Koontalay Apinya, Botti Mari, Hutchinson Anastasia
Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
Institute of Health Transformation, Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Deakin University, Geelong, Victoria, Australia.
J Adv Nurs. 2025 Oct;81(10):6347-6363. doi: 10.1111/jan.16330. Epub 2024 Jul 16.
To describe the outcomes of an e(electronic)-Delphi survey used to achieve consensus on the essential elements that should be included in a multidisciplinary, nurse-led service for patients with chronic heart failure (CHF).
The study design was based on a three-round e-Delphi survey.
A series of three survey rounds were used to gather expert opinions and achieve consensus on the key elements that should be included in a CHF disease management program from a sample of healthcare professionals and organizational leaders with expertise in existing CHF services. Consensus for each item was defined as at least 90% agreement.
There were 20 participants (18 healthcare professionals and 2 organizational leaders) in round-1, 22 (20 healthcare professionals and 2 organizational leaders) in round-2, and 17 (15 healthcare professionals and 2 organizational leaders) in round-3. Fifteen participants attended a final online meeting (13 healthcare professionals and 2 organizational leaders). Consensus was obtained on five essential components: (i) consumer education, (ii) treatment optimization using a multidisciplinary approach, (iii) discharge planning, (iv) provision of supportive community care and (v) mechanisms to respond to early symptoms of decompensated CHF.
Participants focused on mechanisms to improve treatment effectiveness, patient and family knowledge, communication between healthcare providers and supportive care in the community. The proposed model of care may be useful to other health service providers who are designing or adapting CHF models of care for the South-East Asian environment.
This research provides a solid basis for using a Delphi method to resolve the challenges and issues of transferring global model-based recommendations in CHF knowledge. The Delphi method proved successful as an important step in developing a culturally acceptable model of chronic care that meets the goals of local healthcare providers.
描述一项电子德尔菲调查的结果，该调查旨在就多学科、护士主导的慢性心力衰竭（CHF）患者服务应包含的基本要素达成共识。
本研究设计基于三轮电子德尔菲调查。
通过三轮调查收集专家意见，就CHF疾病管理项目应包含的关键要素达成共识，样本来自在现有CHF服务方面具有专业知识的医疗保健专业人员和组织领导者。每项的共识定义为至少90%的同意率。
第一轮有20名参与者（18名医疗保健专业人员和2名组织领导者），第二轮有22名（20名医疗保健专业人员和2名组织领导者），第三轮有17名（15名医疗保健专业人员和2名组织领导者）。15名参与者参加了最后一次在线会议（13名医疗保健专业人员和2名组织领导者）。就五个基本组成部分达成了共识：（i）患者教育，（ii）采用多学科方法优化治疗，（iii）出院计划，（iv）提供支持性社区护理，以及（v）应对失代偿性CHF早期症状的机制。
参与者关注提高治疗效果、患者及家属知识、医疗服务提供者之间的沟通以及社区支持性护理的机制。所提议的护理模式可能对其他为东南亚环境设计或调整CHF护理模式的卫生服务提供者有用。
本研究为使用德尔菲法解决在CHF知识中传递基于全球模型的建议所面临的挑战和问题提供了坚实基础。德尔菲法被证明是开发符合当地医疗服务提供者目标的、文化上可接受的慢性护理模式的重要一步，取得了成功。
