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首页> 外文期刊>International journal of medical informatics >Usability and feasibility of a tablet-based Decision-Support and Integrated Record-keeping (DESIRE) tool in the nurse management of hypertension in rural western Kenya
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Usability and feasibility of a tablet-based Decision-Support and Integrated Record-keeping (DESIRE) tool in the nurse management of hypertension in rural western Kenya

机译：基于平板电脑的决策支持和综合记录保存（DESIRE）工具在肯尼亚西部农村地区高血压护士管理中的可用性和可行性

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Background: Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. Objective: To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Methods: Usability testing consisted of "think aloud" exercises and "mock patient encounters" with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Results: Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. Conclusions: This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions.
机译：背景：移动健康（mHealth）应用近来激增，特别是在中低收入国家/地区，以临床决策支持补充了任务分配策略。相对而言，很少有研究涉及可能影响实施成败的可用性和可行性问题，而针对高血压等非传染性疾病的研究也很少。目的：对基于平板电脑的决策支持和综合记录保存（DESIRE）工具进行迭代可用性和可行性测试，该技术旨在在西部资源有限的环境中帮助农村临床医生在社区一级照顾高血压患者肯尼亚。方法：可用性测试包括与五名护士进行“大声思考”练习和“模拟患者相遇”，以及一个焦点小组讨论。可行性测试包括对五名护士和实施团队的两名成员的半结构化访谈，以及与护士进行的一次焦点小组讨论。使用演绎代码和有效归纳代码进行内容分析。确定严重事件并根据严重性进行排序。错误原因分析用于制定相应的设计更改建议。结果：在可用性测试中发现了57个严重事件，其中21个是唯一的。错误原因分析产生了23个设计变更建议。可行性主题包括沿人和技术两方面实施的障碍，实施的促进者，提供者问题，患者问题和功能要求。结论：这种参与式，以人为中心的迭代设计过程揭示了以前未解决的可用性和可行性问题，这些问题影响了肯尼亚西部DESIRE工具的实施。除了众所周知的技术问题，我们还强调了可能影响移动医疗干预措施实施的人为因素的重要性。

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