scholarly journals Reaching a consensus on research priorities for supporting women with autoimmune rheumatic diseases during pre-conception, pregnancy and early parenting: A Nominal Group Technique exercise with lay and professional stakeholders

2018 ◽  
Vol 3 ◽  
pp. 75 ◽  
Author(s):  
Rhiannon Phillips ◽  
Denitza Williams ◽  
Daniel Bowen ◽  
Delyth Morris ◽  
Aimee Grant ◽  
...  
Keyword(s):  
Decision Making ◽  
Systematic Approach ◽  
Care Pathway ◽  
Nominal Group Technique ◽  
Research Priorities ◽  
Nominal Group ◽  
Shared Decision ◽  
Research Topics ◽  
Autoimmune Rheumatic Diseases ◽  
Early Parenting

Background:Women with autoimmune rheumatic diseases (ARDs) find it difficult to get information and support with family planning, pregnancy, and early parenting. A systematic approach to prioritising research is required to accelerate development and evaluation of interventions to meet the complex needs of this population.  Methods:A Nominal Group Technique (NGT) exercise was carried out with lay and professional stakeholders (n=29). Stakeholders were prepared for debate through presentation of available evidence. Stakeholders completed three tasks to develop, individually rank, and reach consensus on research priorities: Task 1 – mapping challenges and services using visual timelines; Task 2 - identifying research topics; Task 3 - individually ranking research topics in priority order. Results of the ranking exercise were fed back to the group for comment.   Results:The main themes emerging from Task 1 were the need for provision of information, multi-disciplinary care, and social and peer support. In Task 2, 15 research topics and 58 sub-topics were identified around addressing the challenges and gaps in care identified during Task 1.  In Task 3, a consensus was reached on the ten research topics that should be given the highest priority. These were individually ranked, resulting in the following order of priorities (from 1 – highest to 10 – lowest): 1. Shared decision-making early in the care pathway; 2. Pre-conception counseling; 3. Information about medication use during pregnancy/breastfeeding; 4. Personalised care planning; 5. Support for partners/family members; 6. Information about local support/disease specific issues; 7. Shared decision-making across the care pathway; 8. Peer-support; 9. Social inequalities in care, and; 10. Guidance on holistic/alternative therapies.    Conclusions:This systematic approach to identification of research priorities from a multi-disciplinary and lay perspective indicated that activities should focus on development and evaluation of interventions that increase patient involvement in clinical decision-making, multi-disciplinary models of care, and timely provision of information.

EP.TH.602Exploring decision-making of healthcare professionals in patients with benign large non-pedunculated colonic polyps (BLNPCP) virtually using combined focus group and nominal group technique

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
L Wheldon ◽  
J Morgan ◽  
MJ Lee ◽  
S Riley ◽  
SR Brown ◽  
...  
Keyword(s):  
Decision Making ◽  
Healthcare Professional ◽  
Patient Preference ◽  
Healthcare Professionals ◽  
Nominal Group Technique ◽  
Colonic Polyps ◽  
Nominal Group ◽  
Shared Decision ◽  
Patient Factors ◽  
Group Technique

Abstract Aim We aimed to elicit key factors that influence healthcare professional decision-making when deciding treatment for BLNPCP. Background Benign large non-pedunculated colonic polyps (BLNPCP) may harbour covert malignancy and opinions differ about the optimal treatment modality. There are several options available, including endoscopic mucosal resection, endoscopic submucosal resection, combined endoscopic laparoscopic surgery and surgical resection. Despite widespread availability of endoscopic resection techniques, there are high rates of surgery in the UK. Methods Three focus groups of healthcare professionals, comprised of either consultant colorectal surgeons, nurse endoscopists and consultant gastroenterologists, were conducted virtually utilising the Nominal Group Technique. Meetings were recorded and transcribed verbatim. Themes were devolved using the framework approach for qualitative analysis. A priority-ranked list of factors influencing healthcare professional decision-making in this setting was generated. Results Five main themes were identified as influencing decision-making: Shared decision making (patient preference, informed consent); Patient factors (co-morbidity, age, life-expectancy); Polyp factors (Location, size, morphology, risk of cancer); Healthcare professionals (skill-set, personal preference); System factors (techniques availability locally, regional referral networks). Nominal Group Technique generated 55 items across the three focus groups. Nurses and gastroentologists ranked patient factors (particularly drug history and tolerance of procedure) and shared decision making (patient preference) more highly then surgeons. Surgeons placed greater emphasis on polyp factors particularly location and the risk of submucosal invasive carcinoma. Conclusion Decision making is complex and multifactorial. These results support the benefits of complex polyp MDTs and patient involvement in the decision-making. The complexity of decision-making may underpin wide variation in practice.

scholarly journals Prioritization Of Research Under National Aids Control Programme In India Using Nominal Group Technique

1970 ◽  
Vol 8 (1) ◽  
pp. 20-30
Author(s):  
R Sogarwal ◽  
D Bachani
Keyword(s):  
Nominal Group Technique ◽  
Research Priorities ◽  
Control Programme ◽  
Pediatric Hiv ◽  
Nominal Group ◽  
Phase Iii ◽  
Hiv Care ◽  
Policy Makers ◽  
Research Questions ◽  
Group Technique

Introduction: During the fi rst 2 years of the fi ve year plan of India’s National AIDS Control Programme Phase-III (NACP-III; 2007-12), various interactive consultative workshops were organized in collaboration with development partners with the objective of identifying priority areas for operational research and further development of research protocols adopting mentorship approach. Methodology: This article is an attempt to present the Nominal Group Technique (NGT) which was used to identify a set of fundable and practically feasible research priorities under NACP-III specifi cally focusing on Prevention of Parent to Child Transmission (PPTCT) and Pediatric HIV Care in India. The activity was undertaken with support of UNICEF in the year 2010. A total of 110 persons participated in the consultation clustering into 37, 36 and 37 members in Group A, B and C, respectively. The participants refl ected the mix of policy makers / decision makers (8), programme managers (12), implementers (36), subject experts / researchers (28), other stakeholders (16). Results: A total of nine highest priority research questions were identifi ed by all the groups in the assigned themes. The value of Kendall’s W coeffi cient of concordance was 0.68, which shows signifi cant agreement among raters on priority research questions (chi-square=16.35; p=0.03). Conclusion: Based on our experience, we can conclude that NGT was found to be an important tool for setting research priorities that is more democratic and transparent than the traditional methods. By applying various stages of the group sessions, participants can experience the rethinking process with reference information to enhance their judgment. The results of our experience may help programme managers / policy makers to plan similar and more improved method in other element of NACP as well as other health programmes. DOI: http://dx.doi.org/10.3126/saarctb.v8i1.5888 SAARCTB 2011; 8(1): 20-30

Can the current hypodontia care pathway promote shared decision-making?

2019 ◽  
Vol 46 (2) ◽  
pp. 126-136 ◽  
Author(s):  
Sophy Barber ◽  
Sue Pavitt ◽  
David Meads ◽  
Balvinder Khambay ◽  
Hilary Bekker
Keyword(s):  
Decision Making ◽  
Young People ◽  
Shared Decision Making ◽  
Information Exchange ◽  
Care Pathway ◽  
Information Provision ◽  
Alternative Methods ◽  
Teaching Hospitals ◽  
Shared Decision ◽  
Cross Sectional

Objective: To determine the extent to which the current care pathway in hypodontia promotes shared decision-making (SDM). Design: Exploratory cross-sectional study using qualitative methods. Setting: Orthodontic department of two NHS teaching hospitals in Yorkshire. Participants: Young people aged 12–16 years with hypodontia of any severity and at any stage of treatment, and their parents and guardians. Methods: (1) Observation and audio-recording of interdisciplinary consultation in hypodontia clinics (n = 5) without any researcher interference; (2) short, structured interviews with young people with hypodontia (n = 8) and their parent (n = 8) using a topic guide to explore themes around decision-making. Audio-recordings were transcribed and analysed using a thematic framework. Results: Consultations were used as an opportunity for interdisciplinary discussion, information provision and treatment planning. Evidence of good communication was observed but patient engagement was low. The decision to be made was usually stated and treatment options discussed, but time constraints limited the scope for adequate information exchange and assessment of understanding. No methods were used to establish patient and family preferences or values. Interviews suggested parents expect the dental team to make decisions and young people rely on parental advocacy. Despite little evidence of SDM, participants reported satisfaction with their treatment. Conclusions: The current care pathway for hypodontia does not support clinicians in the steps of SDM. Recommendations for improving SDM processes include support to identify preference-based decisions, greater access to comprehensive and accessible patient information to enable preparation for consultation, alternative methods for effective communication of complex information and use of preference elicitation tools to aid value-driven decision-making.

scholarly journals Community Priority Index: utility, applicability and validation for priority setting in community-based participatory research

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Hamisu M. Salihu ◽  
Abraham A. Salinas-Miranda ◽  
Wei Wang ◽  
DeAnne Turner ◽  
Estrellita Lo Berry ◽  
...  
Keyword(s):  
Decision Making ◽  
Participatory Research ◽  
Priority Setting ◽  
Nominal Group Technique ◽  
Community Based Participatory Research ◽  
Self Esteem ◽  
Nominal Group ◽  
Community Settings ◽  
Community Based ◽  
Priority Index

<em>Background</em>. Providing practitioners with an intuitive measure for priority setting that can be combined with diverse data collection methods is a necessary step to foster accountability of the decision-making process in community settings. Yet, there is a lack of easy-to-use, but methodologically robust measures, that can be feasibly implemented for reliable decision-making in community settings. To address this important gap in community based participatory research (CBPR), the purpose of this study was to demonstrate the utility, applicability, and validation of a community priority index in a community-based participatory research setting. <br /><em>Design and Methods</em>. Mixed-method study that combined focus groups findings, nominal group technique with six key informants, and the generation of a Community Priority Index (CPI) that integrated community importance, changeability, and target populations. Bootstrapping and simulation were performed for validation. <br /><em>Results</em>. For pregnant mothers, the top three highly important and highly changeable priorities were: stress (CPI=0.85; 95%CI: 0.70, 1.00), lack of affection (CPI=0.87; 95%CI: 0.69, 1.00), and nutritional issues (CPI=0.78; 95%CI: 0.48, 1.00). For non-pregnant women, top priorities were: low health literacy (CPI=0.87; 95%CI: 0.69, 1.00), low educational attainment (CPI=0.78; 95%CI: 0.48, 1.00), and lack of self-esteem (CPI=0.72; 95%CI: 0.44, 1.00). For children and adolescents, the top three priorities were: obesity (CPI=0.88; 95%CI: 0.69, 1.00), low self-esteem (CPI=0.81; 95%CI: 0.69, 0.94), and negative attitudes toward education (CPI=0.75; 95%CI: 0.50, 0.94). <br /><em>Conclusions</em>. This study demonstrates the applicability of the CPI as a simple and intuitive measure for priority setting in CBPR.

A Framework for Stakeholder-Based Knowledge Valuation in Organizations

2001 ◽  
pp. 298-315 ◽  
Author(s):  
Fons Wijnhoven
Keyword(s):  
Decision Making ◽  
Stakeholder Group ◽  
Industrial Society ◽  
Nominal Group ◽  
Production Factor ◽  
Shared Decision ◽  
Valuation Methods ◽  
Human Resource Accounting ◽  
Resource Accounting ◽  
Post Industrial

Knowledge, an essential production factor in the post-industrial society, is not as rigorously measured as organizational tangibles. Several authors in the tradition of intellectual capital measurement and human resource accounting have tried to solve this by the development of one or more metrics. This chapter assumes that valuation is intrinsically subjective and that knowledge to a large extent is subjective. Consequently, it should be approached by subjective valuation methods. The chapter reviews existing knowledge valuation methods for their validity for a specific stakeholder group, and considers Nominal Group Techniques as a way to converge the resulting opinions. This convergence is important for shared decision-making. Following this approach, knowledge valuation is not accounting but much more the creation and facilitation of productive cooperative systems in the economy.

scholarly journals An examination of the research priorities for a hospice service in New Zealand: A Delphi study

2015 ◽  
Vol 14 (3) ◽  
pp. 232-240 ◽  
Author(s):  
Kay de Vries ◽  
Jo Walton ◽  
Katherine Nelson ◽  
Rhondda Knox
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
New Zealand ◽  
Symptom Management ◽  
Care Service ◽  
Research Priorities ◽  
Palliative Care Service ◽  
Family Carers ◽  
Research Topics ◽  
Research Themes

AbstractObjectives:Palliative care research is relatively diverse and prioritizing research in this field is dependent on multiple factors such as complex ethical decisions in designing and conducting the research; access to participants who may be deemed “vulnerable” and an increasingly medically focused approach to care. The aim of this study was to inform organizational decision-making and policy development regarding future research priorities for a hospice service in New Zealand.Methods:A modified three-round Delphi technique was employed. Participants were drawn from one dedicated specialist palliative care service that delivers care in the community, day-care, hospice inpatient, aged residential care, and acute hospital palliative care service. A purposive sample included palliative care staff (n = 10, 18, 9, for rounds 1–3, respectively) volunteers (n = 10, 12, 11); and patients and family carers (n = 6, 8, for rounds 1 and 2). Patients and family carers were not involved in the third round.Results:At final ranking of six research themes encompassing 23 research topics were identified by staff and volunteers. These were: symptom management; aged care; education; community; patient and family; and bereavement support and young people. Patients and family carers agreed on four themes, made up of 10 research topics. These were: decision-making, bereavement and loss, symptom management; and recognition of need and response of service.Significance of results:The study generated a rich set of research themes and specific research topics. The perspectives of staff and volunteers are significantly different from those of patients and family members, in spite of the recognition by all concerned that palliative care services work within a philosophy of patient-centered care. Open discussion of ideas has the potential to engage both staff and patients and carers in quality improvement initiatives, and to reinforce the value of research for patient care.

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