Developing A Decision Aid for Critically Ill Patients Requiring Renal Replacement Therapy: A User-Centered Approach for Rapid Prototyping (Preprint)

Author:

Zheng MiaoORCID,Yin Changlin,Cao Ying,Zhang Yonghui,Wang Fang,Wang Lihua

Abstract

BACKGROUND

Renal replacement therapy (RRT) is increasingly being adopted as a treatment method for critically ill patients suffering from acute kidney injury, followed by inevitably high rates of morbidity and mortality. Whether or not to choose RRT for critically ill patients is a significant concern for surrogate decision makers and is associated with anxiety and decision dilemmas. While evidence suggests that decision aids (DAs) help to improve the quality of medical decision making, few supports exist in the decision-making process for surrogates when their loved ones in the ICU face the possibility of RRT.

OBJECTIVE

The objective of this study was to develop a web-based DA to help surrogates make better-informed decisions for critically ill patients requiring RRT.

METHODS

To develop the DA, we utilized a systematic process to create a user-centered design by following four steps: (1) competitive analysis — identify existing DAs through a systematic environmental scan; (2) users’ needs assessment — explore surrogates’ decisional needs through semi-structured interviews; (3) user persona development — develop a typical user persona through a manual characterization of users’ expectations for DAs; (4) evidence synthesis — synthesize clinical evidence on RRT decision making according to the above requirements. This process was implemented to efficiently solve design issues before the development began, thereby helping developers to determine their goals more readily and to focus on the needs of target users.

RESULTS

The rapid prototyping of the DA was accomplished through a systematic process and conceiving a user-centered design. (1) Sixteen available DAs related to RRT were identified in the areas of: end-of-life issues (N=2), end stage renal disease (N=5), and chronic kidney disease (N=9). Design decisions for a DA pertaining to RRT for critically ill AKI patients were informed by these methods. (2) Fifteen family surrogates with RRT decision-making experience in an ICU setting were interviewed for the purpose of needs assessment. Users’ potential needs were identified within the domains of professional support, role guidance, information needs, and values clarification. (3) A typical user persona was constructed to help understand users’ needs and to further inform design choices. (4) 27 sources were selected and a total of 21 items were extracted as evidence to augment the content of the prototype. Finally, the DA prototype was designed to include a user guide and a four-step decision guide.

CONCLUSIONS

We have created a novel approach for the rapid prototyping of a web-based DA that is targeted at family surrogates making decisions about RRT for their loved ones in ICU. Future studies are warranted to evaluate the usability, feasibility, and comprehensibility of the DA through iterative refinement.

CLINICALTRIAL

ChiCTR2000031613

Publisher

JMIR Publications Inc.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3