Isabel Hamm , Kerstin Dittmer , Frank Vitinius , David Reinert , Marc Hoemberg , Remo Kamm-Thonwart , Rainer Misgeld , Theresia Krieger
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Practice-based evidence (PBE) was collected from four groups (<em>N</em> = 14 organizations) with different BBN experiences: (1) patient and family representatives, (2) healthcare providers, (3) psychosocial supporters, and (4) health services researchers.</div></div><div><h3>Results</h3><div>The PGD process (16 interviews, three focus group discussions and two surveys) resulted in 166 recommendations (preparation: 55; transmission: 45; follow-up: 66).</div></div><div><h3>Conclusion</h3><div>The PGD approach provided a structured framework for collecting PBE and developing, refining and consolidating recommendations on BBN in pediatric oncology. Involving all affected by BBN was crucial for addressing the complexity of BBN in the recommendations. The mixed-methods design enhanced the reliability and practical applicability of the recommendations.</div></div><div><h3>Innovation</h3><div>To our knowledge, no prior research in pediatric oncology has systematically integrated existing PBE into a structured set of recommendations in Germany. This study introduces a novel PGD process in this field in Germany, incorporating three key innovations: (1) a participatory methodology ensuring active stakeholder engagement, (2) a uniquely diverse expert panel including those affected by pediatric cancer, and (3) a systematic, iterative recommendation development approach rooted in PBE. This methodology results in a Delphi process that diverges significantly from classical approaches, offering a collaborative and structured framework for evidence synthesis.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"7 ","pages":"Article 100413"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Developing multi-perspective practice-based evidence theses for breaking bad news in the German pediatric oncology: A participatory group Delphi study\",\"authors\":\"Isabel Hamm , Kerstin Dittmer , Frank Vitinius , David Reinert , Marc Hoemberg , Remo Kamm-Thonwart , Rainer Misgeld , Theresia Krieger\",\"doi\":\"10.1016/j.pecinn.2025.100413\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>The study aimed to (1) gain a comprehensive, multi-perspective understanding of the preparation, transmission and follow-up of Breaking Bad News (BBN) in pediatric oncology, and (2) to develop and weigh recommendations for BBN in pediatric oncology.</div></div><div><h3>Methods</h3><div>A mixed-methods Participatory Group Delphi (PGD) study was conducted to develop recommendations for the preparation, transmission, and follow-up of BBN. Practice-based evidence (PBE) was collected from four groups (<em>N</em> = 14 organizations) with different BBN experiences: (1) patient and family representatives, (2) healthcare providers, (3) psychosocial supporters, and (4) health services researchers.</div></div><div><h3>Results</h3><div>The PGD process (16 interviews, three focus group discussions and two surveys) resulted in 166 recommendations (preparation: 55; transmission: 45; follow-up: 66).</div></div><div><h3>Conclusion</h3><div>The PGD approach provided a structured framework for collecting PBE and developing, refining and consolidating recommendations on BBN in pediatric oncology. Involving all affected by BBN was crucial for addressing the complexity of BBN in the recommendations. 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引用次数: 0
摘要
目的本研究旨在(1)全面、多角度地了解儿科肿瘤学突发坏消息（Breaking Bad News， BBN）的准备、传播和随访；(2)制定和权衡儿科肿瘤学中BBN的建议。方法采用混合方法参与组德尔菲（PGD）研究，对BBN的制备、传播和随访提出建议。基于实践的证据（PBE）来自四组（N = 14个组织），他们具有不同的BBN经验：(1)患者和家属代表，(2)医疗保健提供者，(3)社会心理支持者，(4)卫生服务研究人员。PGD过程（16次访谈，3次焦点小组讨论和2次调查）产生166条建议(准备：55；传输:45;追问:66)。结论PGD方法为收集PBE和制定、完善和巩固儿科肿瘤学BBN建议提供了一个结构化框架。让所有受BBN影响的人参与进来，对于在建议中处理BBN的复杂性至关重要。混合方法的设计提高了建议的可靠性和实用性。据我们所知，在德国还没有儿科肿瘤学的研究将现有的PBE系统地整合到一套结构化的建议中。本研究在德国该领域引入了一种新颖的PGD流程，包括三个关键创新：(1)确保利益相关者积极参与的参与式方法，(2)包括儿童癌症患者在内的独特多样化专家小组，以及(3)基于PBE的系统，迭代的建议开发方法。这种方法产生的德尔菲过程与经典方法有很大的不同，为证据合成提供了一个协作和结构化的框架。
Developing multi-perspective practice-based evidence theses for breaking bad news in the German pediatric oncology: A participatory group Delphi study
Objectives
The study aimed to (1) gain a comprehensive, multi-perspective understanding of the preparation, transmission and follow-up of Breaking Bad News (BBN) in pediatric oncology, and (2) to develop and weigh recommendations for BBN in pediatric oncology.
Methods
A mixed-methods Participatory Group Delphi (PGD) study was conducted to develop recommendations for the preparation, transmission, and follow-up of BBN. Practice-based evidence (PBE) was collected from four groups (N = 14 organizations) with different BBN experiences: (1) patient and family representatives, (2) healthcare providers, (3) psychosocial supporters, and (4) health services researchers.
Results
The PGD process (16 interviews, three focus group discussions and two surveys) resulted in 166 recommendations (preparation: 55; transmission: 45; follow-up: 66).
Conclusion
The PGD approach provided a structured framework for collecting PBE and developing, refining and consolidating recommendations on BBN in pediatric oncology. Involving all affected by BBN was crucial for addressing the complexity of BBN in the recommendations. The mixed-methods design enhanced the reliability and practical applicability of the recommendations.
Innovation
To our knowledge, no prior research in pediatric oncology has systematically integrated existing PBE into a structured set of recommendations in Germany. This study introduces a novel PGD process in this field in Germany, incorporating three key innovations: (1) a participatory methodology ensuring active stakeholder engagement, (2) a uniquely diverse expert panel including those affected by pediatric cancer, and (3) a systematic, iterative recommendation development approach rooted in PBE. This methodology results in a Delphi process that diverges significantly from classical approaches, offering a collaborative and structured framework for evidence synthesis.
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