Stakeholder-Driven Intervention Development for Dialysis Trials Using a Design Sprint Methodology.
Stakeholder-Driven Intervention Development for Dialysis Trials Using a Design Sprint Methodology.
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利益相关者驱动的干预开发使用设计Sprint方法进行透析试验。
DOI：
10.1016/j.xkme.2023.100729
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发表时间：
2023-12
期刊：
影响因子：
3.9
通讯作者：
Liebschutz, Jane M.
中科院分区：
文献类型：
--
作者：
Michalowski, Allison;Cavanaugh, Kerri L.;Hamm, Megan;Wilkie, Caroline;Olejniczak, Donna M.;Eneanya, Nwamaka D.;Colditz, Jason;Jhamb, Manisha;Bulls, Hailey W.;Liebschutz, Jane M.
耻辱感导致透析肾衰竭患者的疼痛治疗无效，特别是丁丙诺啡疼痛治疗。为了消除偏见，我们采用了设计冲刺（Design Sprint），这是一种行业开发的结构化练习，由跨学科团队在5天内澄清问题，确定并选择解决方案，构建并测试原型。适应性设计冲刺，明确要解决的问题，提出解决方案，并为选定的解决方案创建蓝图。5名患有疼痛和肾脏疾病的患者接受透析，5名医生（肾脏病学，姑息治疗和成瘾医学）和4名大型透析组织领导因其特定的专业知识或经验而招募。通过在线平台（Zoom）和虚拟白板（Miro板）进行。设计冲刺调整和过程的描述。为了使患者感到舒适，一个仅针对患者的阶段包括四个90分钟的会议，为期两周，在此期间，患者参与者使用映射过程来定义关键问题并勾勒出解决方案。在只有医生参与的阶段，包括两次120分钟的会议，参与者完成相同的任务。在两个120分钟会议的联合阶段，患者、医生和大型透析组织代表审查并制定了早期阶段的解决方案，从而制定了干预蓝图。视频会议技术允许地理上不同的代表，并促进患有医疗疾病的患者的参与。电子白板允许交互式书面贡献和对优先事项进行投票，而不仅仅是口头讨论，这可能会使医生参与者享有特权。一位熟练的定性研究人员为这些会议提供了便利。挑战包括会议的时间承诺、因病或紧急情况缺席以及技术困难。适应性设计冲刺是一种有效、快速地将多个利益相关者结合起来，为肾脏疾病的临床挑战开发解决方案的新方法。耻辱感导致透析肾衰竭患者的疼痛治疗无效，特别是在使用丁丙诺啡时，丁丙诺啡是一种用于治疗成瘾的阿片类止痛药，镇静风险较低。为了开发耻辱感干预，我们采用了设计冲刺（Design Sprint），这是一种行业开发的结构化练习，由跨学科小组在5天内澄清问题，确定并选择解决方案，并构建和测试原型。我们进行了3次冲刺(1)单独患者，(2)单独医生，(3)联合患者，医生和透析组织代表。本文描述了sprint的适应性和产品，作为一种收集不同利益相关者声音以高效快速地创建干预蓝图的方法。
Stigma contributes to ineffective treatment for pain among individuals with kidney failure on dialysis, particularly with buprenorphine pain treatment. To address stigma, we adapted a Design Sprint, an industry-developed structured exercise where an interdisciplinary group works over 5 days to clarify the problem, identify and choose a solution, and build and test a prototype. Adapted Design Sprint which clarified the problem to be solved, proposed solutions, and created a blueprint for the selected solution. Five individuals with pain and kidney disease receiving dialysis, 5 physicians (nephrology, palliative care, and addiction medicine) and 4 large dialysis organization leaders recruited for specific expertise or experience. Conducted through online platform (Zoom) and virtual white board (Miro board). Descriptions of the Design Sprint adaptations and processes. To facilitate patient comfort, a patient-only phase included four 90-minute sessions over 2-weeks, during which patient participants used a mapping process to define the critical problem and sketch out solutions. In a physician-only phase, consisting of two 120-minute sessions, participants accomplished the same tasks. During a combined phase of two 120-minute sessions, patients, physicians, and large dialysis organization representatives vetted and developed solutions from earlier phases, leading to an intervention blueprint. Videoconferencing technology allowed for geographically diverse representation and facilitated participation from patients experiencing medical illness. The electronic whiteboard permitted interactive written contributions and voting on priorities instead of only verbal discussion, which may privilege physician participants. A skilled qualitative researcher facilitated the sessions. Challenges included the time commitment of the sessions, absences owing to illness or emergencies, and technical difficulties. An adapted Design Sprint is a novel method of efficiently and rapidly incorporating multiple stakeholders to develop solutions for clinical challenges in kidney disease. Stigma contributes to ineffective treatment for pain among individuals with kidney failure on dialysis, particularly when using buprenorphine, an opioid pain medicine with a lower risk of sedation used to treat addiction. To develop a stigma intervention, we adapted a Design Sprint, an industry-developed structured exercise where an interdisciplinary group works over 5 days to clarify the problem, identify and choose a solution, and build and test a prototype. We conducted 3 sprints with (1) patients alone, (2) physicians alone, and (3) combined patients, physicians, and dialysis organization representatives. This paper describes the adaptations and products of sprints as a method for gathering diverse stakeholder voices to create an intervention blueprint efficiently and rapidly.
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DOI：
10.1093/intqhc/mzaa127
发表时间：
2021-01-12
期刊：
International journal for quality in health care : journal of the International Society for Quality in Health Care
影响因子：
--
作者：
Melles M;Albayrak A;Goossens R
通讯作者：
Goossens R
DOI：
10.1186/1748-5908-6-42
发表时间：
2011-04-23
期刊：
Implementation science : IS
影响因子：
--
作者：
Michie S;van Stralen MM;West R
通讯作者：
West R
影响因子：
13.6
作者：
Kimmel, Paul L.;Fwu, Chyng-Wen;Eggers, Paul W.
通讯作者：
Eggers, Paul W.
DOI：
10.2215/cjn.09780915
发表时间：
2016-09-01
影响因子：
9.8
作者：
Cukor, Daniel;Cohen, Lewis M.;Mehrotra, Rajnish
通讯作者：
Mehrotra, Rajnish
影响因子：
12.7
作者：
Hatzenbuehler, Mark L.;Phelan, Jo C.;Link, Bruce G.
通讯作者：
Link, Bruce G.