Development and validation of a protective factor–based rehabilitation resilience nursing intervention for stroke survivors

OBJECTIVE: To develop and content-validate a protective factor - based nursing intervention aimed at enhancing rehabilitation resilience in stroke survivors. MATERIALS AND METHODS: This study was guided by the Medical Research Council Framework for Developing and Evaluating Complex Interventions (the MRC framework). Focusing on the development phase (Phase I), we systematically integrated existing evidence, theoretical models, and clinical guidelines to construct a structured intervention protocol targeting rehabilitation resilience. A two-round Delphi process was conducted to evaluate content validity, with the Content Validity Index (CVI), coefficient of variation (CV), and Kendall's coefficient of concordance (W) used to assess expert consensus and reliability. RESULTS: Sixteen experts participated in the Delphi process, demonstrating high engagement and authority (authority coefficient = 0.875). Consensus improved across rounds, with CV values decreasing (0-0.29 to 0-0.20) and Kendall's W increasing (0.276 to 0.519). All intervention items achieved excellent content validity (I-CVI = 1.00; S-CVI = 1.00). The finalized intervention protocol is structured across four rehabilitation phases: early rehabilitation, mid-stage rehabilitation, late rehabilitation, and discharge planning, with each phase targeting key protective factors to enhance resilience.Conclusion: A theoretically grounded and evidence-informed rehabilitation resilience nursing intervention was successfully developed and validated. The protocol demonstrates strong content validity, clinical relevance, and feasibility, providing a robust foundation for subsequent feasibility testing and randomized controlled trials. This work addresses a critical gap in the literature by offering a transparent and systematic description of intervention development for resilience-based stroke rehabilitation.