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新型侧向流动检测法在即时检测淋病奈瑟菌中的应用:南非医护人员定性时间序列评估。

Usability of a novel lateral flow assay for the point-of-care detection of Neisseria gonorrhoeae: A qualitative time-series assessment among healthcare workers in South Africa.

机构信息

Research Unit, Foundation for Professional Development, East London, South Africa.

Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, United States of America.

出版信息

PLoS One. 2023 Jun 2;18(6):e0286666. doi: 10.1371/journal.pone.0286666. eCollection 2023.

Abstract

Accurate and user-friendly rapid point-of-care diagnostic tests (POCT) are needed to optimize treatment of Neisseria gonorrhoeae, especially in low-resource settings where syndromic management is the standard of care for sexually transmitted infections. This study aimed to assess the acceptability and usability of a novel lateral flow assay and portable reader for the point-of-care detection of N. gonorrhoeae infection (NG-LFA). This mixed-methods study was conducted as part of a diagnostic performance and usability evaluation of a prototype NG-LFA for detection of N. gonorrhoeae in symptomatic men and women at primary healthcare facilities in the Buffalo City Metro, South Africa. The Standardized System Usability Scale (SUS) was administered, and in-depth interviews were conducted among healthcare professionals (HCPs) and fieldworkers (FWs) at pre-implementation, initial use and 3- and 6-month study implementation to assess user expectations, practical experience, and future implementation considerations for the NG-LFA. Data collection and analysis was guided by the Health Technology Adoption Framework, including new health technology attributes, learnability, satisfaction, and suitability. The framework was adapted to include perceived durability. A total of 21 HCPs and FWs were trained on the NG-LFA use. SUS scores showed good to excellent acceptability ranging from 78.8-90.6 mean scores between HCPs and FWs across study time points. All transcripts were coded using Dedoose and qualitative findings were organized by learnability, satisfaction, suitability, and durability domains. Usability themes are described for each time point. Initial insecurity dissipated and specimen processing dexterity with novel POCT technology was perfected over time especially amongst FWs through practical learning and easy-to-use instructions (learnability). Participants experienced both positive and negative test results, yielding perceived accuracy and minimal testing challenges overall (satisfaction). By 3- and 6-month use, both HCPs and FWs found the NG-LFA convenient to use in primary health care facilities often faced with space constraints and outlined perceived benefits for patients (suitability and durability). Findings show that the NG-LFA device is acceptable and usable even amongst paraprofessionals. High SUS scores and qualitative findings demonstrate high learnability, ease-of-use and suitability that provide valuable information for first-step scale-up requirements at primary healthcare level. Minor prototype adjustments would enhance robustness and durability aspects.

摘要

需要准确且易于使用的即时护理点(POCT)快速诊断检测来优化淋病奈瑟菌的治疗,尤其是在资源有限的环境中,因为综合征管理是性传播感染的护理标准。本研究旨在评估一种新型侧向流动分析和便携式读取器用于即时护理检测淋病奈瑟菌感染(NG-LFA)的可接受性和可用性。这项混合方法研究是在对用于在南非布法罗城大都市的初级保健设施中检测有症状的男性和女性的淋病奈瑟菌的原型 NG-LFA 进行诊断性能和可用性评估的一部分中进行的。在实施前、初步使用以及 3 个月和 6 个月的研究实施期间,向卫生保健专业人员(HCP)和现场工作人员(FW)施行了标准化系统可用性量表(SUS),并进行了深入访谈,以评估 NG-LFA 的用户期望、实际经验和未来实施考虑因素。数据收集和分析由健康技术采用框架指导,包括新的健康技术属性、可学习性、满意度和适用性。该框架经过调整后,纳入了感知耐用性。共有 21 名 HCP 和 FW 接受了 NG-LFA 使用的培训。SUS 评分显示,HCP 和 FW 的可接受性评分在研究时间点均为 78.8-90.6,表明评分良好至优秀。所有转录本均使用 Dedoose 进行编码,定性发现按照可学习性、满意度、适用性和耐用性领域进行了组织。每个时间点都描述了可用性主题。最初的不安全感随着时间的推移而消散,尤其是在 FW 中,他们通过实际学习和易于使用的说明(可学习性)完善了对新型 POCT 技术的标本处理灵巧性。参与者体验了阳性和阴性的测试结果,总体上认为准确性高,测试挑战最小(满意度)。在 3 个月和 6 个月的使用后,HCP 和 FW 均发现 NG-LFA 在经常面临空间限制的初级保健设施中使用方便,并概述了对患者的感知益处(适用性和耐用性)。研究结果表明,即使是非专业人员,NG-LFA 设备也可以接受和使用。高 SUS 评分和定性发现表明具有较高的可学习性、易用性和适用性,为在初级保健层面进行初步扩大规模提供了有价值的信息。原型的一些小调整将增强其稳健性和耐用性方面。

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