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Delphi study on evidence-based CKD prevention strategies for nurses in resource-limited settings: focus on e-learning
Fatema Ahmed1, Qingyuan Ye1, Li Li1
1School of Nursing and Rehabilitation, Shandong University, Wenhua Xi Road No.44, Jinan, Shandong Province, 250012, China.
BMC Nephrology
|September 27, 2025
Summary
This study developed prioritized e-learning strategies for nurses to prevent and detect chronic kidney disease (CKD) in Syria. The findings emphasize culturally adapted, cost-effective tools for resource-limited settings.
Area of Science:
- Nephrology
- Medical Education
- Public Health
Background:
- Interactive e-learning modules are crucial for educating nurses on chronic kidney disease (CKD) prevention and detection.
- These modules aim to enhance nurses' knowledge, screening practices, skills, and self-management support.
- This Delphi study sought to prioritize strategies for CKD prevention education in Syria.
Purpose of the Study:
- To identify and prioritize evidence-based strategies for CKD prevention education tailored to the Syrian context.
- To guide the development and implementation of e-learning modules for nurses in resource-limited settings.
- To improve primary and secondary prevention of conservative CKD care.
Main Methods:
- A second-round Delphi study involving 15 CKD clinical content experts was conducted.
- Experts evaluated and ranked potential CKD prevention strategies and delivery methods based on existing best practices.
- Consensus was assessed using descriptive statistics (median, IQR, percentage agreement) and inferential statistics (Kendall's coefficient, Wilcoxon rank-sum test).
Main Results:
- Identified 9 primary and 32 secondary evidence-based CKD prevention strategies for Syria and similar resource-limited areas.
- Modified nine strategies and deleted three based on expert feedback regarding feasibility, cultural relevance, and cost-effectiveness.
- Replaced genetic screening with early and regular screening for high-risk populations, acknowledging implementation challenges in professional, organizational, and external contexts.
Conclusions:
- The Delphi approach successfully tailored e-learning content for nurses in Syria, integrating clinical work with evidence-based strategies.
- Actionable strategies were developed to strengthen CKD prevention in resource-limited settings.
- Prioritizing cost-effective, culturally adapted, offline, Arabic-translated modules, and nurse-friendly protocols offers a blueprint for conflict-affected regions.
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