背景:在老年人中,骨折后急性疼痛通常得不到充分的控制。移动健康(mHealth)技术可以为疼痛的自我管理提供机会;然而,骨折后急性疼痛管理应用不足,没有一个是为老年人设计的。
目的:本研究旨在设计,发展,并使用以人为本的设计方法评估mHealth应用程序原型,以支持老年人对骨折后急性疼痛的自我管理。
方法:本研究采用多学科和以用户为中心的设计方法。总的来说,7个利益相关者(即,1名内科医师-研究员,2个用户体验设计师,1名计算机科学研究员,1名临床研究助理研究员,和2名药剂师)来自项目团队,连同355个外部利益相关者,参与了我们以用户为中心的开发过程,包括调查,需求启发,参与式设计研讨会,移动应用程序的设计和开发,移动应用程序内容开发,和可用性测试。我们分三个阶段完成了这项研究。我们分析了来自加拿大骨质疏松症患者网络的305名成员和34名医疗保健专业人员的先前调查数据,以确定设计低保真原型的要求。接下来,我们促成了4个参与式设计研讨会,有6名参与者对内容进行反馈,介绍,以及与我们提出的低保真原型的交互。在使用主题分析对收集的数据进行分析后,我们设计了一个中等保真度的原型。最后,为了评估我们的中等保真度原型,我们对10名参与者进行了可用性测试。结果为我们的高保真原型的设计提供了信息。在这项发展研究的所有阶段,我们整合了卫生专业人员的投入,以确保原型中医疗内容的准确性和有效性。
结果:我们确定了在我们的初始低保真原型的设计中必须包括的3类功能:对支持资源的需求,日记条目,和获取教育材料。然后,我们对设计研讨会收集的数据进行了主题分析,其中揭示了4个主题:对用户界面设计和可用性的反馈,请求额外的功能,对医疗指南和教育材料的反馈,以及对其他医疗内容的建议。根据这些结果,我们设计了一个中等保真度的原型。可用性评估测试的所有参与者都发现中等保真度原型有用且易于使用。根据参与者的反馈和经历的困难,我们调整了设计,为高保真原型做准备。
结论:我们设计了,开发,并评估了一个mHealth应用程序,以支持老年人骨折后疼痛的自我管理。参与者发现我们提出的原型可用于管理急性疼痛,并且易于互动和导航。未来将评估我们提出的mHealth应用程序的临床结果和长期效果。
BACKGROUND: Postfracture acute pain is often inadequately managed in older adults. Mobile health (mHealth) technologies can offer opportunities for self-management of pain; however, insufficient apps exist for acute pain management after a fracture, and none are designed for an older adult population.
OBJECTIVE: This study aims to design, develop, and evaluate an mHealth app prototype using a human-centered design approach to support older adults in the self-management of postfracture acute pain.
METHODS: This study used a multidisciplinary and user-centered design approach. Overall, 7 stakeholders (ie, 1 clinician-researcher specialized in internal medicine, 2 user experience designers, 1 computer science researcher, 1 clinical research assistant researcher, and 2 pharmacists) from the project team, together with 355 external stakeholders, were involved throughout our user-centered development process that included surveys, requirement elicitation, participatory design workshops, mobile app design and development, mobile app content development, and usability testing. We completed this study in 3 phases. We analyzed data from prior surveys administered to 305 members of the Canadian Osteoporosis Patient Network and 34 health care professionals to identify requirements for designing a low-fidelity prototype. Next, we facilitated 4 participatory design workshops with 6 participants for feedback on content, presentation, and interaction with our proposed low-fidelity prototype. After analyzing the collected data using thematic analysis, we designed a medium-fidelity prototype. Finally, to evaluate our medium-fidelity prototype, we conducted usability tests with 10 participants. The results informed the design of our high-fidelity prototype. Throughout all the phases of this development study, we incorporated inputs from health professionals to ensure the accuracy and validity of the medical content in our prototypes.
RESULTS: We identified 3 categories of functionalities necessary to include in the design of our initial low-fidelity prototype: the need for support resources, diary entries, and access to educational materials. We then conducted a thematic analysis of the data collected in the design workshops, which revealed 4 themes: feedback on the user interface design and usability, requests for additional functionalities, feedback on medical guides and educational materials, and suggestions for additional medical content. On the basis of these results, we designed a medium-fidelity prototype. All the participants in the usability evaluation tests found the medium-fidelity prototype useful and easy to use. On the basis of the feedback and difficulties experienced by participants, we adjusted our design in preparation for the high-fidelity prototype.
CONCLUSIONS: We designed, developed, and evaluated an mHealth app to support older adults in the self-management of pain after a fracture. The participants found our proposed prototype useful for managing acute pain and easy to interact with and navigate. Assessment of the clinical outcomes and long-term effects of our proposed mHealth app will be evaluated in the future.