People affected by cancer and their carers from gender and sexually diverse communities: their experiences and the role of smartphone applications.

BACKGROUND: People living with cancer, or carers who are from lesbian, gay, bisexual, transgender, queer, intersex or asexual (LGBTQIA+) communities experience unique information and support needs. Accessible technology-based resources providing tailored support are required to promote wellbeing, however this is a growing area of research requiring further investigation. The purpose of this study was to explore the experiences of healthcare services among people living with cancer, and their carers, who belong to sexual or gender diverse communities (LGBTQIA+), and identify how smartphone applications (apps) could support people from LGBTQIA + communities. METHODS: This was a qualitative descriptive study where people living with cancer or carers from LGBTQIA + communities participated in phone interviews. Participants were recruited across Australia via social media advertisements, LGBTQIA + medical practices, and cancer advocacy groups. Participants were asked questions about their experiences, and were provided with screenshots of an existing app and asked to provide feedback on content and inclusiveness. Transcripts were coded and codes grouped together to form similar and concepts. Inductive and deductive analyses were used to create themes. RESULTS: 13 patients (mean age 56 (SD:13)), and three carers (mean age 64 (SD:19)) completed phone interviews. The majority of participants identified their gender as female (patients n = 9, carers 3), and their sexuality as gay or lesbian (patients n = 10, carers n = 3). Four themes were created: (1) navigating disclosure in healthcare, described emotional challenges surrounding disclosure; (2) the power of positive experiences with clinicians, described positive interactions and gaps in care from clinicians; (3) impact of gender and sexuality on informal support, outlined support received from informal network and gaps in support, and; (4) opportunities to increase inclusivity in smartphone apps, generated ideas on how apps can be tailored to meet needs identified. CONCLUSION: Disclosure of gender or sexuality, and interactions with clinicians had the potential to impact participants' experience of cancer care. Gaps in informal networks pointed at how to better support LGBTQIA + communities, and identified opportunities for inclusion in an app that will be tailored and trialled for this community. Future work should focus on addressing systems-level processes in acknowledging and supporting priority groups affected by cancer.

Nurses' assessment of health literacy requirements for adult inpatients: An integrative review.

ISSUE ADDRESSED: This paper reviews current research which examines nurses' assessment of patient's health literacy in the acute hospital setting. Research highlights, that patients with low health literacy have more frequent hospitalisations and are more likely to be re-admitted. Within the healthcare team, nurses are primarily responsible for teaching patients and deciphering health communication, to enhance understanding. Within the acute care setting, there remains a disparity in patient understanding of information, despite nurse-led education. The health literacy assessment and tailoring of information by nurses, is becoming more important with shorter stays, plus limited family visits and the wearing of masks with COVID-19 related changes. METHODS: An integrative review across four nursing databases, from 2010 and June 2022 was conducted. The integrative framework included problem identification, literature search, data evaluation, data analysis with thematic analysis, and results presentation. RESULTS: Nine studies were included. Common themes were nurses' overestimation of patients' health literacy, the use of universal precautions, and adapting communication techniques to improve education moments. CONCLUSION: The findings of this review indicate a tendency among nurses to overestimate their patients' health literacy levels, which can result in ineffective health education and inadequate discharge planning. SO WHAT: Nurses decipher health communication for their patients. Designing tailored patient communication and education could potentially be a cost saving measure for hospitals by reducing length of stay and reducing readmissions. Health literacy training should be incorporated into nursing practice.

The experiences and needs of metastatic spinal cancer family caregivers at home: a systematic review.

PURPOSE: Family caregivers have high responsibilities for caring for persons with metastatic spinal cancer; however, understanding the experiences and needs of family caregivers face to overall recent, what is nurse-led could support them to meet their needs appropriately? Thus, the study aimed to review the experiences and needs of metastatic spinal cancer caregivers at home in the past decades. METHODS: A qualitative systematic review of 8 studies was undertaken. Analysed studies were conducted in different countries (Australia, Cyprus, Italy, Kenya, Pakistan, Thailand, and Turkey), covering a population of 92 caregivers. Thematic analysis was applied to identify family caregiver experiences and needs. RESULTS: Thematic analysis identified four key themes from the included studies: (1) complexity of needs, (2) caregivers' role and physical needs, (3) complexity of psychosocial needs, and (4) understanding supportive care. CONCLUSIONS: The results across 8 different countries indicate that family caregivers of metastatic spinal cancer commonly face diverse challenges in many diverse geographical contexts across cultures, requiring biomedical, practical, physical, and psychosocial support from healthcare systems within the matrix of broader challenges and resources available to improve supportive care for such service users.

Understanding nursing assessment of health literacy in a hospital context: A qualitative study.

PROBLEM: Nurses are fundamental in presenting information to their patients to ensure understanding of information, and health directions enabling improved health outcomes. Limited research exists exploring how nurses assess patient's health literacy in Australia. AIM: To explore Australian nurses' perceptions of patients' health literacy and how nurses assess health literacy to provide patient education. DESIGN: A qualitative study underpinned by phenomenology. METHODS: Registered Nurses (N = 19) across five Queensland hospitals participated in semi-structured interviews which explored nurses' assessment of patient's health literacy level and their practices of delivering education. The transcripts were analysed using an inductive process with interpretative analysis. RESULTS: Four themes were identified: how we assess patient health literacy; challenges with health literacy assessment; consumer focused assessment; and building assessment strategies. Participants relied on cues from the patient to identify when information has not been understood. Participants felt that online training programs in the workplace would assist in education for assessment techniques; identification of patients with low health literacy; and how to best communicate with patients that have low health literacy. CONCLUSION: Formal health literacy assessments should be introduced to hospitals in Australia, but training is required to enable the nurse, the confidence and ability for health literacy assessment. Tailored education based on health literacy assessment would enhance the patient's understanding and improve discharge planning, which may reduce health service costs and readmissions. REPORTING METHOD: The Consolidated criteria for reporting qualitative research (COREQ) guidelines for qualitative research were followed. PATIENT OR PUBLIC CONTRIBUTION: Registered Nurses (N = 19) participated in qualitative interviews, providing data for analysis. RELEVANCE TO CLINICAL PRACTICE: This study shows that nurses are already conducting informal assessments, simply by using observation and looking for cues. More education for nurses about health literacy and how to tailor their discussions with patients will improve communication.

Twelve tips for using Facebook as a learning platform.

The COVID-19 pandemic has forced health educators to adapt quickly to teaching and supporting students online. Social media platforms - of which Facebook is presently the most popular worldwide-has demonstrated its utility in facilitating online learning and fostering student support. In order for educators to get the most out of the platform, they should consider adopting a systematic and evidence-based approach. This article draws upon current literature and the authors' experiences to offer practical tips for health educators wanting to use Facebook as a learning platform and support tool for their students. We offer twelve tips, organized into prescriptive steps for creating and managing a Facebook group, and suggestions for utilizing Facebook's features to foster student learning, collaboration, communication, and socialization.

Management of delirium within intraoperative settings for older adults with hip fracture: a scoping review.

BACKGROUND: Delirium is a common adverse event in older patients undergoing hip fracture repair surgery. The impact of hospital-acquired delirium during intraoperative phase of their treatment can have a significant impact on post-operative outcomes. While non-pharmacological, multicomponent delirium prevention interventions are considered standard practice in acute medical units, delirium management in the intraoperative setting is less clear. OBJECTIVES: The aim was to identify evidence-based delirium management interventions which are, and could be, undertaken within the intraoperative setting for older patients undergoing hip fracture repair surgery. DESIGN: A scoping review following the principles developed by Arksey and O'Malley (2005). DATA SOURCES: Seven databases including Cochrane, CINAHL, Embase, MEDLINE, PsychINFO, PubMed and SCOPUS were systematically searched. The search was limited to the last 11 years (2009-2020). Research studies included both primary and secondary sources of evidence. RESULTS: A total of 2464 articles were initially identified. These articles were further refined using keyword searches and exclusion criteria, with a final set of 16 articles meeting the inclusion criteria. Three main themes were as follows: anaesthetic-related interventions used to prevent delirium; recognising non-modifiable and potentially modifiable risk factors; and screening and diagnosis of delirium. CONCLUSIONS: While there is a strong focus on anaesthetist-led interventions in the intraoperative setting, there are opportunities for more nurse-led interventions through adequate pain management and haemodynamic monitoring that require further research. Identifying the best test for screening and diagnosing delirium in the intraoperative setting requires further research.

Quality of life and associated factors among adults living with cancer and their family caregivers.

This study examined the association of needs, health literacy, and quality of life among adult Nigerians with cancer and family caregivers. A descriptive study was conducted involving 240 adults with cancer and family caregivers attending a tertiary hospital. More than two-thirds of participants reported moderate or high needs. Information (90.8%) and spiritual support (85%) were the domains of highest need among adults with cancer. Family/social support (85%) and spiritual support (81.7%) ranked the highest among family caregivers. A negative correlation was found between needs and quality of life. Stepwise regression analysis showed that needs and literacy explained 36% of the variance in adults with cancer's quality of life and 28% of the variance in family caregivers' quality of life. Spiritual need accounted l for 9.5% and 9.1% of variation for adults with cancer and family caregivers, respectively. Findings suggest that interventions with a focus on social/family and spiritual needs may improve wellbeing of adults with cancer and caregivers in Nigeria. This research are generalizable to other low-income countries where family values and spirituality are often a strong feature of daily life.

The outcomes and experience of people receiving community-based nurse-led wound care: A systematic review.

AIMS AND OBJECTIVES: To review the literature related to the outcomes and experience of people receiving nurse-led care for chronic wounds in the community. BACKGROUND: Chronic wounds lead to a poor quality of life and are an economic burden to the Australian healthcare system. A lack of awareness into the significance of chronic wounds leads to limited resources being available to facilitate the provision of evidence-based care. The majority of chronic wounds are managed by nurses in the community, and a better understanding into current models of care is required to inform future practice. DESIGN: A systematic quantitative literature review. METHODS: A systematic search was conducted in four electronic databases, and the inclusion criteria were as follows: English language, peer-reviewed, published from 2009-2019 and primary research. The data were compiled into an Excel database for reporting as per the Pickering and Byrne (Higher Education Research & Development, 33, 534.) method of systematic quantitative literature review. This review used the PRISMA checklist. The Mixed Methods Appraisal Tool was used for quality appraisal. RESULTS: Twelve studies were included in the review. Home nursing care, social community care and nursing within a wound clinic were identified as three types of nurse-led care in the literature. The findings demonstrate that nurse-led care was cost-effective, reported high levels of client satisfaction and contributed to improved wound healing and reduced levels of pain. CONCLUSIONS: Nurse-led care is a positive experience for people with chronic wounds and leads to better outcomes. The findings suggested a need for further client education and specialised training for healthcare practitioners managing chronic wounds. RELEVANCE TO CLINICAL PRACTICE: This review demonstrates that nurse-led care for people with chronic wounds in the community is cost-effective and improves client outcomes. Raising awareness into the significance of chronic wounds aims to promote the resources required to facilitate evidence-based care.

Partnership between Nurse Navigators and adult persons living with complex chronic disease-An exploratory study.

AIMS AND OBJECTIVES: The aim of this study was to explore nurse navigators and consumers' experience of partnership. BACKGROUND: The nurse navigator has recently emerged as an advanced practice role in the care of persons with complex and chronic disease states. Self-care is an important principle in chronic disease models of care, requiring healthcare practitioners to partner with clients in their care. How nurse navigators and consumers [clients and family] experience partnership has not been explored. DESIGN: An interpretive exploratory qualitative approach was used. Semi-structured interviews were conducted with seven nurse navigators working with adults with complex disease states and eleven of their clients. Interviews were analysed using descriptive content analysis. (COREQ checklist Data S1). RESULTS: Five themes about partnership emerged. Three themes from nurse navigators were as follows: establishing and sustaining relationships, nurse-led planning and aligning care with clients' needs. The two consumer themes were as follows: regular contact means access to the health system and nurse presence is valued. The secondary analysis revealed two themes about partnership between the nurse and consumer: establishing relationships require nursing effort to be established and partnerships are person-focused and nurse-led. CONCLUSIONS: Partnership begins with a relationship, largely driven by the nurse navigator through regular communication and personal contact that was valued by consumers. The nurse-led partnership reduced opportunities for consumers to learn to manage their treatments, particularly how and when to access services, meaning that self-care may not be fully achieved. Client navigation occurs over long periods, which could lead to the navigators being overwhelmed, raising an issue of sustainability. RELEVANCE TO CLINICAL PRACTICE: Nurse navigators establish a client relationship as a foundation for partnership. This partnership needs a focus on promoting client self-care, self-management of treatment, including when and how to access available services, to ensure the sustainability of the nurse navigator model of care.

Volunteers motivations and involvement in dementia care in hospitals, aged care and resident homes: An integrative review.

OBJECTIVE: To review the current literature related to the role of volunteers in dementia care in hospitals, aged care and resident homes. DESIGN: Integrative review method was used to identify and analyse current literature. METHOD: Data extracted included; author, methodology, sample, aims, data collection and analysis, findings, limitations, and comments. The Mixed Methods Appraisal Tool (MMAT) version 2011, was used to appraise the quality of the final articles. DATA SOURCES: Databases searched included CINAHL, Medline, ProQuest Central and PubMed. Keywords and MeSH terms: dementia, cognitive impairment, Alzheimer's disease, volunteers, volunteering, voluntary workers, hospital, acute care, aged care, residents. RESULTS: 14 articles reviewed, and three major themes revealed: volunteer motivation, volunteer involvement, and understanding roles. Recommendations to assist with future volunteer programs in dementia care are presented. CONCLUSION: Volunteer programs are beneficial to patients, family, volunteers, health care, and staff. Research of volunteers' needs, motivations and role required, aiming to improve support and training.

Family functioning and perceived support from nurses during cancer treatment among Danish and Australian patients and their families.

AIMS AND OBJECTIVES: This study aimed to compare family functioning and perceptions of support from nurses among Danish and Australian adult oncology patients and family members. BACKGROUND: Family can have a strong influence on the health of individuals, providing support during a health crisis such as cancer. However, family functioning and supportive care from nurses may vary across cultures and settings. DESIGN AND METHODS: A descriptive, cross-sectional comparative design with patients and family members from Denmark and Australia. Participants were asked to fill in translated versions of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ) and Iceland-Expressive Family Perceived Support Questionnaire (ICE-FPSQ). RESULTS: In total, 232 participants were recruited. The Danish cohort consisted of 56 patients and 54 family members. The Australian cohort consisted of 83 patients and 39 family members. Mean age was 59 years. No significant differences were found between Danish and Australian families. However, compared to patients, family members reported significantly lower overall family functioning, expressive emotions and communication, as well as less emotional support from nurses. CONCLUSIONS: Family functioning was comparable between Denmark and Australia. Family members reported less emotional support than patients. Nurses need to consider the patient and the family as a unit with complex needs that require monitoring and attention during oncology treatment. IMPLICATIONS FOR PRACTICE: Families supporting a member with cancer have significant and often unmet needs. Assessment, information-sharing and health education need to include the family. Supportive care information may be shared between Denmark and Australia and inspires the development of common guidelines for optimal family nursing practice.

A qualitative exploration of oncology nurses' family assessment practices in Denmark and Australia.

BACKGROUND: The nurses' ability to provide supportive care to the patient and the family is influenced by their family assessment skills, which provide them with understanding of the family needs and strengths. When a patient is diagnosed with cancer, it is the family who provides the long-term support for the patient, and nurses need to understand the family needs in order to provide holistic care. OBJECTIVE: The objective of the present study is to understand the factors that influence nurses' family assessment practices in adult oncology setting in Denmark and Australia. METHODS: An interpretive qualitative study was conducted guided by the family systems theory. Focus groups were completed with 62 nurses working in adult oncology areas in Denmark and Australia. A thematic analysis and a computer-generated concept mapping were completed to identify themes within the data. RESULTS: Overall, the nurses valued family as part of the patient care and worked to understand the family concerns. However, the family assessment process was unstructured and did not enable holistic family support. Nurses from both countries discussed that experience and ability to engage with the family influenced the nurse's role in family assessment. CONCLUSION: This study identified that nurses value family as part of patient care, however struggle to assess and support families during oncology care. There is a need for a structured assessment approach and education on family assessment, which could be used across the two countries and possibly internationally.

The client and family experience of attending a nurse-led clinic for chronic wounds.

BACKGROUND: The quality of life for individuals with chronic wounds is diminished due to poor health-related outcomes and the financial burden of wound care. The literature has shown nurse-led wound care to have a positive impact on wound healing and psychosocial wellbeing. However, there is minimal research investigating the lived experience of attending a nurse-led clinic for chronic wounds. The purpose of this study was to explore the client and family experience of attending a nurse-led clinic for chronic wounds. METHODS: Qualitative descriptive study. Semi-structured telephone interviews were transcribed verbatim and thematic analysis was undertaken. RESULTS: Twelve clients and two family members participated, and the average length of interviews was 20min. Three main themes emerged: (1) expecting and managing pain; (2) receiving expert advice and reflecting on previous care; and (3) managing the cost of care. There was an emphasis on the impact of chronic wounds on pain and the ability to complete the activities of daily living. Expert advice, client satisfaction and physical accessibility were highlighted as benefits of the clinic. Cost and minimal client education were identified as challenges of the clinic. CONCLUSIONS: The findings demonstrated that chronic wounds have a significant impact on the client and family attending the nurse-led clinic. Comprehensive pain assessment, improved social support, better client education and cost-effective care is required to optimise the experience for people attending the nurse-led clinic.

Evaluation of the understandability, actionability and reliability of YouTube videos for brain, head, and neck cancer information.

PURPOSE: Online videos accessed via YouTube are a popular method to provide health education. Videos need to be critically evaluated for educational qualities as the information could influence health outcomes. The present study aimed to evaluate the understandability, actionability and reliability of videos available on YouTube regarding brain, head, and neck cancer information. METHODS: A scoping review was conducted with a specific search strategy and inclusion/exclusion criteria based on previous studies. For each video, video characteristics and user engagement activities were recorded. Videos were evaluated using the PEMAT-A/V and modified DISCERN criteria. Spearman's rank correlation, Kruskal-Wallis test and Mann-Whitney U test were used for analysis. RESULTS: Out of 200 retrieved videos, 37 were included and analysed. The median length of the video was 3 min and 33 s. The majority of videos were published by health institutional and private channels (43.2%, n = 16). Health institutional channels received the highest actionability (Md = 37.5, p = 0.049), while private channels resulted in lower views/day (Md = 0.46, p = 0.001) and likes/day (Md = 0.01, p = 0.002). Animated and narrated videos acquired the highest understandability score (Md = 92.31, p < 0.001). Videos with professional transcripts reported higher actionability (Md = 62.5, p = 0.004), reliability (Md = 3.33, p = 0.028), views/day (Md = 29.31, p = 0.026), and likes/day (Md = 0.272, p = 0.023). CONCLUSION: YouTube videos pertaining to brain and head and neck cancer have low understandability, low actionability and moderate reliability. It is beneficial to have a stronger representation of trustworthy and credible organisations for sharing essential health information via YouTube. Including animations and professional video transcripts may improve their overall quality and consumer engagement.

Usability and Evaluation of a Health Information System in the Emergency Department: Mixed Methods Study.

BACKGROUND: A lack of information during an emergency visit leads to the experience of powerlessness for patients and their family members, who may also feel unprepared to cope with acute symptoms. The ever-changing nature and fast-paced workflow in the emergency department (ED) often affect how health care professionals can tailor information and communication to the needs of the patient. OBJECTIVE: This study aimed to evaluate the usability and experience of a newly developed information system. The system was developed together with patients and their family members to help provide the information needed in the ED. METHODS: We conducted a mixed methods study consisting of quantitative data obtained from the System Usability Scale questionnaire and qualitative interview data obtained from purposively selected participants included in the quantitative part of the study. RESULTS: A total of 106 patients and 14 family members (N=120) answered the questionnaire. A total of 10 patients and 3 family members participated in the interviews. Based on the System Usability Scale score, the information system was rated close to excellent, with a mean score of 83.6 (SD 12.8). Most of the participants found the information system easy to use and would like to use it again. The participants reported that the system helped them feel in control, and the information was useful. Simplifications were needed to improve the user experience for the older individuals. CONCLUSIONS: This study demonstrates that the usability of the information system is rated close to excellent. It was perceived to be useful as it enabled understanding and predictability of the patient's trajectory in the ED. Areas for improvement include making the system more usable by older individuals. The study provides an example of how a technological solution can be used to diminish the information gap in an ED context.

Undergraduate nursing students' placement in speciality clinical areas: understanding the concerns of the student and registered nurse.

INTRODUCTION: Student nurses in Australia are regularly placed in acute clinical areas providing them with clinical experience to link theory with real patient situations. Specialist clinical areas such as day oncology and renal dialysis often exclude students on the basis that their clinical area may not be able to meet normal clinical expectations, including holistic care of four to six patients with minimal direction from the registered nurse. However, specialist clinical areas provide students with unique learning experiences. This paper reports on an evaluation of speciality clinical placements for student nurses with an aim to increase our understanding of this type of placement. METHODS: Semi-structured audiotaped interviews were undertaken with 7 third year final semester students and 13 registered nurses working with the third year students. All interviews were transcribed and a thematic analysis conducted. FINDINGS: Key themes from the students and registered nurses were knowledge and preparedness for specialist placement, team work and being included and customising learning needs. CONCLUSION: Speciality placements provide a valuable experience for the undergraduate nurse including opportunities to see excellence in team work, communication and assessment as well as identifying future intention to become an oncology or renal specialist nurse.

Improving the health-related quality of life of adult Nigerians living with cancer and their family caregivers: intervention development.

BACKGROUND: Evidence for the effectiveness of interventions aimed at improving the health-related quality of life of people living with cancer and/or family members is compelling. However, most interventional research has been conducted in high-income countries, and no intervention had been tested in low-income countries such as Nigeria. It is critical to design a culturally theory-based intervention in a resource-poor setting to address the needs and support coping strategies of cancer patients and their family caregivers. METHODS: Theory, evidence, and practical issues were considered. The Medical Research Council framework for developing and evaluating complex interventions and Behaviour Change Wheel provided the framework for intervention design. Findings generated by a needs assessment of adult Nigerians with cancer and their family caregivers and relevant theories (the Spirituality and the Supportive Care Framework for Cancer) informed content development. RESULTS: A theory-based, culturally tailored socio-spiritual intervention was developed to address the specific needs of adult Nigerians with cancer and their family caregivers. A 4-week intervention included strategies designed to improve social and spiritual support, information and health literacy, and health-related quality of life. CONCLUSIONS: A systemic approach was used to conceptualise an evidence-based and theory-informed intervention tailored to address previously identified shortfalls in support available to adults living with cancer and their family caregivers, in Nigeria. If implemented and effective, such an intervention has the potential to improve the health-related quality of life of people living with cancer and their families in Nigeria.

Developing video resources to reduce the burden of caring for persons with brain cancer.

PURPOSE: Co-designed and accessible video resources improve an understanding of health information and can reduce unmet needs for caregivers of persons with brain cancer. This study developed and evaluated video resources that provide health information for persons caring for someone with brain cancer. METHOD: A co-design approach with consumers was used to design, develop, and evaluate video resources. RESULTS: Twelve videos were designed with persons with brain cancer, caregivers, and health professionals. The video design and topics were informed by current literature. The videos were filmed with consumers to ensure authenticity. The evaluation was completed using data analytics and seven interviews with consumers. Content analysis identified four themes: needing information, authenticity, visual engagement, and key messages. The video length and presentation were important aspects to engage the caregiver, particularly when dealing with stress. The storage on YouTube enabled accessibility and various presentation formats met different learning styles. CONCLUSION: The development of co-designed health information videos provided resources to improve caregivers understanding of the information provided by the health professionals. The videos were easy to access and able to be viewed at home with family.

Health professionals' perspectives of patients' and family members' needs in emergency departments and patient pathway improvement: a qualitative study in Denmark.

OBJECTIVE: Besides working in a fast-paced environment, healthcare professionals (HCPs) in the emergency department (ED) are required to promptly respond to patients' needs and simultaneously achieve their organisational goals, which can be challenging. This study investigates how HCPs perceive and support the needs of patients discharged after a brief ED stay, as well as their family members. DESIGN: The study used focus group discussions. The text material was analysed using systematic text condensation. SETTING: Data were collected from two large EDs in Denmark. PARTICIPANTS: Sixteen HCPs were sampled purposively to participate in three focus group discussions. RESULTS: Three main themes were condensed: (1) creating a trustful and reassuring relationship; (2) responding to family members: a bother or a benefit; and (3) working as an interdisciplinary team. The study indicated the need for increased interdisciplinary collaboration to reduce discrepancies in information dissemination, to meet patient and family needs and to deliver a holistic approach. A technical solution was suggested to facilitate collaborative teamwork. CONCLUSION: The study highlighted an existing gap between emergency HCPs' perceptions of patients' and family members' needs and the provision of the current patient and family support. Suggestions for future interventions include focusing on interdisciplinary teamwork, facilitated by a technical solution to support a person-centred and family-centred informative approach.

Development of a health information system to promote emergency care pathways: A participatory design study.

Objective: The successful development and implementation of sustainable healthcare technologies require an understanding of the clinical setting and its potential challenges from a user perspective. Previous studies have uncovered a gap between what emergency departments deliver and the needs and preferences of patients and family members. This study investigated whether a user-driven approach and participatory design could provide a technical solution to bridge the identified gap. Methods: We conducted four workshops, and five one-to-one workshops with patients, family members, healthcare professionals, and information technology specialists to codesign a prototype. Revisions of the prototype were made until an acceptable solution was agreed upon and tested by the participants. The data were analyzed following iterative processes (plan → act → observe → reflect). Results: The participants emphasized the importance of a person-centered approach focusing on improved information. An already implemented system for clinicians' use only was redesigned into a unique patient module that provides a process line displaying continually updated informative features, including (1) person-centered activities, (2) general information videos, (3) a notepad, (4) estimated waiting time, and (5) the nurse and physician responsible for care and treatment. Conclusion: Participatory design is a usable approach to designing an information system for use in the emergency department. The process yielded insight into the complexity of translating ideas into technologies that can actually be implemented in clinical practice, and the user perspectives revealed the key to identifying these complex aspects. The iterations with the participants enabled us to redesign an existing technology.