0.781), and educational and social (α=0.614) needs. The questions regarding psychological needs had very high reliability (α=0.860). Conclusions The questionnaire offers a useful sharable tool to assess and monitor UMMs’ needs, helping the reception system to better know and meet their needs and implement the taking in charge.

Recreational Therapy Competencies, Part 2: Findings from the ATRA Competencies Study

2020 ◽  
Vol 54 (4) ◽  
Author(s):  
Brent Hawkins ◽  
Betsy Kemeny ◽  
Heather Porter
Keyword(s):  
Delphi Study ◽  
Therapeutic Recreation ◽  
Scope Of Practice ◽  
Recreational Therapy ◽  
Final Phase ◽  
Perceived Knowledge ◽  
Knowledge And Skills ◽  
Practice Opportunities ◽  
Service Sectors ◽  
Treatment Settings

The American Therapeutic Recreation Association’s (ATRA) Competencies Study was the final phase of a two-part, multi-year study to better understand the competencies of Recreational Therapists (RTs) across treatment settings and service sectors. One thousand, three hundred and seventy seven RTs were assessed on 747 items within seven areas of RT practice identified in ATRA’s Delphi Study. Each RT rated the extent that each item is being treated, utilized, or provided in their RT practice, their perceived knowledge and skills in relation to the items, and if they were interested in gaining more knowledge related to each item. Results are reported regarding areas of RT practice that were highly, moderately, and lowly rated to further capture the scope of practice of RT as well as identify areas of strength and opportunity to bolster RT practice. Opportunities within the profession to apply these findings are discussed.

Iff and Other Conditionals

2015 ◽  
pp. 613-746 ◽  
Author(s):  
Shalin Hai-Jew
Keyword(s):  
Online Learning ◽  
Delphi Study ◽  
Mixed Methods Research ◽  
Age Groups ◽  
Extensive Literature ◽  
Popular Imagination ◽  
Content Organization ◽  
The World ◽  
Education Status ◽  
High Level

For the past several years, a new form of online learning has emerged, which has captured the popular imagination, and with it, plenty of support from private universities, angel investors, and foundations. Massive Open Online Courses (MOOCs) are a scaled-up version of online learning, albeit on open socio-technical platforms, which enable digital content organization, learner interactivity, computer-based assessments, and peer assessments, as well as back-end “big data” data mining of learner behaviors. MOOCs are being discussed as for-credit university courses, supplementary professional development trainings, and informal and nonformal learning opportunities. They are considered not only for adult learners but also for high schoolers and even potentially for younger age groups. For all the hopefulness that many masses around the world will have access to high-level and well designed college courses, the emergence of MOOCs has sparked a range of forecasts. Some predict that MOOCs will socialize learners around the world to a common academic culture and unleash human potential. Some predict that MOOCs are a threat to the existing higher education status quo. Others suggest that MOOCs have been overly hyped and are an unworkable passing fad. To gain a sense of the attitudes towards MOOCs and their feasibility, a modified electronic Delphi (e-Delphi) study was conducted using the Qualtrics™ survey platform (aka K-State Survey). This chapter describes the processes of setting up the modified e-Delphi study. It describes the extensive literature review undertaken for the development of the survey instrument. The writing describes the major findings from this qualitative and mixed-methods research based on both manual and NVivo-based data analysis. There is a focus on issues that may need to be addressed individually and collectively in order to rollout successful MOOCs.

Development of a Web-Based Nationwide Korean Pediatric Dental Sedation Registry

2017 ◽  
Vol 41 (6) ◽  
pp. 478-481 ◽  
Author(s):  
Sung Chul Choi ◽  
Yeonmi Yang ◽  
Seunghoon Yoo ◽  
Jiyeon Kim ◽  
Taesung Jeong ◽  
...  
Keyword(s):  
Literature Review ◽  
Pediatric Dentistry ◽  
Small Samples ◽  
Easy Access ◽  
Extensive Literature ◽  
Efficacy And Safety ◽  
Clinical Practices ◽  
University Hospitals ◽  
Web Based ◽  
The Web

Objective: Finding a balance between sedation efficacy and safety remains an ongoing challenge. In children, the risk of sedation-related complications is relatively high. It is of utmost importance to determine the factors related to improved overall sedation outcomes. However, most previous reports have been based on small samples at single institutions. The Korean Academy of Pediatric Dentistry (KAPD) developed a Korean Pediatric Dental Sedation Registry using a web-based platform. Study design: Specialists in pediatric dental sedation selected the itemized list included within the registry through an extensive literature review. The web-based registry was built into the KAPD homepage to facilitate easy access to the sedation data. All teaching and university hospitals agreed to participate in the Korean Pediatric Dental Sedation Registry. Conclusion: This is the first attempt to collect sedation data on a nationwide scale in the field of pediatric dentistry. The sedation database established with the registry may facilitate standardizing and improving pediatric dental sedation clinical practices.

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