Hardy Derrylea J, O'Brien Anthony P, Gaskin Cadeyrn J, O'Brien Anthony J, Morrison-Ngatai Erina, Skews Georgina, Ryan Tom, McNulty Neil
School of Health Sciences, Massey University, Palmerston North, New Zealand.
J Adv Nurs. 2004 Apr;46(1):95-109. doi: 10.1111/j.1365-2648.2003.02969.x.
Numerous studies have employed the Delphi technique to seek expert opinion about aspects of clinical practice. When researching literature on the Delphi technique, however, we discovered discrepancies in its application, and a lack of detail when reporting design, administration, and analysis methods. Such lack of specificity hinders the replicability and assessment of the clinical and cultural validity and reliability of Delphi studies.
The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria.
Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarized responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold.
Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark.
When rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritizing experts judgements.
众多研究采用德尔菲技术来征求关于临床实践各方面的专家意见。然而，在研究德尔菲技术的文献时，我们发现其应用存在差异，且在报告设计、实施和分析方法时缺乏细节。这种缺乏特异性的情况阻碍了德尔菲研究临床和文化有效性及可靠性的可重复性和评估。
本文旨在详细阐述德尔菲技术作为一种在文化和临床上有效的方法，用于获取关于临床标准重要性的专家意见的实际应用。
参考一项新西兰双文化心理健康护理临床指标研究，该研究采用了三轮反应式德尔菲调查。同等比例的毛利族和非毛利族护士（n = 20）以及服务对象（n = 10）对91条临床指标陈述对于实现专业实践标准的重要性进行评分。第一轮德尔菲参与者提出的另外21条陈述被纳入后续轮次。在第二轮中，参与者解释他们对第一轮未达成共识的陈述所应用的评分，并将汇总后的回复提供给第三轮的参与者。如果第三轮评分中85%在5点李克特量表上的2分区间内，或者在毛利族护士、非毛利族护士或服务对象群体中的某一组内，则认为达成了共识。将第三轮后的平均评分为4.5设定为重要性阈值。
总体上有75条陈述达成了共识，各群体内部又有24条达成了共识。大多数陈述（n = 86）达到了重要性基准。
当采用严格的参与者选择、群体构成、参与者反馈以及共识和重要性确定方法时，德尔菲技术是一种可靠、具有成本效益且能获取专家判断并确定其优先顺序的方法。
