Bueno Mariana, Stevens Bonnie, Rao Megha, Riahi Shirine, Lanese Alexa, Li Shelly-Anne
Child Health Evaluative Sciences Peter Gilgan Centre for Research and Learning (PGCRL) The Hospital for Sick Children Toronto ON Canada.
Lawrence S. Bloomberg Faculty of Nursing & Faculties of Medicine and Dentistry University of Toronto Toronto ON Canada.
Paediatr Neonatal Pain. 2020 May 30;2(3):82-92. doi: 10.1002/pne2.12027. eCollection 2020 Sep.
The Implementation of Infant Pain Practice (ImPaC) Resource is an eHealth tool designed to support infant pain practice change and ultimately enhance pain outcomes. The aim of this study was to determine users' perspectives on usability, acceptability, and feasibility of the ImPaC Resource. A descriptive prospective mixed-methods quality improvement study was conducted at a pediatric hospital in Canada. Individual "think aloud" interviews were conducted in a nonclinical environment (Phase A); "near live" testing was conducted while users interacted with the Resource in clinical setting (Phase B); individual "think-aloud" interviews were conducted in a nonclinical environment (Phase C). Outcomes included usability (System Usability Scale-SUS), acceptability (Acceptability E-Scale-AES), and feasibility. Interview transcripts were coded per a priori themes using deductive content analysis to create a structured categorization matrix. In Phase A, 10 clinicians interacted with the Resource in individual sessions. Median SUS score was 73.75 (range 52.5-92.5). In Phase B, four clinicians implemented the Resource in the neonatal intensive care unit (NICU) over 4 months. Median SUS score was 85 (82.5-92.5), and median AES score was 24 (21-24). In Phase C, an enhanced prototype was produced, and the same users from Phase B navigated the Resource in individual sessions. Median SUS score was 88.75 (85-95), and median AES score was 27.5 (25-29). Users considered the Resource as feasible for implementation, easy to navigate, engaging, intuitive, comprehensive, and evidence-based. Users highlighted the potential transferability of the Resource to other contexts and settings. The enhanced version of the ImPaC Resource was usable, acceptable, feasible, and met users' expectations and requirements. Results lead the way for evaluation of the Resource in a nationwide cluster randomized trial including 18 NICUs. This knowledge-rich platform is expected to enhance infant pain practices and outcomes in diverse clinical settings.
婴儿疼痛实践（ImPaC）资源实施工具是一种电子健康工具，旨在支持婴儿疼痛实践变革并最终改善疼痛治疗效果。本研究的目的是确定用户对ImPaC资源的可用性、可接受性和可行性的看法。在加拿大的一家儿科医院进行了一项描述性前瞻性混合方法质量改进研究。在非临床环境中进行个体“出声思考”访谈（A阶段）；在临床环境中用户与该资源交互时进行“近似实时”测试（B阶段）；在非临床环境中进行个体“出声思考”访谈（C阶段）。结果包括可用性（系统可用性量表-SUS）、可接受性（可接受性电子量表-AES）和可行性。访谈记录根据预先设定的主题，采用演绎性内容分析法进行编码，以创建结构化分类矩阵。在A阶段，10名临床医生在单独的环节中与该资源进行交互。SUS得分中位数为73.75（范围52.5 - 92.5）。在B阶段，4名临床医生在新生儿重症监护病房（NICU）使用该资源4个月。SUS得分中位数为85（82.5 - 92.5），AES得分中位数为24（21 - 24）。在C阶段，制作了一个增强型原型，B阶段的相同用户在单独环节中浏览该资源。SUS得分中位数为88.75（85 - 95），AES得分中位数为27.5（(25 - 29）。用户认为该资源实施可行、易于浏览、引人入胜、直观、全面且基于证据。用户强调了该资源向其他环境和场所转移的潜力。ImPaC资源的增强版本可用、可接受、可行，并且满足用户的期望和要求。研究结果为在包括18个新生儿重症监护病房的全国性整群随机试验中评估该资源奠定了基础。这个知识丰富的平台有望在不同临床环境中改善婴儿疼痛治疗实践和治疗效果。
