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首页> 外文期刊>BMC Medical Informatics and Decision Making >User-centered and theory-based design of a professional training program on shared decision-making with older adults living with neurocognitive disorders: a mixed-methods study
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User-centered and theory-based design of a professional training program on shared decision-making with older adults living with neurocognitive disorders: a mixed-methods study

机译：与患有神经认知障碍的老年人共享决策的专业培训计划的以用户为本和理论为基础的专业培训计划设计：混合方法研究

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We know little about the best approaches to design training for healthcare professionals. We thus studied how user-centered and theory-based design contribute to the development of a distance learning program for professionals, to increase their shared decision-making (SDM) with older adults living with neurocognitive disorders and their caregivers. In this mixed-methods study, healthcare professionals who worked in family medicine clinics and homecare services evaluated a training program in a user-centered approach with several iterative phases of quantitative and qualitative evaluation, each followed by modifications. The program comprised an e-learning activity and five evidence summaries. A subsample assessed the e-learning activity during semi-structured think-aloud sessions. A second subsample assessed the evidence summaries they received by email. All participants completed a theory-based questionnaire to assess their intention to adopt SDM. Descriptive statistical analyses and qualitative thematic analyses were integrated at each round to prioritize training improvements with regard to the determinants most likely to influence participants’ intention. Of 106 participants, 98 completed their evaluations of either the e-learning activity or evidence summary (93%). The professions most represented were physicians (60%) and nurses (15%). Professionals valued the e-learning component to gain knowledge on the theory and practice of SDM, and the evidence summaries to apply the knowledge gained through the e-learning activity to diverse clinical contexts. The iterative design process allowed addressing most weaknesses reported. Participants’ intentions to adopt SDM and to use the summaries were high at baseline and remained positive as the rounds progressed. Attitude and social influence significantly influenced participants' intention to use the evidence summaries (P??0.0001). Despite strong intention and the tailoring of tools to users, certain factors external to the training program can still influence the effective use of these tools and the adoption of SDM in practice. A theory-based and user-centered design approach for continuing professional development interventions on SDM with older adults living with neurocognitive disorders and their caregivers appeared useful to identify the most important determinants of learners’ intentions to use SDM in their practice, and validate our initial interpretations of learners’ assessments during the subsequent evaluation round.
机译：我们毫不犹豫地了解了为医疗保健专业人员设计培训的最佳方法。因此，我们研究了以用户为中心的和理论为基础的设计如何为专业人士的远程学习计划的开发有助于增加他们的共享决策（SDM）与患有神经认知障碍及其护理人员的老年人。在这种混合方法研究中，在家庭医学诊所和家庭护理服务中工作的医疗保健专业人员以用户为中心的方法评估了具有多个定量和定性评估的迭代阶段的培训计划，每个阶段都是修改。该计划包括电子学习活动和五个证据摘要。 Subsample在半结构化思想会话期间评估了电子学习活动。第二个子样本评估了电子邮件收到的证据摘要。所有参与者完成了一个以理论为基础的问卷，以评估其采用SDM的意图。在每轮中整合描述性统计分析和定性专题分析，以优先考虑最有可能影响参与者意图的决定因素的培训改进。在106名参与者中，98人完成了对电子学习活动或证据总结的评估（93％）。最多代表的职业是医生（60％）和护士（15％）。专业人士重视电子学习组成部分，以获得关于SDM的理论和实践的知识，并通过电子学习活动应用通过电子学习活动来实现多元化临床环境的证据摘要。迭代设计过程允许解决报告的大多数弱点。参与者采用SDM和使用摘要的意图在基线上很高，随着轮次的进展，仍然是积极的。态度和社会影响力显着影响参与者使用证据摘要的意图（P？＆？0.0001）。尽管有很强的意图和对用户的工具裁剪，但培训计划外部的某些因素仍可影响这些工具的有效利用和在实践中采用SDM。一种基于理论的和以用户为中心的持续性发育干预措施与患有神经认知障碍的老年人持续的专业开发干预措施，似乎有助于确定学习者意图在其实践中使用SDM的最重要决定因素，并验证我们的首字母后续评估期间学习者评估的解释。

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