Computer Administered Safety Planning for Individuals at Risk for Suicide: Development and Usability Testing.
Computer Administered Safety Planning for Individuals at Risk for Suicide: Development and Usability Testing.
复制标题
DOI：
10.2196/jmir.6816
复制
发表时间：
2017-05-15
影响因子：
7.4
通讯作者：
Miller, Ivan W
中科院分区：
文献类型：
--
作者：
Boudreaux, Edwin D;Brown, Gregory K;Miller, Ivan W
背景：安全计划是一种简短的干预措施，在许多临床环境中已成为一种公认的做法，以帮助预防自杀。尽管与其他方法相比，它是快速的，但它通常需要20分钟或更长时间才能完成，这可能会阻碍采用。一个自我管理，基于Web的安全规划应用程序可能会减少临床医生的时间，有助于促进标准化和质量，并提供增强的能力，以共享创建plannes.Objective：本研究的目的是设计，构建和测试的可用性的一个基于Web的，自我管理的安全规划application.METHODS：我们采用了以用户为中心的软件设计策略，由一个多学科的团队。该应用程序的可用性测试与自杀患者的目标样本。详细的观察，结构化的可用性评级，并认为大声的程序。自杀意念强度和感知能力，以科普评估前后与Web application.RESULTS：共30名参与者被招募。可用性评级普遍很高，所有患者都成功制定了安全计划。然而，安全计划的完整性各不相同。完成的平均步数为5. 5（SD 0. 9）/6，90%（27/30）的参与者完成至少5步，67%（20/30）完成所有6步。一些安全规划步骤被认为不适用于某些个人。说明中的一些混乱导致修改，以提高每个步骤的可理解性。完成应用后的自杀强度评分显著低于术前评分，术前：平均5.11（SD 2.9）vs术后：平均4.46（SD 3.0），t27=2.49，P= 0.02。完成申请后，科普自杀想法的能力评分高于预评分，差异接近统计学显著性，前：平均5.93（SD 2.9），术后：平均值6.64（SD 2.4），t27=-2.03，P =.05。结论：我们已经迈出了第一步，确定了最大限度地提高自我管理的、基于Web的安全规划应用程序的可用性所需的组件。结果支持初步考虑将该应用程序作为临床接触的辅助手段。这允许临床医生或其他人员在需要时提供澄清，以帮助患者建立计划，并帮助审查和修改草案。
BACKGROUND: Safety planning is a brief intervention that has become an accepted practice in many clinical settings to help prevent suicide. Even though it is quick compared to other approaches, it frequently requires 20 min or more to complete, which can impede adoption. A self-administered, Web-based safety planning application could potentially reduce clinician time, help promote standardization and quality, and provide enhanced ability to share the created plan.OBJECTIVE: The aim of this study was to design, build, and test the usability of a Web-based, self-administered safety planning application.METHODS: We employed a user-centered software design strategy led by a multidisciplinary team. The application was tested for usability with a target sample of suicidal patients. Detailed observations, structured usability ratings, and Think Aloud procedures were used. Suicidal ideation intensity and perceived ability to cope were assessed pre-post engagement with the Web application.RESULTS: A total of 30 participants were enrolled. Usability ratings were generally strong, and all patients successfully built a safety plan. However, the completeness of the safety plan varied. The mean number of steps completed was 5.5 (SD 0.9) out of 6, with 90% (27/30) of participants completing at least 5 steps and 67% (20/30) completing all 6 steps. Some safety planning steps were viewed as inapplicable to some individuals. Some confusion in instructions led to modifications to improve understandability of each step. Ratings of suicide intensity after completion of the application were significantly lower than preratings, pre: mean 5.11 (SD 2.9) versus post: mean 4.46 (SD 3.0), t27=2.49, P=.02. Ratings of ability to cope with suicidal thoughts after completion of the application were higher than preratings, with the difference approaching statistical significance, pre: mean 5.93 (SD 2.9), post: mean 6.64 (SD 2.4), t27=-2.03, P=.05.CONCLUSIONS: We have taken the first step toward identifying the components needed to maximize usability of a self-administered, Web-based safety planning application. Results support initial consideration of the application as an adjunct to clinical contact. This allows for the clinician or other personnel to provide clarification, when needed, to help the patient build the plan, and to help review and revise the draft.