Iwamoto Rikako, Rodrigues Santos Ana Laura, Chavannes Niels, Reis Ria, Diehl Jan Carel
Design for Sustainability, Industrial Design Engineering, Delft University of Technology, Delft, Netherlands.
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden University, Leiden, Netherlands.
JMIR Hum Factors. 2017 Jan 18;4(1):e3. doi: 10.2196/humanfactors.6778.
The lack of adequate information about fever in low-resource settings, its unreliable self-assessment, and poor diagnostic practices may result in delayed care and under-or-overdiagnosis of diseases such as malaria. The mismatches of existing fever thermometers in the context of use imply that the diagnostic tools and connected services need to be studied further to address the challenges of fever-related illnesses and their diagnostics.
This study aims to inform a product-service system approach to design a reliable and accessible fever thermometer and connected services, as well as contribute to the identification of innovative opportunities to improve health care in low-resource settings.
To determine what factors impede febrile people seeking health care to access adequate fever diagnostics, a literature search was conducted in Google Scholar and PubMed with relevant keywords. Next, these factors were combined with a patient journey model to design a new product-service system for fever diagnostics in low-resource settings.
In total, 37 articles were reviewed. The five As framework was used to categorize the identified barriers. The results indicate that there is a poor distribution of reliable fever diagnostic practices among remote communities. This paper speaks to the global public health and design communities. Three complementary considerations are discussed that support the idea of a more holistic approach to the design of fever diagnostics: (1) understanding of the fever diagnostics patient journey, (2) identifying user groups of the thermometers in a specific health care system, and (3) assessing different needs and interests of the different users.
Access to basic, primary health care may be enhanced with better information and technology design made through the involvement of system users.
在资源匮乏地区，缺乏关于发热的充分信息、不可靠的自我评估以及不良的诊断方法，可能导致护理延迟以及疟疾等疾病的诊断不足或过度诊断。现有体温计在实际使用中的不匹配意味着需要进一步研究诊断工具及相关服务，以应对与发热相关疾病及其诊断的挑战。
本研究旨在为产品 - 服务系统方法提供信息，以设计一种可靠且易于获取的体温计及相关服务，并有助于识别改善资源匮乏地区医疗保健的创新机会。
为确定哪些因素阻碍发热患者获得充分的发热诊断，在谷歌学术和PubMed上使用相关关键词进行了文献检索。接下来，将这些因素与患者就医流程模型相结合，为资源匮乏地区的发热诊断设计一个新的产品 - 服务系统。
共审查了37篇文章。使用五个“A”框架对确定的障碍进行分类。结果表明，偏远社区可靠的发热诊断方法分布不佳。本文面向全球公共卫生和设计领域。讨论了三个互补的考虑因素，以支持采用更全面的方法设计发热诊断：（1）了解发热诊断患者的就医流程，（2）确定特定医疗保健系统中体温计的用户群体，（3）评估不同用户的不同需求和兴趣。
通过系统用户的参与进行更好的信息和技术设计，可能会增强获得基本初级卫生保健的机会。
