Page 145 - Encyclopedia of Nursing Research

112 n DEPRESSion AnD CARDioVASCULAR DiSEASES

The first questionnaire that is mailed predictions than roundtable discussions. The
asks participants to respond to a broad ques- technique was later used to solicit opinions
D tion. The responses to this questionnaire of experts on atomic warfare as a means of
are then used to develop a more structured defense. it has since been applied in diverse
questionnaire. Each successive question- fields, such as industry, social services, and
naire is built on the previous one. The sec- nursing because of its usefulness and accu-
ond questionnaire requests participants to racy in predicting and in prioritizing. Also,
review the items identified in the first ques- the Delphi technique has been used in nurs-
tionnaire and to indicate their degree of ing studies to identify priorities for practice
agreement or disagreement with the items, and research.
to provide a rationale for their judgments,
to add items that are missing, and to rank Alice S. Demi
order the items according to their perceived
priority. on return of the second question-
naire, the responses are reviewed, the items
are clarified or added, and the mean degree Depression anD
of agreement and the ranking of each item
are computed. in the third questionnaire, CarDiovasCular Diseases
participants are asked to review the mean
ranking from the second questionnaire and
again to indicate their degree of agreement The American heart Association has esti-
or disagreement and give their rationale if mated that more than one third of American
they disagree with the ranking. Additional adults have at least one form of cardiovascular
questionnaires are sent until the group disease (Lloyd-Jones et al., 2009). Depression
reaches consensus. Many variations of this and cardiovascular disease are major pub-
procedure have been used, the number of lic health problems that affect considerable
questionnaires used ranging from three to percentage of American population and are
seven. among the top leading sources of functional
To be eligible to participate as a panel- impairment and disability. The annual eco-
ist in a Delphi study, the respondent should nomic burden of cardiovascular disease and
(a) be personally concerned about the prob- depression are estimated to be approximately
lem being studied, (b) have relevant infor- 500 and 70 billion, respectively (Lloyd-Jones
mation to share, (c) place a high priority on et al., 2009; Soni, 2009).
completing the Delphi questionnaire on Depression has been investigated
schedule, and (d) believe that the informa- through a variety of theoretical viewpoints,
tion compiled will be of value to self and including psychodynamic, cognitive, socio-
others. Several disadvantages of the Delphi logic, biologic, and the crisis models (Frank-
technique limit its application. First, there Stromberg & olsen, 1997). Clinical depression
must be adequate time for mailing the ques- is a mood disorder in which the patient typ-
tionnaires, their return, and their analysis. ically experiences depressed mood or anhe-
Second, participants must have a high level donia for at least 2 weeks. Depression may
of ability in written communication. And present either as a primary disorder or in
third, participants must be highly motivated association with other comorbid chronic
to complete all the questionnaires. conditions including cardiovascular dis-
The Delphi technique was first developed ease. Most nurses working in outpatients or
by the Rand Corporation as a forecasting tool inpatients health care delivery settings have
in the 1960s, when investigators found that witnessed cardiac patients with depressed
results of a Delphi survey produced better mood.