Validity of nursing interventions for aggressive behavior in neurodevelopmental disorders in child and adolescent psychiatry: A modified e-Delphi study.

Aim: Neurodevelopmental disorders (NDDs) are the most common diagnosis among pediatric and adolescent psychiatric inpatients in Japan. However, there is limited evidence regarding nursing care for hospitalized children with NDDs. This study aimed to establish nursing care guidelines for children with NDDs hospitalized for aggressive behaviors. Methods: The draft of the guidelines was based on qualitative content analysis of interviews with nurses. It was revised to ensure content validity through discussions with multidisciplinary experts in child and adolescent psychiatry. A three-round Delphi survey was conducted among nurses from child and adolescent psychiatric wards across Japan to reach consensus on the guidelines. Results: Sixty-two nurses participated in the final survey. The agreement criterion was set to 80% to improve the content validity of the items. The survey identified 19 guideline items across five domains: "Giving children a sense of security and safety regarding nurses and hospital life," "Helping children reflect on and verbalize the situation and feelings they experience when engaging in aggressive behavior based on a sense of safety and security," "Supporting children's motivation to change their behavior by helping them understand the inappropriateness and disadvantages of aggressive behavior," "After motivating children, assisting them in setting specific behavioral goals to drive change," and "Supporting children in establishing appropriate behavior to achieve their behavioral goals." Conclusion: These guidelines achieved a strong consensus and demonstrated content validity and value for inpatient treatment of children with NDDs.