School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia; Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, United Kingdom.
School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia; Centre for Nursing Research, Sir Charles Gairdner Hospital, WA, Australia.
Int J Nurs Stud. 2024 Dec;160:104888. doi: 10.1016/j.ijnurstu.2024.104888. Epub 2024 Sep 2.
Co-designing healthcare interventions is gaining recognition as a novel and collaborative method. Co-design involves end-users from the start, ensuring that an intervention best meets their needs. Despite its potential benefits, this approach is not yet widely used in developing clinical interventions within intensive care units where the perspectives of patients, family members, and clinicians are crucial.
To describe the application, benefits and challenges of the Double Diamond model to co-design a digital family-led voice reorientation intervention for delirium prevention and management in critically ill adult patients.
The co-design process was guided by the Double Diamond model over a period of 12 months. Development involved patients, family members, and nursing and medical staff as co-designers and decision-makers in the iterative development of the intervention. Data from field notes and group meetings were audio recorded, transcribed verbatim, and content analysed at each phase, which were then presented to the co-designers for verification and refinement.
Co-designers included people with lived experience of the ICU as patients (n = 5) and family members (n = 1) and clinical experts (nursing staff n = 3; medical staff n = 3). Co-designers were highly engaged and reported positive experiences and collaboration in the co-design process. Sharing the diversity of their own personal ICU experiences was found to be beneficial as it not only validated individual feelings but also strengthened intervention development. Differences in interpretations and meanings of the voice messages proposed as part of the intervention were challenging. Maintaining sufficient focus on each phase of the Double Diamond was difficult due to the complexity of the context in which the intervention was being co-designed and the resulting challenges of maintaining the engagement of the co-designers throughout the process.
There were benefits and challenges of engaging people with lived experience in an intensive care unit as co-designers through the Double Diamond design process to develop a digital family-led intervention for delirium prevention and management. Overall, applying the Double Diamond to co-design a clinical intervention is recommended, whereby the collaboration process benefits patients, family members, and clinical staff.
ACTRN12622001568707; ANZCTR - Registration.
共同设计医疗干预措施正逐渐被视为一种新颖且协作的方法。共同设计从一开始就涉及到终端用户，以确保干预措施能够最大程度地满足他们的需求。尽管这种方法具有潜在的好处，但它在重症监护病房内开发临床干预措施方面尚未得到广泛应用，因为患者、家属和临床医生的观点至关重要。
描述双钻石模型在共同设计一种用于预防和管理成人重症患者谵妄的数字家庭主导的声音定向干预措施中的应用、益处和挑战。
该共同设计过程在 12 个月的时间内遵循双钻石模型进行。在迭代开发干预措施的过程中，患者、家属以及护理和医疗人员作为共同设计者和决策者参与其中。从现场笔记和小组会议中获取的数据进行了音频录制、逐字转录，并在每个阶段进行了内容分析，然后将这些数据提交给共同设计者进行验证和完善。
共同设计者包括有重症监护室经历的患者（n=5）和家属（n=1）以及临床专家（护理人员 n=3；医务人员 n=3）。共同设计者参与度很高，并报告了在共同设计过程中的积极体验和协作。分享他们自己独特的重症监护室经历被证明是有益的，因为这不仅验证了个人的感受，还加强了干预措施的开发。作为干预措施一部分提出的声音信息的解释和含义的差异具有挑战性。由于干预措施共同设计所处的复杂环境以及由此导致的整个过程中共同设计者参与度的维持困难，很难保持对双钻石各个阶段的足够关注。
通过双钻石设计过程让有重症监护室经历的人作为共同设计者参与其中，开发用于预防和管理谵妄的数字家庭主导的干预措施具有益处和挑战。总体而言，建议应用双钻石来共同设计临床干预措施，从而使患者、家属和临床工作人员受益。
ACTRN12622001568707；ANZCTR - 注册。
