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Development and usability testing of a web-based decision support for users and health professionals in psychiatric services
Dalarna University, School of Education, Health and Social Studies, Caring Science. Karlstads universitet.ORCID iD: 0000-0002-7236-0836
Dalarna University, School of Education, Health and Social Studies, Social Work.ORCID iD: 0000-0002-3866-5636
2017 (English)In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, no 3, p. 293-302Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported.

METHOD: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers.

RESULTS: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives. (PsycINFO Database Record

Place, publisher, year, edition, pages
2017. Vol. 40, no 3, p. 293-302
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-27766DOI: 10.1037/prj0000278PubMedID: 28737415OAI: oai:DiVA.org:du-27766DiVA, id: diva2:1213720
Available from: 2018-06-05 Created: 2018-06-05 Last updated: 2019-08-15Bibliographically approved
In thesis
1. Legitimizing the knowledge of mental health service users in shared decision making: Promoting participation through a web-based decision support tool
Open this publication in new window or tab >>Legitimizing the knowledge of mental health service users in shared decision making: Promoting participation through a web-based decision support tool
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to explore the manner in which user knowledge and user perspectives can be included and supported in shared decision making (SDM) in mental health services.

The thesis consists of four studies. Study I explored what needs service users identify to participate in deliberative processes and decision making in their care. Study II examined how a decision support tool (DST) for SDM can be designed to enhance service users’ ability to have active and meaningful roles in SDM. Study III investigated barriers and facilitators associated with the implementation of a web-based DST designed to provide a concrete structure to support SDM. In study IV, a theoretical analysis was performed to elucidate the barriers associated with user knowledge being expressed and legitimized in decision-making processes.

Methods: A key feature of the project involved a process of exploring decisional and informational needs and of developing, testing and implementing a DST for SDM. Qualitative data have been collected through focus group and individual interviews with service users and service providers, usability testing with service users and checklists.

Findings: The findings show a number of characteristics specific to the mental health service context that need to be considered when developing support for SDM. Decisions were often complex and found to encompass a number of life domains. Issues related to social context and individual recovery highlighted the necessity to include the knowledge perspectives of service users throughout decision processes. In response, phases for preparation and follow-up was emphasized in the DST. The results indicate that supportive structures are required for service users to express their knowledge perspectives and for providers to include them in their decision-making. Moreover, existing barriers related to organizational structures and to power differentials need to be addressed.       

Conclusions and implications: A DST specifically designed for the mental health context, that methodically invites service users to participate in each phase of the decision-making process might function as a guiding structure to validate service users as knowledgeable agents.

Place, publisher, year, edition, pages
Falun: Dalarna University, 2019
Series
Dalarna Doctoral Dissertations in Health Sciences ; 1
Keywords
User knowledge, SDM, Shared decision making, User involvement, User participation, Mental health services, Psychiatry
National Category
Psychiatry Social Work Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30246 (URN)978-91-88679-01-7 (ISBN)
Public defence
2019-09-13, FÖ4, Falun, 13:00 (English)
Opponent
Supervisors
Available from: 2019-06-24 Created: 2019-06-14 Last updated: 2019-08-15Bibliographically approved

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Grim, KatarinaSchön, Ulla-Karin

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