Development and Multidisciplinary Expert Appraisal of NersCare-ICU: Rule-Based Clinical Decision Support for Loneliness Assessment and Nurse-Family Education in Intensive Care

Background: Loneliness may be overlooked among conscious and communicative intensive care unit (ICU) patients. This study developed NersCare-ICU, a web-based, rule-based clinical decision-support prototype that integrates loneliness assessment, predefined supportive recommendations, and nurse-family education; experts descriptively appraised its clinical, psychosocial, and technical features. Methods: A research and development approach adapted from the ADDIE framework was used. During the 2026 development period, three purposively selected experts (one each in critical care nursing, psychosocial nursing, and IT/web development) independently completed different researcher-developed, domain-specific four-point appraisal forms on 21–25 August 2026. The prototype applies established 11-item De Jong Gierveld Loneliness Scale (DJGLS) dichotomous scoring and published total-score categories; a separate researcher-defined 15-percentage-point profile rule selects predefined support options. We summarized item ratings descriptively as means and percentages of the maximum possible scores. Results: The single-expert appraisals were 90/96 (93.75%; mean 3.75/4), 94/100 (94.00%; mean 3.76/4), and 160/172 (93.02%; mean 3.72/4), respectively. These percentages summarize scores on different forms and do not demonstrate expert consensus or formal content validity. All 10 predefined IT scenarios passed as recorded in the expert form; this finding establishes concordance only with those test scenarios, without measured reliability, usability, security, or clinical outcomes. Conclusion: Three domain-specific expert appraisals and 10 predefined functional tests identified strengths and refinement needs for NersCare-ICU. ICU-specific DJGLS measurement properties, the researcher-defined profile rule, end-user usability, software reliability and security, and clinical effectiveness remain unestablished. The prototype requires targeted technical and clinical evaluation before implementation.

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Publication Details

Journal
Journal of Applied Nursing and Health
Published
2026-11-01
DOI
https://doi.org/10.55018/janh.v8i3.775
Primary Topic
Family and Patient Care in Intensive Care Units
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article
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article

Development and Multidisciplinary Expert Appraisal of NersCare-ICU: Rule-Based Clinical Decision Support for Loneliness Assessment and Nurse-Family Education in Intensive Care

Deris Riandi Setiawan, Yunita Fitri Rejeki, Mona Yulianti, Fitri Sesilia et al.
Journal of Applied Nursing and Health
Family and Patient Care in Intensive Care Units
article

Development and Multidisciplinary Expert Appraisal of NersCare-ICU: Rule-Based Clinical Decision Support for Loneliness Assessment and Nurse-Family Education in Intensive Care

Deris Riandi Setiawan, Yunita Fitri Rejeki, Mona Yulianti, Fitri Sesilia, Rifana Purnama Fadillah
article en

Abstract

Background: Loneliness may be overlooked among conscious and communicative intensive care unit (ICU) patients. This study developed NersCare-ICU, a web-based, rule-based clinical decision-support prototype that integrates loneliness assessment, predefined supportive recommendations, and nurse-family education; experts descriptively appraised its clinical, psychosocial, and technical features. Methods: A research and development approach adapted from the ADDIE framework was used. During the 2026 development period, three purposively selected experts (one each in critical care nursing, psychosocial nursing, and IT/web development) independently completed different researcher-developed, domain-specific four-point appraisal forms on 21–25 August 2026. The prototype applies established 11-item De Jong Gierveld Loneliness Scale (DJGLS) dichotomous scoring and published total-score categories; a separate researcher-defined 15-percentage-point profile rule selects predefined support options. We summarized item ratings descriptively as means and percentages of the maximum possible scores. Results: The single-expert appraisals were 90/96 (93.75%; mean 3.75/4), 94/100 (94.00%; mean 3.76/4), and 160/172 (93.02%; mean 3.72/4), respectively. These percentages summarize scores on different forms and do not demonstrate expert consensus or formal content validity. All 10 predefined IT scenarios passed as recorded in the expert form; this finding establishes concordance only with those test scenarios, without measured reliability, usability, security, or clinical outcomes. Conclusion: Three domain-specific expert appraisals and 10 predefined functional tests identified strengths and refinement needs for NersCare-ICU. ICU-specific DJGLS measurement properties, the researcher-defined profile rule, end-user usability, software reliability and security, and clinical effectiveness remain unestablished. The prototype requires targeted technical and clinical evaluation before implementation.

Journal of Applied Nursing and HealthVol. 8(3)
Openalex Percentile: Top 9%
Family and Patient Care in Intensive Care Units
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Development and Multidisciplinary Expert Appraisal of NersCare-ICU: Rule-Based Clinical Decision Support for Loneliness Assessment and Nurse-Family Education in Intensive Care — Deris Riandi Setiawan, Yunita Fitri Rejeki, et al. · Journal of Applied Nursing and Health (2026) | TGRS Research Map | TGRS