Identifying cancer nursing research priorities using the Delphi technique

BACKGROUND: Nursing research is an integral component of improving the care of people with cancer. However, for research to be successfully integrated and applied to practice, ownership and identification must come from those in practice. The need for local and national strategies for cancer nursing research and the importance of establishing priorities for cancer nursing research have been repeatedly acknowledged. STUDY AIM: The aim of the study was to facilitate a strategic approach to cancer nursing research by identifying the research priorities of cancer nurses. RESEARCH METHOD: A three-round Delphi survey was administered to nurses (n = 112) attending a cancer nursing research conference in Northern Ireland. Participants were asked to identify five research questions that they considered a high priority for cancer nursing. A response rate of 54% (60 delegates) was obtained for round one and this generated 117 statements. These statements were content analysed. Two subsequent quantitative rounds followed this. RESULTS: The top priority areas identified were psychosocial issues, for example communication and information needs; professional issues relating to nurse burnout, stress and nurse-led care; and context of care issues including continuity of care. LIMITATIONS: A potential limitation of the study is the use of conference delegates. However, it is argued that these are the people we wanted to target as they could be considered as experts who already had an interest and clinical background in both cancer research and practice. CONCLUSION: These priorities have helped to provide both direction and focus for the development of a cancer nursing research strategy for Northern Ireland. It is recommended that future research questions should be focused around the highest ranked priorities.     

Nursing Research Priorities in the Pediatric Emergency Care Applied Research Network (PECARN): Reaching Consensus Through the Delphi Method

IntroductionPediatric emergency nurses who are directly involved in clinical care are in key positions to identify the needs and concerns of patients and their families. The 2010 Institute of Medicine report on the future of nursing supports the active participation of nurses in the design and implementation of solutions to improve health outcomes. Although prior efforts have assessed the need for research education within the Pediatric Emergency Care Applied Research Network (PECARN), no systematic efforts have assessed nursing priorities for research in the pediatric ED setting.MethodsThe Delphi technique was used to reach consensus among emergency nurses in the PECARN network regarding research priorities for pediatric emergency care. The Delphi technique uses an iterative process by offering multiple rounds of data collection. Participants had the opportunity to provide feedback during each round of data collection with the goal of reaching consensus about clinical and workforce priorities.ResultsA total of 131 nurses participated in all 3 rounds of the survey. The participants represented the majority of the PECARN sites and all 4 regions of the United States. Through consensus 10 clinical and 8 workforce priorities were identified.DiscussionThe PECARN network provided an infrastructure to gain expert consensus from nurses on the most current priories that researchers should focus their efforts and resources. The results of the study will help inform further nursing research studies (for PECARN and otherwise) that address patient care and nursing practice issues for pediatric ED patients.     

Delphi survey of research priorities

Aim  To identify nurses' priorities for topics and issues to be addressed by a developing nursing research program at a county hospital.
Background  Delphi surveys have been effective at other hospitals to identify research priorities of nurses.
Methods  A Delphi survey was performed in two rounds. Questionnaires were distributed to all 415 nurses who worked at the hospital.
Results  A total of 274 nurses returned the Round I questionnaire (response rate, 66%), and 249 returned the Round II questionnaire (response rate, 60%).
Conclusions  The Delphi survey was successfully used to identify nurses' research priorities at a county hospital. A total of 39 topics were identified from content analysis of research areas described by nurses. Factor analysis revealed three factors: work environment, newborn issues and effects of leadership.
Implications for nursing management  The Delphi survey is a useful way to begin a program of research. Nurses who have a successful experience with research are more likely to become further involved in research, which will allow them to more effectively participate in decision making and improving the work environment. In addition, items were identified that needed to be addressed by nursing managers.     

Establishing nursing research priorities on a paediatric haematology, oncology, immunology and infectious diseases unit: involving doctors and parents.

Following a Delphi survey undertaken with nurses on a specialist children's unit to identify priorities for nursing research, this paper outlines the results of a survey to ascertain the views of doctors and parents regarding the results of the Delphi. This approach was in keeping with national guidance on multi-professional working in paediatric oncology and the importance of service-user involvement in planning and evaluating care. Convenience samples of doctors (n=16) and parents (n=10) were asked to rank the priorities previously identified by nurses. Results highlighted that in the main, nurses, doctors and parents agreed on the key areas that should take priority for research. Nurse's knowledge of day-to-day symptom management, children's quality of life, negotiation and communication in relation to care provision were identified by all three groups as high priorities. There were some areas where the views varied: this was generally in relation to the different primary focus of the individual groups-parents being very concerned with the effect of daily ward routines and procedures and their child's overall hospital experience, nurses with issues such as staff retention and morale, whereas doctors were more concerned with issues around information giving and consent to treatment. Limitations of the study, including sample selection and the transient nature of the population involved are discussed within the paper. The paper concludes that all three groups shared similar views, being focused on issues directly related to patient care. Consensus between the groups should result in future research initiatives reflecting a shared focus and responding to an identified need.     

Establishing nursing research priorities on a paediatric haematology, oncology, immunology and infectious diseases unit: a Delphi survey.

For research to be successfully integrated and applied to practice, ownership and identification must come from those who are most likely to implement research into practice. This was one of the reasons for undertaking a Delphi survey to identify and rank the research priorities for clinical nursing research in a paediatric haematology, oncology, immunology and infectious diseases unit. The 'Nurses' Research Group' initiated the survey as a first step towards developing a strategy for evidence-based nursing. Four members of the research group volunteered to establish a working party to undertake the survey. This paper describes a four-round Delphi survey. The survey questionnaire was sent to all nursing staff on the unit. The initial process identified 151 research topics/themes. Through a process of refinement the priority list was reduced to 89. Repeat rounds were completed, culminating in the identification of four top priority areas of: symptom management, negotiation of care between the child and family, quality-of-life issues and retention of staff. The findings indicate directions for future clinical nursing research that will benefit specialist nurses, children and young people and their families. This paper provides a detailed account of the method, procedure and outcomes of the Delphi survey. The limitations of the Delphi survey method are also addressed and in this survey these included time (the length of time it took to complete the survey and time needed to complete each questionnaire), maintaining motivation of respondents, and the influence of researchers working in the research setting.     

Priorities for adult cancer nursing research: a West Australian replication

Two Delphi surveys have been conducted during the past 20 years to identify cancer nursing research priorities; one in the United States and one in Canada. Sir Charles Gairdner Hospital, the State Cancer Referral Centre in Western Australia, undertook a replication of this Delphi survey to identify nursing research priorities for adult cancer nursing. The aim of this replication was to identify possible changes in priorities and account for cultural difference in the healthcare systems. A total of 45 responses were received from the first Delphi round and 30 from the second. The top ten priorities identified by this sample were different from those identified in prior studies. The top ranked research topic was "What strategies would be most helpful in allowing nurses time to provide emotional support to cancer patients and carers?" These results may stimulate discussion and re-assessment of research priorities in other adult cancer care settings.     

Establishing pediatric cancer nursing research priorities: a Delphi study

The purpose of this study was to have pediatric oncology nurses identify and rate topic priorities for clinical nursing research in the specialty and to determine if nurses in a pediatric cancer center identified different priorities than did nursing colleagues in other settings. The sample consisted of 44 nurses from a comprehensive pediatric cancer center and 43 nurses attending the 12th Annual APON Conference. A decision-making method, the classical Delphi technique, was used. Three rounds of soliciting opinions by questionnaires were completed, and data from each round were reviewed and categorized by a research team of six nurses until group consensus was achieved. The majority of priorities identified by both groups concerned nursing procedures, the pediatric oncology patient, and the specialty itself. The least number of priorities were in the categories of care delivery systems and families. One difference between the two groups was that professional issues dominated the cancer center sample, whereas psychosocial issues were more prominent in the APON sample.     

Research priorities for nursing and midwifery in Southern Ireland

AIM: To identify research priorities for nursing and midwifery in the Southern Health Board area in Ireland for the immediate and long term. METHOD: Ten focus groups were conducted over a 2-month period with 70 nurses and midwives working in clinical, managerial and educational roles participating. Based on focus group findings and a literature review a multi-item Likert type questionnaire was constructed and administered to 520 nurses and midwives (response rate 95%n=494). RESULTS: Research priorities were identified as: (1) impact of staff shortages on retention of RNs/RM's (80%); (2) quality of life of chronically ill patients (76%); (3) stress and bullying in the workplace (76%); (4) assessment and management of pain (75%); (5) skill mix and staff burnout (73%); (6) cardio-pulmonary resuscitation decision making (72%); (7) coordination of care between hospital and primary care settings (69%); (8) medication errors (67%); and (9) promoting healthy lifestyles (64%). Respondents also indicated that these priorities warranted immediate attention. Implications for practice include the need for: (1) emphasis on quality pain control; (2) recognition and exploration of the ethical issues relating to resuscitation; and (3) management of the context within which clinical care is given.     

Public Health Nursing Research Priorities: A Collaborative Delphi Study

Abstract The purpose of this study was to identify research questions and priorities in public health nursing based on the perceived needs of practicing public health nurses, and to assess whether the respondents believed that the profession should provide leadership in the study of the identified questions. Using a modified Delphi survey. 76 research priorities were ranked and produced three factors or categories of questions during the two rounds: outcomes in maternal-child and family planning, outcomes in home health services, and public health nurse recruitment, retention, job satisfaction, and image. Forty-seven (62%) of the 76 priorities were deemed appropriate for nursing to assume leadership in seeking answers. Results reveal a consensus of research priorities generated by front-line nurses consistent with year 2000 health objectives for the nation.     

Clinical nursing research priorities in Australian critical care: a pilot study

The aims of this research project were to identify areas for research in Australian critical care nursing with potential for improvement in patient care, and to advise nursing research policy and priorities with relevance to areas of patients'needs Research participants represented a national sample of clinical nurse specialists (CNSs) and clinical nurse consultants (CNCs) The Delphi method was used to obtain the most reliable consensus of the specialist nurses, and over 238 research priorities were identified initially In the final phase of the research nine high priorities were identified The findings of this study suggest directions for clinical nursing research in critical care     

A study of clinical nursing research priorities in aged care: a Hong Kong perspective

The aim of this study was to identify clinical research priorities in aged care from the perspectives of rehabilitation aged care nurses in Hong Kong. The Delphi method was used whereby 33 registered nurses working in an aged care rehabilitation ward identified 28 research questions pertaining to areas in which nurses could take a leadership role: clinical research that is of highest value to patients and nurse specialists; clinical research which would provide improved community care; facilitate health promotion and disease prevention and be of value to the professional needs of clinical nurses. Study findings have implications and provide direction for clinical nursing research in aged care.     

A Delphi survey of evidence-based nursing priorities in Hong Kong

The purpose of this study was to inform an evidence-based nursing development project within the Hospital Authority, Hong Kong. It considered the specific question of: what are the nursing practice issues which need to be addressed as a matter of priority in order to improve nursing practice, the quality of care or develop some aspect of nursing practice. A three round Delphi survey was adopted. The methodological problems associated with the use of the Delphi method are addressed. An expert panel consisting of 190 Department Operations Managers (nurses) was identified. The data collection focused on issues related to nursing skills and client care and excluded management or educational issues. Agreed categories were prioritized in the final round by utilizing a 11-point rating scale. The group mean score for each category was calculated and rank ordered. The results provided 45 categories that reflected the nursing practice priorities that required more research evidence to guide practice. The top five ranked items were: nurse patient communication, resuscitation, administration of medicines, counselling and nursing documentation. The top 10 items were used to inform the advisory and selection processes for the evidence-based practice development project.     

Priority areas for clinical research in palliative care nursing

This report highlights a number of current research issues and concerns in palliative care nursing. The aim of the study was to identify high clinical nursing research priorities in palliative care, drawing on the expertise of nine (n = 9) clinical nurse consultants currently working in this specialty. The Delphi method was used to collect and process data in the study. Thirteen high research priorities emerged which have relevance for nursing practice, patient and family care in the hospice and community care setting. In the context of this study, the concept of high priority relates to research participant consensus on the most pressing nursing research problems which require investigation to improve clinical practice. Study findings provide direction for clinical research and continuing education in palliative care which may benefit expert nurses and their patients.     

Critical care nursing research priorities in Hong Kong

BACKGROUND: Research is vital to nursing practice especially in an area such as critical care, where nursing practice continues to increase in complexity and nurses assume greater responsibility and accountability for patient care. However, without knowledge of what are the most significant problems or questions affecting the welfare of critically ill patients in Hong Kong, nurses' research efforts may be directed to areas that are not of highest priority in today's climate of decreasing health care resources and changing health care provision. AIM: To identify and prioritize research questions of importance to Hong Kong critical care nurses. METHOD: A three-round Delphi technique was used to solicit, identify and prioritize problems for critical care nursing research. RESULTS: Respondents who completed the third round had a mean of 6.25 years of critical care nursing experience. Ninety-one research topics were ranked important or extremely important. Twenty-seven research priorities ranked as extremely important included topics relating to patient care, family care, nursing, technology, alternative interventions, and illness prevention/health promotion research domains. Thirteen research topics were ranked as least important. None of the participants ranked research topics as not important. STUDY LIMITATIONS: Only full-time active members of the Hong Kong Association of Critical Care Nurses participated in this study and they may not necessarily represent the views of all critical care nurses in Hong Kong. In addition, no attempts were made to compare research priorities between specialty groups of nurses. CONCLUSION: With the re-structuring of Hong Kong's health care system, critical care nurses are expected to take an active role in advancing the profession, and to be accountable for improving patient outcomes by use of effective, evidence-based interventions. The research priorities identified in this study may provide impetus and direction for critical care nursing research initiatives.     

Identifying HIV/AIDS research priorities for the next millennium: a Delphi study with nurses in AIDS care.

The purpose of this study was to identify HIV/AIDS research priorities for the next millennium from the perspective of nurses in AIDS care. The study used a three-round Delphi technique, with study participants (the panel of experts) selected from the membership of the Association of Nurses in AIDS Care. In the first round of the Delphi study, 317 nurses identified more than 2,000 topics they viewed as important for overall HIV/AIDS research and for HIV/AIDS nursing research. Using qualitative analysis, 12 priority topics were generated in the overall research category and 12 priority topics in the nursing research category. In Round II of the Delphi survey, study participants ranked the 12 topics in categories (overall and nursing research priorities) identified in Round I. Finally, in Round III, the top five priority topics from Round II were prioritized in each category. The overall HIV/AIDS research topics identified were (a) HIV community-level education and prevention; (b) development of more tolerable drugs; (c) HIV prevention focusing on individual or specific group behavior; (d) vaccine development; and (e) development of new and more effective drugs. The HIV/AIDS nursing research priorities identified were (a) symptom management; (b) community-level HIV education and prevention; (c) quality of life issues in chronic HIV disease; (d) HIV prevention focusing on individual or specific group behavior; and (e) research related to adherence to drug therapy.     

A Delphi study of district nursing research priorities in Australia.

This study, using a Delphi approach, sought the opinion of a self-selected panel of 320 district nurses regarding research priorities for district nursing in Australia. Over three rounds of questionnaires, the 419 research clinical problem areas requiring research as suggested by the panel were each rated in importance by the panel and then ranked through analysis from high to low average rating scores, thereby, whittling down the list to the top 15% (68) research questions and to a final list of the top 10 research priorities overall. Research questions focusing on discharge planning are dominant in these top 10 priorities, with documentation issues the second most common focus. Other foci in the top 10 priorities are staffing, aged care, palliative care, and assessment. The organization-specific top 10 research priorities focus on wound care, funding, education, and communication issues. Additionally, the top 68 priorities, which are either finitely practice-based or contextual-issues research questions, were categorized into 20 themes. The results will hopefully lead to scarce human and financial resources being directed to practice-relevant research programs that will facilitate improved health for district nursing (primarily home-nursing) clients in Australia and elsewhere.     

1988 Delphi survey of nursing research priorities for New York State

In order to inform decisions about nursing research and health care policy, the Council on Nursing Research of the New York State Nurses Association (NYSNA) conducted a Delphi survey to identify the priorities for nursing research in New York state. The Delphi technique is a method of eliciting judgements from experts for the purpose of short-term forecasting and planning. The survey was conducted by mail in three rounds during 1988. Round I required participants to identify three primary research priorities for the nursing profession. In Round II participants ranked the 37 most frequently identified categories from Round I. The highest 16 categories from Round II were ranked by participants in Round III to provide the final 10 nursing research priority categories for New York state. All members of the New York State Nurses Association holding a minimum of a master's degree in nursing were invited to participate. The response rates were: Round I, 34% (N = 872); Round II, 38% (N = 985); Round III 37% (N = 974). Of the 10 nursing research priority categories identified in the final round, 5 relate to nurses, 2 relate to nursing, and 3 relate to clients. None of the high-risk conditions or populations with whom nurses work appear in the top 10, and only 2 of these are ranked in the top 15 priority categories. These priority categories will be used by the NYSNA Council on Nursing Research to influence its future agenda and activities. They can be used by the nursing profession and others for planning, policy making, and establishing nursing research funding priorities.(ABSTRACT TRUNCATED AT 250 WORDS)     

Establecimiento de prioridades de investigación en enfermería en España: estudio Delphi

ObjectiveTo identify nursing research priorities in Spain as suggested by nurses and service users.MethodA Modified Delphi technique was used. The first round started off with a 24-item document for which consensus had been previously achieved. Experts participating in this modified (two rounds) Delphi technique were: nursing managers (community and hospital care settings), nursing school directors, scientific nursing association representatives, nursing researchers attending the National Nursing Research Conference, and service users.ResultsMain priorities identified for nursing research were: 1) evaluating the effectiveness of nursing interventions, 2) identifying strategies for health promotion empowering service users, 3) developing evidence-based care through implementing and evaluating results, and 4) evaluating the quality of nursing care.ConclusionsResults may help research managers and administrators identify and develop nursing research promotion strategies as well as more strongly sustained funding policies and decisions.     

Identifying nursing research priorities: a first step in program development

This study determined nursing research priorities and focused on the development of a nursing research program within a single institution. Of the 715 nurses within the Department of Nursing, 286 (40%) responded to the first round of a two-round Delphi technique, and 137 (48%) responded to the second. The following clinical priorities were determined: prevention and treatment of pressure sores, pain management, treatment of nosocomial infections, and patient education. Nonclinical priorities included staffing and its effects on turnover and patient care, job satisfaction, and factors influencing the quality of nursing care. Serendipitous findings underscored the relevance of the Department of Nursing's conceptual framework to nursing practice and research, revealed the need for dissemination of current research results, and suggested that nurses want to participate in research without assuming responsibility beyond their expertise.