Nominal group technique questionnaires

National Guideline Alliance (UK)

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National Guideline Alliance (UK). Mental Health Problems in People with Learning Disabilities: Prevention, Assessment and Management. London: National Institute for Health and Care Excellence (NICE); 2016 Sep. (NICE Guideline, No. 54.)

Mental Health Problems in People with Learning Disabilities: Prevention, Assessment and Management.

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Appendix TNominal group technique questionnaires

T.1. Assessment

T.1.1. Case ID

T.1.1.1. Round 1

MHLD CONSENSUS QUESTIONNAIRE (case identification) (PDF, 232K)

T.1.1.2. Round 2

MHLD CONSENSUS QUESTIONNAIRE (case identification) (PDF, 166K)

T.1.2. Brief (initial) assessment

T.1.2.1. Round 1

MHLD CONSENSUS QUESTIONNAIRE (brief assessment) (PDF, 576K)

T.1.2.2. Round 2

MHLD CONSENSUS QUESTIONNAIRE (brief assessment) (PDF, 94K)

T.1.3. Comprehensive assessment

T.1.3.1. Round 1

MHLD CONSENSUS QUESTIONNAIRE (comprehensive assessment) (PDF, 684K)

T.2. Psychological interventions

T.2.1. Round 1

Review Q3.1: Psychological interventions to treat mental health difficulties in people with a learning disability

There is limited available evidence for the utility of psychological interventions to treat mental health difficulties in people with a learning disability (LD). The available evidence was presented to the Guideline Committee on 23^rd July 2015 (GC 6). There was some evidence that psychological treatments may be of benefit in reducing general psychopathology in mild to moderate LD. The Guideline Committee (GC) felt that there was sufficient evidence to recommend adapted CBT for depression in people with a mild LD. However there was insufficient evidence for other psychological interventions and for other mental health difficulties.

Furthermore, there was some qualitative evidence from service users with mild to moderate LD who had accessed CBT sessions to treat mental health difficulties which indicated some issues or preferences with how the treatment was delivered. For example, some service users felt that the involvement of support workers can be valuable and help improve service-user access to sessions, some commented that the use of homework tasks sometimes felt persecutory, and many preferred ‘free floating’ rather than task-oriented sessions.

The GC agreed that a set of general principles for adaptations to psychological interventions in people with an LD would be useful. However, in the context of the lack of available evidence (and according to the agreed procedure in such situations), recommendations would need to be developed using a modified nominal group technique.

Background on the nominal group technique

The nominal group technique is a formal consensus method used when the scientific evidence needed to answer a clinical question is poor quality, inconsistent or non-existent.

This technique has been used in other NICE guidelines, including the guideline on behaviour that challenges in people with learning disabilities.

Highlights include:

A method of obtaining a practical result quickly.
Effective in obtaining consensus from a range of participants, thus generating a wide range of ideas.
Utilises a variety of postal and face-to-face techniques to elicit a consensus view.
Discussion structured by a facilitator.
Individual participants (ie. GC members) record their ideas independently and privately. The ideas are then collected in turn from individuals and are fed back to the group when they are brought together for discussion, followed by a further private vote.

Use of the nominal group technique for general principles for adapting psychological interventions

Round 1: (by email)

Provide GC members with a consensus questionnaire and necessary instructions.
GC members rate their agreement with the initial statements taking into account the research evidence and their clinical expertise.
(FYI. As requested by the guideline committee, the initial statements have been circulated to expert advisers [appointed by the committee], to check content and comprehensiveness.)
Ratings made using a nine-point scale (1= least agreement; 9= most agreement).
Space is also provided for GC members to provide written comments on each statement (optional).

Background work conducted by review team

Combine results to develop graph of distributions.
Calculate median and interquartile ranges, following predefined criteria for determining consensus, e.g.
➢
100% consensus= ratings from all members fall within a single point region (1–3 disagree; 4–6, neither agree nor disagree; 7–9, agree)
Rank the statements 1 to 15 based on consensus percentage.

Round 2: (at GC meeting on 22^nd October)

Provide anonymised distributions of responses to each GC member, together with each member’s response to each statement;
➢
Allows member to see the spread of views and how their own response relates.
Typically, the statements are recirculated and the GC members would vote anonymously again (taking into consideration the anonymous comments from their fellow members). However, the challenging behaviour guideline found that they already had a very high agreement at the first stage and felt that another rating would create 100% agreement (which they felt was inappropriate). We will tailor our approach based on how high the level of agreement is at this stage:
➢
Option 1: If there is already a very high level of agreement, we will do this stage in the process in the October GC meeting. This will involve the discussion of each statement in the top half of the ranking table, together with GC members’ comments. Utilise these statements to develop recommendations.
➢
Option 2: If lower level of agreement, the statements will be recirculated for further rating and results will be discussed at the November meeting. The GC members will then use the statements to develop recommendations.

MHLD CONSENSUS QUESTIONNAIRE (PDF, 215K)

T.2.2. Round 2 (Mild to moderate)

MHLD CONSENSUS QUESTIONNAIRE (PDF, 362K)

T.2.3. Round 2 (Severe to Profound)

MHLD CONSENSUS QUESTIONNAIRE (PDF, 145K)

T.3. Pharmacological interventions

T.3.1. Round 1

MHLD CONSENSUS QUESTIONNAIRE (PDF, 255K)

T.4. Other interventions

T.4.1. Social and environmental interventions

T.4.1.1. Round 1

MHLD CONSENSUS QUESTIONNAIRE (PDF, 136K)

T.4.1.2. Round 2

MHLD CONSENSUS QUESTIONNAIRE (PDF, 145K)

T.4.2. Occupational interventions

T.4.2.1. Round 1

MHLD CONSENSUS QUESTIONNAIRE (PDF, 135K)

T.5. Organisation and service delivery

T.5.1. Round 1

MHLD CONSENSUS QUESTIONNAIRE (PDF, 513K)

T.5.2. Round 2

MHLD CONSENSUS QUESTIONNAIRE (PDF, 210K)

Footnotes

*: Please note that similar process will be followed for other areas: questionnaires for these areas will be circulated after the October GC meeting and results will be discussed at the November GC meeting.

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Bookshelf ID: NBK401818

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