An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation

BackgroundRisk identification and communication tools have the potential to improve health care by supporting clinician-patient or family discussion of treatment risks and benefits and helping patients make more informed decisions; however, they have yet to be tailored to ped...

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Main Authors: Michael D Wood, Nicholas C West, Christina Fokkens, Ying Chen, Kent C Loftsgard, Krystal Cardinal, Simon D Whyte, Elodie Portales-Casamar, Matthias Görges
Format: Article
Language:English
Published: JMIR Publications 2023-11-01
Series:JMIR Pediatrics and Parenting
Online Access:https://pediatrics.jmir.org/2023/1/e46785
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author Michael D Wood
Nicholas C West
Christina Fokkens
Ying Chen
Kent C Loftsgard
Krystal Cardinal
Simon D Whyte
Elodie Portales-Casamar
Matthias Görges
author_facet Michael D Wood
Nicholas C West
Christina Fokkens
Ying Chen
Kent C Loftsgard
Krystal Cardinal
Simon D Whyte
Elodie Portales-Casamar
Matthias Görges
author_sort Michael D Wood
collection DOAJ
description BackgroundRisk identification and communication tools have the potential to improve health care by supporting clinician-patient or family discussion of treatment risks and benefits and helping patients make more informed decisions; however, they have yet to be tailored to pediatric surgery. User-centered design principles can help to ensure the successful development and uptake of health care tools. ObjectiveWe aimed to develop and evaluate the usability of an easy-to-use tool to communicate a child’s risk of postoperative pain to improve informed and collaborative preoperative decision-making between clinicians and families. MethodsWith research ethics board approval, we conducted web-based co-design sessions with clinicians and family participants (people with lived surgical experience and parents of children who had recently undergone a surgical or medical procedure) at a tertiary pediatric hospital. Qualitative data from these sessions were analyzed thematically using NVivo (Lumivero) to identify design requirements to inform the iterative redesign of an existing prototype. We then evaluated the usability of our final prototype in one-to-one sessions with a new group of participants, in which we measured mental workload with the National Aeronautics and Space Administration (NASA) Task Load Index (TLX) and user satisfaction with the Post-Study System Usability Questionnaire (PSSUQ). ResultsA total of 12 participants (8 clinicians and 4 family participants) attended 5 co-design sessions. The 5 requirements were identified: (A) present risk severity descriptively and visually; (B) ensure appearance and navigation are user-friendly; (C) frame risk identification and mitigation strategies in positive terms; (D) categorize and describe risks clearly; and (E) emphasize collaboration and effective communication. A total of 12 new participants (7 clinicians and 5 family participants) completed a usability evaluation. Tasks were completed quickly (range 5-17 s) and accurately (range 11/12, 92% to 12/12, 100%), needing only 2 requests for assistance. The median (IQR) NASA TLX performance score of 78 (66-89) indicated that participants felt able to perform the required tasks, and an overall PSSUQ score of 2.1 (IQR 1.5-2.7) suggested acceptable user satisfaction with the tool. ConclusionsThe key design requirements were identified, and that guided the prototype redesign, which was positively evaluated during usability testing. Implementing a personalized risk communication tool into pediatric surgery can enhance the care process and improve informed and collaborative presurgical preparation and decision-making between clinicians and families of pediatric patients.
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spelling doaj.art-85bcb13727bd4aebbdb3e365c98cc69b2023-11-17T14:45:42ZengJMIR PublicationsJMIR Pediatrics and Parenting2561-67222023-11-016e4678510.2196/46785An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability EvaluationMichael D Woodhttps://orcid.org/0000-0002-3652-8320Nicholas C Westhttps://orcid.org/0000-0001-8382-5136Christina Fokkenshttps://orcid.org/0000-0001-9455-9814Ying Chenhttps://orcid.org/0000-0003-3781-545XKent C Loftsgardhttps://orcid.org/0000-0002-6116-0046Krystal Cardinalhttps://orcid.org/0000-0003-0751-746XSimon D Whytehttps://orcid.org/0000-0002-8590-3916Elodie Portales-Casamarhttps://orcid.org/0000-0002-9998-7858Matthias Görgeshttps://orcid.org/0000-0003-2193-178X BackgroundRisk identification and communication tools have the potential to improve health care by supporting clinician-patient or family discussion of treatment risks and benefits and helping patients make more informed decisions; however, they have yet to be tailored to pediatric surgery. User-centered design principles can help to ensure the successful development and uptake of health care tools. ObjectiveWe aimed to develop and evaluate the usability of an easy-to-use tool to communicate a child’s risk of postoperative pain to improve informed and collaborative preoperative decision-making between clinicians and families. MethodsWith research ethics board approval, we conducted web-based co-design sessions with clinicians and family participants (people with lived surgical experience and parents of children who had recently undergone a surgical or medical procedure) at a tertiary pediatric hospital. Qualitative data from these sessions were analyzed thematically using NVivo (Lumivero) to identify design requirements to inform the iterative redesign of an existing prototype. We then evaluated the usability of our final prototype in one-to-one sessions with a new group of participants, in which we measured mental workload with the National Aeronautics and Space Administration (NASA) Task Load Index (TLX) and user satisfaction with the Post-Study System Usability Questionnaire (PSSUQ). ResultsA total of 12 participants (8 clinicians and 4 family participants) attended 5 co-design sessions. The 5 requirements were identified: (A) present risk severity descriptively and visually; (B) ensure appearance and navigation are user-friendly; (C) frame risk identification and mitigation strategies in positive terms; (D) categorize and describe risks clearly; and (E) emphasize collaboration and effective communication. A total of 12 new participants (7 clinicians and 5 family participants) completed a usability evaluation. Tasks were completed quickly (range 5-17 s) and accurately (range 11/12, 92% to 12/12, 100%), needing only 2 requests for assistance. The median (IQR) NASA TLX performance score of 78 (66-89) indicated that participants felt able to perform the required tasks, and an overall PSSUQ score of 2.1 (IQR 1.5-2.7) suggested acceptable user satisfaction with the tool. ConclusionsThe key design requirements were identified, and that guided the prototype redesign, which was positively evaluated during usability testing. Implementing a personalized risk communication tool into pediatric surgery can enhance the care process and improve informed and collaborative presurgical preparation and decision-making between clinicians and families of pediatric patients.https://pediatrics.jmir.org/2023/1/e46785
spellingShingle Michael D Wood
Nicholas C West
Christina Fokkens
Ying Chen
Kent C Loftsgard
Krystal Cardinal
Simon D Whyte
Elodie Portales-Casamar
Matthias Görges
An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation
JMIR Pediatrics and Parenting
title An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation
title_full An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation
title_fullStr An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation
title_full_unstemmed An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation
title_short An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation
title_sort individualized postoperative pain risk communication tool for use in pediatric surgery co design and usability evaluation
url https://pediatrics.jmir.org/2023/1/e46785
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