Tack Bieke, Vita Daniel, Mansosa Irène, Mbaki Thomas Nsema, Wasolua Naomie, Luyindula Aimée, Toelen Jaan, Lunguya Octavie, Jacobs Jan
Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium.
Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium.
Diagnostics (Basel). 2022 Mar 18;12(3):746. doi: 10.3390/diagnostics12030746.
As part of a field study (NCT04473768) in children presenting with severe febrile illness to Kisantu hospital (DR Congo), we retrospectively compiled user experiences (not performance) with handheld diagnostic devices assisting triage: tympanic thermometer, pulse oximeter (measuring heart rate, respiratory rate and oxygen saturation), hemoglobinometer and glucometer. Guidance documents for product selection were generic and scattered. Stock rupture, market withdrawal and unaffordable prices interfered with procurement. Challenges at implementation included environmental temperature, capillary blood sampling (antisepsis, order of multiple tests, filling microcuvettes and glucose strips), calibration (environmental temperature, cold chain) and liability-oriented communication with a manufacturer. Instructions for use were readable and contained symbol keys; two devices had printed French-language instructions. Shortcomings were poor integration of figures with text and distinct procedures for the oximeter and its sensor. Usability interview revealed appreciations for quick results, visibility of the display and memory function (three devices) but also problems of capillary blood sample transfer, cleaning, too long of a time-to-results (respiratory rate) and size, fitting and disposal of thermometer probes. Pictorial error messages were preferred over alphanumeric error codes but interpretation of symbols was poor. Alarm sounds of the oximeter caused unrest in children and caretakers perceived the device as associated with poor prognosis.
作为在刚果民主共和国基桑图医院对患有严重发热疾病儿童进行的一项现场研究（NCT04473768）的一部分，我们回顾性地收集了使用手持诊断设备辅助分诊的用户体验（而非性能）：鼓膜温度计、脉搏血氧仪（测量心率、呼吸频率和血氧饱和度）、血红蛋白仪和血糖仪。产品选择的指导文件是通用且分散的。库存中断、市场退出和价格过高影响了采购。实施过程中的挑战包括环境温度、毛细血管采血（消毒、多项检测的顺序、填充微量比色皿和葡萄糖试纸）、校准（环境温度、冷链）以及与制造商进行的责任导向型沟通。使用说明可读性强且包含符号键；两台设备有法语印刷说明。不足之处在于图表与文字的整合不佳，以及血氧仪及其传感器的操作步骤不同。可用性访谈显示，用户对快速出结果、显示屏可视性和记忆功能（三台设备）表示赞赏，但也存在毛细血管血样转移、清洁、出结果时间过长（呼吸频率）以及温度计探头的尺寸、适配性和处理等问题。图形错误信息比字母数字错误代码更受青睐，但符号的解读效果不佳。血氧仪的警报声引起儿童不安，看护人员认为该设备与预后不良有关。
