肯尼亚内罗毕一家私立三级医院的医护人员对新生儿进行多参数连续生理监测技术的可行性、易用性和可接受性研究。
Multiparameter Continuous Physiological Monitoring Technologies in Neonates Among Health Care Providers and Caregivers at a Private Tertiary Hospital in Nairobi, Kenya: Feasibility, Usability, and Acceptability Study.
机构信息
UW Clinical Trial Center, University of Washington, Seattle, WA, United States.
Department of Obstetrics and Gynecology, British Columbia Children's and Women's Hospital and The University of British Columbia, Vancouver, BC, Canada.
出版信息
J Med Internet Res. 2021 Oct 28;23(10):e29755. doi: 10.2196/29755.
BACKGROUND
Continuous physiological monitoring technologies are important for strengthening hospital care for neonates, particularly in resource-constrained settings, and understanding user perspectives is critical for informing medical technology design, development, and optimization.
OBJECTIVE
This study aims to assess the feasibility, usability, and acceptability of 2 noninvasive, multiparameter, continuous physiological monitoring technologies for use in neonates in an African health care setting.
METHODS
We assessed 2 investigational technologies from EarlySense and Sibel, compared with the reference Masimo Rad-97 technology through in-depth interviews and direct observations. A purposive sample of health care administrators, health care providers, and caregivers at Aga Khan University Hospital, a tertiary, private hospital in Nairobi, Kenya, were included. Data were analyzed using a thematic approach in NVivo 12 software.
RESULTS
Between July and August 2020, we interviewed 12 health care providers, 5 health care administrators, and 10 caregivers and observed the monitoring of 12 neonates. Staffing and maintenance of training in neonatal units are important feasibility considerations, and simple training requirements support the feasibility of the investigational technologies. Key usability characteristics included ease of use, wireless features, and reduced number of attachments connecting the neonate to the monitoring technology, which health care providers considered to increase the efficiency of care. The main factors supporting acceptability included caregiver-highlighted perceptions of neonate comfort and health care respondent technology familiarity. Concerns about the side effects of wireless connections, electromagnetic fields, and mistrust of unfamiliar technologies have emerged as possible acceptability barriers to investigational technologies.
CONCLUSIONS
Overall, respondents considered the investigational technologies feasible, usable, and acceptable for the care of neonates at this health care facility. Our findings highlight the potential of different multiparameter continuous physiological monitoring technologies for use in different neonatal care settings. Simple and user-friendly technologies may help to bridge gaps in current care where there are many neonates; however, challenges in maintaining training and ensuring feasibility within resource-constrained health care settings warrant further research.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2019-035184.
背景
连续生理监测技术对于加强新生儿的医院护理非常重要，尤其是在资源有限的环境下，了解用户的观点对于为医疗技术的设计、开发和优化提供信息至关重要。
目的
本研究旨在评估两种非侵入性、多参数、连续生理监测技术在非洲医疗机构中用于新生儿的可行性、可用性和可接受性。
方法
我们通过深入访谈和直接观察，评估了来自 EarlySense 和 Sibel 的两种研究性技术，并与参考的 Masimo Rad-97 技术进行了比较。我们纳入了肯尼亚内罗毕 Aga Khan 大学医院的医疗保健管理人员、医疗保健提供者和护理人员作为有目的的样本。数据在 NVivo 12 软件中使用主题方法进行分析。
结果
在 2020 年 7 月至 8 月期间，我们采访了 12 名医疗保健提供者、5 名医疗保健管理人员和 10 名护理人员，并观察了 12 名新生儿的监测情况。新生儿病房的人员配备和培训维持是重要的可行性考虑因素，简单的培训要求支持研究性技术的可行性。关键的可用性特征包括易于使用、无线功能和减少将新生儿连接到监测技术的附件数量，医疗保健提供者认为这提高了护理效率。支持可接受性的主要因素包括护理人员强调的对新生儿舒适度的感知和医疗保健应答者对技术的熟悉程度。对无线连接的副作用、电磁场以及对不熟悉技术的不信任的担忧已成为研究性技术的可接受性障碍。
结论
总体而言，受访者认为研究性技术在该医疗机构中对新生儿的护理是可行、可用和可接受的。我们的研究结果突显了不同多参数连续生理监测技术在不同新生儿护理环境中的应用潜力。简单易用的技术可能有助于弥合当前护理中存在的许多新生儿的差距；然而，在资源有限的医疗保健环境中维持培训和确保可行性方面的挑战需要进一步研究。
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