{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:59:20Z","timestamp":1790830760294,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To 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.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A two\u2010round Delphi expert consensus study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The initial item pool was conceptualized based on an integrated framework combining the Dual\u2010Process Model and the Post\u2010Traumatic Stress Disorder model and generated through a literature review and semi\u2010structured 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\u2010level content validity index.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Experts reached consensus on the preliminary Post\u2010Multifetal Pregnancy Reduction Maternal Psychological Distress Scale (PMRPDS), comprising 16 items across four dimensions: Post\u2010traumatic 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 (\n p<\/jats:italic>\n \u2009<\u20090.001). The content validity index scored 0.983.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Expert consensus was reached on the content of the preliminary PMRPDS, demonstrating established content validity for assessing MFPR\u2010related distress and guiding targeted psychosocial nursing interventions.<\/jats:p>\n <\/jats:sec>\n \n Implications for Nursing<\/jats:title>\n 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\u2010centred perinatal psychosocial care.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n \n \n \n \n What problem did the study address?<\/jats:italic>\n The lack of a specialized assessment tool for psychological distress after MFPR.\n <\/jats:p>\n <\/jats:list-item>\n \n \n What were the main findings?<\/jats:italic>\n A 16\u2010item scale across four core dimensions was developed through a Delphi expert consensus study.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Where and on whom will the research have an impact?<\/jats:italic>\n The research will impact perinatal mental health clinicians, researchers and ultimately, the care received by women undergoing MFPR.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n This study adhered to the Conducting and REporting of DElphi Studies (CREDES) reporting guidelines.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n No Patient or Public Contribution.<\/jats:p>\n <\/jats:sec>\n \n What Does This Paper Contribute to the Wider Global Clinical Community?<\/jats:title>\n \n \n \n Provides the first structured instrument to assess complex psychological distress following MFPR.<\/jats:p>\n <\/jats:list-item>\n \n Establishes a consensus\u2010based foundation for future cross\u2010cultural validation and research, facilitating improved perinatal mental health care protocols.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/nop2.70893","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:40:05Z","timestamp":1790829605000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Consensus on the Content of an Instrument to Assess Psychological Distress Following Multifetal Pregnancy Reduction: A Delphi Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3767-656X","authenticated-orcid":false,"given":"Jin","family":"Xu","sequence":"first","affiliation":[{"name":"Women's Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-8803","authenticated-orcid":false,"given":"Qingge","family":"Li","sequence":"additional","affiliation":[{"name":"Women's Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1411-5939","authenticated-orcid":false,"given":"Hong","family":"Wen","sequence":"additional","affiliation":[{"name":"Women's Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7199-3443","authenticated-orcid":false,"given":"Cuiwei","family":"Ye","sequence":"additional","affiliation":[{"name":"Women's Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2616-4607","authenticated-orcid":false,"given":"Ge","family":"Peng","sequence":"additional","affiliation":[{"name":"Women's Hospital School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000004397"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13108"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005\u20107967(96)00033\u20102"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000044500"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2022.1032212"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1551160"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/pas0001110"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0005\u20107967(99)00123\u20100"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737\u2010016\u20100658\u20109"},{"issue":"1","key":"e_1_2_15_12_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1037\/0033-2909.99.1.20","article-title":"Emotional Processing of Fear: Exposure to Corrective Information","volume":"99","author":"Foa E. 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