Essential components of schizophrenia care: a Delphi approach

St George's, University of London, Londinium, England, United Kingdom
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 12/1998; 98(5):400-5. DOI: 10.1111/j.1600-0447.1998.tb10105.x
Source: PubMed


Other than medication and access to in-patient care, there is little published consensus on the essential components of schizophrenia care. This paper reports a Delphi approach to the identification of these components. This approach identifies and measures the degree of consensus, using a structured iterative series of questionnaires by a group of experienced UK and Irish psychiatrists (n = 15) on the essential components. Pharmacotherapy, in-patient care and community mental health team (CMHT) staffing were explicitly excluded from the study. In total, 106 components were identified and their importance was rated twice. There was consensus on 92% of the components and strong consensus on 64%. The Delphi results were refined by the participants to produce 10 essential components of care.

2 Reads
  • Source
    • "Although Sharkey and Sharples (2001) reported that health researchers were initially slow to adopt the Delphi technique as a research tool, the literature now highlights a wealth of studies employing the technique in healthcare in general (Green et al. 1999, Alahlafi & Burge 2005, Avery et al. 2005, Garasen & Johnsen 2007, Mackellar et al. 2007) and in nursing particularly (Love 1997, Lemmer 1998, Moreno-Casbas et al. 2001, Peters et al. 2001). Studies relevant to mental health have also been conducted (White 1991, Beech 1997, Burns 1998, Skews et al. 2000, Sharkey & Sharples 2001, O'Brien et al. 2002, Hermann et al. 2006, Redmond et al. 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper is a report of a study conducted to identify and gain consensus on appropriate benchmarks for effective primary care-based nursing services for adults with depression. Worldwide evidence suggests that between 5% and 16% of the population have a diagnosis of depression. Most of their care and treatment takes place in primary care. In recent years, primary care nurses, including community mental health nurses, have become more involved in the identification and management of patients with depression; however, there are no appropriate benchmarks to guide, develop and support their practice. In 2006, a three-round electronic Delphi survey was completed by a United Kingdom multi-professional expert panel (n = 67). Round 1 generated 1216 statements relating to structures (such as training and protocols), processes (such as access and screening) and outcomes (such as patient satisfaction and treatments). Content analysis was used to collapse statements into 140 benchmarks. Seventy-three benchmarks achieved consensus during subsequent rounds. Of these, 45 (61%) were related to structures, 18 (25%) to processes and 10 (14%) to outcomes. Multi-professional primary care staff have similar views about the appropriate benchmarks for care of adults with depression. These benchmarks could serve as a foundation for depression improvement initiatives in primary care and ongoing research into depression management by nurses.
    Journal of Advanced Nursing 02/2010; 66(2):269-81. DOI:10.1111/j.1365-2648.2009.05140.x · 1.74 Impact Factor
  • Source
    • "The present study used a technique known as the Delphi process to elicit and quantify the opinions of a group of expert clinicians working in UK early intervention teams [9]. Similar Delphi exercises have been used to: clarify the concept of relapse in schizophrenia [10]; identify the key components of schizophrenia care [11] and delineate the practice model of a community mental health team [12]. The aim of the study was to determine the extent of expert consensus on the essential structural and functional elements of early intervention teams. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Early intervention teams attempt to improve outcome in schizophrenia through earlier detection and the provision of phase-specific treatments. Whilst the number of early intervention teams is growing, there is a lack of clarity over their essential structural and functional elements. A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians. Using published guidelines, an initial list was constructed containing 151 elements from ten categories of team structure and function. Overall there was expert consensus on the importance of 136 (90%) of these elements. Of the items on which there was consensus, 106 (70.2%) were rated essential, meaning that in their absence the functioning of the team would be severely impaired. This degree of consensus over essential elements suggests that it is reasonable to define a model for UK early intervention teams, from which a measure of fidelity could be derived.
    BMC Psychiatry 02/2004; 4(1):17. DOI:10.1186/1471-244X-4-17 · 2.21 Impact Factor
  • Source
    • "The number and representativeness of participants will affect the potential for ideas as well as the amount of data to be analysed. To provide representative information, some studies have employed over 60 participants (Alexander & Kroposki 1999) while others have involved as few as 15 participants (Burns 1998). Obviously the larger the sample size, the greater the generation of data, which in turn in¯uences the amount of data analysis to be undertaken . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Research guidelines for the Delphi survey technique Consensus methods such as the Delphi survey technique are being employed to help enhance effective decision-making in health and social care. The Delphi survey is a group facilitation technique, which is an iterative multistage process, designed to transform opinion into group consensus. It is a flexible approach, that is used commonly within the health and social sciences, yet little guidance exists to help researchers undertake this method of data collection. This paper aims to provide an understanding of the preparation, action steps and difficulties that are inherent within the Delphi. Used systematically and rigorously, the Delphi can contribute significantly to broadening knowledge within the nursing profession. However, careful thought must be given before using the method; there are key issues surrounding problem identification, researcher skills and data presentation that must be addressed. The paper does not claim to be definitive; it purports to act as a guide for those researchers who wish to exploit the Delphi methodology.
    Journal of Advanced Nursing 11/2000; 32(4):1008-15. DOI:10.1046/j.1365-2648.2000.t01-1-01567.x · 1.74 Impact Factor
Show more

Similar Publications