Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
Center for Research, Policy and Implementation, Biratnagar, Nepal.
BMJ Open. 2021 Jan 20;11(1):e045175. doi: 10.1136/bmjopen-2020-045175.
To understand the feasibility and acceptability of a co-design approach to developing an integrated model of healthcare for people with multi-morbid chronic obstructive pulmonary disease (COPD) in rural Nepal.
A rural setting of Nepal.
Data collection included five video recordings, five key informant interviews and observation notes from a final co-design workshop that involved a total of 68 stakeholders: persons with COPD and their family members; healthcare providers, including respiratory physicians; local community leaders; representatives from local, provincial and federal government; academics; and representatives from non-government organisations.
Feasibility and acceptability of using a co-design approach to develop an integrated model of care for people with multi-morbid COPD in rural Nepal.
Our qualitative evaluation of the Hasso Plattner's co-design process found that all stakeholders (including people with COPD/community members, primary care practitioners and local government/senior health officials) were actively engaged in and significantly contributed to the process of co-design. Four main themes were identified which determined the feasibility and acceptability of the resulting integrated model of care: engagement of stakeholders, factors contributing to the co-design, consequences of the co-design process, and challenges and opportunities learnt by the researchers and participants in the co-design process. Based on the relationship between the four main themes emerging from this research, we developed an evaluation framework to guide the co-design of a health service innovation.
Our study demonstrated the feasibility and acceptability of the Hasso Plattner's co-design process. Our findings suggest that this co-design approach can be useful and acceptable to local communities and government agencies. It enabled the meaningful contribution of a diverse group of stakeholders in the design and delivery of health services in low-income and middle-income countries.
了解在尼泊尔农村采用共同设计方法为患有多种慢性阻塞性肺疾病（COPD）的患者开发综合医疗模式的可行性和可接受性。
尼泊尔农村地区。
数据收集包括五次视频记录、五次关键知情人访谈和一次最终共同设计研讨会的观察记录，共有 68 名利益相关者参与：COPD 患者及其家属；医疗保健提供者，包括呼吸内科医生；当地社区领袖；地方、省和联邦政府代表；学者；以及非政府组织代表。
使用共同设计方法为尼泊尔农村患有多种慢性阻塞性肺疾病的患者开发综合护理模式的可行性和可接受性。
我们对 Hasso Plattner 共同设计过程的定性评估发现，所有利益相关者（包括 COPD 患者/社区成员、初级保健从业者和地方政府/高级卫生官员）都积极参与并为共同设计过程做出了重大贡献。确定了四个主要主题，这些主题决定了综合护理模式的可行性和可接受性：利益相关者的参与、促成共同设计的因素、共同设计过程的后果，以及研究人员和参与者在共同设计过程中吸取的挑战和机遇。基于本研究中出现的四个主要主题之间的关系，我们开发了一个评估框架，以指导卫生服务创新的共同设计。
我们的研究表明 Hasso Plattner 的共同设计过程具有可行性和可接受性。我们的研究结果表明，这种共同设计方法对当地社区和政府机构是有用且可接受的。它使不同利益相关者能够在设计和提供低收入和中等收入国家的卫生服务方面做出有意义的贡献。
