JMIR Publications

ABSTRACT

Background:

Risk identification and communication tools have the potential to improve healthcare by supporting clinician-patient/family discussion of treatment risks and benefits and helping patients make more informed decisions; however, they have yet to be tailored to pediatric surgery. User-centred design principles can help to ensure the successful development and uptake of healthcare tools.

Objective:

We aimed to develop and usability evaluate an easy-to-use tool to communicate a child’s risk of postoperative pain to improve informed and collaborative preoperative decision-making between clinicians and families.

Methods:

With research ethics board approval, we conducted virtual co-design sessions with clinicians and family participants (people with lived surgical experience and parents of children who had recently undergone a surgical/medical procedure) at a tertiary pediatric hospital. Qualitative data from these sessions were analyzed thematically using NVivo to identify design requirements to inform the iterative redesign of an existing prototype. We then evaluated the usability of our final prototype in one-to-one sessions with a new group of participants, in which we measured mental workload with the NASA Task Load Index (TLX) and user satisfaction with the Post-Study System Usability Questionnaire (PSSUQ).

Results:

Twelve participants (eight clinicians and four family participants) attended five co-design sessions. Five requirements were identified: A) present risk severity descriptively and visually; B) ensure appearance and navigation are user-friendly; C) frame risk identification and mitigation strategies in positive terms; D) categorize and describe risks clearly; and E) emphasize collaboration and effective communication. Twelve new participants (seven clinicians and five family participants) completed a usability evaluation. Tasks were completed quickly (range 5-17 seconds) and accurately (82-100%), needing only two requests for assistance. The median (interquartile range) NASA TLX performance score of 78 (66-89) indicated that participants felt able to perform the required tasks, and an overall PSSUQ score of 2.1 (1.5-2.7) suggested acceptable user satisfaction with the tool.

Conclusions:

Key design requirements were identified and guided prototype redesign, which was positively evaluated during usability testing. Implementing a personalized risk communication tool into pediatric surgery can enhance the care process and improve informed and collaborative pre-surgical preparation and decision-making between clinicians and families of pediatric patients.