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.
Authors
- Deris Riandi Setiawan (ORCID: https://orcid.org/0009-0001-9461-4948)
- Yunita Fitri Rejeki
- Mona Yulianti
- Fitri Sesilia
- Rifana Purnama Fadillah
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
- Type
- article
- Field-Weighted Citation Impact
- 0.00