Division of General Surgery, Section of Colon & Rectal Surgery, Vanderbilt University Medical Center, Nashville, TN, United States.
Division of Colon and Rectal Surgery, Dell Medical School, University of Texas at Austin, Austin, TX, United States.
JMIR Form Res. 2024 Sep 3;8:e59952. doi: 10.2196/59952.
Diverticular disease is a common gastrointestinal diagnosis with over 2.7 million clinic visits yearly. National guidelines from the American Society of Colon and Rectal Surgeons state that "the decision to recommend elective sigmoid colectomy after recovery from uncomplicated acute diverticulitis should be individualized." However, tools to individualize this decision are lacking.
This study aimed to develop an online educational decision aid (DA) to facilitate effective surgeon and patient communication about treatment options for recurrent left-sided diverticulitis.
We used a modified design sprint methodology to create a prototype DA. We engaged a multidisciplinary team and adapted elements from the Ottawa Personal Decision Guide. We then iteratively refined the prototype by conducting a mixed methods assessment of content and usability testing, involving cognitive interviews with patients and surgeons. The findings informed the refinement of the DA. Further testing included an in-clinic feasibility review.
Over a 4-day in-person rapid design sprint, including patients, surgeons, and health communication experts, we developed a prototype of a diverticulitis DA, comprising an interactive website and handout with 3 discrete sections. The first section contains education about diverticulitis and treatment options. The second section clarifies the potential risks and benefits of both clinical treatment options (medical management vs colectomy). The third section invites patients to participate in a value clarification exercise. After navigating the DA, the patient prints a synopsis that they bring to their clinic appointment, which serves as a guide for shared decision-making.
Design sprint methodology, emphasizing stakeholder co-design and complemented by extensive user testing, is an effective and efficient strategy to create a DA for patients living with recurrent diverticulitis facing critical treatment decisions.
憩室病是一种常见的胃肠道诊断，每年有超过 270 万人次就诊。美国结肠和直肠外科学会的国家指南指出，“在复杂急性憩室炎恢复后，建议对复发性左侧憩室炎进行选择性乙状结肠切除术的决定应该个体化。” 然而，缺乏用于个体化决策的工具。
本研究旨在开发一种在线教育决策辅助工具（DA），以促进外科医生和患者就复发性左侧憩室炎的治疗选择进行有效沟通。
我们使用改良的设计冲刺方法来创建原型 DA。我们组建了一个多学科团队，并采用了渥太华个人决策指南的元素。然后，我们通过对内容和可用性测试进行混合方法评估，包括对患者和外科医生进行认知访谈，对原型进行迭代改进。研究结果为 DA 的改进提供了信息。进一步的测试包括在诊所进行可行性审查。
在为期 4 天的面对面快速设计冲刺中，我们包括患者、外科医生和健康传播专家在内的团队，开发了一种憩室炎 DA 的原型，包括一个互动网站和一份包含 3 个独立部分的手册。第一部分包含关于憩室炎和治疗选择的教育。第二部分阐明了两种临床治疗选择（药物治疗与结肠切除术）的潜在风险和益处。第三部分邀请患者参与价值澄清练习。在浏览 DA 后，患者打印出一份摘要，他们在就诊时携带，作为共同决策的指南。
设计冲刺方法强调利益相关者的共同设计，并辅以广泛的用户测试，是为面临关键治疗决策的复发性憩室炎患者创建 DA 的有效且高效的策略。
