Centre for Implementation Science, King's College London, London, United Kingdom.
JMIR Mhealth Uhealth. 2021 Apr 8;9(4):e24065. doi: 10.2196/24065.
MySurgery is a smartphone app designed to empower patients and their caregivers to contribute toward safer surgical care by following practical advice to help reduce susceptibility to errors and complications.
The aim of this study is to evaluate service users' perceptions of MySurgery, including its perceived acceptability, the potential barriers and facilitators to accessing and using its content, and ideas about how to facilitate its effective implementation. The secondary aim is to analyze how the intended use of the app might differ for diverse patients, including seldom-heard groups.
We implemented a diversity approach to recruit participants from a range of backgrounds with previous experience of surgery. We aimed to achieve representation from seldom-heard groups, including those from a Black, Asian, and minority ethnic (BAME) background; those with a disability; and those from the lesbian, gay, bisexual, transgender, queer (LGBT+) community. A total of 3 focus groups were conducted across a 2-month period, during which a semistructured protocol was followed to elicit a rich discussion around the app. The focus groups were audio recorded, and thematic analysis was carried out.
In total, 22 individuals participated in the focus groups. A total of 50% (n=11) of the participants were from a BAME background, 59% (n=13) had a disability, and 36% (n=8) were from the LGBT+ community. There was a strong degree of support for the MySurgery app. The majority of participants agreed that it was acceptable and appropriate in terms of content and usability, and that it would help to educate patients about how to become involved in improving safety. The checklist-like format was popular. There was rich discussion around the accessibility and inclusivity of MySurgery. Specific user groups were identified who might face barriers in accessing the app or acting on its advice, such as those with visual impairments or learning difficulties and those who preferred to take a more passive role (eg, some individuals because of their cultural background or personality type). The app could be improved by signposting further specialty-specific information and incorporating a calendar and notes section. With regard to implementation, it was agreed that use of the app should be signposted before the preoperative appointment and that training and education should be provided for clinicians to increase awareness and buy-in. Communication about the app should clarify its scientific basis in plain English and should stress that its use is optional.
MySurgery was endorsed as a powerful tool for enhancing patient empowerment and facilitating the direct involvement of patients and their caregivers in maintaining patient safety. The diversity approach allowed for a better understanding of the needs of different population groups and highlighted opportunities for increasing accessibility and involvement in the app.
MySurgery 是一款智能手机应用程序，旨在通过提供实用建议帮助患者及其护理人员减少易出错和易发生并发症的风险，从而增强患者及其护理人员在安全手术护理方面的能力。
本研究旨在评估服务用户对 MySurgery 的看法，包括其感知的可接受性、获取和使用其内容的潜在障碍和促进因素，以及有关如何促进其有效实施的想法。次要目的是分析应用程序的预期用途可能因不同的患者而有所不同，包括很少被听到的群体。
我们采用了多样性方法，从有手术经验的各种背景的参与者中招募参与者。我们旨在代表很少被听到的群体，包括来自黑人、亚洲和少数民族（BAME）背景的人；残疾人士；以及女同性恋、男同性恋、双性恋、跨性别、酷儿（LGBT+）群体的人。在两个月的时间里进行了 3 次焦点小组讨论，在此期间，遵循半结构化协议以围绕该应用程序进行深入讨论。焦点小组进行了音频录制，并进行了主题分析。
共有 22 人参加了焦点小组。共有 50%（n=11）的参与者来自 BAME 背景，59%（n=13）有残疾，36%（n=8）来自 LGBT+社区。对 MySurgery 应用程序的支持度很高。大多数参与者认为该应用程序在内容和可用性方面是可以接受和合适的，并且它将有助于教育患者如何参与提高安全性。清单式格式很受欢迎。围绕 MySurgery 的可及性和包容性进行了丰富的讨论。确定了特定的用户群体，他们可能在获取应用程序或采取其建议方面面临障碍，例如视力障碍或学习困难的人，以及那些更喜欢采取更被动角色的人（例如，由于他们的文化背景或个性类型而有些人）。可以通过引导进一步的专业特定信息、纳入日历和注释部分来改进该应用程序。在实施方面，人们一致认为应该在术前预约之前引导使用该应用程序，并应该为临床医生提供培训和教育，以提高认识和认同。有关该应用程序的沟通应使用通俗易懂的英语阐明其科学依据，并应强调其使用是可选的。
MySurgery 被认为是增强患者授权和促进患者及其护理人员直接参与维护患者安全的有力工具。多样性方法使我们能够更好地了解不同人群群体的需求，并突出了提高应用程序可及性和参与度的机会。
