Developing a Decision Aid to Facilitate Informed Decision Making About Invasive Mechanical Ventilation and Lung Transplantation Among Adults With Cystic Fibrosis: Usability Testing.
Developing a Decision Aid to Facilitate Informed Decision Making About Invasive Mechanical Ventilation and Lung Transplantation Among Adults With Cystic Fibrosis: Usability Testing.
复制标题
DOI：
10.2196/21270
复制
发表时间：
2021-04-14
影响因子：
2.7
通讯作者：
Hajizadeh N
中科院分区：
文献类型：
--
作者：
Dauber-Decker KL;Basile M;King D;Polo J;Calise K;Khan S;Solomon J;Dunne D;Hajizadeh N
囊性纤维化（CF）是一种限制生命的遗传性疾病，可导致慢性肺部感染。我们开发了一个基于互联网的决策辅助（DA），以帮助CF患者在治疗和提前护理计划方面做出更明智的决定。我们围绕两个主要的治疗决定建立了DA：是否进行肺移植和是否同意有创机械通气（插管）。本研究旨在对InformedChoices CF DA在关键利益相关者群体中进行可用性测试。我们使用有声思维可用性测试对CF患者、其代理人和CF临床医生进行了患者需求评估。大声思考的参与者在浏览DA时提供反馈，并在查看后回答调查。来自有声思维会议和调查结果的成绩单被分类为常见的，可推广的主题和优化，以改善内容，理解和导航。我们评估了DA（系统可用性量表）的易用性，并评估了参与者对整体基调的看法，重点是对DA内容的情绪反应，详细程度以及信息对插管或肺移植决策的有用性，包括他们对信息的理解程度以及能够将其应用于自己的决策过程。我们还评估了DA的易用性、美观性，以及参与者是否能够完成一系列可用性任务（例如，在DA中定位特定信息或使用交互式生存估计计算器），以确保在基于临床的提前护理计划讨论期间网站易于导航。2018年3月9日至8月30日，来自3家临床试验机构的共12名参与者入组可用性测试：5名CF临床医生（平均年龄48.2岁，SD 12.0岁），5名CF成人患者，以及2名CF患者的家庭和代理护理人员（CF成人和家庭及代理护理人员的平均年龄38.8岁，SD 10.8岁）。在12名参与者中，DA的平均系统可用性量表评分为88.33（优秀）。有声思维分析确定了3个主题：功能、可见性和导航以及内容和实用性。需要改进的领域包括减少重复、提高理解力和改变流程。建议进行几项修改，以改善DA的内容和实用性，包括增加有关生育替代方案的信息，如收养和代孕。根据调查反馈，我们发现该网站的导航对于参与可用性测试的临床医生、患者和代理人来说都很容易。可用性测试揭示了潜在的改进领域。测试也产生了积极的反馈，表明DA的未来成功。在实现之前集成更改应该可以提高DA的理解、导航和有用性，并导致更大的采用。
Cystic fibrosis (CF) is a life-limiting genetic disease that causes chronic lung infections. We developed an internet-based decision aid (DA) to help patients with CF make better informed decisions regarding treatments and advance care planning. We built the DA around two major treatment decisions: whether to have a lung transplant and whether to agree to invasive mechanical ventilation (intubation). This study aims to conduct usability testing of the InformedChoices CF DA among key stakeholder groups. We performed a patient needs assessment using think-aloud usability testing with patients with CF, their surrogates, and CF clinicians. Think-aloud participants provided feedback while navigating the DA, and after viewing, they answered surveys. Transcripts from the think-aloud sessions and survey results were categorized into common, generalizable themes and optimizations for improving content, comprehension, and navigation. We assessed the ease of use of the DA (System Usability Scale) and also assessed the participants’ perceptions regarding the overall tone, with an emphasis on emotional reactions to the DA content, level of detail, and usefulness of the information for making decisions about either intubation or lung transplantation, including how well they understood the information and were able to apply it to their own decision-making process. We also assessed the DA’s ease of navigation, esthetics, and whether participants were able to complete a series of usability tasks (eg, locating specific information in the DA or using the interactive survival estimates calculator) to ensure that the website was easy to navigate during the clinic-based advance care planning discussions. A total of 12 participants from 3 sites were enrolled from March 9 to August 30, 2018, for the usability testing: 5 CF clinicians (mean age 48.2, SD 12.0 years), 5 adults with CF, and 2 family and surrogate caregivers of people with CF (mean age of CF adults and family and surrogate caregivers 38.8, SD 10.8 years). Among the 12 participants, the average System Usability Scale score for the DA was 88.33 (excellent). Think-aloud analysis identified 3 themes: functionality, visibility and navigation, and content and usefulness. Areas for improvement included reducing repetition, enhancing comprehension, and changing the flow. Several changes to improve the content and usefulness of the DA were recommended, including adding information about alternatives to childbearing, such as adoption and surrogacy. On the basis of survey responses, we found that the navigation of the site was easy for clinicians, patients, and surrogates who participated in usability testing. Usability testing revealed areas of potential improvement. Testing also yielded positive feedback, suggesting the DA’s future success. Integrating changes before implementation should improve the DA’s comprehension, navigation, and usefulness and lead to greater adoption.
登录
查看更多内容
影响因子：
3.5
作者：
Volk RJ;Llewellyn-Thomas H;Stacey D;Elwyn G
通讯作者：
Elwyn G
影响因子：
1.3
作者：
Agrawal, Abhinav;Agarwal, Abhishek;Wang, Janice
通讯作者：
Wang, Janice
影响因子：
5
作者：
Liou, TG;Adler, FR;Marshall, BC
通讯作者：
Marshall, BC
影响因子：
158.5
作者：
KEREM, E;REISMAN, J;LEVISON, H
通讯作者：
LEVISON, H
影响因子：
3.5
作者：
Basile, Melissa;Andrews, Johanna;Hajizadeh, Negin
通讯作者：
Hajizadeh, Negin