Abstract
Changes in health care have dramatically curtailed services to people with severe physical disability and their families. This has placed a greater burden of responsibility on those who live with these conditions and have ongoing care needs. Yet little is known about the subjective problems, challenges, and solutions reported by these people. We demonstrate how the nominal group technique can be used to obtain consumer-oriented information germane to these individuals and their concerns. We conducted nominal group technique meetings with 2 groups for persons with physical disability and a third with a group for family members in caregiving roles. We demonstrate how focus groups can be conducted with the nominal group technique to identify problems experienced by individuals who live with severe physical disability. Recommendations for using the nominal group technique with client populations are presented, and implications for clinical practice are discussed.
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REFERENCES
Chwalisz, K., & Stark-Wroblewski, K. (1996). The subjective experiences of spouse caregivers of persons with brain injuries: A qualitative analysis. Applied Neuropsychology, 3, 28–40.
Council on Scientific Affairs, American Medical Association. (1993). Physicians and family caregivers: A model for partnership. JAMA, 69, 1282–1284.
Delbecq, A. L., & Van de Ven, A. H. (1971). A group process model for problem identification and program planning. Journal of Applied Behavioral Science, 7, 466–492.
Delbecq, A. L., Van de Ven, A. H., & Gustafson, D. H. (1975). Group techniques for program planning: A guide to nominal group and delphi processes. Glenview, IL: Scott, Foresman.
Duggan, C. H., & Dijkers, M. (2001). Quality of life after spinal cord injury: A qualitative study. Rehabilitation Psychology, 46, 3–27.
Elliott, T. (in press). Defining our common ground to reach new horizons. Rehabilitation Psychology.
Elliott, T., Kurylo, M., & Rivera, P. (2002). Positive growth following acquired physical disability. In C. R. Snyder & S. Lopez (Eds.), Handbook of positive psychology (pp. 687–699). New York: Oxford University Press.
Elliott, T., & Richards, J. S. (1999). Living with the facts, negotiating the terms: Unrealistic beliefs, denial and adjustment in the first year of acquired physical disability. Journal of Personal and Interpersonal Loss, 4, 361–381.
Elliott, T., & Shewchuk, R. M. (1998). Recognizing the family caregiver: Integral and formal members of the rehabilitation process. Journal of Vocational Rehabilitation, 10, 123–132.
Elliott, T., & Shewchuk, R. M. (2000). Problem solving therapy for family caregivers of persons with severe physical disabilities. In C. Radnitz (Ed.), Cognitive‐behavioral interventions for persons with disabilities (pp. 309–327). New York: Jason Aronson.
Forsyth, D. R. (1990). Group dynamics (2nd ed.). Belmont, CA: Brooks/Cole.
Forsyth, D. R., & Elliott, T. (1999). Group dynamics and psychological well-being: The impact of groups on adjustment and dysfunction. In R. Kowalski & M. R. Leary (Eds.), The social psychology of emotional and behavioral problems: Interfaces of social and clinical psychology (pp. 339–361). Washington, DC: American Psychological Association.
Frank, R. G. (1997). Lessons from the great battle: Health care reform 1992‐1994. Archives of Physical Medicine and Rehabilitation, 78120–124.
Frankel, S. (1987). NGT C MDS: An adaptation of the nominal group technique for ill-structured problems. Journal of Applied Behavioral Science, 33, 543–551.
French, R. D. S. (1984). The long-term relationships of marked people. In E. E. Jones, A. Farina, A. H. Hastorf, H. Markus, D. T. Miller, & R. A. Scott (Eds.), The psychology of marked relationships (pp. 254–294). New York: W. H. Freeman.
Gallagher, M., Hares, T., Spencer, J., Bradshaw, C., & Webb, I. (1993). The nominal group technique: Aresearch tool for general practice. Family Practice, 10, 76–81.
Grant, J. S., Bartolucci, A., Elliott, T., & Giger, J. (2001, April). Telephone problem-solving partnerships with family caregivers. Paper presented at the convention of the American Association of Neuroscience Nurses, San Francisco.
Hoffman, C., Rice, D., & Sung, H. (1996). Persons with chronic conditions: Their prevalence and costs. JAMA, 276, 1473–1479.
Johnstone, B., Frank, R. G., Belar, C., Berk, S., Bieliauskas, L. A., Bigler, E. D., Caplan, B., Elliott, T., Glueckauf, R., Kaplan, R. M., Kreutzer, J., Mateer, C., Patterson, D., Puente, A., Richards, J. S., Rosenthal, M., Sherer, M., Shewchuk, R., Siegel, L., & Sweet, J. J. (1995). Psychology in health care: Future directions. Professional Psychology: Research and Practice, 26, 341–365.
Kosciulek, J. F. (2000). Implications of consumer direction for disability policy development and rehabilitation service delivery. Journal of Disability Policy Studies, 11(2), 82–89.
Krueger, R. A. (1994). Focus groups: A practical guide for applied research (2nd ed.). Thousand Oaks, CA: Sage.
Kurylo, M., Elliott, T., & Shewchuk, R. (2001). FOCUS on the family caregiver:Aproblem-solving training intervention. Journal of Counseling and Development, 79, 275–281.
Lengnick-Hall, C. A. (1995). The patient as the pivot point for quality in health care delivery. Hospital and Health Services Administration, 40, 25–39.
Long, M. P., Glueckauf, R. L., & Rasmussen, J. (1998). Developing family counseling interventions for adults with episodic neurological disabilities: Presenting problems, persons involved, and problem severity. Rehabilitation Psychology, 43, 101–117.
Longo, D. R. (1993). Patient practice variation: A call for research. Medical Care, 31, YS81–YS895.
Mechanic D. (1998). Public trust and initiatives for new health care partnerships. The Milbank Quarterly, 76, 281–302.
Miller, D., Shewchuk, R., Elliott, T., & Richards. J. S. (2000). Nominal group technique: A process for identifying diabetes selfcare issues among patients and caregivers. The Diabetes Educator, 26305–314.
Morgan, D. L. (1997). Focus groups as qualitative research. In Sage University Series on Qualitative Research (Vol. 16). Newbury Park, CA: Sage.
Olkin, R. (1999). What psychotherapists should know about disability. New York: Guilford.
Ptacek, J. T., Pierce, G. R., Ptacek, J. J., & Nogel, C. (1999). Stress and coping processes in men with prostate cancer: The divergent views of husbands and wives. Journal of Social and Clinical Psychology, 18, 299–324.
Quittner, A. L., Opipari, L., Regoli, M., Jacobsen, J., & Eigen, H. (1992). The impact of caregiving and role strain on family life: Comparisons between mothers of children with cystic fibrosis and matched controls. Rehabilitation Psychology, 37, 275–290.
Robert Woods Johnson Foundation. (1996). Chronic care in America: A 21st century challenge. Princeton, NJ: Author.
Schopp, L., Johnstone, B., & Merrell, D. (2000). Telehealth and neuropsychological assessment: New opportunities for psychologists. Professional Psychology: Research and Practice, 31179–183.
Seal, D. W., Bogart, L. M., & Ernhardt, A. A. (1998). Small group dynamics: The utility of focus group discussions as a research method. Group Dynamics: Theory, Research, and Practice, 2, 253–266.
Shewchuk, R., & Elliott, T. (2000). Family caregiving in chronic disease and disability: Implications for rehabilitation psychology. In R. G. Frank & T. Elliott (Eds.), Handbook of rehabilitation psychology (pp. 553–563). Washington, DC: American Psychological Association.
Shewchuk, R., Franklin, F., Harrington, K., & Reynolds, K. (1999, November). Cognitive mapping framework for community based interventions. Paper presented at the annual convention of the American Public Health Association, Chicago
Shewchuk, R., & O'Conner, S. J. (2000). Using cognitive concept mapping to understand what health care means to elderly persons. Manuscript submitted for publication.
Shewchuk, R., O'Connor, S. J., Fottler, M. D., & Trinh, H. (2001). Health care organizational research: hat does it mean to us? Advances in Health Care Management, 2, 63–90.
Sofaer, S. (1998). Aging and primary care: An overview of organizational and behavioral issues in the delivery of health care services to older Americans. Health Services Research, 33, 298–321.
Stephen, T. D. (1985). Q-methodology in communication science: An introduction. Communication Quarterly, 33(3), 133–208.
Stokols, D. (1992). Establishing and maintaining healthy environments: Toward a social ecology of health promotion. American Psychologist, 47, 6–22.
Temkin, A. J., & Jones, M. L. (1999). Electronic medicine: Experience and implications for treatment of SCI [Special issue]. Topics in Spinal Cord Injury Rehabilitation, 5(3), 1–74.
Wagner, E. H., Austin, B. T., & Von Korff, M. (1996). Organizing care for patients with chronic illness. The Milbank Quarterly, 74511–544.
Ware, J. E., Bayliss, M. S., Rogers, W. H., Kosinski, M., & Tarlov, A. R. (1996). Differences in 4-year health outcomes for elderly and poor chronically ill patients treated in HMO and fee-forservice systems. JAMA, 276, 1039–1047.
Webb, P. M., & Glueckauf, R. L. (1994). The effects of direct involvement in goal setting on rehabilitation outcome for persons with traumatic brain injuries. Rehabilitation Psychology, 39179–188.
Wright, B. A. (1983). Physical disability: A psychosocial approach. New York: Harper and Row.
Wright, B. A., & Fletcher, B. (1982). Uncovering hidden resources: A challenge in assessment. Professional Psychology, 12, 229–235.
Yalom, I. (1995). The theory and practice of group psychotherapy (4th ed.). New York: Basic Books.
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Elliott, T.R., Shewchuk, R.M. Using the Nominal Group Technique to Identify the Problems Experienced by Persons Living with Severe Physical Disabilities. Journal of Clinical Psychology in Medical Settings 9, 65–76 (2002). https://doi.org/10.1023/A:1014931924809
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DOI: https://doi.org/10.1023/A:1014931924809