179 The Development of an Oral Health Nursing Tool in Patients with a Psychotic Disorder another expert was included based on their experience with psychotic disorders and oral health problems; an education specialist was included based on her expertise in and experience with how to best transfer knowledge; and, finally, it was important to include a communication specialist based on their knowledge of and experience with conveying messages for the purpose of encouraging behavioural changes in MHNs. In step 2a, the participants included in step 1a were invited to score the 15 prototype tools of the MCDM. In step 3a, we included professionals: master’s-level advanced nurse practitioners, bachelor’s-level MHNs, and experts by experience based on convenience sampling. Participants were included based on their experience (in working years) with in- or outpatients with psychotic disorders, availability, and willingness to participate. The iterative process of sampling, data collection, and analysis was continued until data saturation was reached; no new codes were found in the last four interviews. Participants were approached by e-mail and recruited from the KieN Early Intervention Service (Leeuwarden), Lentis Psychiatric Institute (Groningen), Dimence psychiatric services (Zwolle), and Friesland Mental Health Care Services (Leeuwarden) in the Netherlands. Data Collection Step 1a: Pressure cooker focus group session Before the start of the pressure cooker focus group session, participants were split between two groups (focus groups 1 (n = 5) and 2 (n = 4)), in which the research team ensured an even distribution of knowledge and experience. In terms of content, both groups discussed the same topics at the same time. First, in step 1a, the session was divided into two parts. The first part was aimed at brainstorming around the question, “how can we make MHNs more sensitive of the urgency of paying attention to the oral care of patients with psychotic disorders?” Because rapidity adds value to the creative process, we used the format of a pressure cooker session [26,27]. A pressure cooker session is a brief intensive session targeting essential topics in limited time. The benefits of a pressure cooker session 6
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