McMullen Colleen A, Williams Mark V, Smyth Susan S, Clouser Jessica Miller, Li Jing
Department of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, 900 S. Limestone Street, 40536 Lexington, KY, United States of America.
Department of Medicine, Washington University, 600 S Taylor Ave, 155K, St Louis, MO 63110, USA.
PEC Innov. 2023 Jan 28;2:100131. doi: 10.1016/j.pecinn.2023.100131. eCollection 2023 Dec.
The purpose of this study was to identify barriers and design interventions to promote adherence to 2017 Guideline for Syncope Evaluation and Management.
Focus groups and interviews were conducted to understand preferences, needs and barriers from patients and providers. Educational materials for patients were developed following a co-design, iterative process with patients, providers and hospital staff. The academic medical center's (AMC) Patient Education Department and Patient & Family Advisory Council reviewed materials to ensure health literacy. We piloted usability and feasibility of delivering the materials to a small cohort of patients.
From Feb to March 2020, 24 patients were asked to watch the video. Twenty-two watched the intake video; of those 8 watched the discharge video. 95% of participants found the intake video informational and 86% would recommend it to others; 100% found the discharge video informational and would recommend it to others. Patients who watched both videos reported the videos improved their overall stay.
Our study described a patient-clinician-researcher codesign process and demonstrated feasibility of tools developed to communicate risk and uncertainty with patients and facilitate shared decision making in syncope evaluation.
Engaging end users in developing interventions is critical for sustained practice change.
本研究旨在识别障碍并设计干预措施，以促进对《2017年晕厥评估与管理指南》的遵循。
开展焦点小组讨论和访谈，以了解患者及医疗服务提供者的偏好、需求和障碍。在与患者、医疗服务提供者及医院工作人员共同设计、反复迭代的过程后，为患者开发了教育材料。学术医疗中心（AMC）的患者教育部门及患者与家属咨询委员会对材料进行了审核，以确保其具备健康素养。我们对向一小群患者提供这些材料的可用性和可行性进行了试点。
2020年2月至3月，24名患者被要求观看视频。22人观看了入院视频；其中8人观看了出院视频。95%的参与者认为入院视频信息丰富，86%的人会向他人推荐；100%的人认为出院视频信息丰富，并会向他人推荐。观看了两个视频的患者表示，这些视频改善了他们的整体住院体验。
我们的研究描述了一个患者-临床医生-研究人员共同设计的过程，并证明了所开发的工具在向患者传达风险和不确定性以及促进晕厥评估中的共同决策方面的可行性。
让最终用户参与干预措施的开发对于持续的实践变革至关重要。
