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支持患者为全膝关节置换做准备:基于证据、理论和个体的“虚拟膝关节学校”数字干预措施的开发。

Supporting patients to prepare for total knee replacement: Evidence-, theory- and person-based development of a 'Virtual Knee School' digital intervention.

机构信息

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

NIHR Leeds Biomedical Research Centre, Leeds, UK.

出版信息

Health Expect. 2023 Dec;26(6):2549-2570. doi: 10.1111/hex.13855. Epub 2023 Aug 22.

Abstract

INTRODUCTION

Digital delivery of pre-operative total knee replacement (TKR) education and prehabilitation could improve patient outcomes pre- and post-operatively. Rigorously developing digital interventions is vital to help ensure they achieve their intended outcomes whilst mitigating their potential drawbacks.

OBJECTIVE

To develop a pre-operative TKR education and prehabilitation digital intervention, the 'Virtual Knee School' (VKS).

METHODS

The VKS was developed using an evidence-, theory- and person-based approach. This involved a mixed methods design with four phases. The first three focused on planning the VKS. The final phase involved creating a VKS prototype and iteratively refining it through concurrent think-aloud interviews with nine patients who were awaiting/had undergone TKR. Meta-inferences were generated by integrating findings from all the phases. ISRCTN registration of the overall project was obtained on 24 April 2020 (ISRCTN11759773).

RESULTS

Most participants found the VKS prototype acceptable overall and considered it a valuable resource. Conversely, a minority of participants felt the prototype's digital format or content did not meet their individual needs. Participants' feedback was used to refine the prototype's information architecture, design and content. Two meta-inferences were generated and recommend: 1. Comprehensive pre-operative TKR education and prehabilitation support should be rapidly accessible in digital and non-digital formats. 2. Pre-operative TKR digital interventions should employ computer- and self-tailoring to account for patients' individual needs and preferences.

CONCLUSIONS

Integrating evidence, theory and stakeholders' perspectives enabled the development of a promising VKS digital intervention for patients awaiting TKR. The findings suggest future research evaluating the VKS is warranted and provide recommendations for optimising pre-operative TKR care.

PATIENT OR PUBLIC CONTRIBUTION

Patient and Public Involvement (PPI) was central throughout the project. For example, PPI representatives contributed to the project planning, were valued members of the Project Advisory Group, had key roles in developing the VKS prototype and helped disseminate the project findings.

摘要

简介

数字化的全膝关节置换术(TKR)术前教育和术前康复可以改善患者术前和术后的治疗效果。严格开发数字干预措施对于帮助确保它们实现预期效果,同时减轻其潜在缺陷至关重要。

目的

开发一种全膝关节置换术术前教育和术前康复的数字干预措施,即“虚拟膝关节学校”(VKS)。

方法

VKS 的开发采用了基于证据、理论和以人为中心的方法。这涉及到一个混合方法设计,分为四个阶段。前三个阶段侧重于规划 VKS。最后一个阶段涉及创建 VKS 原型,并通过与 9 名等待/接受 TKR 的患者进行同步思考访谈,对其进行迭代改进。通过整合所有阶段的发现,生成元推断。整个项目于 2020 年 4 月 24 日在 ISRCTN 注册(ISRCTN11759773)。

结果

大多数参与者总体上认为 VKS 原型可以接受,并认为它是一个有价值的资源。相反,少数参与者认为原型的数字格式或内容不符合他们的个人需求。参与者的反馈用于改进原型的信息架构、设计和内容。生成了两个元推断并建议:1. 全面的 TKR 术前教育和康复支持应在数字和非数字格式中快速获取。2. TKR 术前数字干预措施应采用计算机和自我调整,以满足患者的个体需求和偏好。

结论

整合证据、理论和利益相关者的观点,使我们能够为即将接受 TKR 的患者开发一种有前途的 VKS 数字干预措施。研究结果表明,未来有必要对 VKS 进行评估,并为优化 TKR 术前护理提供建议。

患者或公众参与

患者和公众参与(PPI)是整个项目的核心。例如,PPI 代表参与了项目规划,是项目顾问小组的重要成员,在开发 VKS 原型方面发挥了关键作用,并帮助传播了项目研究结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08b/10632615/ecd636921b16/HEX-26--g001.jpg

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