LeBaron Virginia T, Horton Bethany J, Adhikari Abish, Chapagain Sandhya, Dhakal Manita, Gongal Rajesh, Kattel Regina, Koirala Ganesh, Kutcher Anna, Hass Ben, Maurer Martha, Munday Daniel, Neupane Bijay, Sharma Krishna, Shilpakar Ramila, Shrestha Amuna, Shrestha Sudip, Thapa Usha, Dillingham Rebecca, Paudel Bishnu D
University of Virginia School of Nursing, Charlottesville, VA, United States.
University of Virginia School of Medicine, Charlottesville, VA, United States.
Front Pain Res (Lausanne). 2022 Jul 28;3:910995. doi: 10.3389/fpain.2022.910995. eCollection 2022.
Quality palliative care, which prioritizes comfort and symptom control, can reduce global suffering from non-communicable diseases, such as cancer. To address this need, the Nepalese Association of Palliative Care (NAPCare) created pain management guidelines (PMG) to support healthcare providers in assessing and treating serious pain. The NAPCare PMG are grounded in World Health Organization best practices but adapted for the cultural and resource context of Nepal. Wider adoption of the NAPCare PMG has been limited due to distribution of the guidelines as paper booklets.
Building on a long-standing partnership between clinicians and researchers in the US and Nepal, the NAPCare PMG mobile application ("app") was collaboratively designed. Healthcare providers in Nepal were recruited to pilot test the app using patient case studies. Then, participants completed a Qualtrics survey to evaluate the app which included the System Usability Scale (SUS) and selected items from the Mobile App Rating Scale (MARS). Descriptive and summary statistics were calculated and compared across institutions and roles. Regression analyses to explore relationships (α = 0.05) between selected demographic variables and SUS and MARS scores were also conducted.
Ninety eight healthcare providers ( = 98) pilot tested the NAPCare PMG app. Overall, across institutions and roles, the app received an SUS score of 76.0 (a score > 68 is considered above average) and a MARS score of 4.10 (on a scale of 1 = poor, 5 = excellent). 89.8% ( = 88) "agreed" or "strongly agreed" that the app will help them better manage cancer pain. Age, years of experience, and training in palliative care were significant in predicting SUS scores (-values, 0.0124, 0.0371, and 0.0189, respectively); institution was significant in predicting MARS scores ( = 0.0030).
The NAPCare PMG mobile app was well-received, and participants rated it highly on both the SUS and MARS. Regression analyses suggest end-user variables important to consider in designing and evaluating mobile apps in lower resourced settings. Our app design and pilot testing process illustrate the benefits of cross global collaborations to build research capacity and generate knowledge within the local context.
优质的姑息治疗以舒适和症状控制为首要任务，可减轻全球范围内非传染性疾病（如癌症）带来的痛苦。为满足这一需求，尼泊尔姑息治疗协会（NAPCare）制定了疼痛管理指南（PMG），以支持医疗服务提供者评估和治疗严重疼痛。NAPCare的PMG以世界卫生组织的最佳实践为基础，但根据尼泊尔的文化和资源情况进行了调整。由于指南以纸质手册形式分发，其更广泛的采用受到了限制。
基于美国和尼泊尔临床医生与研究人员之间长期的合作关系，联合设计了NAPCare PMG移动应用程序（“应用”）。招募尼泊尔的医疗服务提供者，使用患者案例研究对该应用进行试点测试。然后，参与者完成一项Qualtrics调查以评估该应用，调查包括系统可用性量表（SUS）和移动应用评分量表（MARS）中的选定项目。计算描述性和汇总统计数据，并在不同机构和角色之间进行比较。还进行了回归分析，以探讨选定的人口统计学变量与SUS和MARS评分之间的关系（α = 0.05）。
98名医疗服务提供者对NAPCare PMG应用进行了试点测试。总体而言，在不同机构和角色中，该应用的SUS评分为76.0（得分> 68被认为高于平均水平），MARS评分为4.10（范围为1 =差，5 =优秀）。89.8%（n = 88）的人“同意”或“强烈同意”该应用将帮助他们更好地管理癌症疼痛。年龄、工作经验年限和姑息治疗培训在预测SUS评分方面具有显著性（P值分别为0.0124、0.0371和0.0189）；机构在预测MARS评分方面具有显著性（P = 0.0030）。
NAPCare PMG移动应用受到好评，参与者在SUS和MARS上对其评价都很高。回归分析表明，在资源较少的环境中设计和评估移动应用时，最终用户变量是需要考虑的重要因素。我们的应用设计和试点测试过程说明了跨全球合作在建设研究能力和在当地背景下产生知识方面的好处。
