ArticleNursing open2026
Consensus on the Content of an Instrument to Assess Psychological Distress Following Multifetal Pregnancy Reduction: A Delphi Study.
Article in Nursing open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsTo reach expert consensus on the content of an instrument to assess psychological distress in women following multifetal pregnancy reduction (MFPR) and to provide a reference for frontline nurses in conducting psychosocial assessment and care planning.
designA two-round Delphi expert consensus study.
methodsThe initial item pool was conceptualized based on an integrated framework combining the Dual-Process Model and the Post-Traumatic Stress Disorder model and generated through a literature review and semi-structured interviews. The degree of consensus was assessed by measuring the concentration and coordination of expert opinions. Content validity of the preliminary instrument was evaluated using the scale-level content validity index.
resultsExperts reached consensus on the preliminary Post-Multifetal Pregnancy Reduction Maternal Psychological Distress Scale (PMRPDS), comprising 16 items across four dimensions: Post-traumatic Stress Response (5 items), Depression and Guilt (4 items), Health Anxiety and Concerns (3 items) and Psychological Adjustment and Coping (4 items). The positive coefficients of the two Delphi rounds were 90.9% and 91.7%, respectively; the authority coefficients were 0.885 and 0.889, respectively; the Kendall's W values for the two rounds were 0.142 and 0.159, respectively, with statistical significance (p < 0.001). The content validity index scored 0.983.
conclusionExpert consensus was reached on the content of the preliminary PMRPDS, demonstrating established content validity for assessing MFPR-related distress and guiding targeted psychosocial nursing interventions. IMPLICATIONS FOR NURSING: The PMRPDS is helpful for nursing staff in systematically assessing psychological distress in women following MFPR. Nursing staff can use the instrument as an assessment and intervention tool to enhance patient-centred perinatal psychosocial care. IMPACT: What problem did the study address? The lack of a specialized assessment tool for psychological distress after MFPR. What were the main findings? A 16-item scale across four core dimensions was developed through a Delphi expert consensus study. Where and on whom will the research have an impact? The research will impact perinatal mental health clinicians, researchers and ultimately, the care received by women undergoing MFPR. REPORTING
methodThis study adhered to the Conducting and REporting of DElphi Studies (CREDES) reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Provides the first structured instrument to assess complex psychological distress following MFPR. Establishes a consensus-based foundation for future cross-cultural validation and research, facilitating improved perinatal mental health care protocols.
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