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首页> 外文期刊>The Journal of cardiovascular nursing >User-centered Development of a Decision Aid for Patients Facing Implantable Cardioverter-Defibrillator Replacement A Mixed-Methods Study
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User-centered Development of a Decision Aid for Patients Facing Implantable Cardioverter-Defibrillator Replacement A Mixed-Methods Study

机译：用户以植入式心脏除颤器替换的患者为患者的决策辅助辅助的决策辅助方法进行混合方法研究

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Background: Because of battery depletion, an implantable cardioverter-defibrillator (ICD) generator requires surgical replacement every 5 to 7 years. Routine replacement is the norm without discussion with patients about whether or not to proceed. Objective: The aim of this study was to develop a patient decision aid (PDA) for patients facing ICD replacement and plan for its implementation. Methods: An embedded mixed-methods study was conducted using questionnaires and semistructured interviews focused on current ICD replacement practices; PDA acceptability, usability, and content; and PDA implementation. Transcripts were analyzed using constant comparative analysis. Results: Eighteen PDA end users in 16 interviews characterized the current ICD replacement approach as automatic without consideration for patient preferences. The PDA was positively received, and the content was iteratively revised 4 times during the interviews. Changes were related to missing and excess information, language, and wording. The PDA was identified as a means to support a shared decision-making (SDM) process, not to be used as a standalone instrument. To shift current practices to an SDM process, participants identified that an invitation to discuss the option of ICD replacement is required-whether initiated by the patient or the clinician. Conclusion: Currently, the option of ICD replacement is rarely offered, and patient preferences are seldom elicited. Participants believed the PDA to be a useful intervention that could help facilitate an SDM process for patients facing ICD replacement. Preparing for implementation during the development phase will allow us to strategize effectively to overcome perceived barriers and capitalize on perceived facilitators during actual implementation.
机译：背景：由于电池耗尽，可植入的心脏病除颤器（ICD）发电机每5到7年需要手术更换。常规替换是常规的规范，没有讨论是否继续进行。目的：本研究的目的是为面临ICD替代品的患者制定患者决策援助（PDA）。方法：采用问卷和半系统采访进行嵌入式混合方法研究，专注于当前的ICD替代实践; PDA可接受性，可用性和内容;和PDA实施。使用恒定的比较分析分析转录物。结果：十八PDA最终用户在16次采访中，其目前的ICD替代方法是自动的，无需考虑患者偏好。 PDA被积极接受，在访谈期间迭代地修订4次内容。变更与缺失和超额信息，语言和措辞有关。将PDA识别为支持共享决策（SDM）过程的方法，不作为独立仪器。要将当前做法转移到SDM过程中，参与者确定了讨论ICD更换选项的邀请 - 无论是由患者还是临床医生发起。结论：目前，很少提供ICD更换的选择，患者偏好很少引发。与会者认为PDA是一个有用的干预，可以帮助促进ICD替代患者的SDM过程。在开发阶段准备实施，允许我们有效地战略克服感知障碍，并在实际实施期间利用被感知的辅导员。

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