The Delphi Technique in Nursing and Health Research is a practical guide to using the Delphi methodology for students and researchers in nursing and health. It adopts a logical step-by-step approach, introducing the researcher to the Delphi, outlining its development, analysing key characteristics and parameters for its successful use and exploring its applications in nursing and health. The book addresses issues of methodology, design, framing the research question, sampling, instrumentation, methodological rigour, reliability and validity, and methods of data analysis.
The Delphi Technique in Nursing and Health Research enables the reader to be aware of the limitations of the technique and possible solutions, to design a Delphi questionnaire for each of the different rounds of a study, to consider different approaches to the technique in relation to a study, to analyse the data from each round of a Delphi study, and to understand the importance of feedback between rounds.
Key Features
- A practical guide to facilitate use of the Delphi technique
- Provides the reader with the necessary information to participate in and conduct Delphi studies
- Examines different types of Delphi, including the e-Delphi, and modifications made to the technique
- Includes examples of real empirical investigations, brief case scenarios and key learning points for each chapter
- Explores the role of the Delphi researcher
- Explores ethical issues and issues of anonymity, use of experts and controlled feedback
Table of Contents:
Preface ix
Acknowledgements x
1 The Delphi Technique 1
Introduction 1
History of the technique 2
What is the Delphi technique? 3
Defining the Delphi technique 3
The Delphi process 4
Original Delphi 4
Idea generation 5
Priority setting versus consensus 5
Non-consensus Delphi 5
Types of Deplhi 6
How has the Delphi evolved? 6
Sampling and the use of experts 7
Defining ‘expert’ 7
Employing an expert panel 8
Size of the expert panel 8
Valid opinion 9
Anonymity 9
Quasi-anonymity 9
Group dynamics 10
Delphi rounds 10
Round 1 11
Subsequent rounds 11
Response rates 12
Enhancing response rate 12
Consensus 13
Does consensus exist in expert panels? 14
Concept of consensus 14
Increasing popularity in nursing and health research 14
Comparison of the Delphi with other consensus methods 15
Nominal group technique 15
Consensus conference 16
Key learning points 16
Recommended further reading 17
2 Debates, Criticisms and Limitations of the Delphi 18
Introduction 18
The qualitative-quantitative debate – which paradigm does the Delphi belong to? 18
Criticisms of the Delphi technique 20
Lack of universal guidelines 20
Size of expert panel 21
Implications of lack of anonymity 22
Expert ‘opinion’ 23
Level of consensus 27
Limitations of the Delphi 28
Pressures of conformity 28
Demanding nature of the technique 29
Key learning points 30
Recommended further reading 31
3 Applications of the Delphi in Nursing and Health Research 32
Introduction 32
Historical application of the Delphi technique in nursing 32
Identification of clinical nursing research priorities 36
Trends of the Delphi in nursing 40
Key learning points 41
Recommended further reading 42
4 How to Get Started with the Delphi Technique 43
Introduction 43
Preparation and practicalities 43
Suitability of the Delphi 43
Availability of resources 44
Level of consensus 45
Identifying target sample – panel of experts 46
Who is the target population? 46
How do you select your experts? 47
Sampling criteria 47
What size does the sample have to be? 48
Response rate and attrition 53
Deciding on nature and delivery of the first round 55
Gaining names and addresses 56
Deciding on a ‘return by’ date 56
Administration 57
Invitation to participate 57
Explicit cover letter outlining the working of the Delphi 59
Design of questionnaire 59
Administration systems 63
Mailing 64
Maximising response rate 64
Content analysis 65
Process 66
Key learning points 67
Recommended further reading 67
5 Conducting the Research Using the Delphi Technique 69
Introduction 69
First round 69
Classical Delphi 69
Modified Delphi 70
Return of first round 71
Consideration of sample size and number of items generated 71
Bootstrapping 72
Content analysis 72
Subsequent rounds 73
Round 2 74
Cover letter explaining Round 2 74
Instructions for Round 2 75
Designing Round 2 questionnaires 76
Likert scales 77
Round 2 analysis 77
Sample motivation 78
Follow-ups/reminders 78
Round 3 78
Individual and group feedback 78
Round 3 analysis 81
Number of rounds 81
When to stop 82
When not to stop 82
Reaching consensus 82
Key learning points 83
Recommended further reading 83
6 Analysing Data from a Delphi and Reporting Results 84
Introduction 84
Analysis of Round 1 85
Content analysis – the practical aspects 85
Demographics for sample profiling 86
Analysis of middle rounds (Round 2) 86
Consensus level 86
Statistical analysis 86
Statistical feedback to panel 87
Exclusion of items with consensus 88
Analysis of end round (Round 3) 89
Determining the end of the process 89
Statistical analysis 89
Items that have gained consensus 90
Items that have not gained consensus 90
Stability of responses 91
Examples of statistical analysis used in recent Delphi studies 92
Reporting of results from a Delphi study 92
Key learning points 95
Recommended further reading 95
7 Reliability and Validity 96
Introduction 96
Reliability 96
Criteria to assess rigour 99
Response rates as a measure of rigour 99
Is the definitive answer reached? 99
Validity 100
Content validity 100
Criterion-related validity 100
Threats to validity 101
Key learning points 104
Recommended further reading 104
8 Ethical Considerations 105
Introduction 105
Ethical principles 105
Respect for human dignity 106
Justice 106
Principle of beneficence 108
Principle of non-maleficence 108
The role of the researcher 108
Ethics documentation 109
Key learning points 113
Recommended further reading 113
9 A Classical Delphi Design Case Study 114
Introduction 114
Background 114
Methods 115
Initial considerations 116
Enhancing response rates 117
Identifying and accessing the sample 117
Round 1 118
Round 2 119
Discussion 122
Lessons learned 123
Conclusion 123
Acknowledgements 123
Further information 124
Publications 124
10 A Modified Delphi Case Study 125
Introduction 125
Aims of the study 126
Methodology 126
Expert panel 126
Round 1 – focus groups 127
Delphi Round 2 – postal round 127
Round 3 – postal round 128
Consensus conference 129
Results 129
Commissioning of health and social care 129
Leadership 131
Generic and specialist roles 131
Clinical governance 132
Teamwork 133
Public involvement 133
Education 134
Practical training versus academia 135
Attitudes to nurse training and education 135
Multidisciplinary education in nurse training 135
Communication 135
Conclusion 136
Recommendations 137
Commissioning of health and social care 137
Leadership 137
Generic and specialist roles 138
Clinical governance 138
Teamwork 139
Public involvement 139
Education 140
Communication 140
Reflections on the modified Delphi 140
Acknowledgements 141
Further information 141
Publications 141
11 e-Delphi Case Study 142
Introduction 142
Sample 142
Setting a consensus level 143
Theoretical framework 143
Data collection and analysis 144
Design of instrument 144
Pilot study 144
Round 1 144
Round 2 145
Round 3 145
Ethical considerations 145
Results 146
Round 1 146
Round 2 146
Round 3 147
Discussion 147
Conclusion 148
Reflections on the e-Delphi 149
Acknowledgements 150
Further information 150
Publications 150
Annotated Bibliography 151
References 164
Index 193
About the Author :
Dr Sinead Keeney is a Senior Lecturer in the Institute of Nursing Research at the University of Ulster.
Felicity Hasson is a Senior Lecturer in the Institute of Nursing Research at the University of Ulster.
Professor Hugh McKenna is Dean of the Faculty of Life and Health Sciences at the University of Ulster.
Review :
"This book is easy to understand and is excellent for learning the Delphi technique. It is a must for anyone wanting to use this technique." (Doody's, 9 September 2011)
