Developing a Q Set Using the Modified Delphi Technique to Investigate ICU Nurses' Perspectives on Working with...

Background/Objectives: ICU nurses manage complex clinical situations of critically ill patients, including rapid patient deterioration and multiple invasive lines. The complexity intensifies in catastrophes when non-ICU nurses are trained on short notice and deployed to support ICU nurses. This article details the rigorous development of the Q set, which is essential for ensuring methodological robustness and validity in a Q methodology study exploring ICU nurses' perspectives on working with non-ICU nurses. Methods: A modified Delphi approach was adopted for the expert consensus on the selection of statements, which ensured an unbiased Q sample construction. The methodology involved (1) concourse generation based on the literature review and semi-structured interviews of ICU nurses and (2) Q sample refinement via expert consensus. Results: The process extracted 152 statements in two Delphi rounds with ICU experts (head nurses, bedside nurses, and nursing faculty). The first round finalized 13 and excluded 8 statements. The second round further added 27 and excluded 5 statements. Thus, the final Q sample comprised 40 statements, which were reviewed by a Q methodology expert. Conclusions: The study improved the rigor, precision, and transparency of Q sample construction in ICU nursing research. The incorporation of the expert consensus minimized the bias to accurately examine ICU nurses' perspectives. The results offer valuable insights into non-ICU nurses' integration in critical care settings to guide staffing policies, training, and inter-professional collaborations.