Birnie Kathryn A, Nguyen Cynthia, Do Amaral Tamara, Baker Lesley, Campbell Fiona, Lloyd Sarah, Ouellette Carley, von Baeyer Carl, Lalloo Chitra, Gerstle J Ted, Stinson Jennifer
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada.
Can J Pain. 2018 Oct 26;2(1):280-291. doi: 10.1080/24740527.2018.1534543. eCollection 2018.
Young children are at risk for poorly managed pain after surgery, with significant negative consequence to their quality of life and health outcomes. Mobile applications offer a highly accessible, engaging, and interactive medium to improve pain assessment and management; however, they generally lack scientific foundation or support.
The aims of this study were to describe a successful parent-science partnership in the development and testing of Achy Penguin, a parent-developed iOS app to help assess and manage acute pain in young children, and to evaluate and refine the usability of Achy Penguin in young children with acute postoperative pain.
Three cycles of iterative usability testing were conducted with 20 4- to 7-year-old children (= 5.8 years) in hospital who had recently undergone surgery (= 6-7 children/cycle). Semistructured qualitative interviews were analyzed using simple content analysis.
Feedback from children and further integration of evidence-based pediatric pain knowledge led to refinements in app pain assessment and management content, as well as app flow and functionality. Changes improved children's ease of use and understanding and satisfaction by simplifying language in app instructions and content, adding audio and pictorial instructions, and increasing the engagement, interactiveness, immersiveness, and general appeal of pain management strategies.
This article showcases the value of collaborative partnerships between various stakeholders (parents, app developers, and researcher/health care providers) to address gaps in pediatric pain care. The Achy Penguin app shows promise for improving pain assessment and management in young children, although further evaluation of app effectiveness and implementation is warranted.
幼儿术后疼痛管理不善，会对其生活质量和健康结果产生重大负面影响。移动应用程序提供了一种高度便捷、引人入胜且互动性强的媒介，可用于改善疼痛评估和管理；然而，它们通常缺乏科学依据或支持。
本研究的目的是描述在开发和测试“疼痛企鹅”（一款由家长开发的用于帮助评估和管理幼儿急性疼痛的iOS应用程序）过程中成功的家长与科学伙伴关系，并评估和优化“疼痛企鹅”在急性术后疼痛幼儿中的可用性。
对20名4至7岁（平均5.8岁）近期在医院接受手术的儿童（每个周期6至7名儿童）进行了三个周期的迭代可用性测试。使用简单内容分析法对半结构化定性访谈进行了分析。
儿童的反馈以及循证儿科疼痛知识的进一步整合，促使应用程序的疼痛评估和管理内容、应用程序流程及功能得到了改进。通过简化应用程序说明和内容中的语言、添加音频和图片说明以及增强疼痛管理策略的参与性、互动性、沉浸感和吸引力，这些改变提高了儿童的易用性、理解能力和满意度。
本文展示了各利益相关者（家长、应用程序开发者和研究人员/医疗保健提供者）之间合作伙伴关系在解决儿科疼痛护理差距方面的价值。“疼痛企鹅”应用程序在改善幼儿疼痛评估和管理方面显示出了前景，不过仍需对该应用程序的有效性和实施情况进行进一步评估。
