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过量用药教育和可携带纳洛酮套件的设计细节:与家庭医学、急诊部、成瘾医学和社区共同进行联合设计。

Design details for overdose education and take-home naloxone kits: Codesign with family medicine, emergency department, addictions medicine and community.

机构信息

Health Design Studio, OCAD University, Toronto, Ontario, Canada.

Department of Family and Community Medicine, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada.

出版信息

Health Expect. 2022 Oct;25(5):2440-2452. doi: 10.1111/hex.13559. Epub 2022 Jul 31.

Abstract

INTRODUCTION

Overdose education and naloxone distribution (OEND) programmes equip and train people who are likely to witness an opioid overdose to respond with effective first aid interventions. Despite OEND expansion across North America, overdose rates are increasing, raising questions about how to improve OEND programmes. We conducted an iterative series of codesign stakeholder workshops to develop a prototype for take-home naloxone (THN)-kit (i.e., two doses of intranasal naloxone and training on how to administer it).

METHODS

We recruited people who use opioids, frontline healthcare providers and public health representatives to participate in codesign workshops covering questions related to THN-kit prototypes, training on how to use it, and implementation, including refinement of design artefacts using personas and journey maps. Completed over 9 months, the workshops were audio-recorded and transcribed with visible results of the workshops (i.e., sticky notes, sketches) archived. We used thematic analyses of these materials to identify design requirements for THN-kits and training.

RESULTS

We facilitated 13 codesign workshops to identify and address gaps in existing opioid overdose education training and THN-kits and emphasize timely response and stigma in future THN-kit design. Using an iterative process, we created 15 prototypes, 3 candidate prototypes and a final prototype THN-kit from the synthesis of the codesign workshops.

CONCLUSION

The final prototype is available for a variety of implementation and evaluation processes. The THN-kit offers an integrated solution combining ultra-brief training animation and physical packaging of nasal naloxone to be distributed in family practice clinics, emergency departments, addiction medicine clinics and community settings.

PATIENT OR PUBLIC CONTRIBUTION

The codesign process was deliberately structured to involve community members (the public), with multiple opportunities for public contribution. In addition, patient/public participation was a principle for the management and structuring of the research team.

摘要

介绍

过量用药教育和纳洛酮分发(OEND)计划培训和装备可能目睹阿片类药物过量的人员,使其能够用有效的急救干预措施做出反应。尽管北美各地都在扩大 OEND,但过量用药率仍在上升,这引发了关于如何改进 OEND 计划的问题。我们进行了一系列迭代的利益相关者共同设计研讨会,以开发一种可带回家的纳洛酮(THN)套件的原型(即两剂鼻腔内纳洛酮和如何使用它的培训)。

方法

我们招募了使用阿片类药物的人、一线医疗保健提供者和公共卫生代表,参加共同设计研讨会,涵盖与 THN 套件原型、使用它的培训以及实施相关的问题,包括使用角色和旅程图来改进设计制品。这些研讨会历时 9 个多月,进行了音频记录和转录,并将研讨会的可见结果(即便利贴、草图)存档。我们对这些材料进行了主题分析,以确定 THN 套件和培训的设计要求。

结果

我们组织了 13 次共同设计研讨会,以确定和解决现有阿片类药物过量教育和培训以及 THN 套件中的差距,并强调在未来的 THN 套件设计中及时响应和消除耻辱感。通过迭代过程,我们从共同设计研讨会的综合中创建了 15 个原型、3 个候选原型和最终的 THN 套件原型。

结论

最终的原型可用于各种实施和评估过程。THN 套件提供了一种集成解决方案,将超短培训动画和鼻腔纳洛酮的物理包装结合在一起,以便在家庭实践诊所、急诊室、成瘾医学诊所和社区环境中分发。

患者或公众贡献

共同设计过程故意让社区成员(公众)参与,并有多次公众参与的机会。此外,患者/公众参与是管理和构建研究团队的原则。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5fd/9615059/a62cef241689/HEX-25--g001.jpg

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