Content Validity of a Self-Management Behavior Assessment Tool for Adult Post-Renal Transplant Recipients Using a Modified Delphi Method

Background: 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. Objective: 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. Methods: 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. Conclusions: 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.

Establishment of the benchmarking tool for evaluating the operation of biorepositories for pathogenic resource using a modified Delphi method

In recent years,as the infectious diseases caused by pathogens such as novel coronavirus and mpox(formerly called monkeypox)spread globally,the significance of identification,preservation,and sharing of pathogenic resources become prominent.Along with the rapid development of biorepositories,it is imperative to evaluate their operation in a scientific manner.By using the literature review and modified Delphi method,this study develops a benchmarking tool for the comprehensive evaluation of the operation of biorepositories for pathogenic resources.The effective response rates of both rounds of expert surveys were 100%.The authority coefficients(Cr)were 0.82 and 0.85,respectively,manifesting the reliability of consultation results.In the second‐round survey,the Kendall’s coefficient of concordance(Kendall’s W)of all indicators ranged from 0.09 to 0.31(P<0.001),the comprehensive score ranged from 4.02 to 4.94,the standard deviation ranged from 0.21 to 0.77,and the coefficient of variation(CV)ranged from 0.04 to 0.22,indicating that the expert opinions reached consensus.The final benchmarking tool was composed of 4 primary indicators,12 secondary indicators,and 65 tertiary indicators.The weights of the four primary indicators allocated through the rank‐sum ratio method,namely organizational structure,management requirements,biobanking capacity,and sharing capacity,were 30.50%,30.08%,25.45%,and 13.97%,respectively.The benchmarking tool established in this study provides references for the comprehensive evaluation of the operation and puts forward advice for the sustainable development of biorepositories for pathogenic resources.

Using the modified Delphi method to research the influencing factors of longterm health-related quality of life in patients with unruptured intracranial aneurysms after endovascular treatment

Background:The purpose of this study was to use the modified Delphi method to identify the influencing factors of health-related quality of life(HRQoL)in patients with unruptured intracranial aneurysms(UIAs)after endovascular treatment.Methods:A modified Delphi method to obtain expert consensus on the content of potential influencing factors of HRQoL in patients with UIAs treated by endovascular intervention was employed.The research team consists of three neuroradiologists and one epidemiologist from Xuanwu Hospital of Capital Medical University.They randomly selected 21 well-known experts in cerebrovascular disease diagnosis and treatment as participating experts.The importance of the indicator is based on the 5-Likert scale.The standard deviation(SD),coefficient of variation(CV),mean(x),and minimum and maximum scores of each indicator were calculated.The consistency was described by Kendall coefficient of concordance with a p value<0.05 indicating that the expert consistency was high.Result:Twenty-one and 18 questionnaires were responded in 2 rounds,with effective response rates of 85.7%and 100.0%,respectively.The average authoritative coefficient(Cr)of all 21 experts was 0.88,familiarity with the indicators(Cs)was 0.82,and the judgment basis of the indicators(Ca)was 0.94.Eventually,the x values of arterial puncture hematoma,hyperlipidemia,gender,marital status,and hospitalization for other diseases were lower than 3.5;CV for marital status and gender was higher than 0.35.The Kendall coefficient of concordance in the first round was 0.19(p<0.001),and the second round was 0.15(p<0.001).Conclusion:In this study,the factors affecting the recovery of HRQoL after endovascular treatment in patients with UIAs were analyzed by the modified Delphi method,which provided a valuable evidence for the clinical management and daily life guidance for UIAs patients.

Using modified Delphi method to propose and validate the components of a child injury surveillance system for Iran

Purpose:Child injuries are a public health concern globally.Injury surveillance systems(ISSs)have beneficial impact on child injury prevention.There is a need for evidence-based consensus on frameworks to establish child ISSs.This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation.Methods:Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components.Qualitative data were analyzed using content analysis method.Then,modified Delphi method was used to validate the functional components.Based on the outcomes of the content analysis,a questionnaire with closed questions was developed and presented to a group of experts.Consensus was achieved in two rounds.Results:In round I,117 items reached consensus.In round II,5 items reached consensus and were incorporated into final framework.Consensus was reached for 122 items comprising the final framework and representing 7 key components:goals of the system,data sources,data set,coalition of stakeholders,data collection,data analysis and data distribution.Each component consisted of several subcomponents and respective elements.Conclusion:This agreed framework will assist in standardizing data collection,analysis and distribution,which help to detect child injury problems and provide evidence for preventive measures.