RT Journal Article
SR Electronic
T1 An advance care plan decision support video before major surgery: a patient- and family-centred approach
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP 229
OP 236
DO 10.1136/bmjspcare-2017-001449
VO 8
IS 2
A1 Sarina R Isenberg
A1 Norah L Crossnohere
A1 Manali I Patel
A1 Alison Conca-Cheng
A1 John F P Bridges
A1 Sandy M Swoboda
A1 Thomas J Smith
A1 Timothy M Pawlik
A1 Matthew Weiss
A1 Angelo E Volandes
A1 Anne Schuster
A1 Judith A Miller
A1 Carolyn Pastorini
A1 Debra L Roter
A1 Rebecca A Aslakson
YR 2018
UL http://spcare.bmj.com/content/8/2/229.abstract
AB Objective Video-based advanc care planning (ACP) tools have been studied in varied medical contexts; however, none have been developed for patients undergoing major surgery. Using a patient- and family-centredness approach, our objective was to implement human-centred design (HCD) to develop an ACP decision support video for patients and their family members when preparing for major surgery.Design and methods The study investigators partnered with surgical patients and their family members, surgeons and other health professionals to design an ACP decision support video using key HCD principles. Adapting Maguire’s HCD stages from computer science to the surgical context, while also incorporating Elwyn et al’s specifications for patient-oriented decision support tool development, we used a six-stage HCD process to develop the video: (1) plan HCD process; (2) specify where video will be used; (3) specify user and organisational requirements; (4) produce and test prototypes; (5) carry out user-based assessment; (6) field test with end users.Results Over 450 stakeholders were engaged in the development process contributing to setting objectives, applying for funding, providing feedback on the storyboard and iterations of the decision tool video. Throughout the HCD process, stakeholders’ opinions were compiled and conflicting approaches negotiated resulting in a tool that addressed stakeholders’ concerns.Conclusions Our patient- and family-centred approach using HCD facilitated discussion and the ability to elicit and balance sometimes competing viewpoints. The early engagement of users and stakeholders throughout the development process may help to ensure tools address the stated needs of these individuals.Trial registration number NCT02489799.