1 Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine , Baltimore, Maryland.
2 Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine , Baltimore, Maryland.
J Palliat Med. 2018 Jan;21(1):89-94. doi: 10.1089/jpm.2017.0106. Epub 2017 Aug 17.
Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery.
The objective is to develop and test acceptability of an ACP video storyline.
The design is a stakeholder-guided development of the ACP video storyline. Design-thinking methods explored and prioritized stakeholder perspectives. Patients and family members evaluated storyboards containing the proposed storyline.
SETTING/SUBJECTS: The study was conducted at hospital outpatient surgical clinics, in-person stakeholder summit, and the 2014 Maryland State Fair.
Measurements are done through stakeholder engagement and deidentified survey.
Stakeholders evaluated and prioritized evidence from an environmental scan. A surgeon, family member, and palliative care physician team iteratively developed a script featuring 12 core themes and worked with a medical graphic designer to translate the script into storyboards. For 10 days, 359 attendees of the 2014 Maryland State Fair evaluated the storyboards and 87% noted that they would be "very comfortable" or "comfortable" seeing the storyboard before major surgery, 89% considered the storyboards "very helpful" or "helpful," and 89% would "definitely recommend" or "recommend" this story to others preparing for major surgery.
Through an iterative process utilizing diverse PCOR engagement methods and informed by SLT, storyboards were developed for an ACP video. Field testing revealed the storyline to be highly meaningful for surgery patients and family members.
以患者为中心的结局研究（PCOR）方法和社会学习理论（SLT）需要研究人员和利益相关者之间进行深入的互动。在接受重大手术前进行预先医疗照护计划（ACP）非常有价值，但系统评价并未发现现有的围手术期 ACP 工具。因此，PCOR 方法和 SLT 可以为准备接受重大手术的患者和家属制定 ACP 教育视频提供信息。
制定并测试用于重大手术患者和家属的 ACP 视频故事情节的可接受性。
本研究采用利益相关者指导的方法制定 ACP 视频故事情节，设计思维方法探讨并确定了利益相关者的观点。患者和家属对包含拟议故事情节的故事板进行了评估。
地点/参与者：本研究在医院门诊外科诊所、现场利益相关者峰会以及 2014 年马里兰州博览会上进行。
通过利益相关者参与和匿名调查进行测量。
利益相关者评估并确定了环境扫描的证据优先级。外科医生、家庭成员和姑息治疗医生团队合作，反复修改脚本，突出 12 个核心主题，并与医学图形设计师合作，将脚本转化为故事板。在 2014 年马里兰州博览会上的 359 名与会者对故事板进行了为期 10 天的评估，其中 87%的人表示，在接受重大手术前看到故事板会感到“非常舒适”或“舒适”，89%的人认为故事板“非常有帮助”或“有帮助”，89%的人会“肯定推荐”或“推荐”这个故事给准备接受重大手术的其他人。
通过利用多样化的 PCOR 参与方法和基于 SLT 的迭代过程，开发了用于 ACP 视频的故事板。现场测试表明，该故事情节对手术患者及其家属具有重要意义。
